Introduction: The airway is assumed to play a role in dentofacial development. So, several studies tried to correlate patients with normal nasorespiratory functions with different malocclusions and airway dimensions. A narrow upper airway is associated with obstructive sleep apnea (OSA). Currently neck size and obesity are considered to be the most important physical characteristics of patients with sleep apnea. Aim: To study the interaction between craniofacial structures and pharyngeal airway space along with soft palate and tongue in patients with different anteroposterior skeletal patterns using lateral cephalogram. The correlation of upper airway and soft-tissue measurements with neck circumference (NC) and body mass index (BMI) was elucidated to evaluate the predictors on lateral cephalogram, in order to determine the etiology of OSA. Materials and Methods: Lateral cephalograms of 45 subjects were used to measure the pharyngeal airway and were divided into three groups (each group included 15 subjects) according to ANB angle: Class I (ANB angle 2°-4°), Class II (ANB angle >4°), and Class III (ANB angle <2°). Velar morphology along with its length was also analyzed and categorized into different types. The NC and BMI of all the patients were also calculated. Student's t-test for paired samples was used to compare the mean values of the study variable vital parameters. Results: Significant reduction was found in pharyngeal airway in ANB group II. The soft palate and tongue size increased with increasing BMI and NC. Conclusion: Sagittal skeleton pattern had a close association with the dimensions of pharyngeal airway passage. The correlation of NC with increase in soft-tissue size (soft palate and tongue) suggested that obesity mediates its effects in OSA through fat deposition in the neck.

Introduction and Aims: Array of palatal rugae in the realm of forensic odontology has been constantly explored owing to their individual uniqueness and resistance to postmortem procedures, while their scope in sex determination and racial profiling remains understated. In this context, the present study aimed to record the diversity of palatal rugae patterns in a South Indian population. Materials and Methods: A descriptive cross-sectional study was conducted among people who reported to the outpatient department of a dental institution. Sample comprised a total of 200 subjects divided into two groups of 100 each, based upon gender. Impressions of anterior maxilla were made of all the study subjects and casts obtained subsequently. Outline of palatal rugae pattern was traced on these models and the data computed. Z test and unpaired t-test were used for statistical analysis and the probability value calculated. In addition, logistic regression analysis was performed to estimate the accuracy of sex allocation. Results: The shape of rugae exhibited highly significant sex difference in the curved type, which was found to be higher in males, and in the wavy type which was higher in females, enabling sex differentiation using palatal rugae patterns. Logistic regression analysis predicted high power of sex allocation for males rather than females in the study population. Conclusion: This study highlighted the uniqueness and greater sex discrimination potential of curved shape of palatal rugae in categorizing males of South Indian population, substantiating their use in the identification of deceased, by relating the antemortem and postmortem dental records.

Aims and Objectives: Gingival fibrous nodule is considered a normal variant of oral mucosa. So far no studies have been done to determine the prevalence and other characteristics of this entity. Hence, this study was taken up to study the prevalence of gingival fibrous nodule is south Indians. Materials and Methods: This clinical study consisted of 4642 adult subjects who were examined for the presence of gingival fibrous nodules. The age range of the subjects was 10-89 years. The study consisted of 2818 males and 1824 females. Results: One hundred and forty-five gingival fibrous nodules were identified in 128 individuals with a prevalence of 2.75%. They were predominant in males, in the mandibular anterior region. Multiple gingival fibrous nodules were more common than solitary form. Conclusion: This study demonstrates the prevalence of gingival fibrous nodules in south Indians.

Aim: This study was undertaken to evaluate the effectiveness of transcutaneous electric nerve stimulation (TENS) as a means of stimulating salivary function in healthy adult subjects. Materials and Methods: Fifty healthy adult subjects with no history of salivary gland disorder were enrolled in the protocol. The TENS electrode pads were placed externally on the skin overlying the parotid glands. Unstimulated saliva was collected for 5 min into graduated tubes. TENS unit was then activated and the stimulated saliva collected for an additional 5 min. Statistical Analysis Used: A paired "t" test was applied to look for statistically significant differences as a group between the amount of unstimulated and TENS-stimulated samples of saliva. Results: Forty-three out of 50 subjects demonstrated increased salivary flow when stimulated via the TENS unit. The mean unstimulated salivary flow rate was 0.354 ml/min (SD 0.19) and the mean stimulated salivary flow rate was 0.49 ml/min (SD 0.24). Statistical analysis of flow rates utilizing the paired t test demonstrated the difference to be statistically significant (P < 0.001). Conclusion: The TENS unit was effective in increasing the salivary flow in two-thirds of healthy adult subjects. A further study in a cohort of patients with salivary gland disorders is warranted.

Aims and Objectives: To evaluate in vivo the efficacy of ultrasound, digital and conventional radiography in identifying periapical lesions. To compare the results of the above imaging modalities with histopathology, which is considered to be the gold standard for diagnosis. Materials and Methods: Thirty patients aged between 15 and 45 years with periapical lesions associated with maxillary or mandibular anterior teeth indicated for endodontic surgery or extraction were selected for the study. Pre-operatively, conventional, digital periapical radiography and ultrasonography were done and interpreted. Endodontic surgery or extraction was performed including curettage of apical tissue to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: In conventional and digital radiography, the periapical lesions were readily identified but observers were unable to differentiate granuloma from cyst using these modalities only. But ultrasonography was able to give the true nature of the periapical pathology. All the cases diagnosed by ultrasound were confirmed with histopathology, and maximal number of cases diagnosed by ultrasound correlated with the histopathological diagnosis. Conclusion: The present study confirms that ultrasound is a promising and reliable imaging technique for differentiating periapical lesions i.e., periapical cysts and granulomas. Based on the echo texture of their contents and the presence of vascularity using color Doppler, periapical cyst and granulomas can be readily identified. The present study is further applicable for the evaluation of periapical lesions of the posterior teeth and evaluation of other jaw lesions.

Introduction: X-rays are potent mutagenic agents capable of inducing both gene mutations and chromosomal aberrations. They act directly on the DNA molecule or indirectly through the formation of reactive compounds that interact with this molecule. In spite of their mutagenic potential, this kind of radiation is an important tool for diagnosis. Aim: The aim of this study is to analyze the genotoxic effects on oral mucosa during conventional and digital panoramic radiography. Objectives: 1. To assess the nuclear abnormalities, mainly micronuclei in exfoliated buccal mucosal cells, before X-ray exposure and 10 days after exposure using conventional and digital panoramic radiography. 2. Comparison of micronuclei count obtained during conventional and digital panoramic radiography. Materials and Methods: One hundred healthy individuals were chosen who were free of all deleterious habits. Epithelial buccal cells were obtained with an exfoliative cytobrush immediately before exposure and 10 days after exposure. The smears were stained using Giemsa stain and analyzed under low-power and high-power microscope. Results: There was a significant difference in the mean values obtained pre- and post-exposure to conventional panoramic radiography, as the mean value of micronuclei before exposure was 0.025 ± 0.01 which increased to 0.064 ± 0.02 post-exposure. Similarly, there was a significant difference in the mean values obtained pre- and post-exposure to digital panoramic radiography, as the mean value of micronuclei before exposure was 0.022 ± 0.01 which increased to 0.041 ± 0.01 post-exposure. In the present study, there was a highly significant increase in the number of micronuclei post-exposure in conventional panoramic radiography when compared to digital panoramic radiography. Conclusion: This results show that panoramic radiography does induce genotoxic effects in buccal epithelial cells and should be used only when indicated, and that digital panoramic radiography is safer as compared to conventional radiography.

Introduction: Enzyme lactate dehydrogenase (LDH) is found in cells of almost all body tissues. Lactate dehydrogenase activity in serum increases as a marker of cellular necrosis. Serum LDH levels have been used as an adjunct biochemical marker in diagnosis in various pre-cancer and cancers. Aims and Objectives: To evaluate role of LDH as a biochemical parameter in the diagnosis of oral squamous cell carcinoma (OSCC), oral leukoplakia (OL) and oral submucous fibrosis (OSMF), to assess the levels of serum LDH in OSCC, OL and OSMF and to compare the same with normal individuals. Materials and Methods: A total of 120 patients were recruited for the study including 30 patients of OSCC, 30 patients of OL, 30 patients of OSMF and 30 normal controls. All were divided into age groups (20-60 years) irrespective of sex. From five milliliters of blood drawn under aseptic conditions, the serum was separated. The sample was subjected to biochemical analysis for quantitative estimation of serum LDH by a semi auto-analyzer. Results: It was observed that serum LDH activity was significantly (P < 0.05) increased in patients with OSCC, OL and OSMF. Conclusion: Serum LDH estimation can prove to be a valuable tool as a biochemical marker as it is a simple, non-invasive procedure and is easily accepted by the patient.

Objectives: The purpose of this study was to assess the relationship between mandibular angle fracture and the status of eruption of the mandibular third molars. Materials and Methods: The sample consisted of 50 mandibular angle fracture cases with or without the presence of mandibular third molars, inclusive of both genders in the age group 18 years and above. The mandibular angle fractures were assessed by taking an orthopantomograph for each case following strict radiation protection protocol after an informed consent was obtained. The captured image was assessed and traced for the presence of mandibular angle fracture, angulation, and status of mandibular third molar by using Windows Trophy DICOM and Master View 3.0 software. Pell and Gregory's and Winter's classifications were followed. Results: We observed the following: Increased incidence of angle fractures in the presence of mandibular third molar, male predominance, the mean average age being 29 years, and the most common cause of angle fractures was road traffic accident; the fractures were observed more on the left side. In the total sample, mandibular third molar was present in 90% of the cases with angle fracture; of this, 73% of the teeth were impacted. Increased incidence of mandibular angle fracture was observed in position A, class II, and mesioangular impaction of third molar, which were statistically significant. Conclusion: The presence of mandibular third molar was in strong association with mandibular angle fracture and there was an increased incidence of position A, class II, and mesioangular impaction, when compared with other positions. This study concludes that there is a direct relationship between the presence and status of impacted third molars with increased risk of mandibular angle fracture.

Aim: Diabetes mellitus is associated with accelerated carotid artery atherosclerosis and increased risk of stroke. This study was conducted with the objective of determining the prevalence of calcified atherosclerotic plaques on panoramic radiographs of patients with Type II diabetes mellitus. Materials and Methods: Panoramic radiographs of 100 patients (age range 50-84 years) with known history of type II diabetes mellitus, visiting the outpatient department were evaluated for the presence of calcified atherosclerotic plaques. Age- and sex-matched controls were evaluated in the same manner. Statistical comparison of prevalence rates was done. Results: The radiographs of diabetics (mean age: 64.45 years) revealed that 26% had atheromatous plaques, whereas those of controls (mean age: 65.36 years) revealed that 6% had atheromatous plaques. A statistically significant difference (P = 0.01410) was obtained using Yates' Chi-square test. Conclusion: People with diabetes mellitus had a greater prevalence of calcified atherosclerotic plaques on panoramic radiographs than non-diabetics. Panoramic radiographs of diabetic patients should be screened for the presence of carotid artery atheromatous plaques for timely medical referral of asymptomatic patients and avoiding any further serious consequences like cerebrovascular accidents.

Objective: To evaluate the presence of incidental findings on cone beam computed tomography (CBCT) images and to recognize their clinical importance. Materials and Methods: A total of 700 CBCT scans between January 2013 to August 2014 at Government Dental College and Hospital were evaluated retrospectively. Results: 459 incidental findings (65.57%) were observed in 700 patients. Most common individual incidental finding was mucosal thickening (119) followed by pineal/habenula calcification (99) and choroid plexus (77). Conclusion: The oral and maxillofacial radiologist should carefully interpret all scans and should not ignore the incidental findings and hence avoid untoward snowballing effects.

Aim: The aim of this study was to evaluate the incidence of temporomandibular joint (TMJ) pain in osteoarthritis patients. Objectives: The three objectives of this study were as follows: 1. finding the occurrence of TMJ pain in osteoarthritic patients; 2. to evaluate the signs of TMJ disorders in osteoarthritic patients; and 3. to assess the involvement of TMJ in osteoarthritic patients. Materials and Methods: Twenty osteoarthritis patients who were under treatment for a minimum of 1 year were included in this study. All of them answered a questionnaire before undergoing examination. The questions pertained to the symptoms of the TMJ pain. Clinical examination of TMJ was done, which included evidence of sound, restricted mouth opening, and deviation. Results: Results indicated that about 40% of osteoarthritis patients had TMJ pain. Conclusion: This study shows the high incidence of TMJ pain in patients with osteoarthritis.

Aims and Objectives: To assess and create awareness of oral medicine specialty among medical practitioners, and to assess the volume of oral medicine clinical cases that they come across in their routine practice and to whom they refer them to. Materials and Methods: Printed and validated questionnaires were given to a sample of 100 medical practitioners of different specialties personally in and around Tirupati and the results were analyzed. Results: Sixty-nine percent of medical practitioners were not aware of oral medicine specialty and only 31% were aware of it. Frequent incidence of oral manifestation of systemic diseases, occasional incidence of facial and TMJ pain, oral mucosal lesions, and rare incidence of salivary gland disorders were noted in their routine practice. Oral manifestation of systemic diseases and oral mucosal lesions were frequently being referred to a general dentist and not to any specific specialty. TMJ and facial pain were referred to an ENT specialist and salivary gland problems to a general surgeon commonly. Conclusion: It is time to reiterate and spread the awareness among the medical professionals about oral medicine speciality in diagnosis and management of many oral ailments. Proper diagnosis and medical management should be the preferred line of therapy for any ailment.

Aims and Objectives: To determine the frequency and common site of fungal infection in biopsies of oral mucosal lesions and also to detect the lesions most likely to be infected with fungal infection. Materials and Methods: A total of 100 patients with oral mucosal lesions were advised routine hematological examination followed by incisional biopsy under local anesthesia. The specimen were fixed in 10% neutral buffered formalin and processed. One section from the specimen was stained with hematoxylin and eosin staining for histopathological diagnosis of the lesion and a second section was stained with Periodic acid-Schiff (PAS) stain for detection of fungal infection. Results: Out of the 100 patients, the most common mucosal lesion encountered was carcinoma (56%) followed by lesions with dysplastic changes (28%), benign lesions (9%), squamous papilloma (2%) and oral submucous fibrosis (5%). The most common anatomic location affected by the mucosal lesions were buccal mucosa, followed by the tongue, gingiva, maxillary tuberosity and floor of the mouth with values of 73%, 16%, 6%, 4% and 1%, respectively. Squamous papilloma had the highest positive association with fungal infection (100%) followed by lesions with dysplastic changes (17.9%) and carcinoma (8.9%). The maximum fungal positive association was encountered in the mucosal lesions over the tongue (18.7%) followed by the buccal mucosa (12.3%). Conclusion: There is statistically significant association of fungal infection with dysplastic lesions and papilloma with the tongue and buccal mucosa as the most common sites. Hence a PAS stain should be performed whenever epithelial dysplasia on the tongue and buccal mucosa is diagnosed.

Introduction: Pulp polyp (PP) is a chronic hyperplastic condition resulting in formation of granulation tissue and proliferative mass. The radiographic appearance of PP has innumerable presentations. Diagnosing and treatment planning of periapical lesions, heavily relies on the radiographic changes surrounding the root structures. Objective: To evaluate different radiographic periapical changes in clinically detected PP patients. Materials and Methods: Patients reporting to Department of Oral Medicine and Radiology and who were clinically diagnosed with PP by an oral diagnostician were subjected to radiographic examination. Digital intraoral periapical radiographs of 50 patients with PP were taken. Various periapical changes in the digital radiographs were recorded by a skilled oral radiologist. The data obtained was subjected to statistical analysis using SPSS ver 17.0 and P-value was set at <0.05 as significant. Result: Periapical changes like periodontal space widening (PDLW), loss of lamina dura, periapical abscess, periapical granuloma, hypercementosis, condensing osteitis and root resorption were noted. Periodontal space widening was seen in all patients (100%), loss of lamina dura was noted in 72%, periapical rarefying osteitis in 56%, condensing osteitis in 8%, hypercementosis, periapical granuloma, and root resorption were seen in 4% of PP patients. Majority of PP were asymptomatic (66%). Pulp polyp was commonly seen in mandibular first molar followed by mandibular second molar and maxillary first molar. Statistically significant difference was noticed between periapical changes in PP patients (P value <0.0001). All PP patients showed definite periapical changes suggesting it to be a periapical lesion. Conclusion: Pulp polyp is confined to the pulpal portion of the tooth which, may or may not cause changes in periapical region. The results of the present study showed that majority of the PP patients were associated with definite periapical changes. This observation suggests that clinically detected PP are radiographically associated with definite periapical changes suggesting it to be a periapical lesion.

CyberKnife stereotactic radiosurgery system is an innovative, effective, frameless, non-invasive substitute for conventional surgical treatment of cancer. It works on the principle of stereotaxy. It is used for the treatment of both cancerous and non-cancerous tumors, intracranial lesions, tumors of lung, spine, prostate, and kidney, recurrent cases of oral squamous cell carcinoma, arteriovenous malformation, and trigeminal neuralgia. It has an advantage over other systems like Gamma knife radiosurgery and linear accelerator (LINAC)-based systems, as it is frameless, has submillimeter accuracy, does not affect the normal cells adjacent to the lesion, and tracks the lesion in synchronization with the patient's respiratory rate. The future of CyberKnife encompasses possibilities such as incremental improvements in accuracy and better shaping of the field of radiation and would certainly allow extension of radiosurgery as an effective substitute for chemotherapy. This paper aims to review and highlight the immense potential that CyberKnife holds in the field of dentistry in treating disorders of the head and neck region, thereby ensuring enhanced longevity for the patients.

The study of variations of DNA and RNA characteristics as related to drug response is known as pharmacogenomics. The application of pharmacogenomics to the clinical management of an individual is referred to as "personalized medicine." Personalized medicine aims to individualize care based on a person's unique genetic profile by using advanced molecular tools like DNA profiling, gene mapping, receptor gene amplification test, fluorescence in situ hybridization (FISH), microarray test, Hercep Test, AmpliChip CYP450 Test, etc. This is relatively a new field that combines genomics (the study of genes and their functions) and pharmacology (the science of drugs) to develop effective, safe medications and doses that will be tailored to a person's genetic makeup. Now personalized medicine has a wide range of applications such as management of cancer, cardiovascular disorders, depression, bipolar disorders, attention deficit disorders, HIV, tuberculosis, asthma, diabetes, and also in the management of pain. This is the first article focusing on its mechanism, overview of the developments, benefits, challenges, and its applications, particularly in dentistry.

Temporomandibular joint (TMJ) disorders are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. According to the Research Diagnostic Criteria (RDC/TMD), temporomandibular disorders (TMDs) may be classified into three different groups: a) myofacial pain dysfunction syndrome (MPDS), b) internal derangement, and c) arthritis. Complicated anatomy of the TMJ was the reason for developing standardized radiographic techniques to diagnose TMDs. The introduction of computed tomography (CT) in the diagnosis of TMJ disorders enabled much better delineation of anatomical structures of the joint due to lack of tissue superposition. Cone beam CT (CBCT) is the latest imaging modality for craniofacial deformities, with a lesser radiation exposure and cheaper cost when compared to CT. A systematic literature search was done to identify articles describing degenerative osseous changes of the TMJ using CBCT and conventional CT. Electronic search of scientific papers was carried out in PubMed (MeSH), ScienceDirect, and Cochrane databases using specific keywords. In this systematic review, all the selected articles demonstrate the role of CBCT and CT in diagnosing the degenerative osseous changes of the TMJ. The studies included in the review suggested that CT has been the method of choice to assess the TMJ dynamics and contours of the cortical bone.

Xerostomia is a subjective sensation of dry mouth with objective evidence of decreased salivary flow. It is a multifactorial condition which increases the risk of oral diseases and has a significant effect on the person's quality of life. So, these patients need special care for maintenance of oral and general health. We, being oral health care professionals, it is our responsibility to diagnose and treat the condition accordingly using a multidisciplinary approach. This paper enlightens the etiology and management of xerostomia.

Every healthcare professional should be aware of Wilhelm Conrad Röntgen's discovery of X-rays over 100 years ago, which had an interesting, eventful, and dramatic history. The physicist from Germany won the first Nobel Prize in physics in 1901 for this discovery. Röntgen was one of the outstanding physicists of the nineteenth century, even without considering his best-known discovery, which opened up new vistas in research. In addition to the discovery of X-rays, Röntgen is credited with three standard components that are currently used in X-ray analysis: The fluorescent screen, the photographic plate, and a prototype of the ionization chamber method. This paper is a wordy tribute to a great scientist and presents a simplified picture of Röntgen's great discovery of X-rays.

The Smith-McCort syndrome (SMC), which was first described by Smith and McCort in 1958, is a rare form of osteochondrodysplasia, specifically a spondyloepimetaphyseal dysplasia. It is one of the rare syndromes that can present with skeletal dysplasia and mimic some of the common bone diseases. Enamel hypoplasia is a part of this disorder. Literature that describes the orofacial characteristics of this syndrome is lacking. Here we report a case of a 23-year-old female, who presented with characteristic orofacial features, along with skeletal abnormalities.

Herpes zoster (HZ) infection of the maxillary and mandibular divisions of the trigeminal nerve manifests orally as unilateral vesicular eruption localized to the skin and mucus membrane of the dermatome innervated by the trigeminal nerve. Herpes zoster infection has been observed in immunocompromised states like uncontrolled diabetes, cancer chemotherapy, lymphoproliferative diseases, and recently in HIV-positive patients. There are only a few case reports of osteonecrosis due to HZ in an HIV-positive patient in an Indian population, this being the first in a North Indian population. We propose that osteonecrosis should be considered as a strong indicator of HIV infection, especially in a developing country like India. The present case highlights the complexities which can arise in an HIV-inflicted individual suffering from HZ infection. Early diagnosis of such infections can lead to effective treatment and prevention of complications.

Oral submucous fibrosis (OSMF) is a chronic, insidious, generalized, and debilitating condition of the oral mucosa predominantly encountered in South-East Asian countries. Oral submucous fibrosis is etiologically linked to the consumption of the areca nut in flavored formulations or as an ingredient in the betel quid chewed by the communities in these countries. The sweet supari, in their multicolored attractive pouches, is the most common chewed product in children. It is considered a harmless mouth freshener and therefore is consumed in larger amount and is kept in the mouth for a longer time and swallowed by the ignorant children. Factors involved in the consumption of sweet supari are levels of awareness, household environment, peer pressure, low cost, easy availability, etc. Here, we report three cases of OSMF in a 9-year-old girl, 13-year-old boy and a 15-year-old girl and literature review.

Benign migratory glossitis, also known as geographic tongue, is a recurrent condition of unknown etiology characterized by loss of epithelium, particularly of the filiform papillae on the dorsum of the tongue. Clinically, it appears as multifocal, circinate, irregular erythematous patches bounded by slightly elevated, white-colored keratotic bands. The condition is very common in adults and older age groups. The present article describes a rare presentation of geographic tongue in a 2.5-year-old child.

Among the eruption disorders, the most common developmental dental anomalies encountered are the retention or impaction of teeth. Impaction of multiple teeth is a common finding associated with some syndromes or systemic disorders. This is a report of a female aged 18 years with normal serum calcium and unusual oral manifestations where in the diagnosis of underlying hyperparathyroidism and thalassemia trait came to light.

Fractures and displacement of fragments involving the genial tubercles due to trauma are rarely seen in patients with a full complement of teeth although spontaneous fractures of the genial tubercles in edentulous atrophic mandible are not uncommon. These are usually displaced and may be missed during routine clinical and radiographic examinations owing to superimposition of the features of a fractured mandible. Very few cases have been reported till date. Their implications lie in functional alterations that occur as a consequence of loss of attachment of the geniohyoid and genioglossus muscles. There is no universal opinion on the treatment of fractures involving the genial tubercles. Possible treatments include no surgical intervention, excision of the avulsed bone fragments, and muscular repositioning. We present a case of mandibular fracture associated with the fracture and displacement of a fragment involving the genial tubercles in a dentate patient where in the finding was incidental and a review of literature.

Ameloblastoma is a well-known odontogenic tumor that can be associated with calcifying odontogenic cysts (COCs), but only a few reports give its clinical and radiographic features. Calcifying odontogenic cyst was first categorized as a distinct entity by Gorlin et al., and has been named after him since then. Calcifying odontogenic cyst is an uncommon developmental odontogenic lesion that demonstrates histopathologic diversity. It is well known that this lesion can occur in association with odontogenic tumors such as complex odontoma and ameloblastoma. The term COC was not included by the World Health Organization (WHO) in its report of 2005 and is called calcifying cystic odontogenic tumor (CCOT). Histopathologic examination of ameloblastomatous CCOT reveals ameloblastic islands containing ghost cells. Although association of ameloblastoma with this lesion is important, only a few cases have been reported in literature. The present case report is of ameloblastomatous calcifying cystic odontogenic tumor, a rare histologic variant, in a 20-year-old male patient in the left mandibular posterior region.

Dens Invaginatus (DI) is a rare developmental malformation of teeth, resulting from an infolding of dental papilla. The increased risk of pulpal pathologies associated with DI makes it clinical relevant. Only few cases have been reported where double DI was found associated with supernumerary teeth. Diagnosis of DI with the conventional radiographs is not easy, so advanced imaging modalities are must. This paper highlights a rare case of bilateral double DI in multituberculated maxillary central incisors with impacted supernumerary teeth with its clinical and imaging features.

Ossifying fibroma (OF) is a benign, non-odontogenic tumor of the jaw, a type of fibro-osseous lesion. Traditionally, this type of lesion was subclassified histologically into ossifying fibroma and cementifying fibroma according to the hard tissues formed, but both types are now known by the unified term, ossifying fibroma. It is generally accepted that the histological subclassification of these two lesions is of academic interest only since differential diagnosis is often arbitrary and their biological behaviour seems to be identical. The present article discusses the case of central ossifying fibroma in a 35-year-old female patient who presented with a swelling in premolar-molar region of left mandible which was symptom-free and present since last 6 months. The diagnosis was confirmed by histopathology.

Neurofibroma is a benign neoplasm of non-odontogenic origin arising from peripheral nerves. It may occur as a solitary lesion or as a part of the generalized syndrome of neurofibromatosis or von Recklinghausen's disease of the skin. It occurs rarely in the head and neck region; intraorally, it affects the tongue, buccal mucosa, and vestibular area, with the posterior mandible being the most common intraosseous location. Clinically, oral neurofibromas usually appear as pedunculated or sessile nodules with slow growth and are usually asymptomatic. The diagnosis can be confirmed by histological examination. Treatment is surgical with excellent prognosis. For illustration, a rare case of a solitary neurofibroma in the mandible is presented.

Peripheral odontogenic fibroma (POF) is a rare odontogenic tumor. It commonly mimics other peripheral exophytic lesions like pyogenic granuloma, peripheral ossifying fibroma, and peripheral giant cell granuloma. It needs to be differentiated from other lesions by its different clinical behavior.

Oral myiasis is a rare parasitic infestation of the house fly in the oral cavity. It is found in cases of extreme neglect of oral hygiene. Here is a case report of a 24-year-old female patient with history of cerebral palsy since childhood, affected with oral myiasis simultaneously affecting the maxilla as well as mandible. This case reports gives an overview of the clinical features of this distressing disease and also throws light on its treatment with a combination of conventional therapy and new drug Ivermectin.

Mucormycosis is an acute opportunistic infection caused by saprophytic fungus of class Phycomycetes order Mucorales and family Mucoracae, found in soil, bread molds, and decaying fruits and vegetables. Even though this fungus is ubiquitous in the nature, the disease is usually prevented by immune system and is therefore rare. Rhizopus, Rhizomucor, Absidia and Cunninghamella are the most common species associated with Mucormycosis. Diabetes, chronic kidney disease, desferroxamine use in dialysis, leukemia, lymphoma, immunocompromised state, burns and open wounds are the risk factors of mucormycosis. Out of six clinical entities of mucormycosis, rhinocerebral mucormycosis is the most common variety which includes three subtypes rhinomaxillary, rhino-orbital and rhino-orbitocerebral mucormycosis. Here are two case reports of Rhinocerebral mucormycosis of different subtypes emphasizing the role of early detection of the disease to limit the spread of infection and reducing the morbidity and mortality.

Lesions of non-endodontic origin may mimic periapical pathosis. Errors in one or more of the clinical reasoning steps of diagnosis of such lesions may ultimately lead to misdiagnosis and ensuing complications. Central giant cell granuloma (CGCG) is one such lesion of non-endodontic origin which can present as periapical pathosis. Here, we present a case of CGCG in a 33-year-old female patient who visited our department with a complaint of growth from the extraction sockets of upper front teeth, which were extracted 1 month back after a misdiagnosis as periapical pathosis. Suspecting a non-endodontic lesion, radiographic examination and incisional biopsy were performed and a final diagnosis of CGCG was made. Biweekly intra-lesional steroids were given for 6 weeks and patient was followed up for 6 months.

Central giant cell granuloma (CGCG) is a non-neoplastic lesion which exhibits a spectrum of clinical behavior ranging from non-aggressive to aggressive variants. The etiopathogenesis of CGCG is still not properly known. In the maxillofacial region, CGCG most commonly occurs in the jaw bones as an asymptomatic swelling. Radiographically, it presents as either unilocular or multilocular radiolucent lesions in the maxilla or mandible. Treatment of CGCG varies from local curettage to wide surgical excision depending upon the extent and progression of the lesion. This paper presents two cases of CGCG having different clinical presentation which resembled varied conditions leading to misdiagnosis (in one case), but was found to be CGCG on histopathologic examination.

Hypercementosis is a non-neoplastic condition in which excessive cementum is deposited in continuation with the normal radicular cementum. Although some cases of hypercementosis are idiopathic, this condition is associated with several local and systemic factors such as supra-eruption of a tooth, inflammation at the apex of a tooth, traumatic occlusion, Paget's disease, etc. Hypercementosis may be isolated, involve multiple teeth, or appear as a generalized process. Posterior teeth are more commonly involved. The radiographic appearance of hypercementosis is an altered shape of the root with maintenance of normal relationship of the shadows of the periodontal membrane and lamina dura. The histologic study of teeth with hypercementosis shows that the cementum formed is usually osteocementum (acellular cementum). The differential diagnosis may include any radiopaque structure that is seen in the vicinity of the root, such as a dense bone island or mature cemento-osseous dysplasia. Patients with hypercementosis require no treatment. Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth. Herein, an interesting case of a mammoth, dumbbell shaped hypercementosis associated with maxillary third molar is reported.