Introduction: Pulp calcifications are relatively frequent findings on dental radiographs. They may be seen in primary, permanent, erupted or unerupted teeth. Calcifications within the pulp are seen in such a frequency that it may be questioned whether their presence represents a pathological state or a mere occurrence of normal biological variation. Aims and Objectives: The aim of this study was to assess the prevalence of idiopathic pulp calcifications in permanent teeth by using digital orthopantomographs (OPG), and to report any association between the occurrence of pulp calcifications with gender, tooth type, dental arches, and the side of the dental arch. Materials and Methods: A total of 150 digital panoramic radiographs of an equal number of male and female patients fulfilling the inclusion criteria were examined. The sample was composed of 150 patients within the age group of 15-50 years. Four thousand three hundred and ninety-nine teeth were evaluated and the pulp calcifications were assessed. The frequency of occurrence of pulp calcifications between gender, tooth type, dental arches, and the side of the dental arch were compared. Results: From 150 orthopantomographs (OPGs), a total of 4399 teeth were examined, and the total number of patients with pulp calcifications were 80 (41 females and 39 males). The overall distribution was more in females, in the maxillary arches, and in the first molars. Patients with bilateral pulp calcifications were more than those with unilateral pulp calcifications. Conclusion: The pulp calcifications assessed in this study were of idiopathic origin, as only healthy patients and healthy teeth were included in the study. Most of the pulp calcifications were seen in the young age group. Therefore, pulp calcifications could be a normal biological variation within the pulp.

Aim and Objectives: To assess the efficacy of cone-beam computed tomography (CBCT) in comparison with multislice-computed tomography (MSCT) in the radiographic evaluation of cysts and tumors of the jaws. Materials and Methods: The study was conducted on 25 subjects diagnosed histopathologically with cysts or tumors of the jaws. They were subjected to MSCT and CBCT. The image pairs obtained were compared for diagnostic quality and dimensional accuracy. Also radiation monitoring was done with a newly devised calculative method. Statistics: Descriptive statistical analysis was carried out for all the groups in this study. The Kappa coefficient (k) for intraclass agreement was used for evaluating the scorings given by the evaluator for the diagnostic quality of the image. Results: A total of 28 lesions were found in 25 subjects. The diagnostic quality assessment suggested that the appearance of the internal structure and the soft tissue resolution of CBCT were inferior to MSCT. The radiation dosages from CBCT were noticeably less than MSCT. The dimensional accuracy of CBCT images was found to match those of the MSCT images. Conclusion: The results from the present study showed that CBCT could provide an image with MSCT-comparable diagnostic quality and accuracy, with a lesser radiation dose and risk, at a lower cost.

Aim: The aim of this study was to evaluate the efficacy of turmeric in oral submucous fibrosis (OSMF) patients. Objectives: To check the treatment efficacy of turmeric in terms of burning sensation on Visual Analog Scale (VAS) and mouth opening, and to evaluate the group which showed the maximum improvement. Materials and Methods: 30 subjects diagnosed with OSMF were included in this study. The patients were administered commercially available turmeric; their mouth opening and burning sensation on VAS scale were evaluated at regular intervals, and the data was then compared. Results: The improvement in mouth opening was not significant; however, the change in burning sensation on VAS was significant. Conclusion: Treatment of OSMF with turmeric is an affordable and effective treatment methodology; however, further research needs to be done.

Aims and Objectives: This study was conducted to determine the efficacy of lycopene in the management of oral submucous fibrosis (OSMF) and to compare its efficacy with intralesional betamethasone injections. Materials and Methods: Forty-four patients were divided randomly into two groups. Group I subjects were treated with 10,000 mcg of lycopene (Lyconex) daily, in two equally divided doses, for two months. Group II subjects were given intralesional injections of betamethasone. Both the groups were assessed in terms of mouth opening and burning sensation. Results: A significant improvement in mouth opening was seen in both the groups and the improvement was better in Group I. The mean improvement in mouth opening in Group I was 37.62% (12 mm) at the end of the study, which was statistically highly significant and weekly evaluation revealed that this high significance was from the third week onward, and Group II patients (only intralesional steroids) showed an average improvement of 13% (3.9 mm) at the final follow-up visit. Conclusion: Lycopene (Lyconex) is better than intralesional betamethasone injections in improving mouth opening and decreasing burning sensation.

Aims and Objectives: (1) To determine the fingerprint patterns in gutkha chewers with oral submucous fibrosis (OSMF) and in healthy controls without gutkha chewing habit and OSMF. (2) To observe and compare the variations of fingerprints in both these groups. Materials and Methods: A prospective study was conducted in the Department of Oral Medicine and Radiology, Career Postgraduate Institute of Dental Sciences and Hospital, Lucknow, with 50 subjects divided into two groups: group A consisted of 25 clinically and histologically proven OSMF cases and group B consisted of 25 controls without gutkha chewing habit and OSMF. Fingerprints were taken using the ink method described by Cummins and Midlo. Statistical analysis was done using Chi-square and Fisher's exact tests. Results: There was a marked decrease of tented arches, ulnar and radial loops, and an increase of simple whorls in OSMF subjects in comparison with normal individuals. Conclusion: Fingerprint pattern is genetically determined. Similarly, the tendency of development of OSMF in gutkha chewers is also genetically determined. An effort was made to compare the fingerprint patterns among gutkha chewers with OSMF in a small sample, which showed that there was a significant decrease of tented arches, ulnar and radial loops, and an increase of simple whorls in OSMF patients in comparison with normal individuals.

Aims and Objectives: The aim of this study was to evaluate and compare the alterations in the plasma lipid profile patterns in oral cancer patients and controls. Materials and Methods: The study population comprised of 15 oral cancer patients and 15 controls. The lipid profile patterns, such as, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), Very-low-density lipoprotein (VLDL) lipoprotein, and triglycerides were estimated in both the groups. Changes in the plasma lipid profiles of both groups were compared. Results: This study evaluated all the plasma lipid profile patterns in both the groups. A significant decrease in the total cholesterol and HDL was observed in oral cancer subjects when compared with the control groups. Conclusion: Lipids are the major cell membrane components, which are essential for various biological functions, such as, maintaining cell integrity, cell growth, and division of normal and malignant cells. The lower plasma lipid status may be a useful indicator for initial changes occurring in neoplastic cells.

Introduction: Estimation of age is an important aspect of forensic science. The assessment of age is useful in forensic odontology and in treatments plans of orthodontic and pedodontic patients. Aims and Objectives: The aim of the study was to determine dental age from orthopantomograph using Demirjian's method and Nolla's method. It was also to evaluate the interrelationship between chronological and dental age according to both these methods and to evaluate which technique was better. Materials and Methods: The study was conducted in the Department of Oral Medicine and Radiology of Babu Banarasi Das College of Dental Sciences (UP, Northern India). A total of 300 subjects (150 girls and 150 boys) of age group from 6 years to 15 years were enrolled. These subjects were grouped by a difference of 1 year into 10 groups (each group comprised of 30 subjects: 15 males and 15 females). For every individual included in the study a panoramic radiograph was taken, with standard parameters and adequate protective measures. Results: The results imply that Demirjian's method is applicable to all age groups and for both genders with better accuracy than Nolla's method, which had a limited utility in younger age group. Thus Demirjian's method is a better method when compared to Nolla's method in Northern Indian population.

Introduction: Gender determination is crucial for identification, as the number of possible matches is reduced by 50%. The inert, mineralized structures of teeth resist post-mortem degradation and survive deliberate, accidental or natural change, better than any other skeletal structure. Tooth size measurements based on odontometric investigations in a specific population can be used in gender determination. Aims and Objectives: To evaluate and estimate the accuracy of using permanent maxillary incisors and canines for gender determination. Settings and Design: The undergraduate students of a dental college, meeting the inclusion criteria, were selected. After short listing the undergraduate students through the convenience sampling technique, a total of 300 subjects were purposively selected. Materials and Methods: The study was conducted on 300 subjects (150 males and 150 females), the mesiodistal dimensions of the maxillary anterior teeth were taken with the help of a digital vernier calliper and manual divider, with a sharp fine tip. Statistical Analysis: The collected data was subjected to statistical analysis. The data was subsequently processed and analyzed using the SPSS software package version 17. Results: The mesiodistal dimensions of the right and left maxillary canines and central incisors were significantly different (i.e., greater) in males as compared to females. Conclusion: The results of the present study showed that the maxillary central incisors and canines revealed a statistically highly significant sexual dimorphism and could be used as an adjunct for the determination of gender in individuals, as well as in groups, such as, in mass disasters or archaeological sites.

Cone beam computed tomography (CBCT) is now an established technology in dentistry, used for three-dimensional imaging of the teeth and jaws. But the current CBCT technology has various limitations causing deterioration of images. Every dentist must be familiar with these limitations while interpreting CBCT images. This article aims to present a pictorial essay describing the various CBCT faults and artifacts, which can help to better understand the factors causing image deterioration in CBCT. To further simplify, we are also presenting a classification of these artifacts and listing the measures to reduce them.

The fastest emerging component of the general population comprises geriatric people, which, in future, will have an impact on oral and systemic health considerations. As there is an increase in the elderly population, it has given rise to new challenges, of which the foremost and important challenge is to provide health care that is cost-effective, accessible, and of fine eminence. Oral health, which forms a major fraction of the general health, has its impact on the physical and mental status, which affects the quality of life of geriatric population. In order to provide excellent oral health care, it is mandatory to focus on the knowledge and education in the field of geriatric dentistry, which will aid in providing optimum health care. Geriatric dentistry has failed to evolve as a distinct, independent specialty at the postgraduate level of dental education. Even at the undergraduate level, there is a lack of training and the constituent aspects of geriatric dentistry are not included in the curriculum. Young graduates need to understand the socio-economic, physical, and psychological problems, and the complexity in treating the elderly patients suffering from chronic diseases and long-term medication, as part of their training in oral medicine. Also, specialized courses in the field of geriatric dentistry, such as "oral medicine advanced education program" and "fellowship in geriatric dentistry," must be developed for the oral medicine specialists to address and meet the needs of elderly population in India.

Styloid process has a close proximity to many vital neurovascular structures in the neck, making it clinically significant. It is said to be elongated if its length is more than 3 cm. Only 4% of the general population has been found to have elongated styloid process, most of which are asymptomatic. An unusual case of a calcified styloid process measuring, 8 cm on the right side and 6.75 cm on the left side, viewed on a digital orthopantomograph as well as on a computed tomographic scan is reported in this article.

Developmental anomalies of the salivary glands are rare. These include aplasia of glands, atresia of ducts, accessory or ectopic glands, and a variety of cysts. Through this case report we are presenting a unique case of bilateral, enlarged, Wharton's ductal openings that have not been documented yet.

Ameloblastic fibro-odontoma (AFO) is a benign mixed tumor of odontogenic origin. It generally occurs in children and teenagers; however, cases occurring in the elderly have also been reported. Generally, the tumor is asymptomatic and is discovered accidently on a radiograph taken for an unerupted tooth, but examples of large tumors causing jaw swelling have been reported in literature. This article presents a case of AFO causing jaw expansion with pain and lymphadenopathy in a 17-year-old male. As the final diagnosis is always confirmed by histopathology, this case is a unique one diagnosed by clinical and radiographic findings as an odontoma and suggesting the differentiation of an AFO to odontoma.

Rhinomaxillary mucormycosis presents with a characteristic destruction and necrosis most commonly affecting immunocompromised patients, especially diabetics. The present reported case was extremely unusual that the characteristic clinical feature of ulceration or necrosis was absent and the patient was apparently healthy (immunocompetent) with mere findings of generalized periodontal pockets, mobility of maxillary teeth, and a diffuse mild swelling in the anterior region of the hard palate on initial (clinical and radiographic) examination. This emphasized the need to include this fatal opportunistic infection in the differential diagnosis of maxillary swellings in otherwise healthy patients showing minimal clinical signs which could camouflage its presence.

Clear cell neoplasms have created a considerable dilemma in the diagnosis of head and neck pathology. Clear cells may be seen in a variety of odontogenic neoplasms, salivary gland neoplasms, and metastatic tumors to the jaws, specifically renal cell carcinoma. We present two cases of clear cell tumors - The first one, clear cell odontogenic carcinoma (CCOC), an odontogenic tumor, and the other, hyalinizing clear cell carcinoma (HCCC), a salivary gland neoplasm. Both these lesions, according to literature, have similar clinical, radiological, histopathological, and immunohistochemical features, with subtle differences. The present findings indicate that although HCCC is salivary gland in origin in the case described here, and CCOC is thought to originate from the dental lamina, and hence odontogenic in origin, both had similar growth patterns and immunohistochemical profiles, which made it impossible to distinguish these two lesions morphologically and immunohistochemically, despite a different cell of origin. These cases are presented here to share our thoughts and difficulties encountered at the time of diagnosis.

Trismus is defined as a limitation in the mouth- or jaw-opening ability due to reduced mandibular mobility. Limited mouth opening can be caused by several disorders affecting the masticatory system. Most of them involve the temporomandibular joint (TMJ) and the masticatory muscles. Ankylosis of the TMJ is a common cause for the occurrence of trismus. Ankylosis of the TMJ may be extra- or intra-articular. Zygomatico coronoid ankylosis is a rare type of extra-articular ankylosis. In case of limitation of mouth opening, coronoid process locking may be overlooked, because attention is generally focused on the TMJ. The union between the coronoid process and zygomatic arch may be due to bony ankylosis or fibrous ankylosis. It may follow facial fractures caused by gunshots, treated and untreated fractures of the zygomatic complex, with or without a concomitant fracture of the coronoid process, mandibular fractures, extension of the intracapsular ankylosis or due to the enlargement of the coronoid process. A review of literature has disclosed 15 reported cases of this disorder. The true incidence of this condition may be even higher. Zygomatico coronoid ankylosis may have been encountered by many clinicians, and yet may have been misdiagnosed or overlooked. The present article reports a rare entity of a post-traumatic case of trismus, for a duration of 18 years, diagnosed as right zygomatico coronoid ankylosis.

Juvenile ossifying fibromas (JOF) are benign central lesions occurring in children. Two variants of this entity have been recognized - trabecular and psammomatoid. These lesions are usually asymptomatic and present only as a growing swelling. We hereby report a case of a trabecular variant of a juvenile ossifying fibroma in a five-year-old boy.

Leiomyoma is a benign smooth muscle tumor that may appear in any location of the body and is most commonly seen in the uterus and gastrointestinal tract. The occurrence of leiomyoma is rare in the orofacial region due to the scarcity of smooth muscles in this region. Overall incidence in the orofacial region is 0.065%. It is most commonly seen in the age group of 40-50 years without much gender difference. Clinically, it appears as a well-defined asymptomatic swelling. Histologically, angioleiomyoma is the most common type of leiomyoma in the orofacial region. Management is done by surgical excision with safe margins. Recurrence of the tumor is rare. We hereby present a case of leiomyoma at a rare site, its treatment, and a review of literature.

Keratocystic odontogenic tumor (KCOT) is a benign intraosseous neoplasm of the jaw with a high rate of recurrence. The lesion commonly occurs in the mandibular molar-ramus area and is rarely seen in the maxilla. Its occurrence in the maxillary sinus along with a displaced third molar is very rare. This article reports a case of KCOT in a 15-year-old boy with a displaced third molar involving the right maxillary antrum.

The nasopalatine duct cyst (NPDC) is the most common of all the developmental, epithelial, and non-odontogenic cysts of the maxilla, believed to originate from the epithelial remnants of the nasopalatine duct. Typically, the lesion is asymptomatic and is detected accidentally on a radiograph. The definite diagnosis must be based on the clinical, radiological, and histopathological findings. Frequently misdiagnosed, the NPDC is not rare. The motive of reporting an entity that is not very rare is that the lesion is mostly misdiagnosed, and to emphasize the importance of cone-beam computed tomography (CBCT) in the diagnosis and optimized treatment planning of NPDCs.

Solitary bone cysts (SBCs) exist generally as asymptomatic solitary lesions and have no epithelial lining. They are uncommon in the jaws and are often polymorphic, show scalloped borders when located between the roots. They have higher predilection for the posterior mandible, mostly occurring near the mental foramen. Various pathomechanisms were proposed, but the triggering factor still remains to be ascertained. Currently, osteolytic pathogenesis is speculated, which may be due to vascular alteration leading to aseptic osseous necrosis. Fibro-osseous lesions are occasionally associated with SBCs, but concomitant presence with tooth agenesis has not been reported. We present a unique case of SBC with familial tooth agenesis in a 16-year-old female patient with a brief review.

Acute leukemias are the most common malignancy in childhood. They represent approximately 30% of malignant diseases in patients under the age of 15 years. Acute lymphoblastic leukemia (ALL) is the most frequent type of leukemia in children. Despite high cure rates, approximately 20% of patients with ALL have disease relapse. Oral manifestations are common in leukemia, particularly in acute leukemias. One of the oral manifestations of leukemia is diffuse gingival enlargement thought to be, at least partly, the result of gross infiltration of the gingiva by blast cells. The occurrence of acute necrotizing gingivitis, although a rare occurrence, is seen in such immunocompromised individuals. This is a case report of a 19-year-old patient who was under remission after treatment for ALL in whom a recurrence of leukemia was detected based on the oral findings and highlights the importance of its early detection by the dentist in preventing further complications and for instituting therapy swiftly.

Lateral periodontal cysts are an uncommon type of developmental odontogenic cysts that typically occur along the lateral aspect of teeth, usually involving mandibular lateral incisors and canines. They are known to commonly originate from the cell rests of Serre and represent the intrabony counterpart of gingival cysts of adults. In majority of cases with no apparent signs and symptoms, they are revealed on routine radiographic examinations; however, definitive diagnosis is made only by histopathological examination. The purpose of this article is to report an unusual case of lateral periodontal cyst located in the anterior region of mandible and to discuss the clinical, radiological, and histopathological features of the cyst.

Necrotizing sialometaplasia is a benign, self-limiting, reactive inflammatory disorder of the salivary tissue, which mimics malignancy both clinically and histopathologically. The etiology is unknown, although it most likely represents a local ischemic event, infectious process or perhaps an immune response to an unknown allergen. A case of necrotizing sialometaplasia of the palate in a 40-year-old male patient is presented. Histopathological examination is necessary for the diagnosis of necrotizing sialometaplasia because the clinical features of this condition can mimic other diseases, particularly malignant neoplasms.

Adenoid cystic carcinoma (ACC) is a slow-growing tumor of the salivary gland with high malignant potential, most commonly involving the minor salivary glands of the head and neck region. It is known for its long clinical course, indolent growth, local recurrence, and late distant metastasis. We report an unusual case of ACC in an adult male patient which remained undiagnosed for more than 15 years.