Salivary levels of TNF-α in patients with recurrent aphthous stomatitis: A cross-sectional study

Introduction: Recurrent aphthous stomatitis (RAS) is a disorder characterized by recurring ulcers involving the oral mucosa in patients with no other signs of disease. The current concept of etiopathogenesis is that RAS is a clinical syndrome with several possible etiologies. The process seen in RAS is probably initiated through an as yet unidentified antigenic stimulation of the mucosal keratinocytes, which stimulates secretion of T- cell activation cytokines- Interleukins and Tumour necrosis factor alpha (TNFα). TNFα causes inflammation by its effect on endothelial cell adhesion and neutrophil chemotaxis. The relevance of TNFα to the pathogenesis of RAS has stemmed from the observations that anti- TNFα drugs such as thalidomide and pentoxifylline have been found to be effective in the treatment of RAS. Therefore, the present study is an attempt to measure the levels of salivary TNFα in patients with RAS which will reflect the local production of cytokines at the site of the disease. Aim: To evaluate the salivary levels of TNFα in patients with recurrent aphthous stomatitis. Materials and Methods: The study comprised of 60 subjects, of whom 30 clinically proven RAS patients of either sex were selected as cases and 30 healthy, age & gender-matched subjects were selected as controls. After taking informed consent, 5 ml of unstimulated saliva was collected from both the study and control group. Determination of salivary TNFα levels was done by Enzyme-Linked Immunosorbent Assay (ELISA) and expressed in picograms per milliliter (pg/ml). The statistical analysis of the RAS group and the control group were done using unpaired t-test. Gender wise comparison of salivary TNFα levels in the study and control groups was done using one-way ANOVA test. Results: There was statistically highly significant increase in the mean salivary TNFα levels in the RAS group compared to the control group (p < 0.001). It was also revealed that the mean salivary TNFα levels in females were more than males in the study group and this difference was statistically significant (p <0.05). Conclusion: It is fair to suggest that TNFα plays a very important mediatory role in the pathogenesis of RAS and may play an important role in the search for a definitive treatment for the disease

Determination of sex from tooth pulp tissue

Objective: This study was carried out to determine the reliability of sex determination from teeth pulp tissue. Patients and methods: This study was carried on 60 maxillary and mandibular premolars and permanent molars (30 male teeth and 30 female teeth) which were indicated for extraction. The teeth were categorized into three groups of 20 each (10 from males and 10 from females).Group 1-pulp tissue from teeth examined immediately after extraction. Group 2- and Group 3-pulp tissue examined from teeth one and five month after extraction, respectively. Teeth was sectioned and pulpal cells were stained with quinacrine dihydrochloride. The cells were observed with fluorescent microscope for fluorescent body. Gender was determined by identification of Y chromosome fluorescence in dental pulp. Results: Freshly extracted teeth and for those examined one month later, sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were all 100%. Conclusion: The fluorescent Y body test is shown to be a reliable, simple, and cost-effective technique for gender identification in the immediate postmortem period up to one month

Psychoneuroimmunological disorders and temporomandibular joint pain: A review

Psychoneuroimmunology characterizes a disease entity that combines psychological components, central nervous system regulation, and immunology, to explain the etiological complexity of a disease. Temporomandibular disorders (TMDs) include a heterogeneous group of painful conditions that involve the temporomandibular joint (TMJ), muscles of mastication, and the adjacent anatomic structures. This review focuses on the psychoneuroimmunological diseases and disorders that mimic the symptoms of TMDs. The differentiation of these disorders is of great significance to the oral physician - differentiating and diagnosing the cause of TMJ pain and treating it effectively to benefit the patient.The literature for this review was taken from Medline/PubMed, other indexed journals, standard text books, and online material

Instruments to measure betel quid dependency among young and adult chewers – A systematic review with meta-analysis

Background: Betel quid (BQ) consumption is prevalent globally, majorly consumed in South-Asia and South-East Asian countries. Among the other country studies done on BQ, the focus has been on its consumption prevalence, its physiological and psychological effects, and aids to discontinue this habit. Systematic literature research on suitability of different instruments (metric or scale) to measure BQ dependency is scarce, hence pointing to the need of more evidence-based studies in this domain. Aim: The aim of the article was to identify the instruments used in the published literature to measure BQ dependency among young and adult chewers and draw a comparison. Methodology: The electronic retrieval systems and databases PubMed (Medline), Cochrane Library, Scopus, Web of Science, and Google Scholar were searched independently by two authors from January 2011 to September 2022 for the collection of desired data. Results: Among 1271 articles, 337 were duplicates and removed, 866 did not meet selection criteria. Out of 68 articles, 57 were excluded due to the lack of relevant data. Finally, only 11 articles were included for the analysis in this systematic review. Conclusion: Due to a scarcity of researches in this direction, no scale can be assigned as the best Dependence Scale, thus necessitating more such systematic reviews and meta-analysis for better comprehension and usage of present dependence scales

Osteochondroma involving mandibular condyle

Osteochondroma is defined as an osteocartilagenous exostosis with cartilage capped exophytic lesion that arises from the bone cortex. It is a slow growing benign tumor that is rarely seen in the maxillofacial region. Osteochondroma of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ) dysfunction and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic growth of the tumor from the condylar head. The treatment of osteochondroma is primarily surgical resection of the tumor. This paper reports a case of osteochondroma of the right mandibular condyle presenting as a painless restricted mouth opening

Keratocystic odontogenic tumor: A case report and review of literature

Keratocystic odontogenic tumor (KCOT) has been identified as a "tumor" after observation of its biological behavior and genetic abnormalities consistent with neoplastic progression. In 2005, the World Health Organization (WHO) working group considered odontogenic keratocyst (OKC) to be a tumor and recommended the term KCOT, distinguishing the lesion from the orthokeratinizing variant, which is now considered an OKC or orthokeratinized odontogenic cyst. Very rarely, KCOTs can transform into more aggressive lesions such as ameloblastoma and primary intraosseous carcinoma (PIOSCC). In this paper, we present a case of KCOT involving the angle and ramus of the mandible, with histopathologic evidence of ameloblastomatous changes. We also discuss about the evolution of this lesion from a cyst to a tumor along with the latest updates of the entity

Orofacial granulomatosis

Orofacial granulomatosis (OFG) is a rare disease, usually presenting as a persistent swelling of the soft tissues in the orofacial region, predominantly lips (cheilitis granulomatosa). The treatment of OFG can be challenging as frequent recurrences are very common. Here, we present a case of an Asian female patient with persistent swelling of the upper lip from the past 6 months. After establishing the diagnosis, intralesional triamcinolone injection (10 mg on a weekly schedule) was planned for a period of 6 weeks. Complete resolution of the lesion was observed. This article presents a unique case of cheilitis granulomatosa (CG) with a brief highlight on the various treatment modalities and a structured algorithm discussing the various differential diagnoses, aiding in formulating an accurate diagnosis and effective treatment

Congenital infiltrating lipomatosis of face: Case report and review of literature

Hemifacial hyperplasia is a rare condition causing unilateral enlargement of all tissues. We report a case of progressive facial asymmetry caused by congenital infiltrating lipomatosis of the face in a 6-year-old boy. The approach to diagnosis in our case is discussed along with a review of cases reported in the literature

Central giant cell granuloma: A case report with review of literature

Central giant cell granuloma (CGCG) is an uncommon, benign, and proliferative lesion of the jaw with an unknown etiology. It is considered widely to be a nonneoplastic lesion. The actual etiology of CGCG is still unclear, although inflammation, hemorrhage, and local trauma have all been suggested. The incidence in the general population is very low, and patients are generally younger than 30 years. The biologic behavior of CGCG of the jaw ranges from quiescent to aggressive with destructive expansion. Here, we report a case of CGCG in an 18-year-old female patient with review of literature