Aims and Objectives: To evaluate and compare the efficacy of diclofenac and meloxicam as mucoadhesive patches in dental pain management. Materials and Method: This study was conducted among 45 adult patients of either sex, who were diagnosed with dental pain and were attending the outpatient department. Written informed consent was obtained from all the patients. A 1 × 1 cm² mucoadhesive patch of any one (diclofenac, meloxicam or placebo) was applied on the attached gingival region of the tooth with pain. Pain was recorded using a ten point visual analog scale (VAS) score at every 5 min for 30 min. Pain was measured and compared before and after the application of the patch. Results: The results showed that patients with diclofenac patch gained mean pain reduction from 6 ± 1.54 mm to 2.60 ± 1.32 mm after 30 min (P < 0.01), and with meloxicam patch gained mean pain reduction from 6.06 ± 2.72 mm to 2.33 ± 1.23 mm after 30 min (P < 0.01), compared to patients with placebo 6.03 ± 2.09 mm to 5 ± 2.10 mm (P > 0.05). The maximum pain reduction was seen with meloxicam patch. Conclusion: Transmucosal mucoadhesive analgesic patches are a better alternative to oral analgesics to control dental pain. Hence, routine use of mucoadhesive analgesic patch for dental pain reduction is recommended in day to day practice.

Introduction: Although oral squamous cell carcinoma mainly occurs in oral soft tissues, involvement of jaw bones occurs in 12–56% of the cases. In these cases, radiographic examination becomes important to observe the pattern of bone involvement. Objectives: To analyze the radiographic features of oral malignancy involving jaw bone and to compare it with the available literature. Materials and Methods: The clinical and radiographic records of 20 cases of oral malignancy showing bone involvement in panoramic radiographs were analyzed from the archives of the department in the present hospital-based retrospective study. Descriptive statistics were used to compare the findings. Results: We observed that the age of the patients presenting with oral malignancy with jaw bone involvement ranged from 35 to 82 years, with a male:female ratio of 1:1. Mandible was involved in 19 cases with preference to the right side (63.2%). In the mandible, the body of the mandible was most commonly involved (89.5%), with ragged margins (80%) and irregular pattern of involvement (75%) being the most common. Pathologic fracture was evident in 6 (30%) cases and floating tooth appearance was present in 10 (50%) cases. Only 3 (15%) cases demonstrated root resorption. Conclusion: Panoramic radiographs are valuable aids in diagnosing the involvement of jaw bones in oral malignancy, and thereby help in devising the treatment plan.

Introduction: Idiopathic osteosclerosis is an area of increased radiodensity observed on panoramic radiographs. The prevalence of this entity is not known, especially in Indians. Aims and Objectives: To determine the prevalence and epidemiological characteristics of idiopathic osteosclerosis. Materials and Methods: Six hundred and forty panoramic radiographs were retrospectively analyzed for the presence of idiopathic osteosclerosis by a single trained oral radiologist. Statistical Analysis: The data obtained were analyzed using Microsoft Excel (Version 2007) for Windows. Results: Idiopathic osteosclerosis was identified in 32 individuals with a prevalence of 5%. There were 21 female (65.7%) and 11 male (34.3%) participants. There were 31 single, unilateral (96.85%) osteosclerotic lesions and 1 (3.15%) bilateral lesion. Right side localization was noted in 19 participants (57.57%) and left side localization in 14 participants (42.42%). Conclusion: This study illustrates the prevalence of idiopathic osteosclerosis in Indians. Further, it depicts the characteristics of idiopathic osteosclerotic lesions.

Aims and Objectives: To determine the effectiveness of transcutaneous electrical nerve stimulation (TENS) in stimulating salivary flow in post-radiated oral cancer patients, and to compare the salivary flow rate between unstimulated saliva and saliva stimulated with TENS in post-radiated oral cancer patients. Materials and Methods: In 30 patients who underwent radiotherapy for oral cancer, unstimulated saliva was collected every minute for 5 min in a graduated test tube. The TENS unit was activated and stimulated saliva was collected for 5 min in a separate graduated test tube, and the flow rate was compared with the unstimulated salivary flow rate. Results: A statistically significant improvement was seen in saliva production during stimulation (P < 0.001). In addition, statistically significant increase in TENS stimulated saliva was observed in patients aged ≥50 years compared to that in patients aged <50 years (P < 0.05). There was no significant difference in salivary flow rate between the two genders in both stimulated and unstimulated conditions, however, statistically significant increase in salivary flow rate was observed in males under stimulated condition (P < 0.01). Conclusion: TENS was highly effective in stimulating the whole salivary flow rate in post-radiated oral cancer patients. It is an effective supportive treatment modality in xerostomia patients caused by radiotherapy in oral cancer patients.

Introduction: Gonial angle is an important angle of the craniofacial complex. Lateral cephalogram and orthopantomogram (OPG) can be used to determine this angle. Objectives: To investigate whether OPGs can be used as an alternative to lateral cephalogram for measuring the gonial angle. Study Design: A total of 100 radiographs were collected from patients with Angle's Class I malocclusion (50 males and 50 females) with age ranging from 15 to 30 years, with a mean age of 18.24 years. Materials and Methods: The radiographs were taken with digital panoramic system (Kodak 8000C) under standard exposure factors, as recommended by the manufacturer. Gonial angle was determined by the tangent of the inferior border of the mandible and the most distal aspect of the ascending ramus and condyle on both panoramic and cephalometric radiographs. Statistical Analysis: Mean values were evaluated using z test. The statistical analysis was performed by using the Statistical Package for the Social Sciences (version 11.5). Results: The mean gonial angle was 121.13° and 122.22° on panoramic and cephalometric radiographs, respectively. There was no statistical significant difference between the measured gonial angles on panoramic and cephalometric radiographs (P > 0.005). Conclusion: Panoramic radiography can be used to determine the gonial angle as accurately as lateral cephalogram. In addition, we can determine the right and left gonial angles of a patient in an OPG without interferences due to superimposed images of anatomical structures in lateral cephalogram.

Background: Oral lichen planus is an inflammatory mucocutaneous disease commonly encountered in the dental clinic. The etiology of oral lichen planus is still unknown. The probable factors associated with oral lichen planus include anxiety, trauma, malnutrition, infection, and autoimmunity. Objectives: The aim of the study was to evaluate the serum levels of fasting and postprandial blood sugar levels, surface antigen of hepatitis B virus (HBsAg), and hepatitis C virus (HCV) autoantibodies in oral lichen planus patients and controls, and to assess the association of oral lichen planus with diabetes, HCV, and HBsAg. Study Design: The study included a total of 25 oral lichen planus patients. Twenty-five individuals who did not have the above clinical conditions were also included in the study and comprised the control group. Both the study and control groups consisted of both sexes in the age group of 20–70 years. Patients were clinically diagnosed as oral lichen planus after obtaining a detailed history and was later confirmed by histopathologic examination. Materials and Methods: Blood samples were collected from both the oral lichen planus patients and controls. Biochemical analysis of blood glucose levels, i.e., fasting and postprandial blood glucose levels, HBsAg, hepatitis C autoantibodies were done by enzyme-linked immunosorbent assay. Results: Blood glucose levels, i.e., fasting and postprandial blood glucose levels, were found to be statistically increased in oral lichen planus patients when compared with controls. There was no significant change in HCV autoantibodies and HBsAg. The results of the present study also showed a significant association of oral lichen planus with diabetes. However, there was no significant association of oral lichen planus with HCV and HBsAg in patients when compared with controls. Conclusion: There was a direct relation of oral lichen planus with diabetes whereas there was no significant association with HCV and HBsAg. However, there was a slight increase in the incidence of HCV in oral lichen planus when compared with controls. Therefore, oral lichen planus patients should be evaluated for the presence of these diseases and vice versa so that it can be diagnosed in early stages and treated accurately.

Introduction: Oral diseases associated with psychological disorders have long been known in medicine. Emotional as well as psychological factors may act as significant risk factors in the initiation and progression of oromucosal diseases. Aims and Objectives: The aim of this study was to determine a correlation between stress and development of certain oral conditions such as lichen planus, myofacial pain dysfunction syndrome, xerostomia, bruxism, aphthous ulcers, and burning mouth syndrome. Materials and Methods: An observational comparative study was conducted among patients reporting to the Department of Oral Medicine and Radiology. A total of 130 patients gave a positive history of oral lesions, out of which 62 were stress related and the other 68 patients served as the control group (oral lesions with no history of stress). All these patients were subjected to routine systemic and oral examination. The results obtained were statistically compared using P value, t-test, and Chi-square test. Results: It was found that lichen planus and burning mouth syndrome were more common in females and myofacial pain dysfunction syndrome was prevalent in males. Xerostomia was found to increase with age. Conclusion: It was concluded that, though the etiology of most oral lesions is not known, the role of stress and other psychogenic factors cannot be ruled out in their occurrence.

Objectives: To assess the knowledge, attitude, and awareness with regards to hepatitis B in dental health care professionals, and to estimate the efforts made by them to prevent the transmission of hepatitis among patients. This study also evaluated the immunization status of hepatitis B among dentists. Materials and Methods: This cross-sectional observational study was conducted among dental professionals in Central India. A Predesigned questionnaire was given to assess the general awareness, attitude, and behavior toward hepatitis B infection and vaccination along with questions to evaluate their own immunization status. Results: A total of 424 dentists responded to the questionnaire. Among them, 24.05% had not received even a single dose of Hepatitis B vaccine while 50.48% had not completed the required course of vaccination. Most common reason cited by dentists for non-immunization was that they had not thought about it (66.03%). Ninety-six percent of the participants were aware of the Hepatitis-B vaccination programme. Conclusion: Despite the availability of an effective vaccine in the market, dentists continue to remain non-vaccinated. It is the lack of awareness and carelessness on the part of dentists coupled with the negligence of the risk that has led them being incompletely vaccinated. There is a need to ensure that every doctor is vaccinated against Hepatitis B before he/she enters professional practice.

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Low bone mineral density (BMD), age, and low body mass index have been found to be major risk factors for osteoporosis. Postmenopausal women with low BMD had thinner mandibular cortex at the mental foramen region and more alveolar bone loss when compared to normal participants, and they are more susceptible to femoral neck fractures. Osteoporotic patients show various oral manifestations; more tooth loss, periodontitis, and decrease in alveolar crestal height. This review will focus on the relationship between osteoporosis and oral conditions such as periodontitis, tooth loss, and oral bone loss.

Protostylids are superstructures on maxillary or mandibular molars, which have rarely been reported in literature, and the significance of their presence has also been underestimated. The dental practitioners may easily misdiagnose a tooth, with such conical tubercles as malformed tooth. Interestingly, this is neither a malformation nor an anomaly but rather an important morphological trait of an individual. Once in a while, one may come across such a distinct morphological trait without being able to diagnose. To the authors' best knowledge, only one similar case has been reported previously, and the second such case internationally. Bearing all such facts in mind, the authors attempt to educate the readers towards the existence of such a trait so that it can be identified and studied in larger numbers. Hence, it is the authors' endeavor to report an unusual case of dual cusped maxillary protostylid along with its clinical significance.

Articular eminence fractures are a rarity in practice and documented cases of articular eminence fractures are far and few and range around 3 to 4, and are due to trauma. To the best of our knowledge, this is the first case of self-inflicted articular eminence fracture documented to date. A high degree of clinical acuity, suspicion, and cutting edge imaging techniques are required to identify and diagnose fractures of the articular eminence. In this case report, we report a case presenting with unexplained facial pain and diagnosed using cone-beam volumetric imaging as fracture of the articular eminence. We attempt to highlight cone-beam volumetric imaging as a diagnostic tool with considerable benefits in the identification and diagnosis of sublime pathologies of the maxillofacial region.

Osteophyte is one of the hallmark radiographic feature of temporomandibular joint (TMJ) degenerative joint disease that has been used to define the presence of disease. The development of osteophyte is an attempt to stabilize the overload caused by occlusal forces, representing areas of newly-formed cartilage. It can cause various clinical symptoms such as pain, decreased jaw movements, nerve compression, and subsequently compromise joint function. Here, we report four cases of patients with TMJ arthritis showing different appearance of osteophyte using cone-beam computed tomography. This paper also reports two cases of bridging osteophyte at the temporomandibular joint, which has not been reported previously in literature.

Retiform hemangioendothelioma is described as a rare variant of low-grade angiosarcoma, characterized by indolent clinical behavior and closely related to Dabska's tumor (DT). Clinically, patients often present with an asymptomatic slow-growing solitary nodular or plaque-like lesion with rare oral involvement. Here, we report a case of a 50-year-old female patient with retiform variety of hemangioendothelioma having maxillary localization with various clinical, radiographical, histopathological, and immunohistological features.

Hemangiomas are common benign vascular tumors of the head and neck region which account for 7% of all benign tumors of infancy and childhood. Adults are rarely affected, and they have a female predilection. Based on the microscopic appearance, they are classified into capillary, cavernous, mixed, and sclerosing variety. Incidence of intraoral capillary hemangioma (CH) is infrequent, and its topographical presentation on the palatal mucosa and gingiva marks extreme rarity. They are uncommonly encountered by the dentists. The aim of this article is to present a case of CH in a 46-year-old male who presented with a swelling on the posterior hard palate on the left side involving the palatal gingiva and palatal mucosa.

Vascular anomalies are a heterogeneous group of congenital blood vessel disorders more typically referred to as “birthmarks.” They are further categorized into vascular tumors and malformations, which are again subdivided into various types based on specific morphology, pathophysiology, clinical behavior and management of particular entity. Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous and arteriovenous malformations are the main subdivisions under the heading of vascular malformations. This paper discusses a case of co-occurrence of portwine stain with intraoral hemangioma.

Unicystic ameloblastoma is a distinct type of ameloblastoma that clinically and radiographically resembles a dentigerous cyst; however, on three-dimensional evaluation, it shows tumorous behavior and histopathologically shows ameloblastic epithelium. Compared to conventional ameloblastoma, it has a low recurrence rate after conservative treatment. We report a case of extensive unicystic ameloblastoma of mandible in a young male patient that showed tumorous characteristics on computed tomography (CT) and was treated conservatively by decompression. CT follow-up after 3 months showed significant bone formation. The lesion was then enucleated. Follow up at 8 months showed tremendous bone healing.

Ameloblastic fibroma is a relatively rare benign odontogenic tumor in which both the epithelial and ectomesenchymal components are neoplastic. A 14-year-old girl presented with a complaint of unerupted maxillary right premolar. The panoramic radiograph revealed a well-circumscribed unilocular radiolucency involving an unerupted maxillary right first premolar. The lesion was enucleated and the material was sent for histopathologic examination. This case emphasized the importance of careful differential diagnosis of intraosseous oral lesions and reported a rare lesion as well as its atypical location.

Stafne cyst, named after Edward Stafne, was first described in 1942 when he noticed asymptomatic radiolucent cavities in intraoral radiographs of 35 different patients. It is usually a well-defined, round, ovoid or occasionally lobulated radiolucency of size 1–3 cm typically located in the submandibular gland fossa. In this paper, we present two cases of Stafne cyst, one with an unusual presentation having trapezoid-shaped radiolucency with scalloped margin involving the inferior border of the mandible and another with the usual presentation. In both the cases, diagnosis was based on clinical and radiological features alone without any surgical exploration. With the condition remaining static throughout the follow-up period, it is proven that noninvasive diagnostic radiography such as computed tomography scan with three-dimensional reconstruction and cone beam computed tomography can be very helpful for the definite diagnosis of Stafne cyst, rather than invasive procedures.

This case report discusses gingivitis artefacta, an oral presentation of self-injurious behavior (SIB), in a 26-year-old male who also presented with excoriations on the chest, abdomen and back (dermatillomania) along with well-circumscribed areas of hair loss on the scalp (trichotillomania). Gingivitis artefacta is a type of periodontal disease caused by self-inflicted injuries to the gingival tissues. The injuries, most commonly, occur due to picking or scratching of the gingiva with fingernails or any foreign object. SIB is a complex disorder. The cause of his behavior appeared to be of psychological origin, and therefore, referral to the Department of Psychiatry was made. Gingivitis artefacta is rarely seen and practitioners need to be aware of such presentations in patients.

Osteosarcoma of the jaws is a rare, aggressive, malignant mesenchymal tumor with an estimated incidence of 5% in 100,000 of the new cases per year. Osteosarcoma of jaws is a very rare disease and may constitute approximately 1% of all head and neck cancers and only 0.14% of intraoral malignancies. Approximately 7% of all osteosarcomas arise in the jawbones. Diagnosis of the tumor is important, especially in early stages for improving prognosis. Here, we report a rare case of osteosarcoma of chondroblastic variant in a 20-year-old girl, who presented with a bony swelling in the right mandibular posterior region, with a radiographic presentation of sunburst appearance, and the histopathological examination confirmed the diagnosis.

Clear cell carcinoma is a rare low-grade carcinoma. It occurs almost exclusively in the intraoral minor salivary glands and represents less than 1% of all salivary gland tumors. It is a new addition in the recent World Health Organization (WHO) classification of salivary gland tumors. The condition follows an indolent course and treatment includes wide surgical excision with or without adjuvant radiotherapy. This case report highlights a very rare case of a 40-year-old female patient with characteristic clinical and radiographic features, diagnosis and management including significant histopathologic features. Combining our case with those reported in literature, a total of 70 cases confirm that clear cell carcinoma is a low-grade malignant neoplasm with distinctive clinical and pathologic features, which highlight the rarity of the condition.

Pleomorphic adenoma (PA) is the most common benign mixed salivary gland neoplasm that accounts for 60% of all benign salivary gland tumors. It has a diverse histological presentation and occurs in both major and minor salivary glands. PA of minor salivary gland in the palate is a common entity. We report the case of a 40-year-old female who presented with a painless, slow growing swelling of the palate over the last 2 years. Computed tomography (CT) scan revealed an isodense structure in the palate. CT scan showed no signs of bony erosion of the palatal region. Incisional biopsy report revealed PA of the palate. The entire tumor mass was excised along with the overlying mucosa. Histopathological examination confirmed the diagnosis of PA of minor salivary gland. There has been no recurrence of the lesion since 1 year.

Trauma to the chin is the most common cause of temporomandibular joint (TMJ) ankylosis along with other causes which include infections and inflammatory destruction of the synovial lining of the joint. Inflammation of the joint may be primary resulting from infection of the joint itself or may result from extension of neighboring infection. The clinical features of ankylosis are limited mouth opening, with no pain and joint sounds, and marked deflection of the mandible to the affected side. This article highlights the clinical and radiographic features of TMJ bony ankylosis.

A large number of oral mucosal lesions result in severe post-affliction deficits. One such defect is neurological fall out. Herpes zoster is a condition that occasionally results in a dreadful post-infection neuralgic pain. Although shingles is generally regarded as a self-limited condition, it can take several weeks to resolve and has the potential for development of complications. To identify this as well as appropriate management is required. Patients affected are in such severe distress that alleviation of pain and successful treatment protocol should be the primary consideration. We report one such case, which was successfully treated, and also intend to highlight the current concepts in the management of such cases.

The diagnosis of pigmented lesions of the oral cavity and perioral tissues is challenging for the clinicians. The term orofacial pigmentation refers to a wide range of lesions and conditions, which change the color of the orofacial tissues. Even though some lesions may definitively be diagnosed on clinical grounds alone, the final diagnosis usually requires clinical, biochemical, and histopathologic evaluation. Clinical tests, such as diascopy and radiography, and laboratory investigations, such as blood tests, can be used to confirm a clinical impression and reach a definitive diagnosis. The oral cavity is the mirror of the body and is often the area where systemic diseases first present. Hereby, we are presenting a rare case of macular hyperpigmentation with lace-like pattern of oral cavity and macular hyperpigmentation of the face, skin, and palms, with a diagnosis of pigmentation due to iron-deficiency anemia.