Large keratocystic odontogenic tumor of the mandible

The odontogenic keratocyst (OKC) is a rare odontogenic cyst of epithelial origin. There are many types of cysts of the jaws, but what make the odontogenic keratocyst unusual are its characteristic features including its potentially aggressive behavior, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Odontogenic keratocysts, now reclassified as keratocystic odontogenic tumors (KCOTs) by the World Health Organization, are a clinical entity with a characteristic microscopic picture, kinetic growth, and biological behavior. The characteristic features are unique among all the different inflammatory and developmental cysts that occur in the jaws. In this report, we present a 35-year-old female patient with a massive KCOT with buccal cortical plate expansion and unusual anteroposterior extension extending from the premolar area up to the condyle

Herpes zoster infection of maxillary nerve: A case report

Herpes zoster of the trigeminal nerve branches caused by varicella zoster is a clinical entity consisting of erythematous macules, papules, vesicles, bullae, small ulcers and erythematous plaques, with characteristic short acute/pre-eruptive phases and long herpetic periods with pain. It is caused by reactivation of latent varicella infection. Herpes zoster is a less common endemic disease compared to varicella. During the prodromal stage, the only presenting symptom may be odontalgia, which may prove to be a diagnostic challenge for the dentist. Emergency treatment for a misdiagnosis such as trigeminal neuralgia, odontalgia, and acute pulpitis, as well as complications reported in literature such as tooth resorption, periapical lesions, periodontal destructions, and osteomyelitis may cause an irreversible damage to the patient. Hence, the dentist must be familiar with the presenting signs and symptoms in prodrome of herpes zoster infection of trigeminal nerve. The present article focuses on the pathogenesis, clinical picture, difficulties in diagnosis and management of such cases

CBCT evaluation of lingual foramen and its anatomic variations in Northeast Indian population

Background: The identification of nearby neurovascular structures is a vital part of dental implant treatment planning. Commonly two implants are placed in the mandibular inter foraminal region to support the overdenture. Placing dental implants in this region is considered relatively safe. The purpose of this study was to employ cone beam computed tomography (CBCT) on a representative sample of Northeast Indians to find out the location and distribution of lingual foramen in the anterior mandible. Study Design: A total of 104 CBCT scans were performed using the Cranex 3D CBCT system. Three Oral and Maxillofacial Radiologists agreed on a visibility grade for assessing the lingual foramen using a 3-point scale. The number and presence of foramina were noted. On cross-sectional pictures, the distance in millimeters between the crest of the alveolar ridge and the superior cortical margin of the foramen was determined. Furthermore, the analysis of the distribution of lingual foramina in terms of frequency and percentages was performed. Results: Scan results showed that the lingual foramen was clearly visible in 65.4% of cases, somewhat visible in 12.5% of scans, and not visible at all in 22.1% of cases. Half of the people in the study had two foramina, whereas 27.9 percent had one and 22.1 percent had none. The mean distance from the crest of the alveolar ridge was 10.84 mm in males whereas 9.91 mm in females Conclusion: The Northeast Indian population exhibits an unusually high prevalence of lingual foramen in the anterior portion of the mandible. This research will aid in the precise pre-operative identification of the position and number of lingual foramina prior to surgical treatments involving the midline of the mandible

Oral health services utilization among the rural population of western Rajasthan, India

Introduction: The greatest burden of oral diseases is on the disadvantaged and socially marginalized populations. In developing countries like India, the availability and accessibility of oral health services in rural areas are limited, and the provision of oral health care is also very limited. Aims and Objectives: To assess the factors affecting the utilization of oral health services among the rural population of western Rajasthan, India. Materials and Methods: A structured self-administered questionnaire was employed as the instrument for data collection. Study was carried out for a period of 1 year in the rural areas of western Rajasthan, India. A total of 5476 people were selected. The questionnaire was explained to all the participants before the distribution, and the participants returned questionnaires after it was completed. Results: Among the total study group of 5476 subjects, 3934 were males and 1542 females. The study group was divided into five equal age groups from 20 to 60 years and above. It was found that 31.57% were illiterate and only 1.53% were graduates. One thousand, four hundred and thirty-six participants (26.22%) stated that cost of dental treatment was the major factor, followed by 1386 (25.31%) who believed in myths associated with dental treatment. Conclusion: Utilization of oral health services among the rural population has been found to be influenced by socio-demographic factors. Improving access to oral health care is a critical and very important first step to improving oral health outcomes and reducing disparities

Efficacy of vitamin E in oral submucous fibrosis: A clinical and histopathologic study

Introduction: Oral submucous fibrosis is a scarring progressive disease characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of the submucosal tissues, i.e., lamina propria and deeper connective tissues. An attempt was made in this study to evaluate the role of vitamin E in the treatment of oral submucous fibrosis by carrying out a comparative study between regular intralesional dexamethasone, hyaluronidase, and local anesthesia with and without oral vitamin E capsules. Materials and Methods: Twenty histopathologically confirmed oral submucous fibrosis cases were randomly selected and divided into two groups, with 10 cases in each group. Group A patients were given intralesional dexamethasone 2 ml (2 mg/ml), hyaluronidase (1500 IU), and 0.2 cc lignocaine (2%), every week. In addition, group B patients were given oral vit E capsules, 400 IU OD, for a period of 8 weeks. Weekly follow-ups were done. Results: Addition of vitamin E to the conventional treatment had synergistic effect with more improvement in the patient′s condition in terms of burning sensation, vesiculation/ulceration, pigmentation, paleness of oral mucosa, tongue protrusion, and extent of mouth opening, which was confirmed histopathologically. Conclusion: Vitamin E has a significant role in the improvement of oral submucous fibrosis, which was proven in the present study

Expression of cyclin D1 in oral squamous cell carcinoma and its correlation with histological differentiation: An immunohistochemical study

Introduction: Cyclin D1 oncogene is a key regulator of cell cycle progression associated with various human malignancies. Aim: To establish the prognostic significance of cyclin D1 in oral squamous cell carcinoma (OSCC) and to correlate its association with clinicopathological parameters. Materials and Methods: A retrospective study was carried out on 50 previously histopathologically diagnosed, formalin-fixed, paraffin embedded (FFPE) tissue samples of OSCC. Immunohistochemical analysis was performed in 50 cases of different grades of OSCC using a commercially available monoclonal anti-cyclin D1 antibody. Statistical Analysis Used: All the compiled data was statistically analyzed using Chi-square and Mann-Whitney test. P values of <0.05 were considered to be significant. Results: Overexpression of cyclin D1 was seen in 68% cases of OSCC with a significant correlation with younger age group; no correlation was reported with respect to gender and site. The intergroup comparison of the cyclin D1 expression between well with poorly differentiated OSCC exhibited a significant correlation. Conclusions: The relative contribution of cyclin D1 expression in OSCC was significant according to the present study and further needs to be determined in large cohorts

Comparison of ultrasound, digital, and conventional radiography in differentiating periapical lesions: An in vivo study

Aims and Objectives: To evaluate in vivo the efficacy of ultrasound, digital and conventional radiography in identifying periapical lesions. To compare the results of the above imaging modalities with histopathology, which is considered to be the gold standard for diagnosis. Materials and Methods: Thirty patients aged between 15 and 45 years with periapical lesions associated with maxillary or mandibular anterior teeth indicated for endodontic surgery or extraction were selected for the study. Pre-operatively, conventional, digital periapical radiography and ultrasonography were done and interpreted. Endodontic surgery or extraction was performed including curettage of apical tissue to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: In conventional and digital radiography, the periapical lesions were readily identified but observers were unable to differentiate granuloma from cyst using these modalities only. But ultrasonography was able to give the true nature of the periapical pathology. All the cases diagnosed by ultrasound were confirmed with histopathology, and maximal number of cases diagnosed by ultrasound correlated with the histopathological diagnosis. Conclusion: The present study confirms that ultrasound is a promising and reliable imaging technique for differentiating periapical lesions i.e., periapical cysts and granulomas. Based on the echo texture of their contents and the presence of vascularity using color Doppler, periapical cyst and granulomas can be readily identified. The present study is further applicable for the evaluation of periapical lesions of the posterior teeth and evaluation of other jaw lesions

Salivary changes in medically compromised patients: A clinical and biochemical study

Introduction: Medically compromised patients require special attention when dental procedures are performed on them. These individuals may require modified or slightly altered techniques. Aims and Objectives: The present study was taken up with two main objectives. The first one being examining and recording various oral manifestations in medically compromised patients, and the second objective was to collect samples of saliva from such patients and to analyze and establish any salivary changes in such medically compromised patients. Materials and Methods: A total of 100 patients were selected for the study. These patients were divided into four groups of 25 patients each: diabetes mellitus group, chronic renal failure group, liver cirrhosis group and control group. All the selected patients were subjected to a detailed general and intra oral examinations and the relevant data was recorded on a specially designed proforma; salivary analysis was done to know the flow rate, pH, total salivary proteins, sodium, potassium, and LDH levels. Results: From the findings, it can be inferred that salivary changes namely changes in salivary pH, salivary flow rates, salivary sodium, salivary potassium, salivary total proteins, and salivary lactate dehydrogenase are significant in medically compromised patients namely uncontrolled diabetes mellitus, chronic renal failure, cirrhosis of liver compared to the control group. Conclusion: pH of saliva was elevated in chronic renal failure patients. Salivary flow rates and sodium were decreased in diabetes mellitus, chronic renal failure, and cirrhosis of liver patients. There was a significant elevation of salivary potassium in chronic renal failure patients. LDH elevation was significant in uncontrolled diabetes mellitus