Acute periodontal lesions

This is a review and update on acute conditions affecting the gingival tissues, including abscesses in the periodontium, necrotizing periodontal diseases, and other acute conditions that cause gingival lesions with acute presentation, such as infectious process not associated with oral bacterial biofilms, muco-cutanenous disorders, and traumatic and allergic lesions. A periodontal abscess is clinically important since it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth, and because bacteria within the abscess have been identified, mainly by the type of etiology, and there are clear diffrences between those affecting a previously existing periodontal pocket ahd those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, with individual evaluation of the need for systemic antimicrobial therapy. the definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal disease (NPD) present three typical clinical features : papilla necrosis, gingival bleeding, and pain. Although the prevalence of these diseases is not high, their importance is clear, since they represent the most severe conditions associated with dental biofilm, with very rapid tissue destruction. In adittion to bacteria, the etiology of NPD includes numerous factors that alter the host response and predispose to these diseases, including HIV infection, malnutrition, stress, and tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine, and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in non-responding conditions and the best option is metronidazole.Once the acute disease is under control, definitive treatment should be provided, including the adequate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms , are infectious diseases, muco-cutaneous diseases and traumatic or allergic lesions. In most cases, the gingival envolvement is not severe, though they are common and may prompt a dental emergency visit. These conditions may the direct result of a trauma or the consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for an adequate management of the case

Histological patterns of head and neck tumors: An insight to tumor histology

This article emphasizes the basis for origin and importance of tumor patterns in diagnosis of oral and maxillofacial tumors. In this article, histological patterns and subpatterns of head and neck tumors are enlisted. Although, undifferentiated tumors remain a challenge to the histopathologist, by describing the histological patterns and the subpatterns of the tumors, an attempt has been made for the diagnosis of the tumors and subsequently for implementation of precise treatment plan for the same

Congenital granular cell epulis of a newborn

The congenital granular cell epulis (CGCE) is a rare tumor, which is apparent at birth. The histogenesis is still uncertain, but several theories, including origin from epithelial, undifferentiated mesenchymal cells, pericytes, fibroblasts, smooth muscle cells, and nerve-related cells have been proposed. This case report describes management of a 2-day-old baby girl having a large, round, soft, single 3 × 4 cm, pedunculated swelling, on the lower anterior ridge, which was causing difficulty in feeding. Clinical diagnosis of congenital epulis (CE) was made and lesion was excised under conscious sedation. A vessel running over the surface of the lesion was continuous on the alveolar ridge. To reduce intra-operative hemorrhage transfixion suture was passed around the vessel on the alveolar ridge. Then the lesion was excised from the base of peduncle with a scalpel. Histopathologically, the diagnosis of a congenital granular cell lesion of the jaw was given. Follow up of 3 months shows no signs of recurrence. CGCE may interfere with feeding, requiring a conservative excision as soon as the child is fit to undergo surgery. Tendency for recurrence and malignant transformation has not been documented

USE OF BITEMARKS FOR HUMAN IDENTIFICATION BY USING INTER-CANINE DISTANCE AND MESIO-DISTAL WIDTH OF MAXILLARY INCISORS.

Aim: to determine the use of bite marks for human identification by using inter- canine distance and mesio-distal width of maxillary incisors. Introduction: Odontogenic evidence is considered to be the third most precise method of identification of human in forensic sciences. Bite-marks on the body are intentionally made, those found on food particles are usually impractically left by the offender at the scene of crime, these marks are of great importance in identification of the offender. The present study was aimed to determine the use of bitemarks for human identification by using inter-canine distance and mesio-distal width of the maxillary incisors. Materials and Methods: 40 consenting volunteers were included in the study. With the help of autoclaved Vernier calliper, the inter-canine distance and mesio-distal width of maxillary incisors were measured and bite on chocolate (CADBURY 5Star) was taken. Using Vernier calliper, Inter-canine distance and Mesio-distal width (2 maxillary central and 2 lateral incisors), were measured from the bite mark. Both measurements obtained were coded and matching was done by two doubly blinded examiners. Results: The probability of correct identification on the basis of IC distance and MD width obtained from bite-marks is 68.35%. The average proportion of correct matching is 0.78 for IC distance measurement and 0.46 for MD width. Conclusion: Metric method can be used for human identification by using bite-mark. IC distance is more reliable and efficient in human identification than MD width.</jats:p

Effect of various temperatures on restored and unrestored teeth: A forensic study

BACKGROUND: In large scale disasters associated with fire the damage caused by heat can make medico legal identification of human remains difficult. Teeth, restorations, and prostheses all of which are resistant to quite high temperatures and can be used as aids in identification process. AIM: Aim of the study was to investigate the macroscopic and microscopic changes of teeth and several dental filling materials exposed to a range of high temperature (200-800°C). Dental restorations include filling materials, crown, and bridges. MATERIALS AND METHODS: Restored and unrestored teeth were placed in a furnace and heated at a rate of 30°C/min and the effects of the predetermined temperatures 200, 400, 600, and 800°C were observed. Macroscopic and stereo microscope findings were observed. RESULTS: Our results showed that teeth and restorative materials resist higher temperatures than theoretically predicted and that even when a restoration is lost because of detachment or change of state, its ante-mortem presence can be confirmed and detected by stereo microscopic examination of the residual cavity. CONCLUSION: We further conclude that a reasonably reliable estimation of the temperature of exposure can be made from an analysis of the teeth and restorative materials