Lingual abscess: a rarity

Abscess of the tongue seems to be a rare clinical entity and is a potentially life threatening infection. This acute enlargement of the tongue can present as an emergency, due to an air-way compromise and disseminated infection to other regions. Thus, a tongue abscess should be considered in all cases of acute tongue swellings, especially when host defenses are severely impaired. In acute cases the diagnosis of tongue abscess can be reached clinically. In later cases, culture and smear analysis are useful diagnostic tools, whereas antibiotics provide considerable amelioration of symptoms. Although none of our cases were life threatening, but we could able to diagnose these cases, based on their classic clinical symptoms and all three cases were confirmed by using standard diagnostic tool. They were put on antibiotics and anti-inflammatory drugs for the relief of symptoms followed by the local drainage. The following article explains pathophysiology, differential diagnosis and management of these tongue abscess cases in detail

The prevalence of tongue lesions in Libyan adult patients

This is the first ever-detailed study of tongue diseases in Libyan population, where the tongue conditions found in 320 patients (9.2%) of 3,460 consecutive patients screened in the department of Oral Medicine and Oral Diagnosis at faculty of dentistry, Benghazi Libya. Both sexes were affected almost equally and only 25 patients were aware of their tongue disease. Forty patients had one or more systemic illness, 34 of them was on regular medications. Fissured tongue was the most prevalent condition, as it has been found in 155(48.4%) patients, depapillated tongue in 82(25.6%) patients and geographic tongue in 55(17.2%) patients, other disease conditions were found in a lesser number of patients. Fifty-four patients had painful tongue conditions; other complaints included malodor, speech interferences or swallowing difficulties. Most conditions were confined to the tongue and in more than 90%, there had been involvement of the dorsum of the tongue. Fortunately, most tongue conditions can easily be diagnosed on clinical grounds by any experienced clinician, hence, the histopathological examination and other investigations are needed in only few cases. There is a wide variation in the prevalence of most of tongue diseases worldwide due to the lack of uniformity in criteria of the studies. Thus, more studies are needed in this regard

Evolution, Epidemiology and Etiology of Temporomandibular Joint Disorders

The temporomandibular joint (TMJ) is unique to mammals, but among different mammalian groups, its morphology and function vary enormously. It is likely that various species show less loading of jaw joints during chewing than humans do. It took approximately 130 million years for the evolutionary process to stabilize this composite, basic vertebrate head skeleton to the jaws. Very little documentations are noted on anthropology of TMJ. When it is concerned with epidemiology, temporomandibular disorders (TMDs) have a number of consistent findings and various causative factors that can contribute to TMDs. The aim of the following article is to provide detailed information regarding its evolution, epidemiology and various causative factors leading to TMDs. Key Message: The masticatory system is extremely complex

Status of occurrence of recurrent apthous stomatitis in a group of Libyan patients

Aim/Objective: This prospective study had a questionnaire prepared to get the information regarding recurrent apthous stomatitis (RAS) in a group of Libyan patients. Materials and Methods: A questionnaire containing a total of 14 questions giving personal and apthous ulcer details were recorded. All the details of each patient were entered into Microsoft Excel sheet and the details were recoded and interpreted. Results: Among 7500 patients who visit the outpatient department every year 460 (6%) of them who were volunteers and gave a history of RAS were selected in the study group. The age of these patients ranged between 10 and 45 years. Among different types of ulcers, 48 (10%) of them showed major apthous ulcer formation, 404 (88%) of them had minor apthous ulcer formation, whereas 8 (2%) of them had herpetiform ulcers. Among 460 patients with h/o RAS 46 (10%) of them were sufferings from different systemic health problems. Total 120 (26%) of them had triggers before the occurrence of RAS and 325 (70%) patients were without any triggers 15 (4%) of them were not aware of any triggers. When the question was asked about occurrence of RAS whether it is related to stress, 384 (83%) of them correlated it with stress and 76 (17%) of them did not. Different sites with their recurrence and duration of the ulcer were recorded. About 45 (9%) were on different treatment modalities. Among 460 of them, 156 (34%) of them had RAS at the day of examination and 304 of them were free from ulcers 304 (66%). Conclusion: Early detection and management of these patients by finding underlying etiology is essential for better management of these cases

An insight into the swine-influenza A (H1N1) virus infection in humans

WHO declares on June 11, 2009, that H1N1 (Swine-influenza A) is pandemic. There have been nearly 30,000 confirmed H1N1 cases across 74 countries. The reports have shown sharp increase in the number of infections reported in recent days from Chile, Japan, and the UK, and other parts of the world, with the most dramatic increase recorded in Australia where more than 1200 cases were reported in a very short duration. As per the latest report of the Ministry of Health and Family Welfare, death from swine flu has reached to 1235. Around 12,3397 people have been tested in India as on February 1, 2010. In India, 23.3% of people who have tested for swine flu are found suffering from swine flu. Also around 4% of people who have tested positive for swine flu have died and could not be saved in India. The New York Times has reported that this is the first flu for being pandemic in the last 41 years. This article enlightens the brief review about the swine influenza virus, its modes of spread, and prevention measures. The aim of this article is to bring awareness in general and know the consequences of the infection

Eruption status of third molars in South Indian city

Aim : The aim of the present study is to determine the number of third molars per person, angulation, level, amount of space for eruption of third molar between ramus of mandible and second molar status of root and also to study the difficulty index. Objective: To study the eruption status of third molar in South Indian population. Materials and methods: The study conducted at Department of Oral Medicine and Radiology. Maratha Mandals NG Halgekar College of Dental Sciences and Research Centre. Belgaum, Karnataka, India A total of 150 patients (54 females and 96 males) visiting outpatient department between the age group of 17 and 30 with a mean age of 23.5 years were selected- Before starting the study, ethical concern taken from the ethical committee and informed consent from each patent who underwent radiographic examination. Results: The results showed approximately 94.66% of the subjects had all four third molars, 8.6% had three third molars, 4.6% had two third molars and 2% had one third molars with 3.3% having agenesis of all third molars. Third molar agenesis showed predilection for upper jaw with higher proportion in females (5 5%) than males (2%). Angular position seen maximum with vertical position (66.16%) with least being horizontal impactions. Level of occlusal plane of third molar similar to that of adjacent tooth seen in 52.65%. Below the occlusal plane in 19.61 %, totally impacted teeth noted in 27.73%. More than 75% of the teeth had complete root formation. Among total number of teeth, 518 (91.51 %) teeth were easy to extract and remaining 33 (5.8%) were difficult to extract. Conclusion: Radiological and clinical findings have correlated to assess whether teeth were easy to extract or difficult. Because of the increasing incidence of unerupted third molars and the association of numerous complications with these retained teeth, assessment of germ position and prognosis of third molar eruption is necessary for better patient management

Assessment of diagnostic accuracy of high-resolution ultrasonography in determination of temporomandibular joint internal derangement

Aim : The aim of this study was to determine the value of dynamic high-resolution ultrasonography (HR-US) in the evaluation of internal derangements of a temporomandibular joint (TMJ) in the open and closed mouth position. Settings and Design : The study designed to collect the sample from the Outpatient Department of Oral Medicine and Radiology at GDC, Bangalore. Patients with pain, clicking, deviation, and tenderness were included in the study as a symptomatic group. The asymptomatic group was free of any symptoms. Materials and Methods : Maximum mandibular range of motion (Open and Closed) was performed during HR-US of TMJ in 100 consecutive patients, (50 symptomatic and 50 asymptomatic cases, a total of 400 joints, with 200 joints in the right and left closed and open mouth position;36 males and 64 females; age range, 16 - 50 years; mean age 27.56 years). Subsequently, the entire group, after clinical diagnosis, went for HR-US. Sonography confirmed the diagnosis by showing internal derangement in 34 (68%) of the symptomatic group and the remaining 16 (32%) patients failed to show any derangement. In the asymptomatic group 40 patients did not show any pathology associated with TMJ, whereas, 10 patients showed internal derangement. The data obtained was analyzed statistically. Results : HR-US performed during the maximal range of motion (Open and Closed) helped to detect 34 instances (68 joints) of internal derangement, which were true positive cases, whereas, 16 patients (32 joints) showed a false positive finding for internal derangement (ID). The results obtained showed a sensitivity of 64%, specificity of 88%, positive predictive value of 84%, and a negative predictive value of 71%, with an accuracy of 76%. Conclusions : Dynamic HR-US being non-invasive can provide valuable information about internal derangement of the TMJ in mandibular closed mouth than open mouth position