Herbinaturals: A new paradigm in dentistry

Danta Swasthya (oral health) is important for the general kausalya (well being) and relates to the quality of Jivana (life) that extends beyond the functions of the craniofacial complex. Danta Amivacatana (oral diseases) continues to be a major health problem worldwide. In mainstream Ausadha (medicine), new medical treatments are assumed to be ineffective, until they are proved to be useful. In addition, the adverse effects associated with mainstream medicine makes their use less desirable and less reliable by the population. Traditional medicine is a socioeconomic and sociocultural heritage, serving approximately 80% of the population of developing countries. Heterogeneity, easy availability, enduring recognition, popularity and fewer adverse side effects are some of the key lineaments of traditional Ausadha. This review attempts to introduce several widely used traditional medicines and plant extracts for treating oral diseases, with a highlight on tooth soap, one of the most unrevealed herbal alternative to tooth paste

Role of cone beam computed tomography in the prompt diagnosis of a nasopalatine duct cyst

The nasopalatine duct cyst (NPDC) is the most common of all the developmental, epithelial, and non-odontogenic cysts of the maxilla, believed to originate from the epithelial remnants of the nasopalatine duct. Typically, the lesion is asymptomatic and is detected accidentally on a radiograph. The definite diagnosis must be based on the clinical, radiological, and histopathological findings. Frequently misdiagnosed, the NPDC is not rare. The motive of reporting an entity that is not very rare is that the lesion is mostly misdiagnosed, and to emphasize the importance of cone-beam computed tomography (CBCT) in the diagnosis and optimized treatment planning of NPDCs

Unilateral segmental odontomaxillary dysplasia: A rare entity of 3 cases and review

Segmental odontomaxillary dysplasia (SOD) is an uncommon, nonhereditary, rare developmental disorder primarily involving the posterior part of the maxilla and related dental components. It is a rare condition of uncertain etiology that results in painless unilateral expansion of the posterior dentoalveolar complex, gingival hyperplasia, lack of one or both premolars in the affected area, delayed eruption of adjacent teeth and malformations of the primary molars. Radiographically, the affected bone is thickened and irregular in outline, with a coarse trabecular pattern that is vertically oriented resulting in a relatively radioopaque granular appearance. The treatment is focused on extraction of the involved teeth, while in some milder cases the teeth may be retained for a long period. The treatment plan should be based on the degree of involvement as well as the functional and esthetic needs in each case. Considering the rarity of the condition, we report three cases of SOD with variable presentations in a 45-year-old, 24-year-old and 23-year-old individual

Diagnostic reliability of panoramic radiography and spiral computed tomography in evaluating topographic relationship of impacted mandibular third molar with inferior alveolar canal

Introduction: The inferior alveolar canal is described as a dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone. Conventionally, preoperative assessment is performed by orthopantomogram (OPG). Spiral computed tomography (CT), allows the clinician to localize and determine the relation of the impacted tooth and the inferior alveolar neurovascular canal (IANC) in three dimensions. Objectives: To describe the anatomical and morphologic variation of IANC as it appears in digital OPG and to correlate its relation with IANC on the CT. Materials and Methods: 100 patients were subjected to OPG and were studied for anatomic and morphologic variation. Eleven patients with mandibular impacted third molar in close proximity to the IANC were further subjected to CT examination. Results: Linear type was the commonest on the left side (39.5% in females and 41.9% in males) and elliptical type on the right side (52.6% in females and 45.2% in males). Morphologic variation showed bifid canal present in only 1 (1.6%) male on the left side. On the left side, narrowing of canal was seen in 4 (100%) teeth on OPG, in which 3 (75%) teeth showed 0 mm with cortical break in the CT. Three (100%) teeth showing interruption of white line (superior radiopaque border of IANC) on the OPG also showed 0 mm with cortical break in the CT. On the right side, 2 (100%) teeth showing narrowing of canal on the OPG correlated with 0 mm with cortical break in the CT and 1 (100%) tooth showed interruption of white line which correlated with 0 mm with cortical break in the CT. Conclusion: The comparison between the OPG patients and the CT patients (selected using the Roods criteria from the OPG patients) showed statistically significant value for narrowing of canal and interruption of white line with 0 mm loss of cortication in CT

Role of antioxidants as a stress factor for potentially malignant, malignant disorders and healthy individuals: A correlative study

Background: The possible role of free radicals in pathogenesis of a disease and its prevention by antioxidants is well-known. Literature reveals an independent correlation between the risk factors and these disorders. The aim of the present study was to ascertain the values of vitamin A, vitamin E, superoxide dismutase (SOD), and malondialdehyde (MDA) in normal individuals and patients with potentially malignant and malignant disorders. Materials and Methods: In this study, serum vitamin A, E, SOD, and MDA levels were assessed in 80 patients divided into four groups marked as a group I normal individuals, group IIa individuals with habits but without any lesions, group IIb with potentially malignant disorders, and group III with malignant disorders. Results: The mean vitamin A level in the group I was 3.07 ± 0.27, group IIa was 1.48 ± 0.37, group IIb was 0.89 ± 0.21, and group III was 0.67 ± 0.17. The mean vitamin E level in group I was 9.89 ± 0.75, group IIa was 8.85 ± 0.42, group IIb was 7.63 ± 0.39, and group III was 6.43 ± 0.34. The mean MDA level in group I was 2.92 ± 0.36, group IIa was 6.05 ± 0.78, group IIb was 10.13 ± 0.75, and group III was 14.15 ± 0.47. The mean SOD activity level among group I was 189.45 ± 14.17, group IIa was 169.05 ± 4.98, group IIb was 115.65 ± 19.60, and group III was 52.63 ± 4.02. Conclusion: There was a significant reduction in serum Vitamin A, Vitamin E, and SOD levels whereas there was a significant increase in serum MDA levels in patients with potentially malignant and malignant disorders as compared to normal individuals

Prospective utility of therapeutic ultrasound in dentistry-Review with recent comprehensive update

Background: The utility of ultrasound (US) for therapeutic purposes is still in its infancy. Therapeutic US (TUS) has been used widely in medical field for urological application, surgical intervention, bone healing, and osteointegration in cancer and healing of full thickness excised skin lesions, and within dentistry as a prediagnostic, diagnostic and therapeutic purpose. The purpose of the paper is to review and determine the efficacy of US as one of the treatment modalities for its role in maxillofacial region to reduce pain and promote soft tissue healing. Materials and Methods: A Medline search included of the international literature published between 1976 and 2011 and was restricted to English language articles, published work of past researchers including in vitro and in vivo studies, recent additions of textbooks on surgical and therapeutic applications of US and, current articles in conference papers and reports accessed from the internet using Google search engine on therapeutic ultrasound. Results: Very few article regarding effect of therapeutic of US for its use of insonation for treatment of patient with pain and soft tissue injury are available. This review article mainly emphasizes the therapeutic utility of US in dentistry for its effectiveness to decrease joint stiffness, reduce pain and muscle spasms and improve muscle mobility. In vivo studies have shown very little clinical effects. Conclusions: Further research is warranted in this clinically important area to make the development of noninvasive, multifunctional ultrasound devices for repair, regeneration and other therapeutic utility a success

Estimation of serum antioxidant enzymes in histopathological grades of oral leukoplakia, oral submucous fibrosis, and oral cancer: A clinicopathologic study

Introduction: This study was undertaken to assess the levels of malondialdehyde (MDA), superoxide distmutase (SOD), beta carotene, and vitamin E in oral submucous fibrosis (OSMF), oral leukoplakia (OL), and oral cancer patients. Though several studies have been done on the levels of antioxidants in these disorders, there are very few available reports in patients with various histological staging of these disorders. Materials and Methods: Blood samples were collected from 40 patients who were divided into three groups: Group I as control with 20 normal individuals, group II with histopathologically confirmed different stages of OSMF and OL, and group III with histopathologically confirmed different stages of oral squamous cell carcinoma (OSCC). Standard methods for estimation of serum values were used and statistical comparisons were performed using SPSS software 16.0 version and the level of significance was calculated. Results: The mean levels of vitamin E, beta carotene, MDA, and SOD among Group I subjects were 9.89 ± 0.75, 112.10 ± 11.97, 2.92 ± 0.36, and 189.45 ± 14.17, respectively. In group II patients with OL having mild dysplasia, serum vitamin E, beta carotene, MDA, and SOD levels were found to be 7.89 ± 0.87, 70.75 ± 2.82, 9.89 ± 0.92, and 119.63 ± 24.97, respectively. In moderate dysplasia, these values were 7.16 ± 0.55, 69.80 ± 5.54, 10.56 ± 0.46, and 115.20 ± 23.03, respectively. Serum vitamin E, beta carotene, MDA, and SOD levels were 7.70 ± 0.57, 70.50 ± 3.54, 9.81 ± 0.11, and 115.00 ± 8.49, respectively, in grade I OSMF and 7.32 ± 0.29, 69.67 ± 3.43, 9.76 ± 0.38, and 113.67 ± 8.32, respectively, in grade II OSMF. In group III patients with well-differentiated squamous cell carcinoma (WDSCC), serum vitamin E, beta carotene, MDA, and SOD levels were 7.01 ± 0.36, 64.32 ± 3.42, 12.98 ± 0.67, and 59.22 ± 4.01, respectively, and in patients with moderately differentiated squamous cell carcinoma (MDSCC), the values were 6.54 ± 0.41, 61.87 ± 2.03, 13.34 ± 0.42, and 58.43 ± 2.26, respectively. The P-value was calculated and the results were highly significant. Conclusion: A decrease in the levels of antioxidants like beta carotene, vitamin E, and SOD and an increase in MDA level in these disorders have been previously reported in the literature

Estimation and comparison of levels of salivary nitric oxide in patients with oral lichen planus and controls

Background: Normal salivary function is considered to be critical for the maintenance of healthy oral mucosa. Oral fluids provide an easily available, non-invasive medium for the diagnosis of wide range of diseases and clinical situations. The objective of this study was to estimate and compare salivary nitric oxide levels in patients with oral lichen planus and healthy individuals. Methods: Saliva was collected by spitting method. Unstimulated whole saliva thus collected was refrigerated at 4°C, and processed within 24 h for the estimation of nitric oxide levels which was done using Griess reaction. The results were analyzed using Student′s " t" test. Results: There was statistically significant difference in the levels of salivary nitric oxide between the study and control groups. Conclusions: The present study clearly indicates a significant increase in salivary nitric oxide levels in oral lichen planus patients as compared to controls

A lateral cephalogram study for evaluation of pharyngeal airway space and its relation to neck circumference and body mass index to determine predictors of obstructive sleep apnea

Introduction: The airway is assumed to play a role in dentofacial development. So, several studies tried to correlate patients with normal nasorespiratory functions with different malocclusions and airway dimensions. A narrow upper airway is associated with obstructive sleep apnea (OSA). Currently neck size and obesity are considered to be the most important physical characteristics of patients with sleep apnea. Aim: To study the interaction between craniofacial structures and pharyngeal airway space along with soft palate and tongue in patients with different anteroposterior skeletal patterns using lateral cephalogram. The correlation of upper airway and soft-tissue measurements with neck circumference (NC) and body mass index (BMI) was elucidated to evaluate the predictors on lateral cephalogram, in order to determine the etiology of OSA. Materials and Methods: Lateral cephalograms of 45 subjects were used to measure the pharyngeal airway and were divided into three groups (each group included 15 subjects) according to ANB angle: Class I (ANB angle 2°-4°), Class II (ANB angle >4°), and Class III (ANB angle <2°). Velar morphology along with its length was also analyzed and categorized into different types. The NC and BMI of all the patients were also calculated. Student′s t-test for paired samples was used to compare the mean values of the study variable vital parameters. Results: Significant reduction was found in pharyngeal airway in ANB group II. The soft palate and tongue size increased with increasing BMI and NC. Conclusion: Sagittal skeleton pattern had a close association with the dimensions of pharyngeal airway passage. The correlation of NC with increase in soft-tissue size (soft palate and tongue) suggested that obesity mediates its effects in OSA through fat deposition in the neck

Diagnostic efficacy of color Doppler ultrasound in evaluation of cervical lymphadenopathy

Background: To evaluate the efficacy of color Doppler ultrasound (CDUS) in differentiating benign and malignant cervical lymph nodes by detecting differences in blood flow patterns. Materials and Methods: In this cross-sectional prospective study, 25 untreated patients with clinical evidence of cervical lymphadenopathy were evaluated. CDUS was performed for 80 cervical lymph nodes. The gray scale parameters of the lymph node and intranodal perfusion sites were the key CDUS features used to differentiate between reactive and metastatic lymph nodes. Histopathological confirmations were obtained and compared with the results of CDUS. Results: Initially, 53 cervical lymph nodes were evaluated by clinical examination. Twenty-seven additional lymph nodes (53 + 27 = 80) were discovered by CDUS evaluation. Gray scale parameters for lymph nodes such as size of lymph node, shape of lymph node, and presence or absence of hilum revealed highly significant results (P < 0.0001). Color Doppler flow signals revealed that central/hilar flow was characteristic for benign nodes whereas peripheral/mixed flow was characteristic for malignant nodes, the findings were highly significant (P < 0.0001). Gray scale and color Doppler features are used to differentiate benign and malignant nodes. Conclusion: Within the limitations of this study, CDUS evaluation was found to be highly significant with a high sensitivity and specificity over clinical evaluation CDUS examination provides a prospect to reduce the need for biopsy/fine needle aspiration cytology in reactive nodes