Adenomatoid odontogenic tumor with impacted mandibular canine: a case report

The Adenomatoid Odontogenic Tumor (AOT) is a rare, slow growing, benign, odontogenic epithelial tumor with characteristic clinical and histological features; which usually arise in the second or third decade. It is a tumor composed of odontogenic epithelium in a variety of histoarchitectural patterns which are embedded in a mature connective tissue stroma. It is mostly encountered in young patients with a greater predilection for females. Maxilla is the predilection site of occurrence, most commonly associated with an unerupted maxillary canine. It presents as a symptom-free lesion and is frequently discovered during routine radiographic examination. This case report describes an unusual case of 20 year old male with only a one month history of tumor in the anterior mandible. The tumor was a well circumscribed intraosseous lesion with an embedded tooth. Histological evidence of calcification was present. The present case lends support to the categorization of AOT as a mixed odontogenic tumo

Evaluation of chemiluminescence, toluidine blue and histopathology for detection of high risk oral precancerous lesions: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Early detection holds the key to an effective control of cancers in general and of oral cancers in particular. However, screening procedures for oral cancer are not straightforward due to procedural requirements as well as feasibility issues, especially in resource-limited countries.</p> <p>Methods</p> <p>We conducted a cross-sectional study to compare the performance of chemiluminescence, toluidine blue and histopathology for detection of high-risk precancerous oral lesions. We evaluated 99 lesions from 55 patients who underwent chemiluminescence and toluidine blue tests along with biopsy and histopathological examination. We studied inter-as well as intra-rater agreement in the histopathological evaluation and then using latent class modeling, we estimated the operating characteristics of these tests in the absence of a reference standard test.</p> <p>Results</p> <p>There was a weak inter-rater agreement (kappa < 0.15) as well as a weak intra-rater reproducibility (Pearson's r = 0.28, intra-class correlation rho = 0.03) in the histopathological evaluation of potentially high-risk precancerous lesions. When compared to histopathology, chemiluminescence and toluidine blue retention had a sensitivity of 1.00 and 0.59, respectively and a specificity of 0.01 and 0.79, respectively. However, latent class analysis indicated a low sensitivity (0.37) and high specificity (0.90) of histopathological evaluation. Toluidine blue had a near perfect high sensitivity and specificity for detection of high-risk lesions.</p> <p>Conclusion</p> <p>In our study, there was variability in the histopathological evaluation of oral precancerous lesions. Our results indicate that toluidine blue retention test may be better suited than chemiluminescence to detect high-risk oral precancerous lesions in a high-prevalence and low-resource setting like India.</p

Efficacy of transcutaneous electrical nerve stimulation (TENS) in the management of trigeminal neuralgia: a systematic review and meta-analysis

Trigeminal Neuralgia is one of the most painful disorders known to man. So making patient pain free and to achieve a better quality of life in TN patients is one of the biggest challenge. Non-invasive procedures like Transcutaneous electrical nerve stimulation (TENS) have been tried clinically for Trigeminal neuralgia. Aim: The systematic review and meta-analysis aimed to compare and evaluate the efficacy of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia. The present review has been registered with PROSPERO – An international prospective register of systematic review CRD42021254136.An electronic search was done in PubMed, Cochrane Library, Science Direct, Google Scholar, EBSCOHOST. The assessments of articles were done using selection criteria and PRISMA guidelines Only prospective clinical trials like Randomized clinical trials (RCTs) and clinical trials were included in this review. A total of three studies were included in the meta -analysis, The proportion of total number of patients after TENS therapy across studies with p-value < 0.0001 for each which showed statistically significance. The overall difference in two groups was significant with standardize mean difference of 3.03 [95% CI: 2.50, 3.56].TENS can be an effective treatment modality for trigeminal neuralgia in reducing the pain intensity with no reported side effects for patients with trigeminal neuralgia alone or even in combination with other first line drugs

A study for determination of various positioning errors in digital panoramic radiography for evaluation of diagnostic image quality

Faulty radiographs have poor diagnostic quality, and repetition of such poor-quality radiographs leads to increased patient exposure to radiation. Since digital panoramic radiography has replaced manual radiography, the only hindrance in producing good-quality radiographs is the positioning errors. Objectives: Our study aims to determine the various positioning errors and their relative frequency and to identify those errors directly responsible for diagnostically inadequate images. Materials and Methods: Five hundred panoramic radiographs taken serially (from the year 2007) were retrospectively assessed for the positioning errors by three oral and maxillofacial radiology specialists using a performa enlisting the errors. The three specialists had different duration of clinical experience and they evaluated the orthopantograms as diagnostically acceptable or unacceptable. They also observed the relative frequency of all the positioning errors. Statistical Analysis: The kappa value for intraobserver agreement was calculated, which suggested that the agreement among the observers was fair. Results: Of the 500 panoramic radiographs viewed by the three observers, 25 (5%) had no errors, while 475 (95%) showed one or more positioning errors. The most common error in our study was found to be head turned to one side (33.8%) and the least common error was patient movement during exposure (1.8%). Conclusion: Positioning errors are very common in digital panoramic radiography, and they lead to production of poor-quality radiographs. The operator should take this fact into consideration and spend more time in patient positioning, thereby reducing the repetition of radiographs and unwanted patient exposure

An unusual case of maxillary osteomyelitis in a young female

Osteomyelitis of facial bones is an uncommon condition. Maxillary osteomyelitis is rare compared to mandibular osteomyelitis because the extensive blood supply and strut-like bone of the maxilla make it less vulnerable to chronic infections. We report an unusual case of maxillary osteomyelitis involving the right half of the maxilla in a 27-year-old, systemically healthy female. She reported with pain in the upper right region of the jaw since 1 year. Her past dental history revealed that she underwent dental extraction 1 year back in the same region due to pain and mobility of teeth. Intraoral examination revealed exposed necrotic bone in the right maxillary region with mobility of teeth and pus discharge. Radiographic investigations confirmed the diagnosis of osteomyelitis of the right maxilla. The patient was advised hemimaxillectomy, following which the patient was given a surgical and later a permanent obturator to close the surgical defect

Evaluation of laser therapy and routine treatment modalities in the management of myofascial pain dysfunction syndrome

Objective: To evaluate the efficacy of laser as a monotherapy and in combination with exercise therapy in comparison to only exercise in the treatment of Myofascial Pain Dysfunction Syndrome (MPDS) or Temporomandibular Myofascial Pain. Materials and Methods: A total of 60 patients with MPDS were included in the study and were randomly divided into three groups: exercise, laser, and the combination of both (exercise and laser). Results: Significant reduction in pain at rest and pain on movement was observed with all three types of treatment modalities. Pain reduction was more in those patients who received combination of exercise and laser therapy. Similarly, decrease in the muscle tenderness was more when combination of exercise and laser therapy was used. Conclusion: The ideal therapy should be fast, cheap, and have a long-term effect. Laser (Helium Neon) as monotherapy or in combination with exercise had shown promising results and can be used as an effective treatment modality for the treatment of MPDS

Keratocystic Odontogenic Tumor: Case Reports and Review of Literature

The lesion traditionally known as odontogenic keratocyst has been renamed by WHO in 2005, as "keratocystic" odontogenic tumor as it is more appropriate and reflects its potential for local, destructive behavior. It is a benign intraosseous neoplasm of jaw, which is unusual due to its characteristic histopathological and clinical features, including potentially aggressive behavior, high recurrence rate and association with the nevoid basal cell carcinoma syndrome. The purpose of this review is to highlight the importance of proper diagnosis of keratocystic odontogenic tumor in order to prevent the recurrence due to improper surgical excision of the lesion

Comparative study of cone-beam computed tomography and multislice computed tomography in the radiographic evaluation of cysts and tumors of the jaws

Aim and Objectives: To assess the efficacy of cone-beam computed tomography (CBCT) in comparison with multislice-computed tomography (MSCT) in the radiographic evaluation of cysts and tumors of the jaws. Materials and Methods: The study was conducted on 25 subjects diagnosed histopathologically with cysts or tumors of the jaws. They were subjected to MSCT and CBCT. The image pairs obtained were compared for diagnostic quality and dimensional accuracy. Also radiation monitoring was done with a newly devised calculative method. Statistics: Descriptive statistical analysis was carried out for all the groups in this study. The Kappa coefficient (k) for intraclass agreement was used for evaluating the scorings given by the evaluator for the diagnostic quality of the image. Results: A total of 28 lesions were found in 25 subjects. The diagnostic quality assessment suggested that the appearance of the internal structure and the soft tissue resolution of CBCT were inferior to MSCT. The radiation dosages from CBCT were noticeably less than MSCT. The dimensional accuracy of CBCT images was found to match those of the MSCT images. Conclusion: The results from the present study showed that CBCT could provide an image with MSCT-comparable diagnostic quality and accuracy, with a lesser radiation dose and risk, at a lower cost