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   Table of Contents - Current issue
July-September 2021
Volume 33 | Issue 3
Page Nos. 233-347

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Excellence… Highly accessed article p. 233
K Anbarasi
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The pressure to publish for a post p. 234
Freny Rashmiraj Karjodkar
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Colchicine as a therapeutic drug in the management of oral submucous fibrosis - A randomized clinical study Highly accessed article p. 236
Somisetty V M. Mounika, Rakesh K Manne, Natarajan Kannan, Swapna S Beeraka, Prathi V Sarath, Kanamarlapudi V Saikiran
Aim: The present study was planned to clinically determine the effectiveness of colchicine as a monotherapy in oral submucous fibrosis (OSMF) patients. Materials and Methods: Thirty OSMF patients were enrolled in the study and randomly divided into two groups by permuted-block randomization. Group A: Patients were treated with 0.5 mg colchicine (Goutnil) tablets twice daily for 3 months. Whereas, in Group B, intralesional injection of dexamethasone 2 mL, hyaluronidase 1,500 IU with 2 mL lignocaine HCl biweekly for 4–6 weeks were given. For all the individuals, baseline parameters like mouth opening, buccal mucosal flexibility, burning sensation, and tongue protrusion were recorded and reassessment was done at 1, 3, and 6 months followed by statistical analysis. Results: A significant decrease in the Visual Analogue Scale (VAS) score for severity of burning sensation was observed in Group A whereas mouth opening and tongue protrusion were higher in Group B patients. Statistically significant differences in the buccal mucosal flexibility were appreciable in the intragroup comparisons of both the groups from baseline to 6-month follow-up. Conclusion : Colchicine can be suggested as an adjuvant drug for reducing the burning sensation for the OSMF patients in whom steroids are contraindicated.
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Prevalence and morphological assessment of bifid mandibular canal using cone beam computed tomography among a group of yemeni adults p. 242
Nabil Qaid, Abdulwahab Aldilami, Khaled AL-Jawfi, Anas Shamala
Objectives: The study aimed to assess the prevalence and morphology of bifid mandibular canal (BMC) using cone beam computed tomography (CBCT) among a group of Yemeni adults. Materials and Methods: The presence and type of BMC were evaluated among 400 CBCT images. Prevalence rate of BMC was also determined according to gender. Further, the diameter and length of BMCs were measured using Ez3D plus software. Chi-square analysis and the analysis of variance (one-way ANOVA) were used. Results: The study concluded that BMCs were found in 60 (15%) of total cases. There was no significant correlation between gender and BMC prevalence. Forward BMC was the most common type (48.3%), followed by retromolar BMC (35.0%) then dental BMC (16.7%); while not even one case of buccolingual BMC was observed. There was a significant difference in the mean diameter of BMC (P value = 0.016). There was a significant difference in the mean length of BMC (P = 0.001). Conclusion: The prevalence of BMCs in Yemeni adults is relatively high, and forward BMC was the most common type. Detecting BMCs by using CBCT imaging is highly recommended prior to any mandibular surgery.
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Analysis of downregulated salivary proteins in oral submucous fibrosis – A quantitative proteomic pilot study p. 248
Anu Babu, Laxmikanth Chatra, Prashanth Shenoy
Background: Oral submucous fibrosis (OSMF) is a chronic debilitating disease of the oral cavity which is strongly associated with chewing of areca nut. The rate of malignant transformation varies between 3% and 19%. As oral lesions are in direct contact with saliva, the altered composition of saliva has shown promising results in surveillance of malignant transformation. Aim: To do quantitative proteomic profiling of saliva in OSMF and to study the downregulated proteins. Methodology: Quantitative proteomic profiling was carried out using Liquid chromatography with Tandem mass spectroscopy (LC–MS/MS) on saliva obtained from patients with OSMF. Results: A total of 172 proteins were identified in saliva samples. Five proteins were downregulated in the samples (fold change average of disease vs. control ratio ≤0.6). Conclusion: Downregulated proteins could serve as potential biomarkers in the early detection of malignant transformation in OSMF.
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A comparative evaluation of effectiveness of InGaAsP laser and therapeutic ultrasound administration before the induction of muscle fatigue on healthy young individuals: A clinical study p. 252
Roopam Saini, Upasana Sethi Ahuja, Nidhi Puri, Chinthalapalli Siva Ram, Manu Dhillon, Akshay Rathore
Background: Muscle fatigue or the inability to maintain muscle strength is a protective mechanism to prevent muscle injury. Phototherapy or low-level laser therapy (LLLT) and therapeutic ultrasound are non-invasive and non-pharmacological forms of treatment modalities that have demonstrated effective and affirmative results when used to prevent muscle fatigue. Aim: The study evaluated the effect of phototherapy and therapeutic ultrasound in reducing muscle fatigue when administered before the induction of fatigue. Methodology: The study design was a blind, randomized, and sham-controlled clinical trial on laser and therapeutic ultrasound. The study sample consisted of 100 healthy young participants randomly allocated to four different groups of lasers, sham laser, therapeutic ultrasound, and sham ultrasound. All the individuals were subjected to clinical examination to record the bite force by the bite force dynamometer, maximum interincisal distance (MID) by using digital vernier calipers, and muscle fatigue by using EMG Retrainer's Device. The laser and therapeutic ultrasound were given on the masseter and anterior temporalis muscle on both sides and both sham groups were submitted to the same procedure but with the devices in the switch-off mode. All the individuals were instructed to chew two pieces of gum (one on each side) for 6 min to induce muscle fatigue and MID, the bite force and muscle fatigue were re-evaluated. Results: Statistically significant improvement was observed between the pre-and post-bite force, MID, and muscle fatigue in both the laser and Therapeutic ultrasound group as compared to the sham control groups with the P-value equal to 0.000. No, statistically significant difference was observed in the improvement of the muscle fatigue when both the treatment groups, i.e., laser and therapeutic ultrasound were compared with a P value >0.05. Conclusion: Muscle fatigue can be effectively reduced if any one of the physical modalities, either laser or therapeutic ultrasound is administered before the long-duration treatments; enabling administration of treatment comfortably and effectively in one appointment.
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Hidden pathologies of maxillary sinus using CBCT scans p. 260
Md Sanaullah, Abhishek Sinha, Sunita Srivastava, Anuj Mishra, Yakshi Singh, Shalini Basu
Introduction: Diagnosis of orofacial pathologies is difficult with the 2 dimensional (2D) images taken from conventional radiography. Cone-beam computed tomography (CBCT) has been developed with 3 dimensional (3D) modalities and has become a better alternative to conventional radiography. Highre solution axial, coronal, and sagittal sections are the most revealing, noninvasive techniques for assessing the maxillary sinus anatomical variations, pathology, and its adjacent structures and areas. Aim: This study aimed to analyze the prevalence of pathological changes in the maxillary sinus of asymptomatic cases using CBCT for diagnostic purposes. Materials and Methods: This study was evaluated among 200 patients for hidden pathologies in the maxillary sinus. Pathological findings were categorized as a mucosal thickening, polypoid mucosal thickening, radiopacification, and no pathological findings. Results: In the present study, the overall prevalence of the mucous retention cyst was found to be 30.25%, the polyp was 4.25%, the mucocele was 0.50%, and the overall mucosal thickenings was 35%. Conclusions: In our study, the mucosal thickening has a very high rate of incidental maxillary sinus pathologies in asymptomatic patients. Therefore, a detailed three-dimensional imaging using CBCT is stated in most patients for proper treatment planning. A careful review of the entire CBCT scans is essential to avoid under-or overestimation of potential complications in providing comprehensive health care.
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Comparative study of implant site assessment using CBCT, tomography and panoramic radiography p. 266
Anand Choudhary, Pallavi Kesarwani, Saumya Verma, K Srikrishna, Devarshi Nandi, Srishti
Aim: The present study was done to evaluate the accuracy of panoramic radiography (OPG), conventional cross sectional tomography (CCST) and cone beam computed tomography (CBCT) to precisely portray structures in the posterior mandible. Materials and Methods: The present in-vitro study was performed on 42 edentulous human mandibles. A region 2cm behind the mental foramen was imaged using an OPG machine followed by imaging the same region using CCST function of the same OPG machine and CBCT. The distances from the alveolar crest to superior margin of the mandibular canal and alveolar crest to the lower border of mandible were measured in radiographs obtained by the three modalities. This step was followed by the comparison of the measurements performed in the cut-section of the mandible considered as Gold Standard. Results: The measurements done in the images obtained by OPG machine exceeded the values of gold standard by a mean of 2.69 mm ± 2.27 mm and 5.84 mm± 0.89 mm respectively. Similarly in CCST function and CBCT images, the measurements exceeded by 4.95 mm ± 2.35mm, 9.55mm ±1.25mm and 0.24mm ±0.20mm, 0.20mm ± 0.13mm respectively. The differences between the measurements made in radiographs and cut section were statistically significant. Conclusions: It was concluded that the measurements made by CBCT images were more precise, in addition CBCT images were also helpful in accurate three dimensional localization of the mandibular canal.
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Diagnostic reporting of calcified carotid atheroma in digital panoramic radiograph – A retrospective study p. 271
Jayachandran Sadaksharam, Iswarya Kathiresan
Context: Cerebrovascular disease remains one of the leading causes of death in many countries. Aim: To evaluate the presence of calcified carotid atheroma in digital panoramic radiographs, thereby referring the patients to cardiology for early management and prevention of stroke. Settings and Design: Hospital- based, cross- sectional retrospective study. Materials and Methods: The study design included 1000 digital panoramic radiographs taken for the needful patients in the Department of Oral Medicine and Radiology for a period of one year from November 2018 to October 2019. Two examiners (experienced maxillofacial radiologists) evaluated the presence of calcified carotid atheroma in panoramic radiographs. Results: Out of 1000 digital panoramic radiographs, 39 panoramic radiographs were found to have the presence of calcified carotid atheroma, of which 9 were male and 30 were female panoramic radiographs. The prevalence was found to be higher in the age group between 45 to 54 years. Conclusion: Panoramic radiographs help to assess the presence of calcified carotid atheromas. Careful evaluation of panoramic radiographs by maxillofacial radiologists for carotid atheromas could be life-saving in the prevention of stroke.
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Association of pulp stones among patients with addictive habits – A descriptive cross-sectional study p. 276
Tapasya Karemore, Trushita Banubakode, Mukta Motwani, Apeksha Dhole, Rutuja Muneshwar
Aim: The study aimed to determine the association of pulp stones among patients with addictive habits in comparison with healthy individuals without any addictive habits. Materials and Methods: A total of 240 patients were included in the study, i.e., 120 patients with addictive habits and 120 healthy individuals without addictive habits. Bite-wing projection of the intact or sound teeth of one side, i.e., either right or left side of the first and second molars of the upper and lower arch was obtained. The presence or absence of pulp stones was observed for the selected teeth. The Chi-square analysis was used to evaluate and compare the occurrence of pulp stones among patients with addictive habits and healthy individuals of a similar age group. Results: Of the 960 teeth examined from both groups, 111 (11.56%) teeth had pulp stones. Pulp stones were observed among 43 patients with addictive habits and in 30 healthy individuals. The occurrence of pulp stones was higher in the first molar followed by the second molar and in the maxillary than in the mandibular arch. Conclusions: No significant association was observed with the occurrence of pulp stones among patients with addictive habits, but a significant association was noted with respect to duration of habit.
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Evaluation of anatomical variations of sella turcica with age and gender using digital lateral cephalogram in Chennai city p. 280
Anandhi Sekar Arthisri, Subramaniyan Dhanapriya, A Niranjana, S Mehazabin, F Massillamani, S Kailasam
Background: Pituitary gland dysfunction might be predicted by examining the alteration of Sella turcica during the routine radiological examination of lateral cephalogram. Aim: The study aimed to analyze the variation in size and shape of sella turcica according to age and gender on lateral cephalogram among the people in the south zone of Chennai city. Materials and Method: A series of lateral cephalogram images from 200 patients comprising 94 males and 106 females were collected retrospectively from archives in the database. The shape and size of sella turcica were measured digitally. Statistical analysis was done using the Chi-square test and unpaired sample t-test. Results: The frequency of distribution of shapes of sella turcica among the people in Chennai city was 46% normal followed by 15.5% irregular dorsum sellae, 14.5% pyramidal shape, 11.5% bridging, 7% oblique anterior wall, 5.5% double contour. The length and depth of Sella turcica was greater in males when compared with that of the females which were statistically significant (P < 0.01). The depth and diameter were higher in the 10–20 years age group than the 20–30 year age group, which was statistically significant (P = 0.01). Conclusion: The size of Sella turcica alters between different age groups and gender. Variations in the shape of Sella turcica were present in nearly half of the individuals in the present study. Thus, the morphology of Sella turcica should be assessed as a part of routine radiographic examination.
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Comparison of efficacy of combination therapy (Low Level Laser Therapy (LLLT) and topical steroid) with topical steroid therapy only in patients with symptomatic oral lichen planus – In vivo study p. 286
Richa Jain, Amit Anil Mhapuskar, Darshan R Prasad Hiremutt, Isha Kale, Kedarnath Kalyanpur, Harshit Bhadani
Aim: To compare the efficacy of combination therapy (low level laser therapy [LLLT] and topical steroids) with topical steroid therapy alone in individuals with symptomatic oral lichen planus. Materials and Methods: The study was conducted on 30 patients who reported to our department with clinically and histologically proven symptomatic oral lichen planus (OLP). All the patients were assessed for the criteria of outcome—pain, burning sensation, size of the lesion, clinical resolution, and recurrence. The patients were randomly assigned into two groups each comprising of 15 patients. Group I (study group) patients received a combination of topical steroid and LLLT while Group II (control group) patients received only topical steroid therapy. Results: A significant pain and burning sensation reduction were found in the patients who were given LLLT (P: 0.05). There was a decrease in the size of the lesion which was statistically significant. A complete clinical resolution was achieved and only 11% recurrence occurred in the study group. This therapy appears to be effective in patients with symptomatic OLP. Conclusion: The LLLT therapy appears to be useful in relieving pain and burning sensation, reduction in the size of the lesion, with complete clinical resolution and minimal recurrence, and hence, can be considered as a valuable aid in managing symptomatic OLP. Thus, the LLLT therapy serves as a potent and independent therapeutic modality in symptomatic OLP.
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Assessing the prevalence of velopharyngeal dysfunction and obstructive sleep apnea by correlating cone beam computed tomography parameters of soft palate with the stop bang questionnaire p. 294
VS Madhu Preetha, BG Harsha Vardhan, K Saraswathi Gopal, Arathy S Lankupalli
Introduction: The relationship between soft palate length and nasopharyngeal depth can be used to determine the velopharyngeal dysfunction and is called Need's ratio. Need's ratio should be in a range of 0.6–0.7 in normal subjects. Any increase greater than 80% demonstrated a risk for developing velopharyngeal dysfunction. Aim: To assess the prevalence risk rate of obstructive sleep apnea using snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck circumference, gender (STOP-BANG) questionnaire and to evaluate various parameters of the soft palate, pharyngeal depth, and determination of Need's ratio using CBCT. Materials and Method: In this prospective study, patients who reported for CBCT assessment in the age group ranging from 20 to 50 years were included. The sample size of the study was calculated to be 42. Furthermore, the patients were screened with the STOP- BANG questionnaire and shapes of the soft palate, velar length, width, and pharyngeal depth were obtained with the CBCT sections, and Need's ratio was calculated. Results: The collected data were analyzed with IBM. SPSS software 23.0. Based on the results of the STOP- BANG questionnaire, P value was found to be significant. Based on the CBCT parameters, the most common shape was the leaf-shaped soft palate. The velar length, width, and pharyngeal depth were found to be higher in males. Need's ratio was found to be increasing with an increase in age. A significant correlation of risk for OSA was established based on a comparison of questionnaire results with the results obtained from CBCT parameters with Need's ratio. Conclusion: CBCT is a static imaging technique, it can identify the anatomic risk factors for developing sleep apnea.
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Candida prevalence in the saliva of controlled and uncontrolled diabetic patients – A clinical study p. 301
Mehta Ruchi, K Bains Sandeep, Bhatia Archana, Dua Nisha, Mahajan Sukriti, Deepika
Context: Diabetes mellitus is a major cause of mortality and morbidity worldwide. The health of oral tissue is related to saliva and both the composition and flow of saliva are altered in diabetic patients. Aim: This study aims to assess the prevalence of Candida in diabetic patients and non-diabetic controls and to assess the relationship between the candidal carriage and glycemic control, the relationship between the oral prevalence of Candida species, and clinical candidal infection, and the effect of antidiabetic therapy and smoking on candidal infection. Settings and Design: This cross-sectional population-based study was conducted on 100 diabetic and 50 non-diabetic (control) patients. Methods and Material: Saliva samples were collected and the concentrated oral rinse technique was used for quantitative oral candidal isolation. A digital colony counter enumerated several candidal colonies on each plate. Statistical Analysis Used: Chi-square test and Mann–Whitney test are used. Results: Colony-forming units (CFU/ml) in diabetics were 3131.14 and in control was 986.8. Out of 55 diet control patients, 30 had a candidal carrier; out of 44 patients on oral hypoglycemic, 30 had candidal carrier; and out of 1 patient on insulin, 1 had a candidal carrier. Out of 19 diabetics (good control), 8 had candidal carrier; out of 28 (moderate control), 12 had candidal carrier; and out of 53 (poor control), 41 had a candidal carrier. Out of 14 smokers, 8 had candidal carriers, and out of 36 nonsmokers, 11 had candidal carriers. Conclusions: Diabetic patients carry a higher number of candida in their oral cavity.
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Application and validation of Lamendin et al.'s adult age estimation method using mandibular premolar teeth on Western Indian (Gujarati) population: An experimental study p. 306
Piyush G Limdiwala, Nagpal Sugandha, Jigna S Shah, Jayasankar P Pillai
Aim: To evaluate the applicability of the method by Lamendin et al. for adult dental age estimation using extracted single-rooted mandibular first premolar in the Western Indian population and to develop a new regression equation. Materials and Methods: Ninety-seven extracted mandibular first premolars were collected from patients in the age range of 15–75 years. The root height, root translucency, and periodontosis parameters were measured. Lamendin's formula was tested on 77 randomly selected specimens. The regression formula was applied to the remaining 20 specimens to validate the same. The data were analyzed using the Interclass Correlation Coefficient (ICC), paired t-tests, and Pearson's correlation tests. Results: The mean estimated age using Lamendin's original formula was 44.75 years (±10.52) for the overall sample (N = 77). There was an overestimation of the age of the study sample by 0.11 year (SD = 11.14; df = 76; P > 0.05). The regression equation based on the data of the mandibular first premolar was Age (Yrs.) =18.423 + 0.441 (P) +0.423 (T) with a SEE = 11.07; r2 = 0.540; Sig. P <0.001. The mean estimated age of the test sample (N = 20) was 35.85 years ± 7.32 (P < 0.05) and 37.87 ± 6.19 (P > 0.05) by applying the new premolar formula and Lamendin's original formula, respectively. Conclusion: A strong positive correlation was found between the actual age and the estimated age using Lamendin's method, and there was no significant difference between the actual age and the estimated age of the study population using Lamendin's original and new premolar formula.
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Comparison of two methods in estimating the relation between dental age and chronological age p. 314
Surya Gunasekaran, Nazargi Mahabob, Captain S Elangovan, Suman Jaishankar, B Senthil Kumar, Deepika Rajendran
Introduction: Personal identification is becoming increasingly important not only in legal medicine but also in criminal investigation, identification, and genetic research. Dental age (DA) estimation has gained acceptance because it is less variable when compared to other age indicators. Aim: This study aims to determine DA by radiographic methods in digital orthopantamogram using Willem's method and in intraoral periapical radiograph using Kvaal's method and also to find out the accuracy of two methods in determining the relation between DA and chronological age. Materials and Methods: The study sample consisted of 75 randomly selected subjects who referred to the Oral Medicine and Radiology department for the purpose to undergo orthodontic treatment, were selected. Orthopantmograph and one intraoral periapical radiograph of right mandibular first molar using paralleling cone technique were taken for each patient The DA was determined using orthopantamography by Willem's method and intraoral periapical radiograph by Kvaal's method. Results: The student's t-test was used to analyze the significance between the two different age estimation methods. In Demirjian's method, the overall mean difference between estimated DA and CA for males was 15.10 years, while for females was 11.88 years. Estimated DA assessment by Willem's method appeared to underestimate chronological age both in males and females. Conclusion: In this study, a significant relation was found between estimated DA and CA in the Willem method (p-0.00) and Kvaal's method (p-0.05). Both the methods seem to be applicable in estimating the age of both genders.
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Efficacy of transcutaneous electric nerve stimulation over systemic pharmacotherapy in the management of temporomandibular joint disorders – A systematic review and meta-analysis p. 321
Indra Gopi, Gopal Maragathavalli, TN Uma Maheshwari
Temporomandibular disorders (TMDs) encompass numerous clinical complications that involve the temporomandibular joint (TMJ), masticatory musculature, and its associated structures, or both. Abundant research in this field has been conducted; however, there is no conclusive evidence reported in the effective management of TMD using physical therapy such as Transcutaneous Electric Nerve Stimulation (TENS). The systematic review and meta-analysis aimed to compare and evaluate the efficacy of transcutaneous electric nerve stimulation over systemic pharmacotherapies in the management of symptomatic patients with temporomandibular joint disorders. The present review has been registered with PROSPERO – An international prospective register of systematic review (CRD42021233019). An electronic search was done in PubMed, Cochrane Library, Science Direct, Google Scholar, Latin American and Caribbean Health Sciences Literature (LILACS), ClinicalTrial.gov, and sci-hub.se. Manual electronic searches were also carried out and articles were handpicked. The assessments of articles were done using selection criteria. There are a vast number of studies done in this subject of interest and hence, only prospective clinical trials like Randomized clinical trials (RCTs) and controlled clinical trials (CCTs) were included in this review. A total of three studies were included in this review, which consisted of prospective RCTs and CCTs. Two studies have been reported for meta-analysis. The included studies show TENS is proven to be effective in the management of TMD. The currently available evidence was insufficient to conclude the effectiveness of transcutaneous electric nerve stimulation and systemic pharmacotherapies in temporomandibular joint disorders. Based on the results of the meta-analysis, we can conclude that there was a significant reduction in pain encountered due to TENS.
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Acute myeloid leukemia presenting in oral cavity – A report of two cases p. 328
A Winnifred Christy, T Jones Raja Devathambi, B Deepika Lakshmi, Gheerthana Venkatesh
Acute myeloid leukemia is a malignant disease of the bone marrow. Because of its high morbidity, early diagnosis and prompt treatment are essential to save lives. This article describes the case reports of a 33-year-old female and a 60-year-old male who came to our dental hospital with gingival overgrowth, gingival bleeding, epistaxis, and facial swelling for about 1 week. After doing a thorough hematological examination, acute myeloid leukemia was diagnosed The oral health care professionals need to be able to recognize oral physiological characteristics, and, when identifying a change of normalcy, investigate it requesting additional tests or referring the patient to a specialized professional.
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Mucosal burning: A case report of rare finding in maxillary sinus carcinoma p. 333
Shriya Dinesh Temgire, Shrinivas S Garje, Vikram V Khare
Malignant tumors in the maxillary sinus (MxS) are rare and are usually diagnosed when perforating the sinus walls in the later stages. Asymptomatic growth of the malignancy is facilitated by the presence of large air space in the MxS. The clinical presentation depends on the sinus wall involvement by the tumors. Symptoms of maxillary sinus carcinoma (MxSCa) can resemble dental infection that the affected patients may visit dental clinics for seeking treatment. This report presents a case of MxSCa, which was secondarily infected along with the rare clinical finding and chief complaint being severe mucosal burning. Attention toward these rare symptoms should be considered, as cases have not been reported with symptoms of burning sensation in MxSCa. Advanced imaging modality such as computed tomography for prompt identification of such lesions is discussed. The patient's first diagnosis is mostly in an advanced stage with a poor prognosis.
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Rare presentation of odontogenic myxoma – A case report p. 336
AC Varsha, Ajay Parihar, Prashanthi Reddy, Ajay L Sutare
Odontogenic myxoma is a benign locally aggressive odontogenic tumor that arises from the mesenchymal portion of the tooth germ. They occur most frequently in the second or third decade of life and rarely occur before the age of 10 and after the age of 50. These are slow-growing tumors, but they may be locally aggressive, especially in the maxilla. Here we report the case of odontogenic myxoma in a 25-year-old male patient in the mandibular anterior region, which is usually seen in the posterior aspect of the mandible.
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Adenoid cystic carcinoma of submandibular salivary gland: A case report with extensive management p. 340
P Venkatalakshmi Aparna, J Venkatesh, S Leena Sankari, N Narmatha
Adenoid cystic carcinoma (ACC) is a relatively rare epithelial malignant tumor of the major and minor salivary glands with deceptive benign histologic appearance characterized by indolent, locally invasive growth with a high propensity for local recurrence and distant metastasis. Typical ACC has a cribriform pattern, presenting a very aggressive course among the histologic variants. According to the Armed Forces Institute of Pathology (AFIP), ACC was considered the fifth most common malignant epithelial tumor of the salivary gland. ACC is more common in the minor salivary gland, the palate being the most common site, submandibular salivary gland and least followed by sublingual and parotid glands. ACC accounts for about 1% of all malignant tumors of the oral and maxillofacial regions. Thus, considering its rarity, we would like to discuss a case report of ACC of the submandibular salivary gland in a 52-year-old female patient with a typical histological pattern, which would epitomize all cases of ACC along with extensive management.
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Aggressive fibromatosis: A diagnostic paradox of 68 years old male patient-A case report p. 344
Saumya Khare, GV Ramachandra Reddy, Ajay K Pillai, Pooja Khare
Fibromatosis develops in the soft tissue and is the proliferation of well-differentiated fibroblasts and myofibroblasts. It is present most commonly in the abdominal region. Aggressive fibromatosis (AF) of the oral or para oral structures has been reported occasionally but, it is quite uncommon in the maxilla. We report a case of AF in a 68-year- old male in the maxilla, who came with a chief complaint of swelling in his upper left back tooth region which extended to the retromolar region and was clinico-histopathologically diagnosed as AF. All proliferative indurated growths are not always clear-cut malignancies.
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