Objectives: To assess the alveolar bone density by fractal dimension (FD) analysis in radiovisiograph of postmenopausal women of mandibular posterior region and to correlate FD values with t-scores of quantitative ultrasound of the calcaneus bone. Materials and Methods: This study, approved by the institutional review board, included 40 participants, aged 45–60 years divided into two groups. Twenty postmenopausal women with osteoporosis comprised group 1, and 20 postmenopausal women without osteoporosis comprised group 2 based on bone mineral density assessment of ultrasound of the calcaneus bone. Digital dental radiograph of mandibular first molar were obtained and used for assessing alveolar bone density by FD analysis and were correlated with t-scores of ultrasound of calcaneus bone. Results: The mean FD values were evaluated using SPSS 14 version software, and were found to be 1.738 and 1.867 for group 1 and group 2, respectively, which was statistically significant (P < 0.001). However, correlation between t-scores and FD values within the study group was not found to be statistically significant (P > 0.05). Conclusion: FD analysis using direct digital periapical radiographs is a novel method, which can be used for early diagnosis of osteoporosis in the alveolar bone.

Aim: The aim of the present study was to determine and compare the antifungal and inhibitory activities of various concentrations of Aloevera gel and Triphala against oral Candiada albicans. Materials and Methods: The fungi (C. albicans) were isolated from 10 patients with pseudomembranous candidiasis and patients with denture stomatitis and transferred to Sabouraud's broth, which was later incubated in Sabouraud's dextrose agar (SDA). Antifungal activity of the Aloevera gel and Triphala was tested by the disc diffusion method, and minimum inhibitory concentration was determined by the broth microdilution method. Results: The mean value for zone of inhibition for Aloevera was 3.35 ± 0.59 mm and 1.06 ± 0.41mm at 100% and 50%, respectively. For Triphala, it was 4.19 ± 0.57 mm and 1.79 ± 0.43 mm at 100% and 50%, respectively (P value < 0.001). Zone of inhibition of 100% Triphala showed higher value than that of Aloevera at the same concentration (P = 0.004). Similar results were obtained at 50% concentration of Triphala and Aloevera (P = 0.004). Minimum inhibitory concentration of Aloevera gel and Triphala against C. albicans was 25% and 12.5%, respectively. Conclusion: Aloevera gel and Triphala both showed antifungal property at higher concentrations and can be used as a promising adjunct for antifungal agents.

Introduction: Ponticulus posticus is an anomaly located on the first cervical vertebra which can be appreciated on the lateral cephalogram that is mostly neglected by the dentists. Aims and Objectives: To assess the prevalence of ponticulus posticus and its relationship with gender and age. Materials and Methods: A sample of 580 patients' lateral cephalograms were retrieved from the archives of the department (Sirona Orthophos XG 5). Seventy-nine lateral cephalograms were excluded, and only 501 lateral cephalograms were taken with the age range of 8 to 60 years. Each digital radiograph was inspected for the presence and absence of ponticulus posticus and further evaluated for both the partial and complete form using Sidexes software and the results were statistically analyzed. Results: Ponticulus posticus was observed in 14.4% of the patients, among which 2.8% had complete and 11.6% had partial type; 59.7% were females and 40.3% were males. Conclusion: Ponticulus posticus is not an uncommon anomaly; therefore, lateral cephalogram should be carefully examined to check for the presence of this anomaly.

Aim: To evaluate the relationship between panoramic radiographic signs and cone-beam computed tomography (CBCT) in the assessment of a superimposed relationship of the impacted mandibular third molars and mandibular canal. Materials and Methods: Panoramic and CBCT images were evaluated independently to assess the relationship between the mandibular canal and the impacted mandibular third molar roots by two oral and maxillofacial radiologists. The results were tabulated and the association of panoramic radiographic and CBCT findings was analyzed using Chi-square test and Fisher's exact test. All of the analyses were carried out with PASW Statistics 18.0. Results: Panoramic radiographic findings were statistically significant with CBCT findings (P < 0.01). Cases of darkening roots without interruption and lingual cortical perforation suggested more frequent buccal placement of mandibular canals. Cases of darkening roots with interruption and complete lingual cortex perforation suggested more frequent lingual placement of mandibular canals. Conclusion: The results of the present study suggest that, although panoramic radiography is an effective method for preoperative evaluation prior to mandibular third molar extraction, its predictability is low with regards to the emergence of nerve lesions. Therefore, it is mandatory to know the true three-dimensional imaging relationship between the mandibular canal and impacted mandibular third molars. Thus, CBCT is the best method for risk assessment and planning prior to surgical procedures to prevent inferior alveolar nerve injury.

Introduction: The science of dental implantology has evolved exponentially in the recent past but the intricacies in the selection of implant site, size and angulations has always been challenging to the clinician and it is very difficult to meet these challenges without dental imageology. Aims: To compare panoramic radiography with computed tomography (CT) and radiovisiography to analyze the relative advantages and disadvantages of these modalities. Materials and Methods: Total 27 sites in 20 patients of mandibular posterior molar edentulous areas were radiographed with four different radiographic methods. The implant sites were selected and the height of the available bone, the mean width of the available crestal bone and density were measured using all the three techniques (except density which was measured on CT alone). Comparison of all the values obtained with the three imaging modalities was done and data tabulated for statistical analysis. The one way analysis of variance (ANOVA) with post hoc analysis using least significance method (LSD) was used to test the differences between each group using the SPSS software version 16. Results: The mean value of vertical measurements using conventional OPG, panoramic CT, RVG, and paraxial CT was found to be 19.32, 18.43, 19.09, and 16.81 mm, respectively. The mean value of density of the bone using paraxial CT was found to be 631.23 HU with a standard deviation of 123.14. The mean value of width of the crestal bone below the height of the crest using paraxial CT was found to be a maximum of 14.03 mm and a minimum of 5.86 mm. Conclusion: The overall results suggested that the paraxial view of CT was better in assessing the parameters of implant site when compared to the other three modalities.

Oral cancer, being the sixth most common cancer in the world, accounts for approximately 13% of deaths worldwide. Metastasis to the lymph nodes is one of the major prognostic factor for oral cancer. Micrometastasis are microscopic deposits of malignant cells lodged in lymph nodes. Tumor recurrence usually reflects the presence of such deposits which cannot be detected initially by conventional methods. Early screening of such cells using immunological and molecular markers would help in better staging of the primary tumor followed by prompt treatment, thus reducing tumor relapse. Therefore, the concept of micrometastasis has resulted in a paradigm shift in the staging of epithelial tumors and the overall understanding of the malignant process.

Curcumin is derived from turmeric and has a variety of therapeutic properties. Various research on curcumin have showed that it also exhibits anti-cancer properties. It is known to act on tumor cells via its effect on a variety of biological pathways involved in mutagenesis, oncogene expression, cell cycle regulation, apoptosis, tumorigenesis, and metastasis. Curcumin has shown anti-proliferative effect in multiple cancers, and is an inhibitor of the transcription factor nuclear factor kappa B (NF-Kb) and downstream gene products (including c-myc, Bcl-2, COX-2, NOS, Cyclin D1, TNF-a, interleukins and MMP-9). Curcumin is one such potential candidate, and this review presents an overview of the current in vitro and in vivo data supporting its therapeutic activity in head and neck squamous cell carcinoma (HNSCC) as well as some of the challenges concerning its development as an adjuvant chemotherapeutic agent.

Propolis is a Greek word meaning “defender of the city.” Constituents of propolis possess health promoting properties. Propolis plays a very important role in the field of medicine and dentistry. This paper is an attempt to review various applications of this compound in improving the general health of an individual.

Metastatic tumors of the orofacial region are uncommon and may occur in the oral soft tissues and jaw bones. The occurrence of prostate as the primary site for jaw metastasis is extremely rare. Mandible and palate are the common prostate metastatic sites. Here, we present a rare case of prostate adenocarcinoma metastatic to maxilla.

The ameloblastic fibro-odontoma (AFO) is a rare mixed odontogenic tumor which shows properties of both ameloblastic fibroma and odontoma. It commonly affects children and young adults. In most cases, it is asymptomatic but may cause painless, slow growing swelling and discomfort. Radiologically, it is a well-circumscribed, mixed radiopaque and radiolucent entity consisting of radiolucency within which radiopaque foci of various sizes and shapes are seen. Histological examination shows both hard and soft tissue. The treatment of AFO usually conservative due to their benign biological behavior and consists of enucleation or surgical curettage. The purpose of this article is to present a case of an AFO in the posterior maxilla, along with discussion on clinical, radiological (including cone beam computed tomography scan), histological findings, and treatment of this tumor.

Charlin's syndrome is an extremely rare condition characterized by pain in the nasal and paranasal areas, which is precipitated by touching the lateral aspect of the ipsilateral nostril. We are presenting one such case of a 42-year-old man who was admitted to Dr. Chaudhary Hospital and Medical Research Centre.

Dentin dysplasia is a rare autosomal dominant disorder affecting dentin and resulting in early loss of teeth. Although dentin dysplasia type I is reported to have an incidence of 1 in 100,000, dentin dysplasia type II is considered to be an extremely rare genetic disorder, the prevalence of which is not clearly reported in the literature so far. Moreover, there remains a lot of controversy regarding classification, terminologies, treatment options, and prognosis of dentin dysplasia. We present here an exclusive report and management by full mouth rehabilitation of two cases of dentin dysplasia type II in siblings with some peculiar clinical characteristics, making it one of a kind of case reports documented so far.

Schwannoma (neurilemmoma) is a benign nerve sheath tumor that is composed entirely of well-differentiated Schwann cells. It is important to highlight that schwannoma is usually found in the head and neck and rarely in the oral cavity. Schwannoma is a benign tumor that originates from the Schwann cells of the peripheral nerves. They are usually asymptomatic, do not recur, and malignant transformation is rare. Here, we report a case of neurilemmoma that was located at an unusual location, i.e., floor of the mouth.

During the routine radiographic investigation of a 65-year-old female we came across radiodense string-like artifacts on the orthopantomograph. These artifacts can be mistaken for electrostatic discharges, ghost images, or ligature wires. The patient revealed a history of undergoing facial lift surgery 7 years ago. Here, we are presenting a case of unexpected and coincidental radiographic finding seen as multiple, linear radiopacities in the jaw bones stressing the need for sufficient knowledge of all the possible types of artifacts.

Osteomyelitis of facial bones is an uncommon condition. Maxillary osteomyelitis is rare compared to mandibular osteomyelitis because the extensive blood supply and strut-like bone of the maxilla make it less vulnerable to chronic infections. We report an unusual case of maxillary osteomyelitis involving the right half of the maxilla in a 27-year-old, systemically healthy female. She reported with pain in the upper right region of the jaw since 1 year. Her past dental history revealed that she underwent dental extraction 1 year back in the same region due to pain and mobility of teeth. Intraoral examination revealed exposed necrotic bone in the right maxillary region with mobility of teeth and pus discharge. Radiographic investigations confirmed the diagnosis of osteomyelitis of the right maxilla. The patient was advised hemimaxillectomy, following which the patient was given a surgical and later a permanent obturator to close the surgical defect.

Central giant cell granuloma (CGCG) is a benign intra-osseous lesion of unknown etiology, and occurs in jaws. Clinically and radiographically difference between its nature - aggressive and non-aggressive can be made. It is characterized histologically by cellular fibrous tissue containing multiple foci of hemorrhage, aggregations of multinucleated giant cells, and occasionally, trabeculae of woven bone. Histologically, identical lesions occur in patients with known genetic defects such as cherubism, Noonan syndrome, or neurofibromatosis type I. It has an increased predilection for mandible and females in younger age group. Surgical curettage or resection is the most common therapy in aggressive lesions. The drawback is undesirable damage to the jaw or teeth, tooth germs, and frequent recurrences. Non-aggressive tumors respond well to such treatments. We are presenting a case of an aggressive type of CGCG of mandible in a young patient, who presented with massive swelling associated with loss of teeth in just 6 months duration.

Berry syndrome or Treacher Collins syndrome (TCS) is an autosomal dominant disorder of craniofacial development with variable expressivity. The most common manifestations of TCS are the antimongoloid slanting of the palpebral fissures, colobomas of the lower eyelids, hypoplasia of zygoma and mandible, and various ear abnormalities. This article explains the clinical and radiographic features of TCS in a 14-year-old male, who had reported to the Department of Oral Medicine and Radiology, and reports the mild expressivity which can be seen in TCS. It also signifies that other abnormalities such as tongue tie and congenitally missing mandibular anteriors may be seen in this syndrome.

Erythema multiforme (EM) is a life threatening mucocutaneous disorder where early diagnosis and management is of utmost important. Among various etiological agents, viral etiology is the most common and is characterized by ulcerations, erosions, and bleeding within the mucosa associated with encrustations and tissue tags. Dermal counterparts present with target iris lesion. Here, we report a case of viral-induced EM major where there are classical oral and dermal lesions in a 28-year-old male patient.

Herpes zoster of the trigeminal nerve branches caused by varicella zoster is a clinical entity consisting of erythematous macules, papules, vesicles, bullae, small ulcers and erythematous plaques, with characteristic short acute/pre-eruptive phases and long herpetic periods with pain. It is caused by reactivation of latent varicella infection. Herpes zoster is a less common endemic disease compared to varicella. During the prodromal stage, the only presenting symptom may be odontalgia, which may prove to be a diagnostic challenge for the dentist. Emergency treatment for a misdiagnosis such as trigeminal neuralgia, odontalgia, and acute pulpitis, as well as complications reported in literature such as tooth resorption, periapical lesions, periodontal destructions, and osteomyelitis may cause an irreversible damage to the patient. Hence, the dentist must be familiar with the presenting signs and symptoms in prodrome of herpes zoster infection of trigeminal nerve. The present article focuses on the pathogenesis, clinical picture, difficulties in diagnosis and management of such cases.

Varicella zoster virus (VZV) is a DNA virus and a member of the alpha herpes viridae family, causing both primary and recurrent infection. Herpes zoster (HZ), commonly called shingles, is a distinctive syndrome caused by reactivation of VZV. This reactivation occurs when immunity to VZV declines because of aging or immune-suppression. HZ can occur at any age but most commonly affects the elderly population. HZ may affect any sensory ganglia and its cutaneous nerve. Most of the infections affect dermatomes of T3 to L2, but approximately 13% of the patients present with infections involving any of the three branches of the trigeminal nerve. Prodromal symptoms include neuropathic pain, headache, malaise, and disrupted sleep. HZ causes pruritic, localized, vesicular rash which usually appears unilaterally in the distribution of one or more adjacent sensory nerves accompanied by neuropathic pain in the affected dermatome. This is a case report of HZ infection in a 55-year-old male patient who was managed with comprehensive medical treatment.