Prevalence of Oral Manifestations and Their Association with CD4/CD8 Ratio and HIV Viral Load in South India

The objective of the present research was to determine the prevalence of oral manifestations in an HIV infected population from south India and evaluate their association with HIV viral load and CD4/CD8 ratio. Intraoral examination of 103 patients, whose CD4/CD8 ratio was available, were conducted. HIV viral loads were available for thirty patients only. The prevalence of oral manifestations was 80.6% (83/103). The most common oromucosal lesion was erythematous candidiasis (EC) (38.8%) followed by melanotic hyperpigmentation (35.9%). Patients having any oral manifestation had a mean CD4/CD8 ratio of 0.24. EC had positive predictive value of 85.0% for CD4/CD8 ratio <0.30. The prevalence of oral manifestations in patients taking ART was lesser (78.6%) as compared to patients not taking ART (82%). Patients having any oral manifestation had a higher HIV viral load as compared to patients not having any oral manifestations (P < 0.05). Pseudomembranous candidiasis (PC) was significantly associated with higher HIV viral loads (>20,000 copies/mL) (P < 0.05). Patients having EC had 4 times greater chance of having CD4/CD8 ratio <0.30. PC can be considered as a marker of immune suppression (HIV viral load >20,000 copies/mL)

Oral Hygiene and Dentition Status in Patients with Congenital Hemorrhagic Disorders: A Comparative Study

Objective: To compare the status of oral hygiene and dentition in patients with congenital hemorrhagic disorders with their age-matched healthy counterparts. Also, the prevalence of fear of dentists/ dental treatment among these patients was assessed. Material and Methods: This study was performed on children and adults with von Willebrand disease (vWD), hemophilia (A or B), and healthy subjects. Oral health and dentition status was assessed using the simplified oral hygiene index (OHI-S), plaque index, and the decayed, missing, filled teeth (dmft/DMFT) index. One-way ANOVA test was employed to compare the oral hygiene and dentition status of subjects in the three groups. A p-value of &lt;0.05 was considered statistically significant. Results: The DMFT score did not vary significantly between the groups (p&gt;0.05). Higher OHI-S scores and a poor oral hygiene status was observed more in the hemophilia group than the vWD group and healthy controls. A total of 27.3% of the subjects in the vWD group, 18.2% of subjects in the hemophilia group, and no subjects in the healthy group had a fear of dentists or dental treatment. Conclusion: Subjects with vWD had a higher number of carious teeth when compared to the other groups. Poor oral hygiene status was observed in subjects with hemophilia

Remodeling of the antegonial angle region in the human mandible : a panoramic radiographic cross-sectional study

Objectives: This study analyzed changes in the antegonial region in relation to age, gender, and dental status. Study design: A total of one thousand patients (five hundred males and five hundred females), who were prescribed panoramic radiograph for various purposes were included in the study. The patients were categorized according to age, gender and dentition status. Panoramic radiographs were traced and antegonial angles and depths were measured. Results: A trend of decrease in the antegonial angle and increase in antegonial depth with age was observed in both males and females. Furthermore there were differences between right and left side antegonial angle and depth, with left side angle more than right and right side depth more than left. There was a significant decrease in the values of antegonial angle and significant increase in the values of antegonial depth as the dentition status changed from completely dentulous to partially dentulous and from partially dentulous to completely edentulous state. Conclusions: The antegonial angle decreases with the advancing age and thereby increases the antegonial depth. Similar trends are seen when teeth are lost. Furthermore there is an inherent asymmetry in the antegonial region in right and left side

Condylar Changes and Its Association with Age, TMD, and Dentition Status: A Cross-Sectional Study

The present study was undertaken to evaluate the prevalence of radiographic changes in the condylar morphology and its association with age, clinical signs and symptoms of temporomandibular dysfunction and dentition status and also to evaluate the intra examiner and inter examiner reliability in assessing condylar changes using panoramic radiographs. A total of 75 subjects were recruited for the study. They were divided into 3 age groups. 20–40 yrs (Group A), 41–60 yrs (Group B) and 61 yrs and above (Group C). In each age group 25 subjects were evaluated both clinically and radiographically. The prevalence of radiographic changes in condylar morphology and symptoms of temporomandibular dysfunction was 81.3% and 18.6%, respectively. Radiographic abnormalities in the mandibular condylar morphology increased with age. They were seen more frequently in patients with clinical signs and symptoms of temporomandibular dysfunction and in patients with loss of teeth. Intra examiner and inter examiner reliability was high indicating a good reliability in assessing the condylar changes using panoramic radiograph

Non-syndromic multiple odontogenic keratocysts: report of case

Odontogenic keratocysts (OKCs) are epithelial developmental cysts which were first described by Phillipsen in 1956. Lesions are frequently multiple and a component of Nevoid Basal Cell Carcinoma Syndrome (NBCCS) (Gorlin Goltz syndrome/Bifid rib syndrome). We hereby report a case of multiple OKCs in a non – syndromic patient and highlight the general practitioner the importance of diagnosing the disease and enforcing a strict long-term follow-up whenever such a case is identified

Solitary large intraoral neurilemmoma of the maxillary vestibule: report of a rare case with brief literature review

Aim: This current report aimed at presenting a rare case of a large solitary intraoral neurilemmoma of the buccal vestibule followed by a brief review of literature of neurilemmoma published between 1997 and 2017. Background: The diagnosis of slow-growing intraoral lesions requires a thorough patient history and clinical examination. Despite the best efforts of even the most experienced oral medicine expert, a definitive diagnosis may sometimes only be reached through excisional biopsy and histopathological evaluation. Case description: To the best of our knowledge, there have been only two cases of neurilemmoma of the buccal vestibule reported in the literature till date and, looking at the size of the lesion, our case is the largest among the ones reported. Conclusion: In the present case, a rare presentation of solitary buccal vestibular neurilemmoma establishes the need for the consideration of a wide range of pathologies in the differential diagnosis. Clinical significance: Clinicians should include neurilemmoma in their differential diagnosis for asymptomatic, slow-growing intraoral growths and ensure complete excision to prevent tumor recurrence. The reader should be able to recognize the clinical features of neurilemmoma and describe the histopathological features and management of the condition

EFFICACY AND SAFETY OF TETRAHYDROCURCUMINOID IN THE TREATMENT OF ORAL LEUKOPLAKIA: A PILOT STUDY

Objective: The objective of this study is to evaluate the efficacy and safety of tetrahydrocurcuminoid (THC) in the treatment of oral leukoplakia. Methods: Patients with oral mucosal lesions with clinical features of leukoplakia were selected, and an incisional biopsy of the lesion was performed to confirm the diagnosis. Demographic data, habit history, and complete medical history were documented. Subjects were given 2% THC gel (Sami Labs, Bengaluru) with advice to apply the gel to the affected areas, 5 times daily for 12 weeks. The lesion was examined, and its characteristics were documented in a standard manner at baseline, 3, 6, 9, and 12 weeks. Results: Of the eight patients, 6 were males with age range from 40 to 70 years (mean age of 56 years). All the patients reported a reduction of burning sensation within 3 weeks of starting treatment and were completely asymptomatic by the end of the study. There was a decrease in the size of the lesion during the follow-up period. Reduction in thickness of the lesion was found in six of eight patients. Histological improvement a stage better was seen in three patients after completion of treatment. However, there was no histological improvement in four patients, and one patient progressed to mild dysplasia from hyperkeratosis without dysplasia. Conclusion: THD when topically applied in gel form is remarkably effective in alleviating clinical symptoms. The remarkable histological improvement was seen in 3 of 8 patients

Usefulness of salivary alpha amylase as a biomarker of chronic stress and stress related oral mucosal changes ' a pilot study

Introduction: Salivary biomarkers are suggested to provide a reliable, noninvasive and objective measurement of chronic psychosocial stress and helps in assessment of pivotal role of stress in causation or precipitation of multitude of health problems Objectives: To evaluate the usefulness of salivary alpha amylase activity as an objective indicator of chronic stress and to find out any correlation between stress- related mucosal complaints and its levels. Study Design: Study was conducted among 50 subjects suffering from chronic stress related problems and 50 nonstressed individuals who were screened with a psychometric questionnaire. Brief case history and oral examination was carried out and about one ml of unstimulated saliva was collected. Salivary alpha amylase levels estimated were compared between study and control group and between subjects with and without oral mucosal changes using non parametric Mann Whitney U test Results: There was statistically significant higher salivary alpha amylase levels in study group (p = .002) and salivary alpha amylase between the oral mucosal complaints group and without oral mucosal complaints group within the total study population were found to be statistically significant (p=0.045). Conclusion: Salivary amylase activity increases in patients with chronic psychosocial stress and may be used as a biomarker of chronic stress, but it may not be an indicator to suggest the development of stress related oral mucosal changes

Clinical Study Condylar Changes and Its Association with Age, TMD, and Dentition Status: A Cross-Sectional Study

The present study was undertaken to evaluate the prevalence of radiographic changes in the condylar morphology and its association with age, clinical signs and symptoms of temporomandibular dysfunction and dentition status and also to evaluate the intra examiner and inter examiner reliability in assessing condylar changes using panoramic radiographs. A total of 75 subjects were recruited for the study. They were divided into 3 age groups. 20-40 yrs (Group A), 41-60 yrs (Group B) and 61 yrs and above (Group C). In each age group 25 subjects were evaluated both clinically and radiographically. The prevalence of radiographic changes in condylar morphology and symptoms of temporomandibular dysfunction was 81.3% and 18.6%, respectively. Radiographic abnormalities in the mandibular condylar morphology increased with age. They were seen more frequently in patients with clinical signs and symptoms of temporomandibular dysfunction and in patients with loss of teeth. Intra examiner and inter examiner reliability was high indicating a good reliability in assessing the condylar changes using panoramic radiograph

Oro-facial aspects of leprosy : report of two cases with literature review

Leprosy is a chronic infectious disease affecting primarily the skin, peripheral nerves, respiratory system and the eyes. Leprosy induces various types of clinical presentation affecting the patient´s immune response. Cellmediated immunity is considered to be the crucial defence against the disease and the magnitude of this immunity defines the extent of the disease. The article presents two case reports of manifestations of leprosy in the oro-facial region, with a brief review of various other important oro-facial manifestations of leprosy. The first report deals with granulomatous nodules in the palate while the second report presents bilateral facial palsy in leprosy patients. Both the reports gain importance due to rare oral manifestation in a borderline leprosy patient in the first case, while the second case presents a rare bilateral Bell´s sign. The role of the dental profession and especially the Oral Medicine specialist is of great importance in early diagnosis of oral lesions