Clinical Epidemiological Study of Oral Pre-cancer and Cancer in a Tertiary/Referral Hospital

Aim: To study the prevalence of oral cancer in patients reported to the Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital.Materials and Methods: After selecting the patients with the clinical criteria the history of the habits, duration in months and frequency per day, duration of the symptoms, oral mucosal site involvement, lymph node involvement, associated with lesions were recorded in a structured proforma. Incisional biopsy under Local anaesthesia and histological examination was performed. The results obtained were analysed statistically.Results: 200 patients were diagnosed with oral cancer, 49% were male and 51% were females. In that 51(25%) were associated with premalignant lesions, 94 had only one habit, 74 had a combination of habits, 40% were histopathologically moderately differentiated followed by 33% poorly differentiated and 27% well differentiated. And patients with stage III (31%) and IV (43%) were reported predominantly than stage I (12%) and II (14%).Conclusion: Early diagnosis and intervention prevent the progression of oral cancer.Keywords : Tobacco, awareness, oral cancer, epidemiology.Â

Significance of serum nitric oxide and superoxide dismutase in oral submucous fibrosis and squamous cell carcinoma: A comparative study

Introduction: This study aimed at comparative analysis of serum nitric oxide (NO) and superoxide dismutase (SOD) levels as therapeutic and prognostic biomarkers in patients with oral submucous fibrosis (OSMF) and squamous cell carcinoma (SCC). Materials and Methods: Eighty-seven patients were grouped into Group I (n = 29, OSMF), Group II (n = 29, oral SCC), and Group III (n = 29, controls). Two ml of venous blood was collected from patients after overnight fast to avoid any dietary influence on the serum beta-carotene. Standard protocols were followed in transfer, storage, and processing of blood. Modified copper-cadmium reduction method for rapid assay to estimate the serum NO and EnzychromTM SOD assay kit to determine SOD levels were used. Results: The mean level of NO level in Group I, Group II, and Group III was 42.49, 50.08, and 32.81, respectively, and mean level of SOD in Group I, Group II, and Group III were 207.65, 196.93, and 226.57, respectively. The P values were calculated and were statistically significant (<0.001). Conclusion: An increase in level of oxidant NO in OSMF followed by SCC and decrease in level of antioxidant SOD in OSMF followed by SCC were noted. These levels of NO and antioxidant SOD can be used as prognostic and therapeutic biomarkers

Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report

Paraneoplastic pemphigus is a rare immunobullous disorder commonly associated with lymphoproliferative neoplasms and less commonly in carcinomas with a poor prognosis. The neoplasms produce autoantibodies that react with members of plakin family to produce a suprabasilar split and varied clinical presentations in the skin and mucous membrane. Oral erosions are the first manifestation most resistant to treatment and persist even after the underlying tumour has been resected or treated. We report here a rare case of paraneoplastic pemphigus with an underlying squamous cell carcinoma of the oesophagus that constitutes only 8% of the neoplasms associated with this condition. It was successfully managed by a multidisciplinary approach involving the Departments of Dermatology, Surgical Oncology and Oral Medicine. The oral erosions were resistant to treatment however, a patient-tailored treatment was advocated using professionally administered debridement with hydrogen peroxide diluted with hypotonic saline, high potency topical steroids, analgesic oral rinses and topical anaesthetics with systemically administered immunomodulators. Hence, management of such cases exhibiting systemic and oral manifestations require a multidisciplinary team approach to improve the quality of life of the patients

Osteophytes in temporomandibular joint, a spectrum of appearance in cone-beam computed tomography: Report of four cases

Osteophyte is one of the hallmark radiographic feature of temporomandibular joint (TMJ) degenerative joint disease that has been used to define the presence of disease. The development of osteophyte is an attempt to stabilize the overload caused by occlusal forces, representing areas of newly-formed cartilage. It can cause various clinical symptoms such as pain, decreased jaw movements, nerve compression, and subsequently compromise joint function. Here, we report four cases of patients with TMJ arthritis showing different appearance of osteophyte using cone-beam computed tomography. This paper also reports two cases of bridging osteophyte at the temporomandibular joint, which has not been reported previously in literature

Stylocarotid syndrome: An unusual case report

Patients presenting with vague head and neck pain can lead to wide-ranging differential diagnosis. Elongation of styloid process (SP) should also be considered as one of the etiological factors for cervical pain radiating to jaws, pharyngodynia, and difficulty in swallowing. Symptomatic elongation of SP or mineralization of stylohyoid ligament is referred as Eagle′s syndrome. It is a rare entity presenting with an array of symptoms like recurrent throat pain, dysphagia, otalgia, and neck pain. History and physical examination play a vital role in diagnosing this condition and further radiological investigation confirms the diagnosis. The preferred radiologic modality is 3D-computed tomography, which gives accurate information about length, angulation, type of elongation, and relation to vital structures and hence helps in execution of treatment planning. This paper describes clinical approach, imaging investigations, and management of a case of Eagle′s syndrome

Diagnostic accuracy of color doppler ultrasonography in evaluation of cervical lymph nodes in oral cancer patients

Aims: To assess the diagnostic accuracy of color doppler ultrasonography (CDUS) in differentiating metastatic from reactive lymph nodes in oral cancer patients. Material And Methods: Study comprised 80 adult subjects with oral cancer, divided in two groups based on clinical criteria. Group I included 40 patients with clinically suspected metastatic cervical lymph nodes, Group II included 40 patients with clinically suspected reactive cervical lymph nodes. Study population was evaluated with CDUS for color flow signals and intranodal vascular resistance (Pulsatility Index and Resistivity Index), followed by Fine Needle Aspiration Cytology, used as a standard, to confirm the etiology of the lymph node enlargement. Statistical Analysis Used: Chi-Square Test (SPSS 15.0 version) was used to evaluate the significance of the parameters used between the two study groups. Results: Sensitivity of CDUS by vascular flow pattern was 94.1%, specificity of 100%, with accuracy of 95.4% and by vascular indices the sensitivity was 81.4%, specificity of 100%, and accuracy of 85.5%, with statistically significant correlation.(P < 0.05) Conclusion: CDUS plays a definitive role as an adjunct to clinical evaluation of differentiating metastatic from reactive cervical lymph involvement in patients with oral cancer as it aid in grading and staging of oral cancer and can determine the treatment plan prognosis and morbidity by diminishing the possibility nodal dissection

Rare variant of ameloblastoma: A case report

Ameloblastoma is second most common odontogenic tumor of jaws that presents with typical clinical, radiological, and histopathological appearances. Provisional diagnosis of this tumor is based on clinical and radiological features; however, final diagnosis is made by histopathological examination which classifies it in to various types, i.e. follicular, plexiform, acanthomatous, granular cell, desmoplastic, and basal cell type. Follicular and plexiform patterns are most common. Hybrid ameloblastoma (HA) is rare entity in which conventional types (follicular and plexiform) of ameloblastoma co-exist with desmoplastic ameloblastoma (DA). Its radiological appearance differs from conventional ameloblastomas and sometimes resembles fibro-osseous lesions (FOL). There are only 35 cases of HA reported in literature. We present a novel case of hybrid desmoplastic/follicular ameloblastoma of anterior mandible with emphasis on its radiologic features. Differential diagnosis of the lesion from conventional ameloblastomas and FOL are discussed