Developmental anomalies affecting the morphology of teeth – a review

Introduction: The development of tooth is a complex process wherein there is series of interactions between the ectoderm and ectomesenchyme. The role of genes in determining the shape and form of a specific tooth has already been defined, the alterations in which can lead to a variety of anomalies in regards to number, size, form, shape, structure, etc. Objective: To review the literature on the developmental anomalies of teeth. Literature review: The developmental anomalies affecting the morphology exists in both deciduous & permanent dentition and shows various forms such as gemination, fusion, concrescence, dilacerations, dens evaginatus, dens invaginatus, enamel pearls, taurodontism or peg laterals. These anomalies have clinical significance concerning esthetics, malocclusion and more importantly predisposing the development of dental caries and periodontal diseases. Conclusion: Knowledge of various diagnostic criteria for identification of these developmental anomalies is significant for early diagnosis and pertinent treatment

GIANT CELLS AND GIANT CELL LESIONS OF ORAL CAVITY- A REVIEW

Giant cells are large mononucleated or multinucleated cells that are seen in a variety of physiological as well as pathological conditions. Multinucleated giant cells (MGCs) are important mediators of tissue remodeling and repair and also for removal of foreign materials and various pathogens.  The commonly encountered giant cells arise from monocyte precursors, formed due to different mechanisms. Depending upon the mechanism of their formation these cells assume distinctly variable phenotypes.  The giant cell lesions of oral cavity have been classified on the basis of etio-pathogenesis, the presence of which at times being pathognomic. We attempt to review the basic information regarding the mechanism of formation and morphology of giant cells and its significance in the associated giant cell lesions. Also we have tried to describe the clinical, histopathological and immunohistochemical aspects of various giant cell lesions of the oral cavity

The Histopathological Spectrum of Pyogenic Granuloma: A Case Series

Background. Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i) cellular phase, (ii) capillary phase/vascular phase, and (iii) involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH) and non-lobular capillary hemangioma (non-LCH). Case Presentation. In this series, four cases (varied age groups and both genders) of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue. Conclusion. In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification

Pyogenic granuloma of the upper lip: A common lesion in an uncommon location

Pyogenic granuloma is a non-neoplastic reactive lesion that commonly occurs in gingiva. It is rarely found in other locations such as the lips, tongue, palate and buccal mucosa. Lesions affecting the upper lip are even rarer and very few cases have been reported in the literature. In such situations, the lesion may mimic other conditions such as minor salivary gland tumours, mesenchymal tumours, and infectious lesions, which may create diagnostic difficulty. This case report describes an uncommon location of pyogenic granuloma occurring on the upper lip in a 49-year-old male patient. Keywords: Gingival lesions, Granuloma, Pyogenic, Upper li

Endodontic management of mandibular canine with two roots and two canals: a rare case report

Abstract Background In general, mandibular canines have a single root and a single canal. The occurrence of two roots and two canals is a rare entity ranging from 1 to 5%. The anatomy of root canal morphology plays a decisive role in determining the conditions under which endodontic treatment can be performed effectively. Successful endodontic treatment comprises proper diagnosis, meticulous cleaning and shaping followed by three dimensional obturation. Failure to do so may lead to postoperative diseases, pain and further complications. This paper reports successful management of a mandibular canine with two roots and two canals. Case presentation 45-year-old Nepalese women with a non-significant medical history presented with a chief complaint of pain in a lower left front tooth. The pain disturbed her sleep and lingered for several minutes even after removal of a thermal stimulus. Clinical examination and testing revealed generalized severe attrition with tenderness to percussion in the mandibular left canine. Electric pulp test for all the mandibular anteriors revealed almost no response in the mandibular left canine. Intraoral periapical radiographs in different angulations were taken which revealed two roots and two canals. A clinical diagnosis of chronic irreversible pulpitis with symptomatic apical periodontitis was made and root canal therapy was performed following the standard protocols. Conclusion Although the prevalence of two roots and two canals in mandibular canine is very low, the clinician should always be mindful of variations in the number of roots and canals for proper management of such cases

Occurrence of Recurrent Aphthous Stomatitis (RAS) as a Rare Oral Manifestation in a Patient with Gilbert’s Syndrome

Recurrent aphthous stomatitis is an ulcerative disease of the oral cavity and can occur in isolation or as a manifestation of many systemic diseases. It is a quite common entity and may hence often be overlooked as an isolated lesion. Gilbert’s syndrome is a genetic disorder where a deficiency of an enzyme associated with the conjugation of bilirubin results in unconjugated hyperbilirubinemia. The disease is generally asymptomatic and is aggravated by certain trigger factors. No associated oral manifestations are known. In this case report, we discuss the concomitant presence of recurrent aphthous stomatitis in a patient of Gilbert’s syndrome. The presence of such recurrent stomatitis may represent as an oral manifestation of Gilbert’s syndrome. Early identification of these entities may improve the overall quality of life of the patient

The Provision of Dental Care to COVID-19 Survivors: A Concise Review

10.1016/j.identj.2022.05.0090020-6539INTERNATIONAL DENTAL JOURNAL724421-43

Sleep apnoea is a risk factor for severe COVID-19

Background Obstructive sleep apnoea (OSA) is associated with higher body mass index (BMI), diabetes, older age and male gender, which are all risk factors for severe COVID-19.We aimed to study if OSA is an independent risk factor for COVID-19 infection or for severe COVID-19.Methods OSA diagnosis and COVID-19 infection were extracted from the hospital discharge, causes of death and infectious diseases registries in individuals who participated in the FinnGen study (n=260 405). Severe COVID-19 was defined as COVID-19 requiring hospitalisation. Multivariate logistic regression model was used to examine association. Comorbidities for either COVID-19 or OSA were selected as covariates. We performed a meta-analysis with previous studies.Results We identified 445 individuals with COVID-19, and 38 (8.5%) of them with OSA of whom 19 out of 91 (20.9%) were hospitalised. OSA associated with COVID-19 hospitalisation independent from age, sex, BMI and comorbidities (p-unadjusted=5.13×10−5, OR-adjusted=2.93 (95% CI 1.02 to 8.39), p-adjusted=0.045). OSA was not associated with the risk of contracting COVID-19 (p=0.25). A meta-analysis of OSA and severe COVID-19 showed association across 15 835 COVID-19 positive controls, and n=1294 patients with OSA with severe COVID-19 (OR=2.37 (95% 1.14 to 4.95), p=0.021).Conclusion Risk for contracting COVID-19 was the same for patients with OSA and those without OSA. In contrast, among COVID-19 positive patients, OSA was associated with higher risk for hospitalisation. Our findings are in line with earlier works and suggest OSA as an independent risk factor for severe COVID-19