Simultaneous Occurrence of Dens Invaginatus and Fusion

Although Dens invaginatus and fusion are well-known and well established dental anomalies, they are rarely seen in supernumerary teeth. In this article, simultaneous occurrence of Dens invaginatus and fusion between maxillary lateral incisor and a supernumerary tooth is described. Dens invaginatus is clinically significant due to the possibility of the pulpal involvement; pulpitis, necrotic pulps and chronic periapical lesions are often associated with this anomaly without clinical symptoms. Fusion has a negative impact on the aesthetics, especially when it occurs in maxillary anterior teeth. It is difficult to clinically make differential diagnosis between fused teeth and geminated teeth, especially when these anomalies take place together with hypodontia or supernumerary tooth. It has been found that sequel of such teeth may result in delayed eruption, ectopic eruption or even impaction of permanent teeth; hence proper diagnosis by clinical and radiographic methods and intervention at appropriate time is of paramount importance. The accurate knowledge of variations in morphology of tooth and pulp cavity greatly assists the dentist in planning successful treatment options

Verrucous hemangioma of the oral cavity: A rare diagnostic dilemma

Verrucous hemangioma (VH) is an uncommon, congenital, vascular malformation that involves dermis and subcutaneous connective tissue of skin. VH lesions are initially present at birth, and therefore, the diagnosis in the elderly may be difficult. Review of literature reveals that VH lesions are commonly located unilaterally on the lower extremities. VH may clinically present as keratotic, papular, nodular, or plaque-like lesions that are reddish-blue in color. VH does not resolve spontaneously and has a tendency to relapse. The diagnosis of VH is generally done on the basis of histopathology. Early diagnosis is important to get a better cosmetic result. VH requires a large, deep excision to avoid recurrence because of frequent extension into subcutaneous fat planes. Intra-oral lesions of VH have rarely been reported in the literature. We present an extremely rare case of VH occurring in the retromolar triangle area of oral cavity

Correlation of ultrasonographic measurements, histopathological grading, and clinical staging in oral submucous fibrosis

Aims and Objectives: To evaluate the presence and thickness of submucosal fibrosis in oral submucous fibrosis (OSMF) patients ultrasonographically and to correlate these findings with the clinical stage and histological grade of OSMF. Materials and Methods: Forty participants (twenty cases and twenty controls) were included in the study. The patients diagnosed clinically as having OSMF and consented for biopsy were included in the cases, and completely healthy individuals with no habit history or oral lesions were included in the control group after matching the body mass index. After clinically staging, the patients' transcutaneous ultrasonography (USG) was performed and after that punch biopsy was taken and the specimen was graded histopathologically. Results: The data were statistically analyzed using Mann–Whitney test and Spearman's rank correlation. The cases showed increased submucosal thickness as compared to the controls. The USG measurements statistically correlated with the clinical stage and histopathological grade of OSMF. Conclusion: USG proves to be a valuable adjunctive modality in diagnosing, staging and also evaluating the prognosis of OSMF

Efficacy of aloe vera and triamcinolone acetonide 0.1% in recurrent aphthous stomatitis: A preliminary comparative study

Introduction: Aloe vera has various pharmacological actions due to which it has been selected as an alternative treatment modality in treating various oral diseases. It has antibacterial, antifungal, antiinflammatory, antioxidant, antitumor, and immune boosting. It has been used for the management of oral lesions such as oral lichen planus, oral submucous fibrosis, radiation-induced mucositis, burning mouth syndrome, xerostomia, recurrent aphthous ulcers. Aim: The aim of this study is to the compare the effects of the topical aloe vera gel and triamcinolone acetonide 0.1% in patients with minor ulcers of aphthous stomatitis. Materials and Methods: Thirty-four patients presenting with clinical signs and symptoms of aphthous stomatitis were included for the randomized single blinded study after informed consent. Group A patients received topical aloe vera gel (Forever Bright Aloe vera Gel), and Group B patients received topical triamcinolone acetonide 0.1% (kenacort oral paste) three times a day for 7 days or till the ulcer heals completely. The parameters such as the size of the ulcer, burning sensation, and pain were recorded at each visit. Results: In this study, kenacort oral paste was found to be effective than aloe vera in wound healing (measured by the diameter of ulcer). In contrast, aloe vera gel had a better response in terms of pain and burning sensation. Conclusion: Aloe vera has a wide spectrum of unique properties and uses. It is a promising agent in treating oral lesion in the field of oral medicine. It can be used as an alternative medicine and in patients who are allergic to steroid medication

”VELscope as an adjuvant chairside diagnostic tool” – A clinical case series

The aim of this study was to evaluate the use of visually-enhanced lesion scope (VELscope) as an adjuvant diagnostic tool along with clinical examination. VELscope device which works on the principle of tissue fluorescence and helps in diagnosis or identification of suspected dysplastic lesions. The use of VELscope in dentistry is contributory as it aids in the detection of dysplastic changes in oral potentially malignant disorders and appropriate surgical margins for resection, VELscope-guided biopsy procedures, indicative of bacterial, fungal, and viral infections, and also inflammatory lesions. The cases discussed in the report are clinical cases where VELscope has been used as an accessory tool to enhance the clinical efficacy of diagnosis. There are different domains of cases where the use of VELscope has been assessed, also cases where VELscope can be beneficial to identify most preferred site of biopsy, aiding in the identification of fungal, bacterial presence, and evaluation of premalignant lesions and different oral carcinomas. Both the advantages, limitations, and significance of the device in each clinical condition have been discussed. VELscope is a handheld, noninvasive adjuvant device which can be used along with conventional clinical conditions for enhanced diagnostic accuracy. It can also be used as a screening tool for the early detection of oral carcinoma and dysplastic lesions in mass screening and tertiary centers. Further studies are required to establish the efficacy of VELscope in the clinical practice of oral medicine and radiology. Increasing incidence of oral carcinoma is a worrying scenario. Early detection of these conditions can be assessed by various diagnostic methods which broadly includes conventional staining dyes such as Lugol's iodine, methylene blue, toluidine blue, or light-based detection such as chemiluminescence, VELscope, Vizilite, or optical-based system such as colposcopy and optical coherence tomography. VELscope can be one of the tool for assessing dysplastic lesions at an early stage. Due to its portability, cost-effectiveness, and noninvasive advantages, it can be a promising tool for screening mass population for oral carcinomas

Lobulated capillary hemangioma: A series of 3 cases with review of literature

Enlargements of soft tissue of the oral mucosa often present a diagnostic challenge because a diverse group of pathologic processes can produce such lesions. Lobulated capillary hemangioma of oral mucosa is a well-known benign lesion occurring most commonly on gingiva. Diagnosis of such lesions becomes difficult many times as an enlargement may represent a variation of normal anatomic structures, inflammation, cysts, developmental anomalies, and neoplasm. Some of these lesions are reactive in nature. This article focuses on a series of three similar cases on gingiva, clinically diagnosed as “pyogenic granuloma” and histopathologically as “lobulated capillary hemangioma.

Assessment of efficacy of ultrasonography in cervical lymphadenopathy in oral malignancies

Aims and Objectives: To substantiate the use of ultrasonography in diagnosis of cervical lymphadenopathy in oral malignancies and to assess if ultrasonographic examination done prior to lymph node (LN) biopsy can yield important information regarding the diagnosis. Materials and Methods: Twenty subjects with histopathologically confirmed oral malignant lesions with clinically palpable and untreated cervical LNs included into study. These patients were subjected to clinical examination (number of LNs, shape, size, location, overlying temperature, overlying skin, tenderness, consistency, and fixity to the underlying structures), and ultrasonographic evaluation (number of LNs, shape, size (mm), location, borders, matting, peripheral halo, hilum, calcification, necrosis, reticulation, and echogenicity) of the LNs, and finally, histological assessment was done after surgical excision during the course of treatment. Results: Predominantly male (65%) patients were having with malignant LN involvement with age group of 60–69 years, i.e., 35%. Ultrasonogram is superior to clinical examination as it detected additional 49 nodes. Malignant nodes tend to have longest axial diameter (17 mm with standard deviation of 8.7 mm). Over all 52 malignant nodes were round, whereas 35 nodes were oval in shape. Most of the nodes were detected in submandibular region. Around 61 (70.9%) nodes had sharp borders and 26 (29.9%) had smooth borders. Loss of echogenic hilus is a common feature of malignancy showing 70% sensitivity and 67% specificity. Most of malignant nodes were hypoechoic. Around 51 (58.6%) of nodes showed intranodal necrosis, whereas it was absent in 36 (41.4%) nodes. Matting and edema were present 25 (28.7%) nodes. Intranodal calcification was present in 37 nodes. Sensitivity of USG was 90%, whereas specificity was 100%. Conclusion: Ultrasonographic examination of cervical LNs can yield important information regarding the diagnosis. Ultrasound examination should be done prior to FNAC and ideally an ultrasound-guided FNAC