Solitary plasmacytoma of jaw bone: A case report and systematic review of fifty cases from literature.

Solitary plasmacytoma of bone (SPB) is a localized form of plasma cell neoplasm where jaw involvement is rare. Distinguishing SPB from other plasma cell neoplasms is critical for treatment and survival. Here, a case of SPB of mandible in an elderly female is reported. Histopathological diagnosis of plasma cell neoplasm was confirmed immunohistochemically with MUM1 and CD138 positivity and multiple myeloma (MM) was ruled out on performing systemic workup. Prognosis of SPB worsens when it transforms into MM. A systematic review was undertaken with the objective to determine the factors affecting conversion of SPB to MM. An electronic search was undertaken with PubMed/MEDLINE, Web of Science and Science Direct. Fifty cases of SPB of jaw from 29 publications were reviewed. SPB commonly presents as a painless swelling. Radiographically, it is commonly seen as multilocular radiolucency with well-defined borders. Follow-up data showed that nine cases turned into MM in a mean duration of 1 year 9 months and 12 patients died after median disease-free survival of 6 years 9 months. Prognosis of SPB is found to be affected by tumor size (≥5 cm), anaplasia of tumor cells, Ki-67 labeling index, vascularity of the tumor, presence of clonal bone marrow plasma cells, serum immune globulin level, dose of radiotherapy and persistence of M protein after treatment. There is a need to identify prognostic subgroups in SPB based on these factors. Furthermore, studies are necessary for standardization of treatment protocol to halt or prolong the progression of SPB to MM.

Dentinogenic ghost cell tumor: A case report.

BACKGROUND: Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic neoplasm. It is considered to be a solid variant of calcifying odontogenic cyst (COC). This tumor makes up for only 2%-14% of all COCs and less than 0.5% of all odontogenic tumors which owes to its rarity. The purpose of this paper was to describe a case of DGCT and the treatment adopted in our case, and to provide a review of this case in the indexed literature. CASE SUMMARY: In this article, we discussed a case of 18 year old male who reported with a chief complaint of a recurrent swelling and dull aching pain in upper left back region of the jaw. Computed tomography scan was carried out which revealed hypodense lesion with a few hyperdense flecks within it suggesting the presence of calcification. On incisional biopsy, diagnosis of COC was given. After segmental resection of the lesion, histopathogically odontogenic epithelium was noted along with calcifications, ghost cells and dentinoid material. Special staining was done with van Gieson and it showed pink areas of dentinoid material and yellow colour represented ghost cells. Hence, amalgamation of careful clinical examination, use of advanced radiographic imaging and detailed histopathological examination confirmed the diagnosis of DGCT. The patient was followed up for one year and there was no recurrence of the lesion or signs of any residual tumor. CONCLUSION: Radical treatment should be carried out along with mandatory long-term follow up in order to avoid recurrence in aggressive lesions.

Exposed Dental Implant? Local Autograft A Saviour!

Implant exposure due to faulty placement, posses as the most common reason for implant failure. The implant placed too close to buccal or lingual cortex have lead to such failure on numerous occasions. Also, anatomic variations like the thin buccolingual width of alveolar ridge predispose exposure of the implant. 25-year-old female patient had undergone surgical placement of implants in mandibular anterior region 2 months back in the private dental clinic. The clinician noted Grade I mobility in one of the implants placed. The case was referred to the author. Thin overlying gingiva depicted an entire buccal aspect of the implant, which suggested more than 90 % loss of buccal cortex. According to literature and review of similar case reports, the only way suggested was to surgically remove the implant and wait for 12-24 months for the bone to heal for subsequent placement. Rather than the removal of implants as suggested, the author followed a naval approach of reinforcing buccal cortex using an autogenous cortical block from mandibular symphysis. The reinforcement surgery had certainly saved patients time, money and most importantly limits a crucial period of edentulism, which may be enforced on a patient in case the implant was removed.

Management of Biomedical Waste: An Exploratory Study.

BACKGROUND: Dental operatories pose a threat due to the high chances of infection transmission both to the clinician and the patients. Hence, management of dental waste becomes utmost importance not only for the health benefit of the dentist himself, but also people who can come into contact with these wastes directly or indirectly. The present study was conducted to find out the management of biomedical waste in private dental practice among 3 districts of Karnataka. MATERIALS AND METHODS: The study population included 186 private practitioners in 3 districts of Karnataka (Coorg, Mysore, Hassan), South India. A pre-tested self-administered questionnaire was distributed to assess the knowledge and practices regarding dental waste management. Descriptive statistics was used to summarize the results. RESULTS: Out of 186 study subjects, 71 (38%) were females and 115 (62%) were males. The maximum number of participants belonged to the age group of 28-33 years (29%). Undergraduate qualification was more (70%). 90 (48%) participants had an experience of 0-5 years. Chi-square analysis showed a highly significant association between participant who attended continuing dental education (CDE) program and their practice of dental waste management. CONCLUSION: Education with regards to waste management will help in enhancing practices regarding the same. In order to fill this vacuum CDE programs have to be conducted in pursuance to maintain health of the community.

Oral submucous fibrosis: Comparing clinical grading with duration and frequency of habit among areca nut and its products chewers.

AIMS AND OBJECTIVES: To evaluate the effect of frequency, duration and type of areca nut products on the incidence and severity of oral submucous fibrosis (OSMF). MATERIALS AND METHODS: Patients with the limited mouth opening and associated blanched oral mucosa with palpable fibrous bands were included in this study. Biopsies were done and the informed consent was taken from each patient included in this study. The tissues were taken from the affected areas and then studied histopathologically. The data was analysed statistically using X(2)-test. RESULTS: In this present prospective study done in 197 subjects (189 males and 8 females) who were screened and diagnosed clinically having OSMF with age ranging from 22 to 61 years with mean 38.8 years. Gutkha-chewing habit alone was identified in 58 subjects and those associated with gutkha and tobacco were 33 with mean age of 28.2 years and 32.3 years, respectively. The number of people getting affected with OSMF is more associated with gutkha and areca nut with the P-value of the analysis ranging from 0.05 to 0.01. CONCLUSION: The occurrence of OSMF is related to areca nut and its products. The duration and frequency of its use and type of areca nut product has effect on the incidence and severity of OSMF. Gutkha and pan masala have more deleterious and faster effects on oral mucosa. The gutkha-chewing habit along with the other habits does not have any significant effect on the rate of occurrence and incidence and severity of the OSMF.