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2009| April-June | Volume 21 | Issue 2
December 1, 2009
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Drug induced neutropenia manifesting as oral ulcerations
Rachna Kaul, Chaya M David, G Savitha, J Rema, BK Ramnarayan, CJ Sanjay, PS Shilpa
April-June 2009, 21(2):72-75
As dental practitioners, we often come across oral ulcerations of varied etiology. Among all the causes of oral ulcers, those due to neutropenia are significant. Neutropenia can occur in many systemic conditions and also in patients on long-term therapy of certain drugs like phenytoin. The diagnosis of neutropenia in time leads to early recognition of the cause of this fatal condition. Here, we report a case of a 50-year-old female patient who developed oral ulcerations secondary to phenytoin-induced neutropenia. Early diagnosis of the condition led to discontinuation of the offending drug and significant improvement in her blood picture and also prevented her from falling prey to many other systemic infections that neutropenia can cause.
Sonia Saggoo, Anita Munde, Manjula Hebbale, Manjiri Joshi
April-June 2009, 21(2):76-78
Hereditary hypohidrotic ectodermal dysplasia, also called the Christ-Siemens-Touraine Syndrome is characterized by congenital dysplasia of one or more ectodermal structures and is manifested by hypohidrosis, hypotrichosis and hypodontia. It is usually an X-linked recessive mendelian character which is rarely seen in males. It results from abnormal morphogenesis of cutaneous and oral embryonic ectoderm. Patients with this disorder exhibit smooth , thin and dry skin, fine and blond scanty hair. Intra-orally anodontia or hypodontia, with impaired development of alveolar process is seen. A case report of a rare case of this disorder in a female patient aged 18 years is hereby presented.
: A family investigation and review
VG Mahima, Karthikeya Patil, Madhur Kapoor, Shalini Kalia
April-June 2009, 21(2):83-88
Rendu-Osler-Weber syndrome is a rare genetic condition characterized by mucocutaneous and visceral fibrovascular dysplasia leading to multiple macular or papular vascular lesions of skin, mucosal surfaces and occasionally viscera that show tendency towards hemorrhage. The orofacial features of the condition in an affected family and in particular a 33-year-old Indian male patient, are illustrated along with summarization of management aspects in a dental setup.
Capsaicin-fighting fire with fire
Poonam Agarwal, Vaishali Keluskar, Anjana S Bagewadi, Arvind Shetti
April-June 2009, 21(2):51-54
Chronic pain conditions involving the maxillofacial region represent a major health problem and patients with persistent pain are difficult to manage successfully. Most of these conditions are often comorbid with additional health issues. Capsaicin has been studied in various models of pain and neuropathy. Currently, its best known use is as a topical analgesic and anti-inflammatory. Its use as a noxious stimulus offers several benefits and has been used with considerable success in conditions like postherpetic neuralgia, atypical facial pain, musculoskeletal pain etc. Adverse events from capsaicin are mainly at the application site (burning, stinging, erythema), and systemic events are rare. This review highlights the emerging evidence on the use of capsaicin in the commonly encountered orofacial pain conditions.
Salivary coagulopathy and immunoglobulins in oral submucous fibrosis
R Pinakapani, P Shambulingappa, MC Shashikanth
April-June 2009, 21(2):62-66
: The etiopathogenesis of oral submucous fibrosis is still obscure. Immunological disorders have been associated with it and as the disease produces changes localized to the oral cavity, it is assumed that saliva may play an important role in the etiopathogenesis. The purpose of this study was to detect salivary coagulopathy, immunologic alterations and their comparison in oral submucous fibrosis patients and controls.
Materials and Methods
: Salivary coagulopathy procedures and quantitative estimations of serum immunoglobulins were carried out by serial radial immunodiffusion method in 60 oral submucous fibrosis patients and equal age- and sex-matched healthy controls. The obtained data was analyzed using Mann-Whitney and Chi-square tests.
: The results indicated the presence of a precipitating factor in saliva responsible for salivary coagulopathy, dependent upon the severity of the disease and not on age, sex or duration of the disease. As compared to the controls, serum IgG and IgA, but not IgM levels were raised significantly among patients. IgG levels were increased in all the grades, while IgA levels were increased in Grade II and Grade III cases only. IgM levels in Grade II and Grade III cases showed no significant alterations, however, were reduced in Grade I cases. The serum immunoglobulin levels showed no correlation with the duration of the disease.
: Alteration in saliva and immunity do indicate an immunological basis in the etiopathogenesis of this complex clinical entity.
Conventional and digital radiographic methods in the detection of simulated external root resorptions: A comparative study
CJ Sanjay, Chaya M David, G Savitha, J Rema, BK Ramnarayan
April-June 2009, 21(2):67-71
: To evaluate and compare the efficacy of conventional and digital radiographic methods in the detection of simulated external root resorption cavities and also to evaluate whether the detectability was influenced by resorption cavity sizes.
: Thirty-two selected teeth from human dentate mandibles were radiographed in orthoradial, mesioradial and distoradial aspect using conventional film (Insight Kodak F-speed; Eastman Kodak, Rochester, NY) and a digital sensor (Trophy RVG advanced imaging system) with 0.7mm and 1.0mm deep cavities prepared on their vestibular, mesial and distal surfaces at the cervical, middle and apical thirds. Three dental professionals, an endodontist, a radiologist and a general practitioner, evaluated the images twice with a one-week time interval.
: No statistical significance was seen in the first observation for both conventional and digital radiographic methods in the detection of simulated external root resorptions and for small and medium cavities but statistical difference was noted in the second observation (P<0.001) for both the methods.
: Considering the methodology and the overall results, conventional radiographic method (F-speed) performed slightly better than the digital radiographic method in the detection of simulated radiographic method but better consistency was seen with the digital system. Overall size of the resorption cavity had no influence on the performance of both methods and suggests that initial external root resorption lesion is not well-appreciated with both the methods as compared to the advanced lesion.
Calcifying epithelial odontogenic cyst with odontome in left mandible
R Kamala, Abhishek Sinha, Mamta Sharma
April-June 2009, 21(2):79-82
Calcifying epithelial odontogenic cyst is a mixed odontogenic benign tumor but most of the cases present cystic characteristics. We present a case report of calcifying epithelial odontogenic cyst with odontoma in a 20-year-old male who presented with a painless unilateral swelling of the jaw. The lesion involved an impacted 37 which was displaced to the lower border of the mandible and a calcified mass that was within the cystic lesion that was recognized as odontoma. The lesion was surgically removed along with 36 and 37 was allowed to erupt.
Large erupted complex odontoma
Vijeev Vasudevan, V Manjunath, Radhika Manoj Bavle
April-June 2009, 21(2):92-97
Odontomas are a heterogeneous group of jaw bone lesions, classified as odontogenic tumors which usually include well-diversified dental tissues. Odontoma is a term introduced to the literature by Broca in 1867. Trauma, infection and hereditary factors are the possible causes of forming this kind of lesions. Among odontogenic tumors, they constitute about 2/3 of cases. These lesions usually develop slowly and asymptomatically, and in most cases they do not cross the bone borders. Two types of odontoma are recognized: compound and complex. Complex odontomas are less common than the compound variety in the ratio 1:2.3. Eruption of an odontoma in the oral cavity is rare. We present a case of complex odontoma, in which apparent eruption has occurred in the area of the right maxillary second molar region.
Autofluorescence and diffuse reflectance spectroscopic analysis of oral premalignancy and malignancy
S Jayachandran, Virender Gombra, S Ganesan, Sivabalan
April-June 2009, 21(2):55-61
Early detection of squamous cell carcinoma in the oral cavity can improve survival. It is often difficult to distinguish neoplastic and premalignant disorders with standard white light illumination. Fast and noninvasive, diagnostic techniques based on fluorescence spectroscopy have the potential to link the biochemical and morphologic properties of tissues to individual patient care. In this study comparison between malignant, premalignant and healthy mucosa groups was done based on autofluorescence and diffuse reflectance spectroscopic analysis. Fluorescence spectroscopy is a new diagnostic modality with the potential to bridge the gap between clinical examination and invasive biopsy.
Papillon-Lefevre syndrome: A case report with review of literature
Rajeev Gadgil, Ajay Bhoosreddy, Varun Gul Bhatia
April-June 2009, 21(2):89-91
Papillon-Lefèvre syndrome is an extremely rare genodermatosis inherited as an autosomal recessive trait, affecting children between the ages of 1-4 years. It has a prevalence of 1-4 cases per million persons. Males and females are equally affected and there is no racial predominance. The disorder is characterized by diffuse palmoplantar keratoderma and premature loss of both deciduous and permanent teeth. Often, there is associated hyperhidrosis of the palms and soles resulting in a foul-smelling odor. Well-demarcated psoriasiform plaques occur on the elbows and knees. The second major feature of PLS is severe periodontitis, which starts at age 3 or 4 years. We report a case of a 14-year-old patient with Papillon-Lefevre syndrome.
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