An Unusual Presentation of “Two-Thirds Tumor” in the Mandible – A Diagnostic Quandary with a Review of the Literature

An adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of the oral cavity commonly found in the maxillary anterior region and is associated with impacted canines in young females. It rarely occurs in the mandibular region with no impacted or missing teeth. A 21-year-old female reported to the clinic with swelling on the right side of the face for the past six months with no history of pain. Radiographic features such as unilocular radiolucency with thinning of the cortical borders and considerable buccal cortical expansion, as well as some evidence of radiopaque specks were noted. Histopathological examination revealed cells with hyperchromatic nuclei, rosette-like structures with focal areas of calcified mass, and concentric rings resembling Liesegang rings, suggestive of AOT. The tumor was treated surgically by enucleation and cauterization. Although follicular type is a common variant, the tumor presented in this case was of extrafollicular type noted in the mandibular canine and premolar regions of a young female patient with no related impacted tooth

Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla : Report of five cases

Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech

Dimensional Distortion in Orthopantomogram

The Orthopantomogram is a laminographic type of radiograph, wherein the image suffers from a variable degree of horizontal, as well as vertical distortion. This study was carried out to know the amount of percentage distortion in the images of metallic spheres on the Orthopantomograph in different areas of both the jaws. The study revealed that horizontal distortion was maximum in the mandibular midline followed by maxillary midline and was least in the maxillary premolar followed by mandibular premolar. The vertical distortion was maximum in the mandibular midline followed by maxillary midline and was least in the mandibular premolar followed by mandibular molar

Crystal growth <i> vs.</i> conventional acid etching: A comparative evaluation of etch patterns, penetration depths, and bond strengths

The present study was undertaken to investigate the effect on enamel surface, penetration depth, and bond strength produced by 37&#x0025; phosphoric acid and 20&#x0025; sulfated polyacrylic acid as etching agents for direct bonding. Eighty teeth were used to study the efficacy of the etching agents on the enamel surface, penetration depth, and tensile bond strength. It was determined from the present study that a 30 sec application of 20&#x0025; sulfated polyacrylic acid produced comparable etching topography with that of 37&#x0025; phosphoric acid applied for 30 sec. The 37&#x0025; phosphoric acid dissolves enamel to a greater extent than does the 20&#x0025; sulfated polyacrylic acid. Instron Universal testing machine was used to evaluate the bond strengths of the two etching agents. Twenty percent sulfated polyacrylic acid provided adequate tensile bond strength. It was ascertained that crystal growth can be an alternative to conventional phosphoric acid etching as it dissolves lesser enamel and provides adequate tensile bond strength

Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in the oral mucosa

Angiolymphoid hyperplasia with an eosinophilia (ALHE) is a rare benign entity whose etiology and pathogenesis is under debate. Clinically, it is characterised by cutaneous papules or nodules on the head and neck. Literature reveals very few cases of this entity in the oral mucosa. Here, we report a case of ALHE in a 25 year-old woman, who presented with a painless, 5mm x 5mm, sub mucosal erythematous nodule on left angle of mouth at lower lip. Histological examination of lip biopsy specimens revealed an increase in small vessels. The vascular walls consist of prominent endothelial cells with a histiocytoid appearance, which protruded into the lumen. Many eosinophils and lymphocytes were also seen around the vessels. The diagnosis of ALHE was made from the above findings

Soft Tissue Myxoma - A Case Report

Myxoma of bone is a benign neoplasm commonly found in the maxillofacial region These myxomas of bone are considered by Stout as true neoplasms. Odontogenic or central myxomas are common as compared to soft tissue myxoma. Soft tissue myxomas are deeply situated in the skin or in the subcutaneous tissue but very few cases of intra oral soft tissue myxoma are documented and very little information is available

Albright′s Hereditary Osteodystrophy: A Constellation of Clinical Features

Pseudohypoparathyroidism (PHP) is an inherited metabolic disorder characterized by end-organ resistance to the action of PTH (Parathyroid Hormone). There are four types of PHPs namely Ia, lb, Ic and II. PHP Ia is associated with a constellation of clinical features referred to as Albright′s Hereditary Osteodystroohy (AHO). The oral manifestation of AHO found in the literature includes aplasia and or enamel hypoplasia, late tooth eruption and enlarged radicular channels susceptible to caries. Here, we are reporting a rare case of a 14-year-old girl with Albrigt′s hereditary osteodystrophy with disintinctive oral manifesitations

Cephalometric evaluation of adenoids, upper airway, maxilla, velum length, need ratio for determining velopharyngeal incompetency in subjects with unilateral cleft lip and palate

Objectives: Children with cleft lip and palate (CLP) are seen to have reduced airway size and large adenoids, which might lead to different characteristics in the upper airway and surrounding tissues from both morphological and functional perspectives. Decrease in adenoid size and increase in need ratio in cleft patients might lead to velopharyngeal incompetency (VPI) and development of nasality in adulthood. No studies have been conducted on the Indian population with variables contributing to VPI. So the aim was to evaluate the size and position of the adenoids, upper airway, maxilla, velum length and need ratio contributing to VPI in subjects with and without unilateral cleft lip and palate (UCLP) during juvenile and adolescent stages. Materials and Methods: Cephalograms of 120 subjects with 6-17 years were taken and various linear and angular measurements were measured and data was analyzed using the unpaired t test. Results: Adenoids were significantly larger and the upper airway smaller in the juvenile and adolescent cleft group than in the non-cleft group. In the adolescent cleft group, airway was larger than that in the adolescent non-cleft group. The maxilla was small and retropositioned in juvenile and adolescent subjects as compared to non cleft cases. Length of velum was smaller and need ratio was larger in both juvenile and adolescent groups as compared to the non-cleft group, suggestive of velopharyngeal incompetence. Conclusion: Decreased Adenoids, restricted airway, small, retruded maxilla, smaller velum length and larger need ratio larger were seen in the cleft group as compared to the non-cleft group, which was suggestive of VPI

Oral Lumenoscopy: An Adjuvant in Early Screening of Oral Cancer

The World Health Organization has strongly identified prevention and early detection as one of the major objectives in the control of oral cancer worldwide. Population-based mass screening of oral cancer appears to be a promising health promotion strategy with significant increase in survival rate- However, the current protocol comprising conventional visual inspection and palpation of oral soft tissues for the early detection of premalignant or malignant changes appears to be deficient. 1 Neoplastic epithelial cells tend to have an altered nuclearcytoplasmic ratio. Dehydration with acetic acid highlights this nuclear density and imparts an "acetowhite" appearance to tissue. This phenomenon can be further amplified by replacing conventional lighting with diffuse blue-white chemiluminescent illumination. This article aims to review the usefulness of this screening technology in early detection of oral cancer. The oral lumenoscopy has been proposed to be a method to improve oral screening methods which assist in the identification, evaluation and monitoring of oral mucosal changes. It is a simple, inexpensive and objective method that can provide real-time result for the detection of oral neoplasia which can be used in day to day practice by general dentist