Tumor thickness and depth of invasion in squamous cell carcinoma of tongue as indicators of the loco-regional spread of the disease: A preliminary study.

Background: Magnetic resonance imaging (MRI) is a routinely used imaging modality for pre-treatment radiologic evaluation of tongue carcinoma, providing accurate information regarding the extent of the disease. Aims and objectives: To investigate the role of MRI-derived depth of invasion and tumor thickness evaluation in squamous cell carcinoma of the tongue, and to assess if any correlation exists between depth of invasion, tumor thickness, nodal metastasis, muscles, and space involved. Materials and methods: Thirty-three patients with oral squamous cell carcinoma of the tongue who had undergone pre-treatment MRI and excisional biopsy were included. The tumor thickness (TT) and depth of invasion (DOI) were evaluated on MRI and histopathologic images. Result: The relation between different methodologies for assessing showed a very high correlation for the tumor tissue thickness (r = 0.99, p < 0.05) and depth of invasion (r = 0.82, p < 0.05). The tumor thickness and the depth of invasion increased with the loss of differentiation in the carcinoma histopathologically. As the depth of invasion increases, the extent of the spread of the carcinoma to tongue musculature, lingual septum, and spaces also increases. Conclusion: The present study has depicted a high correlation between the tumor thickness and the depth of invasion between MRI and histopathological findings and is the first of its kind to correlate DOI to the invasiveness of the disease.

Evaluation of the Function of Vitamin D in Treating Oral Lichen Planus.

Objectives: The objective of the current research was to evaluate the role of vitamin D in the management of oral lichen planus. Materials and Method: Based on their vitamin D levels, 90 individuals with oral lichen planus were equally divided into three groups. Deficient subjects received oral vitamin D supplementation. Result: The majority of improvements were observed in patients who were taking vitamin D supplements. It was discovered that the data comparison was statistically considerable. Conclusion: It was determined that vitamin D was crucial for the management of oral lichen planus.

Lepromatous Leprosy Manifesting As Chronic Macrocheilia: Report of a Rare Case.

Leprosy is a chronic debilitating disorder caused by the acid-fast bacilli Mycobacterium leprae (M. leprae) and Mycobacterium lepromatosis. These bacilli exhibit a distinctive predilection for the skin and peripheral nerves, although they can potentially impact any system in the body. Lately, there has been a notable reduction in mucosal symptoms, largely attributed to the timely diagnosis and treatment of leprosy. Nonetheless, oral lesions continue to hold significant epidemiological importance due to their crucial role in disease transmission. Oral manifestations, although rare, are frequently encountered in individuals afflicted with multi-bacillary leprosy. Chronic macrocheilia is an exceedingly rare manifestation of the disease, with only a few documented case reports and case studies. This article aims to document an exceptionally uncommon case of lepromatous leprosy with chronic macrocheilia as the sole presenting feature.

Clinical and CBCT Assessment of Crestal Bone Changes in Immediate and Delayed Placement of Implant.

Objectives: The present research was done to assess the crestal bone changes in immediate and delayed dental implant placement. Materials and Method: Twenty four implant sites in participants within the age group of 25-60 years in both genders were done with immediate (Group I) and delayed implant (Group II) placement method. Clinical parameters such as pain, mobility, and radiographic assessment for crestal bone alterations were recorded at baseline, 3 months, and 6 months. Results and Conclusion: On intergroup assessment, the mean variation of the pain, mobility, and crestal bone loss was insignificant.

Compressive Strength Evaluation of Three Distinct Implant Design Approaches.

Objectives: The study was done to assess the implant-abutment interface static compressive. strength of three design types and implant-abutment connection failure style. Materials and Methods: The implants at 306 with respect to the y-axis were aligned using a stainless steel holding device. Twenty specimens from each system totaled 60 total. A unidirectional vertical piston in a computer-controlled universal testing machine (MTS 810) generated static compression loading until failure. Specimens were macroscopically examined for fracture of the screw and implant, abutment looseness, and longitudinal displacement. Analysis of variance was used to analyze the data (ANOVA). Result: The screw-vent system had a mean compressive strength of 335.6 22.7 psi for the Unipost system, 384.3 37.1 psi for the screw-vent system, and 245.3 25.4 psi for the ITI-1 piece abutment connection. Conclusion: The connection between the Unipost implant and abutment showed a statistically significant variation.

Vitamin D in the Treatment of Oral Lichen Planus: A Systematic Review.

Oral lichen planus (OLP) is a chronic mucocutaneous condition that affects up to 2% of the general population, and typically presents with long-standing, non-responsive lesions, with episodes of exacerbation and remissions. The etiopathogenesis of OLP is still unclear, although, it has been postulated that it is most likely a T-cell-mediated condition of an unknown antigen. The treatment remains a challenge with no defined treatment strategy. Vitamin D has anti-inflammatory and immunomodulatory properties, along with its regulatory effect on keratinocyte proliferation and differentiation; thus, suggesting its possible role in the treatment of OLP. This systematic review aims to evaluate the therapeutic role of vitamin D in OLP treatment. We searched PubMed/MEDLINE, and Google scholar search engines for studies evaluating vitamin D as a treatment modality in OLP from January 2000 to August 2022. Articles were searched with the combination of Medical Subject Heading (MeSH) terms. A web platform for visualizing risk-of-bias assessment was used in this review, and descriptive statistics were calculated. Out of the seventeen retrieved studies, five articles meeting the inclusion criteria were considered in this systematic review. All the included studies demonstrated significant amelioration in the OLP symptoms in patients who were given vitamin D supplements as an adjuvant to the conventional steroid therapy and or placebo. This systematic review signifies the role of vitamin D as adjuvant therapy for OLP. However, more studies with larger sample size are required to validate these results.

Intraoral osseous choriostoma---Case report and review on its biological occurrence.

The terminology choriostoma describes a tumor-like lesion belonging to hamartomatous group of pathology, that is, normal tissue found in abnormal location. Osseous choriostomas in oral cavity are rare and mostly the cases have been reported in tongue but rarely arising from the interdental gingiva. There are various pathological entities arising from gingiva that give a thought of wider differential diagnosis starting from inflammatory to traumatic origin. Hamartomas in oral cavity are very rare which can definitely be attributed to the sparse literature which leads to misdiagnosis as well failure to understand its biology. In this report, we present a case of osseous choriostoma arising from interdental gingiva in a young female patient in the lower arch.

Palliative oral care in patients undergoing radiotherapy: Integrated review.

Maintaining a patient's quality of life is main the aim while treating cancer patients. Patients getting treated for oral cancer encountered with numerous symptoms at the time of radiotherapy and most of these are side effect which can persist even after few months to year after the treatment gets over. Radiotherapy is a vital aspect of both curative and palliative cancer care. Understanding the basics complications of radiotherapy along with its primary management of oral symptoms can assist family physicians in providing complete primary care for their cancer patients. Palliative oral care helps to ease symptoms from the cancer treatment. Oral care negligence is still a major cause of worsening of posttreatment quality of life of an individual. The article mainly empathies on the oral health care need to be taken care by primary care physicians in the cancer patients during and after the radiotherapy. Consequences associated with radiotherapy in oral cavity and its systematic overview of preventing and managing acute and chronic condition. It enlightens the importance of dentist role on improving quality of life of these patients.

Qualitative and morphological evaluation of the mandibular bone using computed tomography.

CONTEXT: Determining the amount of cortical and cancellous bone present in the mandible is an important criterion for the selection of proper implant size and reduction of post implant placement complications. It becomes difficult to manage the presence of lingual undercuts when there is perforation of either the buccal or lingual cortical plates. Computed tomography (CT) images of the mandible can reduce the risk of complications by evaluating the thickness of cortical and cancellous bone in the mandible. AIMS: Evaluate thickness of the buccal and lingual cortical plates and cancellous bone. Gender variation in the cancellous bone and cortical bone thickness. Determine the shape of the mandible. SETTINGS AND DESIGN: A retrospective study was conducted using the CT scan images of pathologies pertaining to the Head and Neck region. METHODS AND MATERIAL: CT scan images of 30 patients, comprising of 22 males and 8 females. The mental foramen was considered as the anatomical landmark and the vertical marking was considered at a height of 20 mm from basal bone. The thickness of both cortical and cancellous bone was noted 6 mm anterior to it and 18 mm posterior. The shape of the buccal and lingual cortical bone was also considered. STATISTICAL ANALYSIS: Statistical analysis was done using Student's t-test or Chi-square test. RESULTS: The mean thickness of cortical bone was more in anterior mandible than posterior mandible and cortical bone density was thickest at height of 20 mm, whereas for cancellous bone, it was highest at 5 mm from the basal bone, thickness. Buccal concavity, type A (68.2%), was the most common in the anterior region for males, followed by round shape, type C (56-58%) in the posterior region. For females, type C (25-31%) in the posterior region and lingual concavity, type B (18-30%) were the most common types in the anterior region. CONCLUSIONS: Lingual concavity may pose serious problems in cases of perforations during implant placement. Lingual cortical plates were thicker than the buccal cortical plates and it is concave anterior mandible. Thus, CT imaging can help in characterizing the quantity and morphology of the mandible.

Knowledge, attitude and practice of dental professionals towards substance use.

INTRODUCTION: The dentist must be aware of this drug use in their individual patients to: (1) avoid possible contraindications during dental treatment, (2) be aware of the many oral and craniofacial manifestations of such drug use, (3) be able to provide necessary dental treatment to combat the dental/oral ravages of drug use, and (4) be able to refer such patients, if so desired by the patient. AIMS AND OBJECTIVES: The aim of the study is (1) To determine the knowledge of abusive drugs among dentists and (2) To determine the attitude and role of dentists in identifying patients with abusive drugs. SUBJECTS AND METHODS: A modified 27-item questionnaire was formulated and distributed among the study. The participants were to return the filled questionnaire to the investigators within a week. A total of 203 validated entries were collected. Data were entered into Microsoft Excel 2007 and analyzed in SPSS V20. Associations between categorical variables were determined using Chi-square or Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS: Irrespective of the educational qualification drugs are perceived harmful with definite oral manifestations, and dentists should be concerned with identifying individuals with drugs. It is believed that trying drugs once could lead to possible addiction and that dental practitioners should have their skills developed to handle cases and referred to deaddiction centers with modification of treatment plans. CONCLUSIONS: Educating dental graduates and postgraduates about the oral implications of drugs intake and making it a part of the dental curriculum may help us dealing with the global issues of drugs. Even making dental students a part in counseling and part of the behavioral therapies advocated in treating drug addicts.

Quantitative analysis of AgNOR counts and pap stain in exfoliative cytology specimens of oral mucosa in bidi smokers and nonsmokers.

Background: Bidi smoking is a serious health hazard which is common throughout South Asia and parts of the Middle East. It has been strongly implicated to various benign and malignant lesions of oral cavity and oropharynx. These tobacco-filled leaves deliver more than three times the amount of nicotine, carbon monoxide, and tar as cigarettes which exert injurious effects on cells reflected in terms of accelerated proliferative activity in normal oral mucosal cells. Aim: This study aimed to compare the exfoliated cells from the oral mucosa of bidi smokers and nonsmokers, with emphasis on proliferative activity. Materials and Methods: Exfoliative smears were obtained from the oral mucosa of forty participants (twenty nonsmokers and twenty smokers) with age group ranging from 30-80 years, in and around Barwala (Haryana). The cytologic smears were evaluated using Papanicolaou (PAP) stain and AgNOR in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. Only PAP Class I and Class II smears were observed. Results: Comparison of the mean number of AgNORs showed a significant difference between nonsmokers and smokers. Inflammatory alterations were found in 70% of smokers and 55% of nonsmokers. A significant difference in proliferative activity was observed between smokers and nonsmokers classified as PAP Class II. Conclusion: A significant difference of AgNORs/nucleus was observed between bidi smokers and nonsmokers.

RésuméContexte: Bidi fumeurs est un grave danger pour la santé qui est commune dans toute l'Asie du Sud et certaines parties du Moyen-Orient. Il a été fortement impliqué dans diverses lésions bénignes et malignes de la cavité buccale et l'oropharynx. Ces feuilles de tabac offrent plus de trois fois la quantité de nicotine, monoxyde de carbone et de goudron que les cigarettes qui exercent des effets préjudiciables sur les cellules reflétés sous la forme d' une accélération de l'activité proliférative des cellules de la muqueuse buccale normale. Objectif: Cette étude visait à comparer les cellules exfoliées de la muqueuse orale des bidis fumeurs et non fumeurs, avec l'accent sur l'activité proliférative. Matériels et méthodes: frottis Exfoliative ont été obtenus à partir de la muqueuse orale de 40 participants (20 non-fumeurs et fumeurs) avec 20 Groupe d'âge allant de 30-80 ans, dans et autour de Barwala (Haryana). Le frottis cytologique ont été évalués à l'aide de la coloration de Papanicolaou (PAP) et d'AgNOR afin d'évaluer la présence d' altérations cytologiques évocateurs d'infl ammation, dysplasie, la kératinisation, et l'activité proliférative des cellules épithéliales. PAP uniquement les catégories I et II de Papanicolaou n'a été observé. Résultats: comparaison du nombre moyen d'AgNORs ont montré une différence entre les non-fumeurs et les fumeurs. Des modifications ont été trouvés infl ammatory dans 70% des fumeurs et 55% des non-fumeurs. Une différence dans l'activité proliférative a été observée entre les fumeurs et les non-fumeurs PAP, le niveau d'emploi de la classe II. Conclusion: une différence de AgNORs/noyau a été observée entre fumeurs et non-fumeurs bidi. Mots-clés: AgNOR, frottis exfoliative, les fumeurs.

Panoramic radiograph as a forensic aid in age and gender estimation: Preliminary retrospective study.

BACKGROUND: The temporomandibular joint is a hinge joint which is formed by the mandible with articulation of the jaw with the cranium. The morphology of the mandible is evaluated by measuring the gonial angle ramus height and bigonial width. AIM: The aim of this study to investigate the impact of age and gender on ramus height, gonial angle and bigonial width in the dentulous odisha population using digital panaromic radiographs. MATERIALS AND METHODS: A total of 50 dentulous participants (25 males and 25 females) aged between 10 and 80 years were included in this study. The data were collected after comprehensive examination by 1 principal and two coinvestigators. STATISTICAL ANALYSIS: The mean difference between gender and different age groups was calculated using SPSS version 20.0. Unpaired t-test and one-way ANOVA were used for comparison studied parameters according to gender, side and different age groups followed by Tukey's post hoc test. RESULTS: A statistically significant gender difference was seen for gonial angle, ramus height and bigonial width. All the parameters increased with increase in age. This difference was statistically significant on the right side for gonial angle and ramus height. CONCLUSION: This study is useful as for age and sex determination using mandible as primary object in forensic odontology.

Non Aggressive Mandibular Osteoblastoma- A Rare Maxillofacial Entity.

Benign osteoblastoma is a very rare, bone tumour occurring in the facial region. These lesions are most frequently seen in long bones. They are characterised by proliferation of compact or cancellous bone. The lesion is usually asymptomatic until it causes significant facial asymmetry or displacement of the teeth if present in the alveolar region. The clinical appearance of osteoblastoma is very similar to peripheral ossifying fibroma or any fibro-osseous lesion. The tumour is characterised by bone formation along with the presence of numerous osteoblasts. This case report describes the presence of a bony hard mass in the right side of mandible of a 27-year-old female patient with the chief complaint of a painless growth since past 10 years. The growth slowly increased in size displacing the teeth associated with it. The patient also complained of difficulty in speech and mastication.

Giant central ossifying fibroma of the maxilla presenting with a pus discharging intra-oral sinus.

Central ossifying fibroma (COF) is a rare benign fibro-osseous neoplasm which has a predilection for mandible and is encountered in middle aged women. It arises from mesenchymal blast cells of the periodontal ligament, and with a potential to form fibrous tissue, cementum and bone. It is a well circumscribed lesion mainly comprising of fibrous tissue with varying amounts of bone or cementum or osteo-cementum like tissue. We present an uncommon case of COF of the maxilla in a 35-year-old male who presented with a pus discharging sinus in the maxilla. Due to the bizarre size of the lesion we have termed as 'giant' COF. There is extensive facial asymmetry on the right side with obliteration of the maxillary antrum, deviation of the nose and upward displacement of the orbit.

Congenital mucous retention cyst of the anterior hard palate! The first case report.

Children may be born with birth defects, the most common being oro-facial clefts and fissural cysts. A well circumscribed pedunculated soft tissue growth that occurs congenitally is known as congenital epulis of the newborn or 'Neuman's Tumour' as described in the literature. It is a rare lesion and the diagnosis has to be confirmed histologically. We present a rare case of a 7-year-old child with a congenital growth in the pre-maxillary region of the anterior hard palate clinically diagnosed as congenital epulis however, histologically confirmed as a mucous retention cyst. An elaborate clinical differential diagnosis is discussed. The anterior hard palate is devoid of salivary glands and the presence of a mucous retention cyst in the area is suggestive of ectopic salivary gland tissue and in a child manifesting at birth is probably the first case to be reported in the English literature.

Copper Beaten Skull! Can It be a Usual Appearance?

'Copper beaten' skull refers to the prominent convolutional markings seen in multiple bones of the skull. Underlying cause is thought to be related to increased intracranial pressure resulting from such processes as craniosynostosis, obstructive hydrocephalus and/or intracranial masses. However, the copper beaten appearance of the skull has poor sensitivity in detecting increased intracranial pressure as such an appearance can also be seen in normal patients. In this article, we have reported a case of a 5 years old child with classical features of beaten silver skull. How to cite this article: Desai V, Priyadarshini SR, Sharma R. Copper Beaten Skull! Can It be a Usual Appearance? Int J Clin Pediatr Dent 2014;7(1):47-49.

A comparative study on diagnostic accuracy of colour coded digital images, direct digital images and conventional radiographs for periapical lesions - an in vitro study.

OBJECTIVES: The identification and radiographic interpretation of periapical bone lesions is important for accurate diagnosis and treatment. The present study was undertaken to study the feasibility and diagnostic accuracy of colour coded digital radiographs in terms of presence and size of lesion and to compare the diagnostic accuracy of colour coded digital images with direct digital images and conventional radiographs for assessing periapical lesions. MATERIALS AND METHODS: Sixty human dry cadaver hemimandibles were obtained and periapical lesions were created in first and second premolar teeth at the junction of cancellous and cortical bone using a micromotor handpiece and carbide burs of sizes 2, 4 and 6. After each successive use of round burs, a conventional, RVG and colour coded image was taken for each specimen. All the images were evaluated by three observers. The diagnostic accuracy for each bur and image mode was calculated statistically. RESULTS: Our results showed good interobserver (kappa > 0.61) agreement for the different radiographic techniques and for the different bur sizes. Conventional Radiography outperformed Digital Radiography in diagnosing periapical lesions made with Size two bur. Both were equally diagnostic for lesions made with larger bur sizes. Colour coding method was least accurate among all the techniques. CONCLUSION: Conventional radiography traditionally forms the backbone in the diagnosis, treatment planning and follow-up of periapical lesions. Direct digital imaging is an efficient technique, in diagnostic sense. Colour coding of digital radiography was feasible but less accurate however, this imaging technique, like any other, needs to be studied continuously with the emphasis on safety of patients and diagnostic quality of images.

Growing Old is Mandatory But Growing Up is Optional: An Explanation to Geriatrics.

Growing old is an inevitable process and aging graciously requires a healthy body where oral cavity occupies an important place. Geriatric dentistry is a specialized multidisciplinary branch of general dentistry designed to provide dental services to elderly patients. The rise in life expectancy has attributed to the substantial reduction in mortality which brought about by improved health care facilities, sanitation, environmental and public health reforms coupled with better hygiene and living conditions. The goal of geriatric treatment is to achieve optimal oral health, thus enhancing overall health. This begins with a concerted effort between the patient and the healthcare and dental teams. When medical problems exist, the physician and other involved healthcare professionals should be consulted, as these diseases can affect the safety and efficacy of various dental treatments. Thus a unified approach should be followed to assist geriatric patients to maintain optimal oral health and a high quality of life. Here in, this article we have reviewed the categories geriatric patients are divided to, various aging theories, changes occurring in various systems with their effects on system along with the various dental effects and age changes in them and treatment needs and strategies' concerning the elderly population.