Exfoliative Cytology in the Oral Mucosa of Patients with Fanconi Anaemia: A Morphometric Approach

Patients with Fanconi anaemia (FA) are prone to develop squamous cell carcinomas at an early age. Exfoliative cytology can be used to detect changes to the health of the oral mucosa. Objective: The aim of this study was to evaluate morphometrical and morphological changes using exfoliative cytology and to analyse and quantify the proliferative activity using silver nucleolar organiser regions (AgNOR) in epithelial cells of the tongue in FA patients,after haematopoietic stem cell transplantation (HSCT). Methods: Oral smears were collected from the tongues of 20 FA children and adolescents after haematopoietic stem cell transplantation (FA) and 20 healthy children (C) using exfoliative cytology. The smears were stained using the Papanicolaou technique and silver impregnation. The cells were morphologically analysed and the nuclear area (NA), the cytoplasmic area (CA), and the nucleusto-cytoplasm area ratio (NA/CA) were calculated. Results: Mean values for the FA and C groups were: NA (71.85 and 55.21μm.; p< 0.01); CA (2127.48 and 1441.61μm.; p< 0.01); NA/CA (0.03 and 0.04; p< 0.01), respectively. A significant increase in the NA and CA for the FA group (p< 0.01) was seen, and an alteration in the NA/CA ratio. No morphological differences were found between the groups. Class I smears were predominant in both groups. No differences were found between the groups for the mean values of AgNORs per nucleus. Conclusion: This study suggests that morphological changes occurred in the oral epithelium cells of children and adolescents with Fanconi anaemia when subjected to HSCT

Assessing the Radiographic Position of the Mental Forament in a Brazillian Population

The mental foramen is a clinically important landmark for several clinical dental procedures. The aim of this study is to assess the anatomic position of the mental foramen (MF) in panoramic radiographs of a Brazilian population. The sample consisted of 2,100 panoramic radiographs, obtained from 8,600 clinical files from the School of Dentistry at the Universidade Federal do Paraná. Two calibrated examiners investigated the MF according to the classification of Tebo and Telford, which locates the right and left MF into 6 different positions in relation to the apex of the adjacent teeth. Results: The MFs were similarly distributed between the apices of the mandibular premolars (class III) and below the apex of the mandibular second premolar (class IV). More specifically, on the right side 41.8% (n = 878) of the MFs were classified as class III, while 47.52% (n = 998) were classified as class IV. On the left side 42.47% (n = 892) were classified as class III, while 47.38% (n = 995) were classified as class IV. The results indicate that MFs are often located adjacent to the apex of the mandibular second premolar. However, slight variations may occur in the positioning of the MF to the mesial direction. Clinicians and surgeons must be aware of the position of the MF and its potential variations prior to anaesthetics and surgical procedures in the mandible.

Changes in Candida Profile in Patients Undergoing Intensity Modulated Radiotherapy for Head and Neck Malignancies

The increased oral Candida colonization that resulted for radiotherapy often leads to candidiasis. Intensity Modulated Radiotherapy (IMRT) is a technique of delivering radiation with improved dose distributions sparing the surrounding normal tissue and decreasing the ill-effects. Objective: To identify and quantify changes in the Candidal carriage of patients undergoing IMRT for head and neck malignancy. Methods: Saliva from 37 patients undergoing IMRT for head and neck malignancy was collected. The Candida species profile pre- and post-IMRT was evaluated using semi quantitative fungal culture. The changes in the distribution of the growth of Candida species due to IMRT was analyzed using Wilcoxon sign rank test. Results: Twenty-two patients were Candida-positive pre-IMRT, while 24 patients were Candida-positive post-IMRT. Candida species isolates pre-IMRT were C. albicans (63%), C. tropicalis (26%), C. glabrata (7%), C. krusei (4%) and post-IMRT, were C. albicans (55%), C. tropicalis (30%), C. glabrata (12%) and C. krusei (3%). C. albicans showed increased growth post-IMRT in the range of 103 to 104 colony-forming units per ml of saliva (p>0.05). Conclusion: There was no significant effect of IMRT on the distribution of growth of Candida. Candida albicans was the most common species. A change towards non C. albicans species post-IMRT was seen.

Caries Risk Profiles amongst Preschool Aged Children Living in the Sleman District of Yogyakarta, Indonesia

Objective: To assess the caries risk factors of preschool aged children. Methods: Data was collected from a sample of 85 preschool children and their mothers. An interview, and a clinical and microbiology assessment was included in this study. Clinical examinations were performed to measure the dental caries experience and plaque visibility of the children and mothers. The presence and levels of Mutans Streptococci (MS) in the saliva was measured using a commercial kit by Dentocult SM and evaluated using the manufacturer’s chart. Results: Sixty-five children had a high risk of caries (76.5%), 12.9% had a low risk, and 10.6% had a moderate risk of caries. Active cavities were found in more than half of the mothers and children. The majority of the child subjects had a snacking habit between meals (85.9%). High risk scores of 2 and 3, indicating salivary levels of MS, was found in 41.1% of children. Fluoride exposure experienced by the study population was very limited. Conclusion: Results suggest that the majority of the population had a high caries risk. There was a high occurrence of teeth with cavities in children and active carious lesions in the mothers. There was a high frequency in snacking habits, the presence of plaque and bleeding gums, high levels of salivary MS, and low protective factors for the children. Results suggest that management of caries related factors are needed in order to prevent caries in the future.

Agenesis of the Maxillary First Permanent Molars: A Clinical and Radiographic Evaluation of a Rare Case

Congenitally missing first permanent maxillary molars is a rare finding in any given population. The reported prevalence rate of maxillary first molar agenesis ranges from 0.2 to 1.5%. The exact aetiology of this dental anomaly is not clearly documented. Generally, it can occur in association with other dental disturbances. The purpose of this article is to describe the clinical and radiographic evaluation of a case with bilateral congenitally missing first permanent molars and its association with dental anomalies such as microdontia and hypodontia.

Job Stress and TMD in Productive Age (Study on Accountants in Jakarta)

Introduction: It is known that stress is one of the risk factors for Temporomandibular Disorders (TMD). Studies of TMD in people with high levels of job stress are lacking. The primary reason for choosing accountants for this study is because these individuals work under considerable stress. Objective:The aim of this study was to investigate the relationship between intensity and frequency of job stress and the occurrence of TMD in accountants in Jakarta. Methods:A cross sectional study was performed of 116 accountants aged 21-50 in Jakarta. The subjects were asked to fill two kinds of questionnaire. The first was the Job Stress Survey questionnaire (JSS)designed by Vagg and Spielberger in 1998 to examine the intensity and frequency level of job stress. The second was the TMD Diagnostic Indexdeveloped by Himawan et al. in 2006to assess the TMD. A cross tabulation was done between the intensity level of job stress, the frequency level of job stress, and TMD occurrence. The study received ethical clearance from Faculty of Dentistry, Universitas Indonesia. Results: Fisher’s Exact test showed that there was a significant relationship between intensity of job stress and the occurrence of TMD in accountants (p = 0.003). Chi square test showed that there was a significant relationship between frequency of job stress and the occurrence of TMD in accountants (p = 0.032). Conclusion:There is a relationship between intensity and frequency of job stress, and the occurrence of TMD in accountants

Atypical Presentation of Lateral Periodontal Cyst in an Elderly Female Patient - A Rare Case Report

The lateral periodontal lateral cyst (LPC) is a uncommon developmental odontogenic cyst defined as a radiolucent lesion which develops along the lateral aspect of an erupted vital tooth. LPC represents approximately 0.8% to 2% of all odontogenic cysts .The most frequently reported location of a lateral periodontal cyst is the mandibular canine premolar area, followed by the anterior region of the maxilla. Lateral periodontal cyst is usually asymptomatic and presents as a round, oval or teardrop-like well-circumscribed interradicular radiolucent area, usually with a sclerotic margin lying between the apex and cervical margin of the teeth . The lateral periodontal cyst usually is seen in the fifth to sixth decade of life with a male preponderance. This paper reports an unusual and an atypical case of an inter radicular radiolucent cystic lesion in located between the mandibular central incisor and canine area in an 87 year old female patient mimicking clinically and radiographically as an residual cyst but histopathologically confirmed as an lateral periodontal cyst.DOI: 10.14693/jdi.v23i1.96

The Micrograph Image of Early Experimental Dental Caries in Permanent Teeth in Hanoi Medical University

Objectives: This reseach aimed to describe micrograph images of experimental carious lesions at early stage. Method:  Experimental study. 60 permanent extracted premolars (patient aged 18-25) were cleaned and removed remaining soft tissue. Each tooth  was painted with acid-resistant coating leaving an enamel window of approximately 1 × 1 mm2 in buccal surface. After 96 hours being soaked in demineralization solution to create artificial carious lesion, the coating  was removed, and all teeth  would be evaluated using ICDAS criteria and made tooth specimens to be observed under a scanning electronic microscope  (SEM). Results: After being soaked in demineralization solution, the carious lesion gained was at stage  ICDAS 1 with 66.7% ; and 33.3% at stage 2. Mean depth and area of the lesions was 107.6 µm and 1.14 µm2, respectively. The difference in depth and area of lesions between  group ICDAS 1 và ICDAS 2 was significantly statistical with p=0.0001. Micrograph images showed that after being soaked in demineralization solution, enamel surface became rough, enamel rods lost minerals in the body more than in the sheath, cross-sectional images showed widened gaps between the rods due to demineralization. There was a difference in demineralization degree between  group ICDAS 1 and 2. Conclusion: Image of cariouslesions gained after being soaked in demineralization solution showed that naturally carious and artificially carious-like lesions shared many similar characteristics due to theevaluation based on ICDAS criteria for detecting early  carious lesions and scanning electronic microscope. DOI: 10.14693/jdi.v23i1.97

Genotoxic and Cytotoxic Potential of Smoke Crack Cocaine on the Epithelium of the Human Oral Mucosa

Crack cocaine is an illicit drug derived from cocaine. It can produce some damages to the lungs and oral cavity. Objective: The aim of this study was to analyze the frequency of micronuclei and some nuclear alterations in epithelial cells of crack cocaine users. Methods: Oral smears were collected from clinically normal-appearing buccal mucosa exfoliative cytology of 30 individuals (15 crack cocaine users and 15 controls). Results: Crack cocaine users consumed about 3.8 grams per day and the time consumption of the drug was of 6.4 (+3.3) years. The prevalence of micronuclei, binucleated cells, broken egg cells, budding cells, picnosis, karyolysis, and karyorrhexis was determined. The frequencies of micronuclei for case and control groups were, respectively, 2.87 + 3.46 and 0.57 + 1.6 (p=0.018). No statistical difference was observed for binucleated cells, broken egg cells, budding cells, picnosis, and karyolysis. The frequency of karyorrhexis was significantly increased on crack cocaine users than controls (54.07 + 38.58 and 24.87 + 23.97, p=0.001). Conclusion: Smoke crack might have a cytotoxic and genotoxic effects to the oral mucosa due to increased frequency of micronuclei and karyorrhexis. Thus, individuals who used crack cocaine in the long term need to be frequently examined in order to prevent neoplastic transformation.Keywords: Crack Cocaine; Micronucleus Tests; Mouth Mucosa; Cytological Techniques; Carcinogens

Distribution of Gingival Inflammation in Mouth breathing patients: An Observational pilot study

Background:  Mouth breathing has been reported to affect gingival health in children. However, studies on the effect of mouth breathing in adult patients are scarce. The objective of present cross sectional study was to examine the relationship between mouth breathing and gingival condition and to evaluate the distribution of gingival inflammation in young adult mouth breathing patients. Methods: Study groups comprised of participants with mouth breathing (test group) and nose breathing (control group) patients with gingivitis. Both the groups underwent periodontal examination. PI, GI and BOP % sites were recorded and analyzed statistically for the differences in mean values. Results: Mouth breathing patients showed higher full mouth GI and BOP scores. Upper anterior segment in mouth breathing patients showed highest GI and BOP followed by lower anterior segment, lower posterior and upper posterior region. Conclusion: Within the limits of present study, our findings suggest that relative to control group participants, test group i.e. patients with mouth breathing had higher gingival inflammation and bleeding sites in upper anterior region.Keywords: Mouth breathing; gingivitis; young adult; cross sectional pilot stud