Diagnostic efficacy of panoramic mandibular index to identify postmenopausal women with low bone mineral densities

Objectives: The aim of the study was to compare and assess the accuracy of panoramic mandibular index (PMI) and antegonial index (AI) in the panoramic radiographs of postmenopausal women with normal and low skeletal bone mineral densities( BMD) diagnosed by using dual energy x-ray absorptiometry ( DXA). Study Design: In panoramic radiographs obtained from 40 post menopausal women( 20 normal and 20 osteoporo tic) aged between 50-75 who’s BMD has already been assessed by a DXA, the mean was calculated for PMI and AI index values measured in the right and left mandibles. The PMI and AI index values were evaluated using the student’s t test. The correlation between the observers for indices was calculated by Pearson correlation coefficient test. Results: A statistically difference was shown between the PMI values in the osteoporotic group and normal group (t = 13.280, p < 0.001); however, AI showed no significant difference between the groups. For PMI, the area under the receiver operating curve (ROC) analysis in identifying women with low BMD was 0.821 ( Standard error: SE = 0.0676), 95% confidence interval (Cl) = 0.668 to 0.924) which was moderately accurate. Conclusion: PMI values were found to be smaller among female patients with osteoporosis, compared with normal patients in the present study. Our results suggest that PMI has a better efficacy in identifying postmenopausal women with osteoporosis in comparison with AI

Langerhans cell histiocytosis with oral manifestations: a rare and unusual case report

Langerhans cell histiocytosis (LCH), is a rare, proliferative disorder in which the accumulation of pathologic Langerhans cells leads to local tissue infiltration and destruction. We present a case of a 32 years old, completely edentulous female patient who presented with erythema of hard palate, maxillary alveolar mucosa and mucosa over the distobuccal part of mandibular alveolar ridge with foci of ulcerations. Histopathologic features were suggestive of LCH which was confirmed by immunohistochemistry which was CD1a positive, confirmatory for LCH. Bone scan revealed multiple bone involvement. At this stage, disease had already progressed to multisystem involvement with endocrinal abnormalities (primary hypothyroidism and hyperprolactinemia), requiring aggressive treatment. Therefore, this case is a reminder of the possibility of occurrence of this rare disease in the oral cavity which might manifest itself in multiple presentations thus easily leading to the misdiagnosis and therefore, it could be easily overlooked by dentists

Tumour associated tissue eosinophilia as a predictor of locoregional recurrence in oral squamous cell carcinoma

Objectives: The increasing global burden of oral cancer has driven much of the focus of research to the determina - tion of reliable prognostic markers which may have significant effects on survival and the control of post-treatment morbidity. This study was undertaken to evaluate tumour associated tissue eosinophilia (TATE) quantitatively in oral cancer specimens and observe for its possible association with tumour stage, patterns of locoregional recurren - ce and overall prognosis. Study Design: 14 patients undergoing surgical resection for primary oral squamous cell carcinoma (OSCC) were subjected to grey scale ultrasonography (USG) to assess tumour dimensions. The findings were compared with the cTNM stage initially documented. TATE was evaluated along the invasive tumour front (ITF) using H & E stained sections of histopathological specimens for 10 continuous high power fields (HPF) and graded as mild, moderate or intense. Patients were followed up over 5 years and observed for patterns of recurrence. Results: Loco regional recurrence was significantly associated with intense degree of TATE. ( p <0.001) cTNM stage as well as USG stage did not correlate with the degree of TATE with p =0.419 and 0.772 respectively. None of the patients with mild/ moderate dysplasia developed locoregional recurrence within the period of follow up. Conclusions: Analysis of TATE in OSCC patients may provide an early indication of future locoregional recurren - ce. Identification of an appropriate biopsy site representing the ITF where TATE analysis can be performed may be a simple, inexpensive method of obtaining valuable prognostic information at the time of diagnosis