Muscle Activity in Pre-Treatment and Post-Treatment Oral Submucous Fibrosis Patients: Electromyography Study.

Background: Oral submucous fibrosis (OSMF) is a premalignant condition of insidious onset which affects the oral mucosa, pharynx, and esophagus. The muscles of mastication are known to be affected resulting in limited mouth opening. Electromyography (EMG) is a sophisticated method of measuring and evaluating muscle activity. Previously, EMG was primarily utilized in medical sciences, but it is currently being used extensively in both the medical and dentistry fields. Objectives: The aim of the study is to evaluate the electromyographic activity of masseter muscle in OSMF patients before and after treatment and to compare with healthy controls. Materials and Methods: This prospective case-control clinical study comprised 180 OSMF patients who were divided into four groups and 45 healthy individuals served as the control group. The OSMF individuals were injected with hyaluronidase 1,500 IU mixed in 1.5 ml of dexamethasone and 0.5 ml of lignocaine HCL intralesionally twice a week for one month along with a basic physiotherapy regimen consisting of mouth exercises two times daily. The control subjects were given placebo capsules. The treatment was carried out for a month and the electromyographic masseter muscle activity was evaluated among the OSMF patients and control group before and after treatment. Results: The results revealed that the electromyographic activity of master muscles in OSMF patients showed increased activity when compared with healthy controls. Patients with OSMF showed decreased muscle activity after treatment. Conclusion: When compared with healthy controls, OSMF patients had higher electromyographic activity of the masseter muscles and the muscle activity was decreased following treatment. In OSMF patients, EMG may help in determining the involvement of the mastication and facial expression muscles. It can also be used as a diagnostic tool to assess the treatment outcome of muscle activity in OSMF patients.

The Reliability of a New Device for Measuring the Maximum Bite Force.

OBJECTIVE: To test the inter- and intraexaminer reliability of a recently developed instrument for measuring the maximum bite force (MBF). Material and Methods. Sixty patients who were clinically confirmed as having Oral Submucous Fibrosis (OSMF) and 60 healthy controls were included in this study. For each subject, age, gender, weight, height, and body mass index (BMI) were recorded. The maximum bite force was recorded in alternate order with a bite force sensor (D1) and an occlusal force meter (D2). Bite force was measured in the first molar region. Pearson's correlation coefficient and kappa statistic were applied to assess the reliability between D1 and D2 in the assessment of maximum bite force. The independent t-test was performed to find the statistical significance between the two study groups. The paired t-test was applied to find out the difference between the right and left disease in groups of two devices separately. The one-way analysis of covariance (ANOVA) was performed to find the significant difference between grades of OSMF. RESULTS: The results of the kappa values were 0.8531 ± 0.0724 and 0.7336 ± 0.0737 for interdevice reliability in OSMF patients in right and left sides. Similar findings were obtained in right and left sides of healthy individuals (0.7549 ± 0.0816 and 0.9440 ± 0.0806) and in the total sample (0.8132 ± 0.0544 and 0.8303 ± 0.0538). Pearson's correlation coefficient between two devices revealed a high and significant positive correlation between D1 and D2 separately and in the whole sample. CONCLUSION: The observations of the present study suggest that the bite force sensor can be used as a reliable device for measuring bite force.

Assessment of Maximum Bite Force in Oral Submucous Fibrosis Patients: A Preliminary Study

Abstract Objective: To determine the maximum bite force (MBF) in oral submucous fibrosis (OSMF) patients and to compare them with that of healthy subjects. Material and Methods: Twenty patients who were clinically confirmed, as OSMF and 20 healthy controls matched for age, gender, and number of intact functional teeth were included in this study. For each subject, age, gender, weight, height and body mass index (BMI) were recorded. The MBF registration was carried out by the two evaluators, who were previously calibrated. Bite force was measured in the first molar region using a force transducer occlusal force meter for each subject seated at the upright position, with Frankfort's plane nearly parallel to the floor, and no head support. The Student's independent t-test was used to determine the statistical significance in relation to mean height, weight, BMI and the presence of number of intact teeth and MBF between the healthy subjects and OSMF individuals. A comparison of grades of OSMF with all variables was carried out by one-way ANOVA test. Results: No significant difference was found in mean age, mean height, weight, BMI and the presence of the number of intact teeth between healthy individuals and OSMF patients. The mean MBF in healthy subjects was 628.23 ± 24.39 N and 635.47 ± 31.22 N in OSMF patients. Even though the healthy subjects reported a higher MBF than OSMF patients did, the difference was statistically non-significant. With regards to sides, no significant difference was observed in mean MBF in healthy subjects and OSMF patients on the right (p=0.7818) and left side (p=0.6154). Conclusion: The healthy subjects reported higher MBF values than OSMF patients did and the difference was statistically non-significant.

Evaluation of the possible role of copper ions in drinking water in the pathogenesis of oral submucous fibrosis: a pilot study.

We aimed to investigate the concentration of copper ions in drinking water and to assess whether copper has a role in the pathogenesis of oral submucous fibrosis (OSMF). We studied 50 patients with clinically and histologically diagnosed OSMF from the Yadgir district of Karnataka in India. Fifty healthy people matched for age and sex were used as controls. In both groups concentrations of copper ions in serum, saliva, and home drinking water were measured using atomic absorption spectroscopy and intelligent nephelometry technology. Serum ceruloplasmin concentrations were also estimated in both groups. The mean (SD) concentration of copper in the home drinking water of patients with OSMF was significantly higher (764.3 (445.9)µmol/L) than in the controls (305.7 (318.5)µmol/L) (p<0.001). Patients with OSMF also had a significantly higher copper concentrations in serum and saliva, and serum ceruloplasmin than controls (p<0.001). For the first time these data have shown a positive association between copper concentrations in home drinking water and OSMF. It raises the possibility that increased copper in drinking water contributes to the development of OSMF, and adds to that ingested when areca nut is chewed.

Complex odontoma: report of two unusual cases

Odontomas are the most common benign, slow-growing and nonaggressive odontogenic tumors of the jaws. They are usually clinically asymptomatic and are diagnosed on routine radiological examination in the second decade of life. The eruption and infection of odontomas are uncommon and very few cases are reported in the literature. This paper reports two cases of complex odontomas with such unusual features.

Florid cemento-osseous dysplasia: Review and report of two cases.

Only three Indian patients of florid cemento-osseous dysplasia have been reported (less than 2%), according to the review of recent literature (2003). This makes the occurrence of FCOD a relatively rare phenomenon. The age group may vary from 19-76 years and typically presents in the fourth and fifth decade. In most of the cases, patients do not have family history of the disease. We report two cases showing classic radiologic features. The diagnosis of our cases were made radiographically.