Background: Biotransformation plays a crucial role in carcinogen activity. Genetic polymorphisms in xenobiotic-metabolizing enzymes crucial to a carcinogen and drug metabolism lead to variations in their activity. These enzymes increase cancer risk by an altered action on environmental carcinogens. The objective of this study was to analyze the significance of genetic polymorphisms in CYP1A1 and GSTM1 (carcinogen-metabolizing enzymes) genes in patients with oral submucous fibrosis (OSMF). Method: The study subjects included 50 patients. Twenty-five were diagnosed with OSMF, 5 with malignant transformation in OSMF, and 20 age and sex-matched healthy controls. Genotypes of CYP1A1 and GSTM1 were determined by polymerase chain reaction-restricted frequency length polymorphism. Results: 10%, 40%, and 60% GSTM1 null genotype were observed in normal subjects, OSMF patients, and OSMF patients with malignancy, respectively. 15%, 48%, and 40% CYP1A1 polymorphism were noted in normal subjects, OSMF patients, and OSMF with malignancy, respectively. Conclusion: Polymorphism in CYP1A1 and GSTM1 null genotype may increase the risk of OSMF. Combined polymorphisms may be an increased risk factor than single-gene polymorphism.

Context: The concept of field cancerization necessitates substantiation of clinical assessment and histopathological examination by molecular markers. Molecular tumor biomarkers such as p53 protein overexpression aid in assessing the malignant transformation of such potentially malignant oral lesions. Aim: To identify the molecular changes in oral leukoplakia by studying the immunoexpression of tissue p53 and correlating it with the clinical and histological findings to establish an appropriate treatment plan. Methods and Material: Biopsy samples taken from 25 oral leukoplakia cases were subjected to histopathological and immunohistochemical analysis to determine the percentage positivity of p53 expression. Histopathological grading was based on dysplastic features and level of epithelial involvement. Dysplasia grading in IHC sections was estimated by p53% positivity in the cells. The obtained data were subjected to statistical analysis. Results: 24 samples were considered for statistical analysis due to the loss of epithelium in the IHC section of one sample. The results showed a statistically significant association between histopathological and IHC grading of dysplasia with a P value less than 0.05 in Fisher Exact test. Conclusion: Increased expressions of p53 in potentially malignant oral lesions are proportional to the risk of malignancy. The gold standard histopathological result does not reveal the molecular abnormality associated with a potentially malignant oral lesion. Therefore molecular analysis of such lesions will aid in the effective prevention of oral cancer.

Background: Orofacial clefts (OFCs) are the most common congenital deformities in the human face, with a prevalence of around 1:800 to 1:1000 among the Indian population. Aim: To assess the Paired box 7 (PAX7) gene polymorphisms in the etiology of non-syndromic cleft lip and cleft palate (NSCL/P) in the Indian population using a case-parent trio design and to contemplate parent-of-origin effects. Materials and Methods: The study comprised forty case-parent trios of NSCL/P from the Indian population. Genomic deoxyribonucleic acid (DNA) was isolated from the cases and their parents. The polymorphisms rs6659735, rs553934, rs624761, rs609959, and rs4075768 of the PAX7 gene were genotyped using Agena Bio MassARRAY analysis. The transmission disequilibrium test (TDT) was performed using the PLINK software and the pairwise linkage disequilibrium analysis by the Haploview software. Results: The genotyping of the polymorphisms rs6659735, rs553934, rs624761, rs609959, and rs4075768 was done. We found a significant association of the rs6659735 (P-value = 0.03, Odds ratio = 4.5) with NSCL/P in the allelic frequencies of the Indian case-parent trios. In addition, the parent-of-origin effects were observed as the allelic TDT analysis showed a significant paternal transmission of the rs6659735 (P-value = 0.04), whereas the rs553934 (P-value = 0.04) showed an excess maternal transmission. Conclusions: The parent-of-origin effects were observed as the two polymorphisms demonstrated a significant parental transmission. The rs6659735 showed a significant paternal transmission, whereas the rs553934 showed an excess maternal transmission, suggesting that the PAX7 gene may influence the risk of NSCL/P in the Indian population.

Objective: The objective of this study was to evaluate the short-term efficacy and safety of the topical application of amlexanox paste with triamcinolone acetonide paste and tacrolimus paste in the treatment of oral erosive lichen planus. Study Design: This study was a randomized double-blinded placebo-controlled clinical trial. Forty patients aged 18–70 years with erosive oral lichen planus received amlexanox 5% paste (n = 10), triamcinolone acetonide 0.1% paste (n = 10), tacrolimus 0.03% paste (n = 10), and glycerin as placebo (n = 10) for 15 days. Outcome measures included pain using visual analog scale (VAS) scores, and the erosive area in cm² was evaluated both before (baseline) and during the trial (i.e., days 7 and 15). Results: After 15 days of treatment, all the groups showed significant reductions in erosive areas and VAS scores (P <.001) except for the glycerin-treated group, where it was found to be non-significant. No systemic side effects and adverse reactions were observed in the present study. Conclusion: It was found that the topical application of 5% amlexanox paste appeared as effective as 0.1% triamcinolone acetonide paste and 0.03% tacrolimus paste in the treatment of oral erosive lichen planus.

Background and Objective: Most patients with oral cancer receive chemoradiotherapy with or without surgery for treatment and develop oral mucositis, a debilitating adverse. Currently, there is no standard regimen for the management of radiation-induced mucositis. This study aims to evaluate the effect of honey on radiation-induced mucositis. Methods: The study consisted of 204 subjects of both genders, diagnosed and treated by radiotherapy for head and neck carcinoma and who had developed oral mucositis. The control group (n = 102) received 0.9% normal saline while the interventional group (n = 102) received honey as a topical application. Both groups were evaluated by the World Health Organization oral mucositis assessment scale at baseline (I visit) and four follow-up visits. Results: A decrease in the progression of the lesion and symptomatic relief were found in the interventional group. There was neither symptomatic relief nor a decrease in mucositis grade in the control group. Conclusion: Within the limits of this study, the results showed that the topical application of honey could be used to alleviate the symptoms in the management of radiation mucositis as it is easily available, simple, and economical.

Context: Temporomandibular joint (TMJ) is a ginglymoarthroidal joint of synovial variety. The joint's pathology includes those predominantly of musculoskeletal origin, which poses a complex problem in the clinical scenario. The management of temporomandibular joint disorders (TMD) remains a challenge due to the intricate anatomy of the joint and the multipart etiologies associated with it. Aims: This study aimed to compare the effectiveness of pulsed short wave therapy (PSWT) with pharmacotherapy in symptomatic TMD patients. Methods and Material: A total of 62 patients were included in this randomized control trial and were randomly allotted into two groups. Patients in Group I received PSWTand Group II received a combination of a muscle relaxant and a nonsteroidal anti-inflammatory drug (NSAID) for 5 consecutive days. Visual analog scale (VAS) scores were recorded during the follow-up. Statistical Analysis Used: The statistical analysis was performed using Stata/SE 17.0 statistical software. Results: There was a statistically significant difference in the groups for different periods. Kaplan–Meier function and extended survivor function tests showed better pain alleviation in the short wave therapy group. Conclusion: The current study shows that PSWT decreased pain without adverse effects. Therefore, it could be considered a safe and potentially effective adjuvant therapeutic modality for TMD.

Introduction: Oral submucous fibrosis (OSMF) is a chronic insidious and a well-recognized potentially malignant disorder of the oral cavity. Due to its high morbidity and malignant transformation rate, relentless efforts have been made to improve effective management, despite not much improvement in the prognosis. Omega 3 polyunsaturated fatty acids have been reported to have anti-inflammatory properties. With its antioxidant, anti-inflammatory, and immunomodulating properties, Spirulina has shown promising results in the management of OSMF. This present study was conducted to compare the effectiveness of Omega-3 fatty acids and Spirulina in the management of OSMF. Aims and Objectives: To find out and compare the effectiveness of Omega-3 fatty acids and spirulina in the management of OSMF. Methods and Material: 40 OSMF patients with clinically diagnosed OSMF were selected and divided into two groups. Group A was given biweekly intralesional injections of 1.5 ml Dexamethasone in 4 mg/1 ml and Hyaluronidase 1500 IU mixed with Lignocaine 0.5 ml for six weeks and with omega-3 fatty acid capsules 1 gm three times daily for three months. Group B received similar intralesional injections but with spirulina 500 mg twice daily for three months. All the patients were followed up every month for 3 months and then after six months. Results: Both groups improved mouth opening, cheek flexibility, and VAS burning sensation except tongue protrusion (p < 0.05). When the efficacy was compared between two drugs, statistically insignificant results were found for mouth opening, tongue protrusion, cheek flexibility, and burning sensation. Conclusion: Omega 3 and Spirulina can be effective adjunctive treatment options in patients with OSMF to reduce subjective symptoms. Statistically, significant improvement was seen in both groups.

Geographic tongue (GT) is a benign inflammatory condition of the tongue with map-like areas of erythema. In symptomatic cases, pharmacotherapy is advised to improve quality of life and reduce chances of recurrence. Aim: The study aimed to compare the usage of antihistamines and topical corticosteroids in the management of symptomatic geographic tongue. Objective: The objective was to evaluate the most common drug used in symptomatic geographic tongue management and assess the association between patient gender and drugs given. Materials and Methods: The treatment data of patients (n = 88) was collected from Dental Information Archival System with data from June 2019 to February 2021. The usage of antihistamines and topical steroids was assessed over two weeks to relieve clinical symptoms. Results: The association between drug type, drug name, and reduction in the clinical symptoms after two weeks of the review was statistically significant, with an X₂ value of 9.132 at a P value of 0.010 (p < 0.05). The association between drug type, drug name, and gender was not statistically significant (p > 0.05). 38.6% of cases were prescribed Diphenhydramine maleate syrup. It was followed by Betamethasone Mouthwash which was used for 31.8% of cases. Triamcinolone acetonide and Chlorpheniramine tablets were prescribed for 15.9%and 13.6%patients, respectively. Conclusion: Antihistamines should be the first drug type of choice in treating symptomatic GT. Topical steroids could be considered an adjunct or standalone second drug type of choice.

Introduction: Oral submucous fibrosis (OSMF) is a potentially malignant disorder affecting the oral mucosa, now accepted globally as a disease. The Indian subcontinent has high malignant transformation potential with multifactorial etiologies and unclear pathogenesis. Immunological pathogenesis has been hypothesized as a causative factor for oral submucous fibrosis. Aim: To quantitatively evaluate IgG and IgM in serum of oral submucous fibrosis, thereby observing any possible association of these immunoglobulins in the pathogenesis of this disease. Material and Methods: A case-control study was done among 60 subjects, including 30 patients with clinically confirmed OSMF and 30 in the control group. Two milliliters of blood was collected from both groups. Quantitative analysis of serum IgG and IgM was done by turbidometric immunoassay. The results were analyzed by unpaired student's t-test and one-way analysis of variance (ANOVA). Results: All patients of OSMF showed increased serum IgG compared to the control group, and the differences were found to be statistically significant (P >.05). On comparing IgM levels between the control and study group, differences were statistically nonsignificant (P < 0.457). Conclusion: The elevation of immunoglobulin levels supports the concept of autoimmunity.

Introduction: Oral submucous fibrosis is a chronic, premalignant condition of the oral mucosa, affecting millions of people globally and it is one of the precancerous conditions most prevalent in India. Previously published studies have evaluated the serum lipid profile and C-reactive protein in various potentially malignant disorders and oral squamous cell carcinoma, but to our knowledge, no studies are available comparing the pre- and post-treatment serum lipid profile and C-reactive protein values in oral potentially malignant disorders, so that their real prognostic value can be assessed. Aim: The present study aims to evaluate the serum lipid profile and C-reactive protein as a prognostic marker in Oral Submucous Fibrosis patients. Materials and Methods: A total of 30 clinically diagnosed OSF patients of either gender in the age group of 20 – 50 years were selected. A complete history taking followed by a thorough oral examination was done on all patients. About 5 mL of blood sample was collected before treatment and after 6 weeks of treatment for estimation of serum lipid profile and C-reactive protein Results: The mean values of serum lipid profile were decreased among OSF patients and the difference between pre- and post-treatment was statistically significant. The comparison of the mean values of the pre- and post-treatment CRP level of the study subjects among OSF patients was found to be statistically significant (P = 0.022). Conclusion: Hence, pre- and post-treatment serum lipid profile and CRP levels contribute to being of prognostic value in OSF.

Background: Better knowledge of the prevalence of oral complications in children with malignancy improves oral health through an interdisciplinary approach between oncologists and pediatric dentists. Aim: This study aimed to assess the prevalence of oral health status in pediatric cancer patients to palliate and relieve the discomfort. Materials and Methods: This study was conducted in a cancer hospital in Hyderabad for 10 days. 158 patients aged [1-15 yrs] diagnosed with malignancy and receiving chemotherapy were selected and evaluated with a self-validated questionnaire followed by oral examination. Results: The data collected was processed and analyzed using the SPSS22 version [Corporation (IBM), Washington, DC., USA]. Mucositis 47% was the most common complication, followed by gingivitis 23.9%, xerostomia 12%, oral pain 11.6%, herpes 3%, and candidiasis 1.8%. Conclusion: Oral care of pediatric cancer patients is of critical importance in maintaining the patient's overall well-being, which can be achieved by a systematic approach at different stages of treatment.

Background: Most studies of COVID vaccination focused on cell-mediated immunity and serum IgG antibodies, overlooking the role of anti-Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) neutralizing IgA antibodies in preventing viral infection. SARS-CoV-2 vaccine generates variable Anti-Spike IgG responses following one or two vaccine doses in almost all individuals for protection. Aim: The study aimed to quantify and estimate the Anti-Spike SARS-CoV-2 IgG antibody response after the second dose of the Covishield vaccine in healthcare workers (HCWs) over the time frame of one, three, and six months. Material and Methods: 30 HCWs who had received both doses of the Covishield vaccine were selected and divided into three groups based on the time elapsed after the second dose of vaccine for serological analysis. Post-vaccination antibody responses were measured using the SARS-CoV-2 IgG Quantitative assay (detection threshold: ≥50 AU/ml) using chemiluminescent microparticle immunoassay (CMIA). Data were analyzed using the Kolmogorov-Smirnov test, Kruskal-Walli's test, and Mann-Whitney U test. Result: Vaccination leads to measurable anti-spike IgG antibodies in HCWs. Only 1 individual was seronegative. The highest antibody titer was reported after one month of the second dose (3615.3 AU/ml). The lowest antibody titer (491.5 AU/ml) was seen after six months of the second dose of Covishield is statistically significant. Conclusion: Anti-Spike SARS-CoV-2 IgG antibody determination is necessary for an immune response after vaccination. This titer decreases with time consequently as the duration after the second dose of the Covishield vaccine increases. This helps assess the requirement of a booster dose for effective immunity against coronavirus.

Background: The acceptance and availability of effective vaccines are crucial for the success of vaccination programs. Medical doctors and students are the epitome of shaping the public interest in vaccines. Aim: To evaluate the general public's attitudes, including dental students and health care professionals, at the national level towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels. Methods: A national-level cross-sectional study was carried out in May-June 2021 using an online questionnaire. The sample was categorized based on age, gender, academic level, and location. The dependent variable was the willingness to take the COVID-19 vaccine. The independent variables included demographic characteristics, COVID-19-related experience, and the drivers of the COVID-19 vaccine-related attitude suggested by the WHO SAGE. Results: The number of people who answered the questionnaire was 1271. The males accounted for 38.9%, and females were 61.1%. The age group, 18-45 years with 14.7%, has the highest percentage of people who have not taken vaccination. In context to gender, 13.5% of males and 13.1% of females have not taken vaccination. The percentage of vaccination hesitancy is highest in rural areas with 19.5%. The health care professionals were vaccinated with the highest percentage of 89.8%. Conclusion: The vaccination acceptance level of the population for COVID-19 vaccines was good, approximately 63%, and their worrisome level of vaccine hesitancy 27% was governed by demographic, social, and economic factors. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were major hurdles to vaccination.

Context: Accumulated evidence suggests that X-radiations can induce genotoxic effects and are not safe at any particular radiation dose level. Various assays have been proposed as potential tools in cytogenetic biomonitoring studies, but they have limitations. Aims of the Study: To assess the genotoxic effects of panoramic radiography on oral mucosa by estimating micronuclei count (using acridine orange) and AgNORs (using silver stain) from cytological smear cells and to compare these two biomarkers. Material and Methods: 100 subjects who underwent panoramic radiography for dental treatment with pre-defined inclusion and exclusion criteria formed the sample for this cross-sectional study. Two smears were prepared using a cytobrush from the buccal mucosa wet fixed using 95% ethyl alcohol. After 10 days and 40 days, the subjects were recalled for a similar repetition of smear preparations from the same site. Before all the procedures, ethical approval was obtained from the institute's ethical committee where the study was conducted, and written informed consent was taken from all the patients before they participated in the study. Statistical Analysis: The results obtained were further assessed using one-way analysis of variance (ANOVA) and Post Hoc Tukey's HSD for inter and intra observational comparisons. Results: Radiation exposure from panoramic radiography showed a statistically significant increase in micronuclei. However, the AgNOR count remained unchanged after radiation exposure. Conclusion: MN count is better for detecting the short-term genotoxic effect of panoramic radiation exposure on buccal mucosal cells than AgNORs.

Introduction: Panoramic radiographs have the unique ability to cover maxilla, mandible, and associated structures in a single image. Hence, the soft tissue calcifications within the region covered can be identified. Aim: To assess the prevalence of incidental findings of soft tissue radiopacities on digital panoramic radiographs. Materials and Method: 2036 digital panoramic radiographs were included in the study. For convenience, each radiograph was divided into 12 segments by 3 vertical lines, and 2 horizontal lines. Calcifications were analyzed based on the anatomical location, number, shape, size, and internal structure. Results: The overall prevalence of soft tissue calcifications was 5.1%. Six types of soft tissue calcifications were identified, which included stylohyoid ligament calcification (53.3%), carotid artery calcification (24.8%), lymph node calcification (5.7%), tonsillolith (3.8%), sialolith (3.8%) and thyroid and triticious cartilage calcification (8.6%). Conclusion: There is no sufficient data in the literature, and hence more studies are needed with a wider sample size to correlate with the available data.

Context: Lichen planus is an idiopathic chronic inflammatory mucocutaneous disease that frequently involves the oral mucosa and skin. It has been proposed that psychological factors like high stress and anxiety levels have a strong association with lichen planus. Estimation of the stress level in patients with oral lichen planus. Aims: To estimate the stress in patients with Oral Lichen Planus by Hospital Anxiety and Depression Questionnaire, Depression Anxiety Stress Scale 21, and State-trait anxiety inventory and compare these with normal healthy individuals. Methods and Material: Twenty oral lichen planus patients and twenty normal subjects were included in the study. Every individual gave the hospital Anxiety and Depression Questionnaire, Depression Anxiety Stress Scale 21, and State-trait anxiety inventory. Statistical Analysis Used: Data obtained were analyzed with SPSS software 26. The findings of various parameters were evaluated and analyzed statistically using Mann Whitney U test. Results: Hospital Anxiety and Depression Questionnaire, State-trait anxiety inventory, Depression Anxiety Stress Scale 21 scores were significantly higher in the oral lichen planus group than in normal individuals. Conclusions: Psychological factors like anxiety and depression play a major role in the pathogenesis of OLP, and non-invasive procedures like the Hospital Anxiety, and Depression Questionnaire, Depression Anxiety Stress Scale 21, and State-trait anxiety inventory scores can be used as a useful indicator to estimate stress levels in OLP patients.

Background: Saliva, a complex fluid secreted by the salivary glands within the oral cavity, is the first to interact with smoke while smoking. Nicotine in smoke causes structural and functional changes in the saliva, leading to a significant reduction in salivary flow. Aim: The present study was done to compare the salivary flow between reverse smokers, regular smokers, and non-smokers with the help of the Modified Schirmer Test (MST) to assess unstimulated saliva. Materials and Methodology: Ninety subjects were randomly divided into three groups; Group A (30) subjects who had the habit of reverse smoking daily for >6 months, Group B (30) subjects who had the habit of smoking daily for >6 months, and Group C (30) healthy, non-tobacco users. MST was done in the morning hours; they were not asked to eat/drink for 2 h before the procedure. Later, they were asked to raise their tongue, and the rounded end of Schirmer's strip was placed on the floor of the mouth. Wetting of the strip was recorded every 1, 2, and 3-minute intervals. Results: Data was recorded, and statistical analysis was done by the paired t-test. The mean value of salivary flow rate in reverse smokers per 3 minutes (19.73 ± 4.16) was less when compared to conventional smokers (22.53 ± 2.75) and healthy individuals (31.53 ± 2.90), with a significant P value of P < 0.0001. Conclusion: There was a significantly reduced unstimulated salivary flow rate in reverse smokers compared to conventional smokers and healthy individuals.

Background: Vitamin D deficiency (VDD) is a pandemic and usually under-diagnosed, under-treated nutritional deficiency globally. Among the Indian population, VDD may be due to lower dietary vit D and calcium intake, low socioeconomic status, etc. VDD can manifest as delayed tooth eruption, absence of secondary dentin formation, altered coronal pulp morphology, enlarged pulp space, and high pulp horns. Radiographic changes can be detected by various advanced imaging techniques but with multiple drawbacks. Intraoral radiographs (IOPA) can be an easy, chair-side and routine method of detecting coronal pulp morphology (CPM) changes due to VDD. Aims and Objectives: To assess correlation of vit D deficiency (VDD) and changes in coronal pulp morphology (CPM) using dental radiographs among young adults. Material and Methods: 60 subjects were included in the study and divided into two groups: one with CPM changes and the second group without CPM changes. All the subjects underwent digital intraoral imaging and serum evaluation for vit D. The subjects were classified into deficient, optimal, and overdose categories. At the same time, the tooth morphology was divided into normal and chair/constricted types. Results: The correlation of vitamin D levels with the pulp horn heightof all three molars were negative and statistically insignificant. Pulp chamber height and width showed negligible and insignificant relationships with vitamin D levels. Conclusion: This study could not prove a significant correlation, but the data generated might help carry out advanced research in a related context. Using an Intraoral Periapical radiograph for evaluating VDD can also be a baseline screening in largepopulations in the future.

Background: Soft palate is an anatomical structure that helps modify the quality of voice and breath while swallowing. In patients with cleft palate, obstructive sleep apnea, oral submucous fibrosis, and skeletal craniofacial malocclusions, soft palate dysfunctions are frequently seen. Knowing the soft palate's morphological variations thus helps us to assess and manage such patients better. Aims: To assess the morphology of the Soft Palate in Cone-Beam Computed Tomography in different age and gender groups and to find its association with: Need's ratio, Velar Length, Width, and Pharyngeal Depth in different morphological velar types. Methods and Material: The study sample consisted of 60 patients aged 20-50 years. Patients who underwent Cone Beam Computed Tomography scans of the whole maxilla (16X16 FOV) were taken up for the study. Measurements and Interpretation of Velar Length, Width, and Pharyngeal Depth were made. Results: A statistically significant correlation was observed in Velar width with an R-value of 0.04. An increase in velar width was noted with an increase in age. Leaf shape soft palate was the more prevalent type, followed by rat tail and butt shape. In male patients, the velar length and pharyngeal depth were significantly greater compared to female patients. Conclusion: By knowing different types of the soft palate and all the variations in the parameters as the reference, the dental surgeon can plan any invasive surgical procedure related to velopharyngeal dysfunctions better and avoid any complications arising from velopharyngeal dysfunctions.

Introduction: Skeletal remains have a vital role in the differentiation of sex in forensic studies. Skull is the second most sexed skeleton after the pelvis. PA cephalogram is more precise and provides numerous anatomic points and planes in the frontal profile for comparison. Aim: To introduce a new parameter 'Mastoid to Gonion height,' and compare its accuracy with established PA cephalometric parameters in sex determination using discriminant functions. Materials and Methods: A hundred males and females each aged 25 to 60 years were included. A total of eight planes were constructed on PA cephalograms and measured. The data were analyzed using discriminant analysis. Results: The linear measurements were found greater in males than females. Among the studied parameters, Bizygomatic width and Mastoid to Gonion height had a high sex discriminating ability. The discriminant function (DF) equation correctly predicted the gender in 88.5% of subjects. Conclusion: The new parameter “Mastoid to Gonion” height has been successfully introduced. It is found to be the second-best strong predictor parameter and can be used singly for sex determination. The parameter Bi-zygomatic width also contributed most significantly and can be used singly. The DF equation is proposed to predict new cases.

Background: Oral potentially malignant disorders (OPMDs) are divided into two groups precancerous lesions, a benign lesion with morphologically altered tissue, which has a greater than normal risk of transforming into malignancy, and precancerous conditions, a disease or patient's habit that does not necessarily alter the appearance of local tissues but is associated with a greater or normal risk of precancerous lesion or cancer development in that tissue. Aim: This systematic review aims to evaluate the effectiveness of topical herbal therapeutics in the management of potentially malignant oral disorders. Objective: Primary objective was to evaluate the efficiency of tulsi, aloe vera, and turmeric in the management of OPMDs, and the secondary objective was to determine the herbal therapeutic response in patients with oral leukoplakia oral sub, mucous fibrosis, and lichen planus. Data Sources and Search Methods: The search was done using the MeSH [medical subject headings] terms and keyword search in the electronic databases, namely Pub Med and Google Scholar. The studies included in this systematic review were identified by a comprehensive search from the electronic search engines like Pub Med Advanced search (from April up to January 2021) and Google scholar. The search yielded 39 articles out of which 11 articles were only included based on the inclusion criteria. Data Collection and Analysis: All the studies included were based on the data extraction and analysis of the studies for quality. The outcome measure evaluated the reduction in burning sensation, mouth opening, and clinical resolution of the lesion. Results: A total of 39 articles were included in this systematic review from electronic searches using Pub Med advanced search and Google scholar. Conclusion: For management of oral submucous fibrosis topical aloe vera gel showed 90% of complete clinical response, oral lichen planus topical tulsi and turmeric gel showed 90% complete clinical response, and only two studies were conducted on oral leukoplakia which had a high risk of bias; hence, this systematic review does not yield to a piece of conclusive evidence for the management of oral leukoplakia using topical herbal therapeutics.

Aim: To determine if In silico methods can be used to identify pathogenic non-synonymous variants in the ACTN3 (alpha actinin 3) alpha actinin gene that encodes for alpha actinin 3 three protein employing computational tools. Materials and Methods: In silico methods of detecting pathogenic variants were initiated by identifying 854 reported non-synonymous mutations in the ACTN3 gene from the Ensembl database. The non-synonymous variants of ACTN3-201 (transcript ID: ENST00000502692.5) were derived from the Ensembl database. Variants found to be pathogenic were curated using SIFT tool (The Sorting Intolerant From Tolerant), PolyPhen2 (Polymorphism Phenotyping v2), and PROVEAN (Protein Variation Effect Analyzer). The panel of curated variants was analyzed for protein stability based on substituting existing amino acid residue with a variant encoded amino acid using IMutant 3.0. Results: Among 854 variants reported in the ACTN3 gene, 26 were found to be harmful, and possibly pathogenic. The SIFT tool identified 15 variants to be highly intolerant, PolyPhen2 identified two other variants as possibly damaging, and PROVEAN predicted two variants to be highly harmful. Finally, IMutant 3.0 showed that one (single nucleotide polymorphism) resulted in decreased stability of the ACTN3 protein. Conclusions: Applying in silico approaches can help researchers identify variants exhibiting putative association with the disease phenotype.

Myoepithelioma, which is benign, is a salivary gland neoplasm representing 1.5% of all the neoplasms of salivary glands. The commonest location of its occurrence is parotid gland. In this condition, there is proliferation of myoepithelial cells arranged in cords, mantles, or nests. A 20-year-old woman presented with a well-circumscribed, asymptomatic swelling on the left half of the hard palate, which was gradually increasing in size for 10 years. A provisional diagnosis of pleomorphic adenoma was made. Computed tomography scan showed a well-defined soft tissue density lesion, which on histopathologic examination revealed a well-circumscribed, partially encapsulated neoplasm comprising monomorphic tumor cells in clusters and lobules with plasmacytoid characteristics. Therefore, it is necessary to consider myoepitheliomas also as one of the differential diagnoses while dealing with palatal swellings.

Ewing's sarcoma (ES) is an atypical malignant neoplasm of long bones rarely affecting the head and neck region. Here, we report a case of a 13-year-old male patient with a chief complaint of an unhealed socket and swelling in the right mid-facial region, following an extraction. Intraoral examination revealed an unhealed socket with respect to permanent maxillary right second molar region. Advanced imaging such as cone-beam computed tomography (CBCT) revealed an aggressive, expansive, osteolytic lesion involving the right posterior maxillary alveolus, extending into the maxillary sinus. Histopathology and tumor markers such as the cluster of differentiation (CD)99 were deterrent in the diagnosis.

Mucormycosis is an opportunistic fulminant fungal infection that can cause significant morbidity and frequent mortality in susceptible patients. Common predisposing factors include diabetes mellitus and immunosuppression. Even though this fungus is ubiquitous, the immune system usually prevents the disease, and it is rare. But in the present pandemic era, Mucormycosis has become a prevalent disease among immunocompromised patients and individuals with systemic pathosis. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The fungus invades the arteries leading to thrombosis that subsequently causes tissue necrosis. The infection can spread to orbital and intracranial structures by direct invasion of blood vessels. Here, we describe an interesting and rare case of sino-nasal mucormycosis in a seropositive, uncontrolled diabetic and suspected Covid positive individual to emphasize early diagnosis and treatment of this fatal fungal infection.