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EDITORIAL |
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Elusive spirals of potentially malignant disorders and oral cancer |
p. 94 |
Radhika M Bavle DOI:10.5005/jp-journals-10011-1269 |
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RESEARCH ARTICLES |
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Correlation of periodontitis during pregnancy and incidence of low birth weight babies |
p. 95 |
Prashanthi Reddy, Tushar Phulambrikar, PV Wanjari, Rajeev Srivastava DOI:10.5005/jp-journals-10011-1269 Objective: To verify a possible association between periodontitis and low birth weight babies.
Materials and methods: Two hundred and eighty antepartum women were examined aged between 18 and 37 years. Demographic, medical and clinical histories were taken under obstetrician's guidance. A thorough periodontal examination was done in all the participants with their consent which included bleedina on Drobina. Docket death and clinical attachment level.
After delivery, gestational age (in weeks) and birth weight of baby (in kg) were collected from hospital records. Infants were placed into following categories by gestational age (WHO) and by birth weight preterm-<37 weeks, term-37 to 42 weeks, post-term-42 weeks completed and above, low birth weight<2,500 gm, normal birth weight-2.500 to 3,900 gm, high ,weight->3,900 gm.
Results: Based on the findings of the study, a significant correlation was observed between periodontitis and low birth weight and preterm low birth weight (p<_0.001) and a significant relation was observed between periodontitis and gestational age (p < 0.001).
Conclusion: Periodontitis was considered a risk indicator for reduced gestational age and birth weight. Multicentric trials will greatly help to establish the independent role of periodontal disease and their relationship in terms of pregnancy outcomes. |
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Efficacy of ultrasonography in the diagnosis of inflammatory swellings of odontogenic origin |
p. 98 |
Jai Sanghar, S Ramasamy, J Sankar, Ravi David Austin DOI:10.5005/jp-journals-10011-1270 Objective: The purpose of this study was to evaluate the efficacy of ultrasound in the diagnosis of inflammatory swellings of odontogenic origin.
Study design: The study group consisted of 25 patients with inflammatory swellings of odontogenic origin. Only patients with unilateral swellings were considered for inclusion in the pathologic study group and normal contralateral side was taken as control.
Results: Clinically, four cases were diagnosed as cellulitis and 21 cases as abscesses. Under ultrasonography (USG) diagnosis, six cases were diagnosed as edema and two cases as cellulitis and 15 cases as preabscess and two cases as abscesses, considering the intra operative diagnosis as the gold standard technique. The ultrasonography technique presented sensitivity of 92%.
Conclusion: USG can differentiate facial edema, facial cellulitis, and dentoalveolar abscess. USG can also evaluate the extension of these swellings. It is prudent to subject patients with inflammatory swellings of the maxillofacial region to USG in order to determine the appropriate treatment plan. |
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Genetic damage in exfoliated cells from oral mucosa of individuals exposed to x-rays after panoramic radiograph: A cross-sectional study |
p. 102 |
Ramalakshmi Madhavan, Manikandan Kumaraswamy, S Kailasam, S Manoj Kumar DOI:10.5005/jp-journals-10011-1271 Objectives: In the past decades, X-rays have been used widely for diagnosis in dentistry. However, it is well known that ionizing radiation causes damage (including single- and double-strand breaks) to deoxyribonucleic acid (DNA) and DNA-protein crosslinks, and induces cellular death. Therefore, outlining the cytogenetic effects induced by X-ray is necessary to identify the degree of cancer risk and minimize potential risks to patients and clinicians.
Materials and methods: Cytogenetic biomonitonng studies focusing on oral mucosa cells in individuals exposed to dental X-ray were reviewed.
Results: Dental X-ray can induce DNA damage and cytotoxicity in oral mucosa cells.
Conclusion: These results will contribute to a better understanding of X-ray-induced effects upon the cellular system in individuals continually exposed to known genotoxic/cytotoxic agents.
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A study to determine the association between tobacco smoking habit and oral candidal infection in median rhomboid glossitis by cytologic and histopathologic methods |
p. 106 |
Anitha Bojan, Winnifred Christy, Kaleel Kurian, S Elangovan DOI:10.5005/jp-journals-10011-1272 Objectives: To determine the association, if any, between tobacco smoking and candidal infection in median rhomboid glossitis (MRG) and to histopathologically evaluate the presence of dysplastic changes in it.
Study design: Hospital-based study consisting of 100 subjects who satisfied the clinical criteria of MRG- Smears and swabs were collected to ascertain the presence of Candida and sub-typing was done utilizing the CHROMagar technique. Biopsy and histopathological examination was done to determine the presence or absence of dysplasia of the lesional tissue.
Results: All the subjects were male and had the habit of smoking- Smears and swabs taken from glossal lesion of 60 subjects' showed 100% candidal positivity. Tissue section from 31 subjects showed histological picture consistent with MRG and 23 (74%) showed dysplastic changes.
Conclusion: MRG is a Candida-associated lesion and the tobacco-smoking habit in our cohort may play an important role in increasing the candidal colonization. As some of our cases exhibited mild epithelial dysplasia, both candidal colonization and smoking habits may have contributed to the dysplastic changes.
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Prevalence of habit of tobacco and its deleterious effects in general population of Jaipur District, Rajasthan
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p. 113 |
Vela Desai, Rajdeep Kaur Gill, Rajeev Sharma DOI:10.5005/jp-journals-10011-1273 Introduction: Usage of tobacco is prevalent worldwide in some or other form in all age groups. Smoking and tobacco use is a major public health issue in developing countries. As Rajasthan is a place with different cultural and traditional variations when compared with other parts of the world. To extract if the same diversity exists in the usage of tobacco in Jaipur district Rajasthan, this study was conducted as no similar studies have been done previously
Materials and methods: A total of 552 patients who visited Outpatient Department of Jaipur Dental College, Jaipur, were studied. Complete information regarding presence of smoking and other forms of tobacco was recorded in case history proforma and any of tobacco-related oral lesions among these patients were examined.
Results: In age group of <20 years, 109 males and 62 females gave history of habit of tobacco. A total of 164 males and 146 females were in the age group of 21 to 50 years, which made the highest total of 56.169o. Diagnosis included leukoplakia in 111 patients, lichenoid reaction (p-value > 0.05) in 12.84% subjects, oral cancer was reported in 33 patients (p-value = 0.001) whereas smoker's palate in 25 patients and OSMF being the most common. Awareness level about ill effects of tobacco was 51.10 %.
Conclusion: High incidence of tobacco usage in smokeless form is seen in Jaipur population especially in adolescents. There were no significant findings found between males and females. Of all lesion examined, OSMF was found to be more prevalent. Therefore, it is important to take immediate steps to curb the habit.
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Quantitative assessment of argyrophilic nucleolar organizer regions in nonsmokers, smokers and oral submucous fibrosis: A pilot study |
p. 117 |
GV Sowmya, BN Padmavathi, Mohitpal Singh, Prashant Nahar DOI:10.5005/jp-journals-10011-1274 Background: Nucleolar organizer regions (NORs) are defined as nucleolar components containing a set of argyrophilic proteins, which are selectively stained by silver methods- After silver-staining, the NORs can be easily identified as black dots exclusively localized throughout the nucleolar area and are called AgNORs. AgNORs have been used to assess biologic aggressiveness of lesions, such as smokers, submucous fibrosis and squamous cell carcinoma of oral cavity.
Materials and methods: The study consisted of 42 individuals, of which 15 healthy controls who neither had any habit nor mucosal lesions, 15 were smokers with leukoedema and 12 were smokers with oral submucous fibrosis The cytosmears obtained were subjected to the silver-staining method for AgNOR proteins- The difference in AgNOR counts were calculated among and between groups using the one-way ANOVA with post hoc and Scheffe's test.
Results: The mean AgNOR count ranged from 3.11 in normal, 5.13 in leukoedema to 673 in oral submucous fibrosis. When comparison of mean AgNOR counts was prepared between the normal and study groups, it was also found to be statistically significant (p < 0.05).
Conclusion: The mean AgNOR counts was higher in smokers with oral submucous fibrosis and leukoedema when compared to normal individuals without habits. This significant increase in AgNOR counts in smoker's mucosa indicates changes that could be assessed at cellular level before any structural changes in the mucosa could take place
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Facial soft tissue thickness in North Indian adult population |
p. 121 |
Tanushri Saxena, Sunil Ramchandra Panat, NC Sangamesh, Anand Choudhary, Ashish Aggarwal, Nidhi Yadav DOI:10.5005/jp-journals-10011-1275 Objectives: Forensic facial reconstruction is an attempt to reproduce a likeness of facial features of an individual, based on characteristics of the skull, for the purpose of individual identification - The aim of this study was to determine the soft tissue thickness values of individuals of Bareilly population, Uttar Pradesh, India and to evaluate whether these values can help in forensic identification.
Study design: A total of 40 individuals (19 males, 21 females) were evaluated using spiral computed tomographic (CT) scan with 2 mm slice thickness in axial sections and soft tissue thicknesses were measured at seven midfacial anthropological facial landmarks.
Results: It was found that facial soft tissue thickness values decreased with age. Soft tissue thickness values were less in females than in males, except at ramus region. Comparing the left and right values in individuals it was found to be not significant.
Conclusion: Soft tissue thickness values are an important factor in facial reconstruction and also help in forensic identification of an individual. CT scan gives a good representation of these values and hence is considered an important tool in facial reconstruction- This study has been conducted in North Indian population and further studies with larger sample size can surely add to the data regarding soft tissue thicknesses.
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Long-term outcome of surgical excision of leukoplakia in a screening intervention trial, Kerala, India |
p. 126 |
Gigi Thomas, Ramadas Kunnambath, Thara Somanathan, Babu Mathew, Manoj Pandey, Sankaranarayanan Rangaswamy DOI:10.5005/jp-journals-10011-1276 Oral cancer is often preceeded by precancerous lesions and conditions, such as leukoplakia, erythroplakia and oral submucous fibrosis. One of the approaches for control of oral cancer is to detect oral precancerous lesions early in the development and prevent their malignant transformation to invasive cancer either by chemoprevention or by surgical excision of the lesions with concurrent control of tobacco and alcohol use and other specific etiological factors. However, the value of specific approaches, such as surgery in long-term control of lesions and prevention of malignant transformation is not known. We describe our experience with cold knife surgical excision of oral leukoplakia diagnosed in the context of a community-based oral cancer cluster randomized oral cancer screening trial in Kerala, jointly organized by the Regional Cancer Centre, Trivandrum and the International Agency for Research on Cancer of the WHO, Lyon. France. During the period from January 1997 to December 2002, 111 subjects underwent surgical excision- Thirteen patients were found to have malignancy on histopathology and were not considered for further analysis. At the last follow-up, 9 (13%) patients could not be traced and 19 (27%) patients died due to causes other than oral cancer. Of the remaining 70 cases, 48 (68-6%) were remaining disease free with no evidence of recurrence or new lesions, 16 (16.9%) developed new leukoplakic lesions, (one patient developed recurrence as well), three (4.2%) developed recurrence. Recurrence was more common among those who continued the habits, but this was not statistically significant.
There were four (5 7%) cases of malignant transformation during the mean follow-up period of 8-1 years. The superiority of surgical excision over other modalities of management of leukoplakia could not be established in the present study.
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Evaluation of cachexia in oral submucous fibrosis |
p. 130 |
Pooja Singh, Harshkant Gharote, Preeti Nair, Karthik Hegde, Nisheeth Saawarn, R Guruprasad DOI:10.5005/jp-journals-10011-1277 Introduction: Patients with cancer suffer from a wasting syndrome associated with anorexia/cachexia. Anorexia is associated with a marked loss of appetite and/or an aversion to food. Cachexia is associated with loss of body mass and is often associated with weakness, fatigue leading to poor quality of life. It has been observed in those individuals with oral submucous fibrosis (OSMF), a premalignant condition, are generally thin and there seems to be a relation between loss of appetite and consumption of areca nut in these individuals.
Aims: Evaluation of cachexia in OSMF patients based on the criteria given for defining cachexia by group of scientists and clinicians in the cachexia consensus conference.
Materials and methods: Twenty OSMF cases (group I) and 20 healthy individuals with areca nut chewing habit (group II) were assessed for body mass index (BMI), hemoglobin and serum albumin level. Their fatigue and anorexia scores were calculated by using structured questionnaires.
Results: Correlation between fatigue and anorexia was statistically significant for OSMF group but was statistically not significant in group 11. Comparisons of BMI, hemoglobin, fatigue and anorexia between two groups were statistically not significant, however, serum albumin was found to be statistically significant.
Conclusion: From the present study it can be concluded that the early process of cachexia begins during the progression of OSMF. The areca nut chewing practice associated with OSMF may play some role in this context.
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Viability of human dental pulp in determination of sex of an individual by identifying srygene through DNA analysis: A single blind pilot study |
p. 133 |
Prachi Ravikant Naik, Deepa Das Acath, Gapal H Sharma, Amita Rahul Navalkar DOI:10.5005/jp-journals-10011-1278 Recognition of importance of human teeth in personal identification has been recognized from time immemorial. In any natural calamity or man-made catastrophe identification of an individual is of paramount importance. Here tooth plays an important role as it is the last one to get affected in a disaster due to its durable nature and good survival rate. This information comes under the aegis of forensic odontology and is of paramount importance from legal and social viewpoints. This analysis uses highly informative genetic markers and can be carried out easily in a typical forensic lab oratory. The SRY gene marker (sex determining region Y) is a sex-determining gene on the Y chromosome in the therians (placental mammals and marsupials) and this gene marker is considered as a signature gene to differentiate the male from female sex chromosome. The detection of SRY gene in the DNA from a forensic sample can be confirmatory to type the gender as male. This study was taken up to identify the viability of human tooth pulp by identification of SRY gene in gender determination. |
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REVIEW ARTICLES |
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Systemic affliction of oral focal sepsis |
p. 137 |
Vidya Krishnan DOI:10.5005/jp-journals-10011-1279 Multitude of etiologies can cause diseases in various systems. One important etiology is focal sepsis in the oral cavity which has been hypothesized till now to cause various diseases. This hypothesis has now been proved beyond doubt. This article aims to throw light at the effects of oral focal sepsis on the systems, their management and the role of the dentist in prevention of these manifestations. |
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Role of defensins in oral diseases: An overview
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p. 142 |
Sharanamma B Bhagawati, Basavaraj T Bhagawati, Sachin Mittal DOI:10.5005/jp-journals-10011-1280 The oral cavity outreaches as a particular environment in which there is a continuous interplay between bacteria, fungi and viruses and the epithelial barrier. Among the innate mechanisms that aim to establish a regulated equilibrium between health and disease, natural antimicrobial peptides, especially those part of the defensins' family, have emerged as fundamental mediators. Their biological role is emphasized by the large number of expressed genes as well as the multiplicity of the individual molecules present on biological tissues and fluids, in physiological and pathological conditions. Furthermore, the direct antimicrobial action, defensins may play a pivotal role in the orchestration of the innate response and contribute to the interplay between the innate and adaptive immunity. This review focuses on the specificities of defensins. |
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Probiotics and oral health |
p. 146 |
Tejavathy Nagaraj, B Ravi, SN Sankara, K Madhu DOI:10.5005/jp-journals-10011-1281 Probiotics, bacterial cultures or living microorganisms, upon ingestion in certain quantity promote and enhance health benefits. An International Life Science Institute Europe consensus document proposed a simple and widely accepted definition of probiotics as 'viable microbial food supplements which beneficially influence the health of human'. These bacteria should also adhere to the interstinal mucosa and finally should have the ability to inhibit the gut pathogens. |
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CASE REPORTS |
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A solitary palatal mass
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p. 149 |
T Manigandan, V Shivakumar, B Karthika, SC Selvamuthukumar, Nalini Aswath DOI:10.5005/jp-journals-10011-1282 Myoepithelioma is a rare benign neoplasm of major and minor salivary glands, composed almost exclusively of sheets, islands or cords of cells with myoepitheliomal differentiation. Myoepithelioma represents 15% of all salivary glands neoplasm, most commonly occurs in parotid gland. Here, we report a rare case of myoepithelioma of hard palate.
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Oral soft tissue myxoma |
p. 152 |
Leena James, Akshay Shetty, Namitha Jaypal, Durga Okade DOI:10.5005/jp-journals-10011-1283 The intraoral soft tissue myxoma is an extremely rare, slowly growing, benign mesenchymal tumor. The myxomas are insidious, infiltrative tumors which occurred in all age groups, with an average patient age of occurrence of 38 years. Most frequent locations were the cheek, floor of the mouth and palate. The lesions were present from 2 weeks to 6 years prior to treatment. The recommended therapy is surgical resection with adequate margins. We present a rare case report of soft tissue myxoma arising from the tongue in a 62-year-old male patient.
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Chronic myeloproliferative disorders: A rarest case with oral manifestations and dental management
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p. 155 |
Pritesh B Ruparelia, Kosha Pritesh Ruparelia, Rajan Shirolkar, Anurag Tripathi DOI:10.5005/jp-journals-10011-1284 Chronic myeloproliferative disorders (CMPD) are rarest hematological disorders (malignant myeloid neoplasms). The three most common chronic myeloproliferative disorders are polycythemia vera, essential thrombocythemia and chronic idiopathic myelofibrosis. Clinical manifestations (including oral manifestations) of these disorders are overlapping with each other and with other hematologic disorders, which makes the diagnosis of CMPD a challenging task. In this article we report a rare to rarest case of CMPD at dental outpatient department, its oral manifestations and its management in dental clinics. |
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Cleidocranial dysplasia in son and father: Report of two rare cases with review of literature
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p. 158 |
S Manoj Kumar, Chandra Mouli, P Mahesh Kumar, S Kailasam DOI:10.5005/jp-journals-10011-1285 Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal disease, which is caused by mutation in the gene on 6p21 encoding transcription factor CBFA1, i.e runt-related transcription factor 2 (RUNX2). The disease is characterized by a persistently open anterior fontanelle and skull sutures, hypoplastic or aplastic clavicles, dental abnormalities, short stature, a wide pubic symphysis and a variety of other skeletal changes. A major finding of CCD is hypoplasia or aplasia of clavicular bones resulting in the ability of the patient to approximate the shoulders. Delayed closure of the anterior fontanelle and of metopic sutures causes frontal bossing. We report a rare case of CCD in a 15-year-old boy and in his father and emphasize the importance of clinical and radiographic findings in CCD. |
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Schwannoma
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p. 162 |
Subba Rao Vanukuru, Vivekanandh Reddy Gangili, Jithendar Reddy Kubbi, Navadeepak Kumar Korvipati, MS Muni Sekhar DOI:10.5005/jp-journals-10011-1286 Schwannoma in the head and neck is usually arising from parapharyngeal space, but masseteric schwannoma is very rare. We report a schwannoma arising from masseter muscle in a 60-year-old male patient, who was presented with a history of painless swelling on the left cheek for 3 years and the mass was surgically removed from the left cheek of a 55-year-old man and pathological examination revealed schwannoma with Antoni A and B patterns, and numerous hyalinized masses (Verocay bodies) surrounded by spindle-shaped cells and was diagnosed as schwannoma.
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A rare case of oligodontia |
p. 165 |
MLV Prabhuji, Shaeesta Khaleel B Ahmed, K Raghunatha, Vijeev Vasudevan, R Murali, D Devaraju DOI:10.5005/jp-journals-10011-1287 Agenesis of permanent teeth is a congenital abnormality where some of the teeth are missing as the follicles needed for the growth of the teeth are completely absent. Documental evidence of this condition is very limited in literature and the etiology is still obscure. The present article highlights a clinical case of oligodontia without any association of systemic condition or syndrome.
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Erythema multiforme in a patient with recurrent non-hodgkins lymphoma/chronic lymphocytic leukemia |
p. 168 |
Siva Kumara Shankari, K Jayanthi, Bhawna Gupta DOI:10.5005/jp-journals-10011-1288 Erythema multiforme major (EMM) is a hypersensitivity reaction usually secondary to medications, viruses or other infections. Its presentation is fairly typical with a symmetrical distribution of vesicles, bullae or targeted lesions on the upper body, arms, legs, palms, feet and oral mucosa. The authors present a delineated case of EMM in association with chronic lymphocytic leukemia (CLL) and non-Hodgkin's lymphoma (NHL) with a very unusual clinical presentation evolving overtime into a unique, almost dermatomal distribution. Typical therapies were not initially helpful and intravenous immunoglobulin antibody had to be administered. |
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