Hypervascular neurofibromas in a case of neurofibromatosis type 1: a case report

Neurofibromatosis type 1 is one of the most frequently inherited diseases affecting 1:3500 newborn. The diagnosis of Neurofibromatosis type 1 is not dilemmatic because of typical clinical features. The key feature of Neurofibromatosis type 1, neurofibromas, are complex tumours arising from peripheral nerve sheaths. Neurofibromas may be focal growths or can extend along the length of a nerve, involving several fascicles and including nerve branches. Neurofibromas sometimes exhibit hypervascular characteristics. Few reports suggest the bleeding tendency observed in neurofibroma, although not common, occasionally causes a large amount of bleeding during surgical intervention. Hypervascular characteristics of these tumors may be a confusing factor for the diagnostician. This report describes the case of Neurofibromatosis type 1 presented with neurofibroma exhibiting hypervascular characteristics and emphasizes the importance of necessary investigations prior to sur gical procedure

Chronic idiopathic hyperphosphatasia with unusual dental findings: a case report

Chronic idiopathic hyperphosphatasia(CIH) or juvenile Paget disease is believed to be a distinct disease characterized by an increase in the serum alkaline phosphatase, cortical thickening and bowing of the long bones, especially the femora. It is a rare autosomal recessive bone disorder, with excessive bone resorption and bone formation. Skeletal malformations in the legs may cause problems in walking and may eventually result in short stature. The radiographic appearances include widening of the diaphyses, vertebral osteoporosis, acetabular protrusion, and thickening of the skull vault. Intensive bisphosphonate treatment prevented the development of deformity and disability but there is no published data on long-term efficacy. Bisphosphonate therapy showed suppression of bone turnover, doubling of trabecular thickness with no mineralization defect, and no osteopetrosis. We report a female of 21 years, a case of chronic idiopathic hyperphosphatasia congenital form, with a history of fracture, short stature and malformed teeth. She had a waddling gait, bone deformities, kyphoscoliosis and curvature of her limbs

Osteogenesis Imperfecta (Type IV) with Dental Findings in Siblings

Osteogenesis imperfecta (OI) is a hereditary disorder characterized by increased tendency for bone fractures due to high fragility. The clinical and radiological features of OI manifest in different age groups, although the disease is congenital in nature. Besides bone fragility, features like laxity of the ligaments, blue sclera, growth retardation, and scoliosis are also observed. In severe cases, respiratory distress and death have been reported. The most important oral finding in OI is the presence of yellowish-brown-coloured brittle teeth characteristic of dentinogenesis imperfecta. Genetic factors play a very important role in the pathogenesis of OI either as a dominant or recessive factor. When a child has OI, there is a 25% chance of the sibling to have the same disorder. We report two cases of OI in siblings born to parents with a history of consanguineous marriage. The clinical and radiological features of the two cases are described in detail

Atypical Presentation of Lateral Periodontal Cyst in an Elderly Female Patient - A Rare Case Report

The lateral periodontal lateral cyst (LPC) is a uncommon developmental odontogenic cyst defined as a radiolucent lesion which develops along the lateral aspect of an erupted vital tooth. LPC represents approximately 0.8% to 2% of all odontogenic cysts .The most frequently reported location of a lateral periodontal cyst is the mandibular canine premolar area, followed by the anterior region of the maxilla. Lateral periodontal cyst is usually asymptomatic and presents as a round, oval or teardrop-like well-circumscribed interradicular radiolucent area, usually with a sclerotic margin lying between the apex and cervical margin of the teeth . The lateral periodontal cyst usually is seen in the fifth to sixth decade of life with a male preponderance. This paper reports an unusual and an atypical case of an inter radicular radiolucent cystic lesion in located between the mandibular central incisor and canine area in an 87 year old female patient mimicking clinically and radiographically as an residual cyst but histopathologically confirmed as an lateral periodontal cyst.DOI: 10.14693/jdi.v23i1.96

Indiscriminate Use of Smokeless Tobacco Leading to Oral Cancer at a Young Age; A Case Report with Literature Review on Tobacco Consumption

Oral Squamous cell carcinoma (OSCC) constitutes the sixth most common cancer in world. Oral cancer is known as an elderly disease mostly occurring between the 5th and 6th decades of life. It is mainly attributed to the use of tobacco and alcohol. Only 4-6% of OSCC is reported to occur below 40 years of age. This report describes a rare occurrence of OSCC in a 35 year old male patient, with a disproportionate history of tobacco chewing since the age of 14years; and literature review about tobacco use among younger generation

Estimation of salivary cortisol level in post-menopausal women with psychosomatic disorders

Background: Stress is an undesirable or health threatening response of the body, which is brought on by deleterious external influences (stressors). Objective measurement of psychosocial stress helps in assessment of pivotal role of stress in precipitation of multitude of health problems and a solution to the same. Salivary biomarkers are suggested to provide a reliable and non-invasive method for the estimation of these general health problems. Salivary cortisol is such biomarker used as tool in the examination of human physiological stress response. Post-menopausal women show an increase in stress levels and hence suffer with multiple health related problems. Hence the present study aimed to estimate salivary cortisol levels in post-menopausal women with clinically diagnosed psychosomatic disorder/disorders of the head and neck region, so as to establish salivary cortisol as a biochemical indicator of stress.Methods: Thorough intra-oral and extra-oral examination was performed to check for the presence of psychosomatic disorder of head and neck. Unstimulated saliva was collected from 100 post-menopausal women with and 100 without clinically diagnosed psychosomatic disorder/disorders through ‘Spit Technique’. Salivary cortisol was estimated using ELISA method.Results: The results were statistically significant as they showed that the salivary cortisol was in higher levels in post- menopausal women with clinically diagnosed psychosomatic disorder/disorders.Conclusion: The geriatric patients feel that they have very little skills or resources to deal with the high levels of stress that they are experiencing and hence suffer from lack of self-worth. The results of this study recommend that stress evaluation should be done on a regular basis for all post- menopausal women. For individuals who do not reveal their psychological distress, salivary analysis of cortisol may be used as an aid to diagnose their situation in conjunction with clinical diagnosis.Keywords: Post-menopausal women, psychosomatic disorder, head and neck, salivary cortisol, biomarker

A CASE REPORT OF TRANSORAL REMOVAL OF SUBMANDIBULAR GLAND SIALOLITH

Salivary calculus or sialolithiasis is a disease that affects the salivary glands characterized by the formation of mineralized structures within the glandular substance or excretory ducts of the salivary gland. The formation of these salivary stones is due to the crystallization of minerals in saliva. It causes blockage of salivary ducts and results in painful inflammation or sialadenitis of the salivary gland. Among the salivary glands submandibular gland has highest incidence of sialolithiasis due its anatomic features. The patient commonly experiences pain and/or edema when the ducts are obstructed. The case report presented here is of sialolithiasis of submandibular gland which had caused pain and swelling in the floor of the mouth

Status of Serum and Salivary Levels of Superoxide Dismutase in Type 2 Diabetes Mellitus with Oral Manifestations: A Case Control Study

BACKGROUND: Type 2 Diabetes Mellitus is a very well known metabolic disorder that has reached epidemic proportions worldwide. Evidence suggests that oxidative stress increases in Diabetes Mellitus because of the excessive production of reactive oxygen species and an impaired antioxidant defence mechanism. This study estimated, compared and correlated the serum and salivary Superoxide dismutase levels in healthy subjects and subjects with Type 2 Diabetes Mellitus having oral manifestations.MATERIALS AND METHODS: In this study, serum and salivary Superoxide dismutase levels were estimated in 45 healthy subjects and 45 patients with Type 2 Diabetes Mellitus with oral manifestations.RESULTS: The mean serum and salivary Superoxide dismutase levels were significantly decreased in subjects with Type 2 Diabetes Mellitus with oral manifestations compared to the healthy subjects. Positive correlation in both healthy and diabetics was observed between serum and salivary samples.CONCLUSION: This study highlights that the abnormally high levels of oxidative stress in diabetics coupled with simultaneous decline in antioxidant defence mechanism results in complications in Diabetes mellitus. Thus exploring saliva for antioxidant markers that accurately reflect the redox status of the body is worthwhile.KEYWORDS: Type 2 Diabetes Mellitus, Superoxide dismutase, antioxidan

Oral leukoplakia: A review of clinical features and trends in management

Introduction: Oral potentially malignant disorders (OPMD) conisit of the group of diseases of great importance for dentists. Oral leukoplakia (OL) has long been the subject of debate by numerous researchers. A common etiologic factor is tobacco, which is associated with oral cancer. The aim of the study is to indicate the severity of the lesion, the most common clinical characreistics and localization. The prevalence of leukoplakia in the world is 2.6% with a rate of malignant conversion ranging from 0.1% to 17.5%. Literature data about the prevalence and annual rate of malignant transformation, approximately 2%, indicate that these changes should be taken seriously and regularymonitored Conclusion: Occurate diagnosis provides the key to preventing to malignant transformation. Various medical and surgical treatment modalities for this lesion have been described. This article highlights various trends in the diagnosis and treatment of oral leukoplakia

Xeroderma Pigmentosum: Man Deprived of His Right to Light

Xeroderma pigmentosum (XP) is a hereditary autosomal recessive disorder characterized by photo hypersensitivity of sun exposed tissues and subsequent several-fold increased risk for malignant changes resulting from impaired ability to repair UV-induced DNA damage. Estimated incidences vary from 1 in 20,000 in Japan to 1 in 250,000 in the USA, and approximately 2.3 per million live births in Western Europe. Diagnosis is made clinically by the presence of unusual sunburns or lentiginosis or onset of cancers at an early age. It is confirmed by cellular tests for defective DNA repair. Although there is no cure for XP as of now, skin problems can be ameliorated with the use of sunscreens, sun avoidance methods, and recurrent tumor excisions. Oral isotretinoin and topical application of 5-fluorouracil to treat actinic keratoses are other therapeutic options. T4N5 and photolyase liposomal lotions are innovations in the therapy of XP. Genetic counselling implicating the effect of consanguineous marriages should be considered in the management of XP patients