Comparative study of oral micronucleated cell frequency in oral submucous fibrosis patients and healthy individuals

Objectives: To determine the frequency of micronucleated cells and micronuclei in oral submucous fibrosis patients and to compare with healthy individuals. Study design: Twenty patients with oral submucous fibrosis and twenty age-sex-matched healthy individuals as control group participated in this study. Exfoliated cells were obtained by scraping from right and left buccal mucosa and were screened for micronucleated cells and micronuclei. Frequencies were compared between oral submucous fibrosis and control group. Also comparison was made between chewing site and non-chewing site of buccal mucosa. Results: Frequency of micronucleated cells and micronuclei in oral submucous fibrosis patients ranged from 0.6% to 5.3% and 0.50% to 5.74%, where as in control group ranged from 0.5% to 0.9% and 0.22% to 0.88% respectively. Micronucleated cells and micronuclei in oral submucous fibrosis patients were statistically significantly elevated (p < 0.05) as compared to control group. The mean percentage frequencies were higher on chewing site; however there was no statistically significant difference. Conclusion: The present study revealed an increase in micronuclei in oral submucous fibrosis patients compared to healthy individuals. With gutkha chewing habit in younger age, chances of malignant transformation are high relatively. Thus micronuclei test can be used as an early indicator of genotoxicity in oral submucous fibrosi

Methylene Blue as a Diagnostic Aid in the Early Detection of Potentially Malignant and Malignant Lesions of Oral Mucosa

BACKGROUND: In vivo stains are the prompt resources, which have emerged in recent years to aid as clinical diagnostic tools in detecting early potentially malignant and malignant lesions. Toluidine blue, by its property of retaining in the increased DNA and RNA cellular activity areas, aids in delineating the suspicious areas. However, it is hazardous if swallowed, and has been shown to have toxicity to fibroblasts. Methylene blue has a similar chemical structure and exhibits similar physicochemical properties as toluidine blue. It is less toxic to the human body and has recently been proposed for screening some gastrointestinal or prostate tumors. The application of this material in detecting oral lesions has so far not been addressed. The objective of this study was to evaluate the sensitivity and reliability of in vivo staining with methylene blue as a diagnostic adjunct in screening for oral malignant or potentially malignant lesions.METHODS: The present study involved the examination of 75 patients suspected of having oral malignant or potentially malignant lesions by methylene blue staining. The results of methylene blue uptake were compared with a simultaneous biopsy of these lesions.RESULTS: The overall sensitivity was 95% (100% for malignancy and 92% for potentially malignant lesions) and specificity was 70%. The positive predictive value was 91% and negative predictive value of 80% was observed in the study.CONCLUSION: We consider that methylene blue staining is a useful diagnostic adjunct in a large, community-based oral cancer screening program for high-risk individuals.KEYWORDS: Methylene blue, Oral malignant, Potentially malignan

Comparison of Radiovisiography and Digital volume tomography to direct surgical measurements in the detection of infrabony defects

Objectives: To compare the linear measurements of Radiovisiography (RVG) and Digital volume tomography (DVT) to direct surgical measurements in the detection of periodontal infrabony defects. Study design: RVG and DVT images were taken prior to periodontal surgery for 28 infrabony periodontal defects. After defect debridement, direct bony defect measurements were made from the cemento enamel junction (CEJ) to the base of the defect (CEJ-BD) and to the alveolar crest (CEJ-AC) with a periodontal probe. These same measurements were made on the RVG and DVT images and then compared to the direct surgical values. Results: DVT correlated strongly with surgical measurements, whereas RVG correlated less favorably (P=0.0109, P=0.0193 respectively).No significant difference for CEJ-AC (P=0.0599) was seen between DVT and surgical measurements; however, there was a significant difference for the distance CEJ-BD (P=0.0105). Conclusion: DVT technique is significantly more accurate than RVG in the detection of infrabony periodontal defects

Malignant melanoma of the mandibular gingiva

Oral malignant melanoma is an infrequent neoplasia making up less than 1% of all melanomas, which exhibits much more aggressive behavior than those found on the skin. We present an aggressive case of oral malignant melanoma located on the mandibular gingiva in a 24-year-old male patient, who developed metastases to not only the regional lymph nodes but also the lungs and liver. The advanced stage of the disease contraindicated any surgical intervention and palliative chemotherapy was planned

Efficacy of digital volume tomography in the preoperative assessment of position of inferior alveolar canal with impacted mandibular third molars in a subset of Indian population

Context: Choosing an imaging source, which provides minimum radiation exposure to the patient, to facilitate surgical removal of impacted mandibular third molars (MTMs), thereby avoiding unwanted neurological complications. Aim: The aim of the study was to assess the efficacy of digital volume tomography (DVT) in evaluating the position of inferior alveolar canal (IAC) in relation to impacted MTMs and comparing it with conventional radiography (CR) in a subset of the Indian population. Materials and Methods: Four experienced observers assessed two groups: 33 DVT and 33 CR images, for the position of root-tips of impacted MTM in the proximity to IAC, in both vertical and horizontal planes. The diagnostic information was compared in both the groups. Statistical Analysis: Chi-square test, Mann–Whitney U-test, and Kappa statistics were used. Results: Comparison between DVT and CR revealed no statistically significant variation in assessing relationship in the vertical plane. There was, however, a significant difference between the groups, while comparing the diagnostic information for the horizontal dimension, for both the mesial and the distal roots, with an advantage for DVT (P < 0.05 for both mesial and distal roots). Conclusion: DVT is highly accurate in predicting neurovascular bundle exposure. It is indispensable for preoperative evaluation of impacted MTM

Evaluation of efficacy of tacrolimus 0.1% in orabase and triamcinolone acetonide 0.1% in orabase in the management of symptomatic oral lichen planus randomized single blind control study

Objectives: Studies done on the management of oral lichen planus using tacrolimus are limited. The aim of the study is to compare the efficacy of tacrolimus with tramcinolone acetonide topically in the management of symptomatic oral lichen planus and also to evaluate adverse effects and opportunistic yeast infections. Materials and methods: A randomized controlled study was conducted on 60 patients with symptomatic lesions of oral lichen planus with biopsy proven who fulfilled the inclusion criteria. Study group comprised of 30 patients who received topical 0.1 tacrolimus in orabase therapy for 4 weeks. Control group comprised of 30 patients who received topical 0.1% triamcinolone acetonide in orabase for 4 weeks. Results: Significant improvement of symptoms (7.80 ΁ 1.90 to 1.2 ΁ 2.6) and clinical scores (3.1 ΁ 1.27 to 2.3 ΁ 1.1) in study group as compared to control group (7.60 ΁ 2.01 to 2.7 ΁ 2.5) and (2.73 ΁ 1.46 to 1.2 ΁ 1.4). No significant adverse effects were observed and no recurrence was noted during treatment and follow-up. Conclusion: Study group has shown significant clinical response (p = 0.002) when compared to control group. However, double-blind, controlled studies are needed to evaluate the efficacy of tacrolimus in the treatment of symptomatic oral lichen planus and to address the safety for long-term therapy

Comparison between cone-beam computed tomography and direct digital intraoral imaging for the diagnosis of periapical pathology

Purpose: Early precise evaluation of periapical inflammatory lesions is necessary not only for diagnosis but also for treatment and follow-up. This study was performed to compare direct digital intraoral periapical images with three-dimensional (3D) images acquired from cone-beam computed tomography (CBCT) for the diagnosis and treatment planning of periapical pathology. Materials and Methods: Sixty teeth with clinical and/or radiographic evidence of periapical pathology were examined with direct digital imaging (DDI) and CBCT technique. Both the image dataset were evaluated by three oral radiologists. Numbers of roots and root canals, presence and location of periapical lesions, size of the lesion, root resorption and root fracture, and relation of the lesion to cortical bone and neighboring structures were studied. Cone-beam computed tomography periapical Index (CBCTPAI) was used and the values were compared using Wilcoxon-matched pairs test. The scores obtained for the 5-point scale for presence/absence of periapical lesion were also compared using Wilcoxon-matched pairs test. Results: Among 60 teeth, both the techniques demonstrated periapical lesions in 52 teeth, and an additional 5 teeth were found to have periapical lesions in the CBCT images. In regards to individual roots, 67 lesions were found in both the techniques, and 33 more roots were found to have lesions in CBCT images. Statistical analysis showed significant difference in both the imaging modalities for ascertaining the presence or absence of lesion on the 5-point scale and significant difference between DDI and CBCT in relation to the CBPAI scores. Conclusions: A high-resolution 3D technique can be of value for diagnosis of periapical problems, especially for multirooted teeth. CBCT is a promising technology for the diagnosis and management of periapical pathology