Osteolipoma of buccal mucosa: case report and literature review

Osteolipoma affecting oral cavity is indeed rare. We hereby report a case of osteolipoma affecting buccal mucosa. A review of literature of osteolipoma of oral cavity, particularly on radiographic/imaging findings was done. Only 16 cases of Osteolipoma of oral cavity are reported in the literature. The radiographic findings of our case, i.e. multiple dense homogenous radio-opaque structures was reported earlier only in one case [out of 16] of osteolipoma of oral cavit

Oral Field Cancerization: A Review

The concept of oral field cancerization (OFC) has been ever changing since its first description by Slaughter et al in 1953. The concept of OFC explains the mechanisms by which second primary tumors (OPTs) develop- OPTs are the tumor-, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. The "classical" mechanism, which was originally observed by Slaughter describes that in the individuals with adverse habits, large areas of the aerodigestive tissue are affected by long-term exposure to carcinogens. In this preconditioned epithelium, multifocal carcinomas can develop as a result of independent mutations, and thus would not be genetically related. Although this mechanism was accepted for a quite a long time, the controversies began with the advent of new mechanism called the "clonal theory-, which explains that a single cell, on exposure to carcinogens, is transformed and give- rise to one large extended premalignant field by clonal expansion and gradual replacement of normal mucosa. In this field of various subclones, two separate tumors can develop after accumulation of additional genetic alteration-. Both tumors have the same clonal origin, and would thus share at least one early genetic event, which occurred before the initial clonal expansion. Also, the molecular studies regarding OFC have been expanding exponentially since a few years. The need for chemoprevention and the management of OFC with its resultant effect of development of second primary tumors has been challenging till today. Hence, the article tries to explain the conflicting aspects of various mechanisms by which SPTs develop, the molecular techniques, chemoprevention and therapeutic implications for oral field cancerization

Awareness of oral medicine specialty among medical practitioners in and around Tirupati: A survey

Aims and Objectives: To assess and create awareness of oral medicine specialty among medical practitioners, and to assess the volume of oral medicine clinical cases that they come across in their routine practice and to whom they refer them to. Materials and Methods: Printed and validated questionnaires were given to a sample of 100 medical practitioners of different specialties personally in and around Tirupati and the results were analyzed. Results: Sixty-nine percent of medical practitioners were not aware of oral medicine specialty and only 31% were aware of it. Frequent incidence of oral manifestation of systemic diseases, occasional incidence of facial and TMJ pain, oral mucosal lesions, and rare incidence of salivary gland disorders were noted in their routine practice. Oral manifestation of systemic diseases and oral mucosal lesions were frequently being referred to a general dentist and not to any specific specialty. TMJ and facial pain were referred to an ENT specialist and salivary gland problems to a general surgeon commonly. Conclusion: It is time to reiterate and spread the awareness among the medical professionals about oral medicine speciality in diagnosis and management of many oral ailments. Proper diagnosis and medical management should be the preferred line of therapy for any ailment

Salivary Glucose and Oral Mucosal Alterations in Type II Diabetic Mellitus Patients

Aim: The study was undertaken: 1) To assess salivary glucose (SaG) levels in diabetic and nondiabetic subjects and to determine if saliva could be used as a noninvasive tool to diagnose and monitor Type II diabetes mellitus. 2) Correlation of SaG levels with serum glucose (SeG) levels in nondiabetic and diabetic patients. 3) To correlate the oral manifestations of diabetes mellitus with serum and SaG levels. Material and Methods: Both fasting and postprandial serum and SaG levels were analyzed from 70 Type II diabetic and 70 nondiabetic subjects. The detailed examination of oral cavity in relation to periodontal and dental status and subjective oral complaints were recorded. The obtained values were subjected to statistical analysis. Results: The mean fasting salivary glucose (FSaG) was 5.469 + 2.347 mg/dL and 7.634 + 4.468 mg/dL in nondiabetic and diabetics, respectively (P = 0.000) and postprandial salivary glucose (PSaG) was 6.434 + 2.111 mg/dL and 8.736 + 4.962 mg/dL in nondiabetic and diabetics, respectively (P = 0.000). The positive correlation was found between SeG levels and SaG in diabetics (P = 0.000). Strong positive correlation was observed between SeG and SaG with oral manifestations in Type II diabetic patients (P < 0.05). Conclusion: Saliva can be a useful tool in regular monitoring of “already diagnosed Type II diabetics” (by their SeG levels) rather than diagnosing subjects with “unknown status of diabetes mellitus.” Strong positive correlation exists between SeG level and SaG level with oral manifestations in Type II diabetic patients

Radiosensitizers, radioprotectors, and radiation mitigators

Radiotherapy is regarded as one of the most important therapeutic modality for the treatment of malignant lesions. This field is undergoing rapid advancements in the recent times. With the use of radiosensitizers and radioprotective agents, the course of radiotherapy has improved the sensitization of tumor cells and protection of normal cells, respectively. The aim of this paper was to critically review and analyze the available compounds used as radiosensitizers, radioprotectors, and radiation mitigators. For reviewing, the author used the electronic search for the keywords ′Radiosensitizers′, ′Radioprotectors′, ′Radiation mitigators′ on PubMed for inclusion of previously published articles and further search of reference papers on individual radiosensitizing and radioprotecting agents was done. Radiosensitizers are agents that sensitize the tumor cells to radiation. These compounds apparently promote fixation of the free radicals produced by radiation damage at the molecular level. The mechanism of action is similar to the oxygen effect, in which biochemical reactions in the damaged molecules prevent repair of the cellular radiation damage. Free radicals such as OH + are captured by the electron affinity of the radiosensitizers, rendering the molecules incapable of repair. Radioprotectors are compounds that are designed to reduce the damage in normal tissues caused by radiation. These compounds are often antioxidants and must be present before or at the time of radiation for effectiveness. Other agents, termed mitigators, may be used to minimize toxicity even after radiation has been delivered. This article tries to discuss the various aspects of radiosensitizers, radioprotectors, and radiation mitigators including the newer agents

Detection of human papilloma virus (HPV) and human immunodeficiency virus (HIV) in oral squamous cell carcinoma: A polymerized chain reaction (PCR) study

Aims and Objectives: Certain strains of human papillomavirus (HPV) have been shown to be etiologically related to the development of uterine, cervical, and other genital cancers, but their role in the development of malignancies at other sites is less well established. Previous studies have shown HPV in tumors of the head and neck, but its prevalence has varied depending on the detection methods and the types of tumor and/or tissue examined. This study was undertaken for the detection of high-risk HPV types 16 and 18 and human immunodeficiency virus (HIV) in oral squamous cell carcinoma. Materials and Methods: Twenty-five patients histologically diagnosed with oral squamous cell carcinoma and 10 apparently normal persons as controls were selected for the present study. Two biopsy specimens were removed surgically by incision biopsy for histopathological examination and polymerized chain reaction (PCR) study. Results: Out of 25 oral squamous cell carcinoma subjects, 8 were found to be HPV positive in PCR. Out of these eight subjects, four had HPV 16 and the other four had other genotypes, and one subject was HIV positive. Conclusion: The conclusion drawn from the present study was that well-defined risk factors like HPV may play a prominent role in the development of oral squamous cell carcinomas, in addition to other risk factors. Further studies with a larger sample size are necessary to arrive at conclusions and to explore the relationship of HPV and HIV in oral squamous cell carcinoma

Comparison of panoramic radiograph with cone-beam computed tomography in assessment of maxillary sinus floor and nasal floor

Introduction: Panoramic radiograph is frequently prescribed by dentists for implant planning and, hence, accurate assessment of anatomical structures in panoramic radiograph is of utmost importance. Aims: The aim of the present study is to know the accuracy of panoramic radiograph in assessment of relationship between maxillary sinus floor and posterior teeth roots, and the distance from alveolar crest to nasal floor by comparing it with that of cone-beam computed tomographic (CBCT) image. Materials and Methods: Panoramic and CBCT images of 30 patients were analyzed. The topographic relationship of each root of posterior teeth to the maxillary sinus floor was evaluated and classified into three classes. The distance from the peak point on maxillary alveolar crest to nasal floor was measured in panoramic radiograph as well as in CBCT image. All the measurements were made by built-in measurement tools. Results: Class 1 roots in panoramic radiograph showed high agreement (86%) with CBCT image, followed by class 0 (76%). There was a significant difference in the measurements of alveolar bone height (ABH) in the nasal floor region with a P value of 0.018. Conclusion: Panoramic radiograph is reliable in assessment of nasal floor and maxillary sinus, provided position of the patient, distortion, and the inherent magnification factor are taken into consideration

Typical Radiographic Findings of Dentin Dysplasia Type 1b with Dental Fluorosis

Dentin dysplasia is a rare inherited autosomal dominant disorder characterized by rootless teeth. We hereby report a case of dentin dysplasia type 1b with typical radiographic findings: short and blunt roots, pulpal obliteration, horizontal/crescent shaped radiolucencies in pulp chambers, and multiple periapical radiolucencies. However, the present case did not show the autosomal dominant pattern of inheritance and the patient also exhibited concurrent dental fluorosis, transposition of 13 and 14, and multiple cusps in maxillary first molars. Moreover, on careful review of previously documented cases of radiographs of dentin dysplasia, the horizontal/crescent shaped radiolucencies in pulp chambers are a rare finding, which is characteristically seen in the present case