Oral submucous fibrosis (OSMF) is a potentially malignant disorder (PMD) and crippling condition of oral mucosa. It is a chronic insidious scarring disease of oral cavity, pharynx and upper digestive tract, characterized by progressive inability to open the mouth due to loss of elasticity and development of vertical fibrous bands in labial and buccal tissues. OSMF is a debilitating but preventable oral disease. It predominantly affects people of Southeast Asia and Indian subcontinent, where chewing of arecanut and its commercial preparation is high. Presence of fibrous bands is the main characteristic feature of OSMF. The present literature review provides the compilation of various classification system based on clinical and/or histopathological features of OSMF from several databases. The advantages and drawbacks of these classifications supersede each other, leading to perplexity. An attempt is made to provide and update the knowledge about this potentially malignant disorder to health care providers in order to help in early detection and treatment, thus reducing the mortality of oral cancer.

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Aims: This study was designed to evaluate the efficacy of Dapsone for treating erosive lichen planus and to observe side effects occurring for the drug during the treatment. Materials and methods: Twenty-two patients who were resistant to treatment with systemic antioxidants and topical vitamin were treated with systemic Dapsone 100 mg per day for 3 months. Improvement of signs and symptoms of the disease and the side effects of the drug were evaluated every 15 days and posttreatment recurrence of the disease was assessed after 6 months of treatment. Results: A significant improvement in the burning sensation and reduction in size of the erosive areas were noticed with a 3 months course of Dapsone therapy. Systemic side effects were minimal. A reduction in hemoglobin percentage of 0.92 gm from the baseline values was the only observed side effect Conclusion: Results of this study show that Dapsone is an effective drug in erosive lichen planus. Dapsone can be used as a steroid sparing agent when steroids are contraindicated. There are minimal side effects for Dapsone when used in the dose of 100 mg per day for 3 months.

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Purpose: Soft palate plays a significant role in various important functions in the head and neck region- Its varied morphology is implicated in variety of diseases. Therefore, it is essential to establish the morphology of soft palate in normal patients to establish the variations in its morphology in various diseases. The present study aims to investigate the variation of the soft palate morphology in Indian subpopulation and possibly classify types of soft palate, to evaluate the dimensional differences of the soft palate between each types and to investigate the proportional differences in different age and gender groups. Materials and methods: Two hundred digital lateral cephalograms were analyzed for the velar morphology and categorized into different types. In addition length and thickness of the soft palate was also measured. Results: In addition to original seven types of soft palate two more morphological variants of soft palate were observed. The velar length was significantly higher in males and the velar width was significantly less in females. Also a significant increase in velar length was observed with increase in age. Conclusion: Type 1 was the most common of all the variants. Moreover, additional morphological variants which did not fit into the classical categories were also observed. There was no significant correlation between the different age groups and the types of soft palate. The velar length and width was significantly greater in males than in females. A significant increase in velar length was noted with increase in age.

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Ramsay Hunt syndrome (RHS) is defined as an acute peripheral facial neuropathy caused by the reactivated latent varicella zoster virus (VZV) in the geniculate ganglion; characterized with erythematous vesicular rash of the skin of the ear canal, auricle, facial skin, oral mucosa and facial palsy (also known as herpes zoster oticus). This article reports a case of Ramsay Hunt Syndrome (RHS) in a 37-year-old male patient depicting the classical signs.

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Oral cancer is one among the ten most common cancers in the world and shows a marked geographic variation in occurrence. It causes considerable morbidity and is associated with a 5-year survival rate of less than 50%. Current treatment primarily consists of surgery and radiotherapy and improvement in long-term cure rates with these modalities has reached a plateau. As, curative therapy available for oral cancer often results in debilitating changes in appearance, speech, swallowing and breathing, preventive strategies are desirable. Cancer chemoprevention is the use of natural, synthetic or biologic chemical agents to reverse, suppress, or prevent carcinogenic progression. Chemoprevention has been an extensively-studied strategy and continues to hold promise in the management of oral cancer. Many agents have been evaluated as possible chemopreventive agents including vitamin A and retinoids, betacarotene, vitamin E and dietary agents. Recently, molecularly targeted approach has generated interest among researchers worldwide which includes cyclooxygenase-2 (COX-2) inhibitors, EGFR inhibitors and adenovirus vectors. This article reviews the various aspects of chemoprevention and describes important chemopreventive agents and design of chemopreventive trials.

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A genetic basis for the development of cancer has been hypothesized for nearly a century and has been supported by familial, epidemiological and cytogenetic studies. Current view is that carcinogenesis is a multistep process involving activation of oncogenes or inactivation of tumor suppressor genes. Tumor suppressor gene is a gene whose protein product can inhibit the transformation of a normal cell to a tumor cell and therefore, whose loss of function can contribute to the malignant transformation of cell. The retinoblastoma gene (Rb) is the first tumor suppressor gene identified and plays a key role in the regulation of cell cycle. A diverse body of evidence now indicates that pRb stands in the midst of a regulatory pathway and suffers disruption during the pathogenesis of majority of human tumors, including oral cancers- However, recent studies point to a more general function of pRb. In addition to tumor suppression, Rb has a role in cellular differentiation and apoptosis. This review provides an insight into the complex functions of pRb with particular reference to its role in tumor suppression.

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Ulcerative colitis (UC) belongs to the inflammatory bowel diseases (IBD), which may be divided into two major groups, ulcerative colitis (UC) and Crohn's disease (CD). It affects part or whole of the large intestine, frequently of the lower colon and rectum, causes inflammation and ulcers. The leading initial symptom of UC is diarrhea with blood and mucus, pain, tenesmus. UC is usually associated with recurrent attacks with complete remission of symptoms in the interim. Extraintestinal manifestations including various oral lesions have been associated with UC. The oral lesions in UC are rare and commonly occurring are mucosal ulcers, aphthous ulcers, pyostomatitis vegetans, etc. at any part of the oral cavity. Microscopically the oral lesions mimic colonic crypt abscess without granulomatous inflammation, spongiotic epithelium with eosinophilic and neutrophilic intraepithelial microabscesses and submucosa shows edema with neutrophils, eosinophils and lymphocytes. The seventy of the oral disease usually reflects the seventy of intestinal disease; oral manifestations may be used as additional criteria to determine the severity of disease and probably response to therapy. Here, we present a rare case report with oral manifestations as indicators for intestinal disease flare-ups in a patient diagnosed with UC.

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Amelogenesis impertecta (Al) is a diverse collection of inherited diseases that exhibit qualitative or quantitative tooth enamel defects in the absence of systemic manifestations. Also known by varied names, such as hereditary enamel dysplasia, hereditary brown opalescent teeth, this defect is entirely ectodermal, since mesodermal components of the teeth are basically normal. This article details a case of Al along with complete review which presents in his twin siblings with clinical, radiological and histopathological report.

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Objectives: A study was conducted to assess the contribution of the cancellous and endosteal surface of the cortical bone to the trabecular pattern seen in an IOPA radiograph. Materials and methods: An in vitro study analyzing the contribution of the endosteal surface of cortical bone and cancellous bone to the trabecular pattern was conducted, using 60 specimens of desiccated human mandibles. The mode of execution involved IOPA radiographic evaluation of premolarmolar segments in the specimens before and after removal of cancellous bone. The radiographs were numbered for identification and subjected to evaluation by 5 dentomaxillofacial radiologists who were doubleblinded to ensure an unbiased interpretation. Results: The trabecular pattern appreciation by the experts in the IOPA radiographs before and after removal of cancellous bone displayed immaculate correlation as per the Goodman-Kruskal Gamma Coefficient values which was 0.78 indicating a very large correlation. The relative density of trabecular pattern was significantly higher in radiograph before than after removal of cancellous bone with p-value less than 0.05. Conclusion: Based on these results it was adjudged that both the cancellous and endosteal surface of cortical bone contributed significantly to the trabecular pattern in an IOPA radiograph.

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Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely, their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring in the oral cavity. The aim of this paper is to present the importance of diagnosis and treatment of intraoral lipoma. Clinicians must be able to recognize rare lesions, like intraoral lipomas, to provide appropriate treatment, thereby ensuring comfort and quality of life for the patient.

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Herpes zoster is a localized, generally painful cutaneous eruption that occurs most frequently among older adults and immunocompromized persons. It is caused by reactivation of latent varicella zoster virus (VZV) Approximately one in three persons will develop zoster during their lifetime. A common complication of zoster is postherpetic neuralgia (PHN), a chronic, often debilitating pain condition that can last months or even years. The risk for PHN in patients with zoster is 10 to 18%. Approximately 3% of patients with zoster are hospitalized. Death attributable to zoster are common among immunocompromized persons. Prompt treatment with the oral antiviral agents, corticosteroids and analgesics decreases the severity and duration of acute pain from zoster. This article reviews herpes zoster and reports one such case, which was treated successfully without any complications.

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Objectives: The study was conducted to assess the prevalence of oral submucous fibrosis among patients visiting dental college in rural area of Jaipur, Rajasthan aged 15 years and above. Materials and methods: A cross-sectional study was conducted to access the prevalence of oral submucous fibrosis among 6,800 outpatients at NIMS Dental College in rural area of Jaipur, Rajasthan. Subjects were interviewed using a structured proforma. The clinical diagnosis of OSMF was made when patient showed characteristic features of OSMF. The statistical analysis was done with SPSS software version 11.5. Results: The prevalence of OSMF in the study population was 231 (3.39%). Majority of subjects were males 188 (81.38%). The prevalence of OSMF was maximum in 15 to 24 years of age group 98 (42.42%). Conclusion: The observations and findings of the study clearly indicate that prevalence of OSMF and use of smokeless tobacco is on the rise in younger age group. Preventive measures like awareness programs should be started as early as possible- Tobacco counselling on various smokeless tobacco products, like gutkha, khaini, betel nut, cessation program should be periodically conducted.

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Stem cells have the remarkable potential to develop into many different cell types in the body. Serving as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells as long as the person or animal is still alive. Presently dental treatment for missing teeth largely utilize partial or complete dentures and titanium implants which are not equivalent, neither in function nor esthetics, to natural teeth. However, progress in stem cell biology and tissue engineering may present new options for replacing heavily damaged or lost teeth, or even individual tooth structures. This review summarizes the emerging concepts of whole-tooth replacement strategies and challenges in the field of dentistry.

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Objectives: The objective of the study was to evaluate the occlusal status of teenage patients and to determine the possible association of gender with the type of malocclusion. Materials and methods: The study sample consisted of 410 patients. Patients who did not fulfil the inclusion criteria for the study were excluded, thus the final sample accounted for 318. The selected subjects were interviewed by trained examiners and underwent thorough clinical evaluation pertaining to orthodontic diagnosis. Statistical analysis: The Pearson's Chi-square test was done to assess the statistical significance between males and females while taking p-values of less than 0.001 as statistically significant. Results: Among the 318 samples, 166 (52.2%) of them were females and 152 (47.8%) were males. Angle's class I molar relation was common (69.2%) followed by normal molar relation (10.1%), class III and its subdivision and class II and its subdivision were found common among males and females respectively. In regard to canine relationship, majority of them were class I followed by class II and III- Normal overjet and overbite was observed in 53.5% of the cases and there was higher incidence of increased overjet and overbite in females and reverse overjet in males Conclusion: The prevalence of malocclusion noted in the present study was 89-9% and it was more common in females. Class I canine relationship 96.9% was the most common one followed by class I molar relation (69.2%). Angle class II division 2; canine class III relationship and scissors bite were the least common (0.6%) occlusal alterations.

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Ewing's sarcoma (ES) is an uncommon malignancy that occurs usually in childhood. In most of the reported cases, the occurrence of this tumor is more in the mandible than the maxilla. A case of Ewing's sarcoma of the mandible along with the maxilla is discussed. A complete clinical, radiographic, biochemical and histological evaluation was done, ultrasonography revealed a sunray pattern; microscopically, the tumor was composed of monotonous small round cells that exhibited immune reactivity for CD99 and vimentin. The patient was subjected to multi-agent chemotherapy. This case elucidates the importance of professional knowledge of the relevant aspects of malignant lesions, such as ES. Although the prognosis remains poor, an increased rate of survival is now associated with early diagnosis and combined therapy.

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Facial asymmetry can be attributed to various conditions from developmental to malignancy. Depending upon the etiology, the treatment plan has to be modified- With the latest imaging modalities we are in a better position to find whether the asymmetry is due to soft tissue or bone pathology. The case of a patient who reported with facial asymmetry and whose radiograph showed unilateral condylar hyperplasia is presented here.

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Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor, which presents as a noninvasive lesion of the jaws with slow but progressive growth. AOT is often misdiagnosed as an odontogenic cyst. It accounts for about 2.2 to 7.1% of all odontogenic tumors. It is predominantly seen in young females, in the anterior maxilla, associated with unerupted canines. This report describes a rare case of AOT in the mandible. This paper highlights the controversies regarding its origin and management in the light of recent findings.

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Transmigration of canine is a rare phenomenon and eruption of such transmigrated canine is even rarer. The prevalence of transmigrated canine has been found to be only 0.14 to 0.31 %. We present a case report with review of literature on its etiological possibilities.

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Multiple myeloma consists of a clonal proliferation of plasma cells in the bone marrow, with varying degrees of differentiation. The disease is more frequently seen in men and the average age at diagnosis is about 60 years. The diagnosis is established by blood and urine examination and biopsy. Patients may present renal failure, bone pain, fatigue, recurrent infections and nervous system dysfunction. Oral manifestations may be the first sign of multiple myeloma, highlighting the importance of the dentist in the early diagnosis of the disease. This paper reports a case of multiple myeloma in a 72 years old male patient.

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Chondrosarcoma (CS) is a malignant neoplasm that results in abnormal bone and cartilage growth. Although CS is rare, it is the second most common primary bone malignancy. Mesenchymal chondrosarcoma (MC) is a rare histological variant of CS that accounts for only about 1 % of all CS and has high predilection for the head and neck region. It is usually seen in younger age group compared to conventional CS and the maxillary alveolus is the most common site. The tumor is unique because of its aggressive growth with a high tendency for late recurrence and delayed metastasis- We present two cases of MC, one case involving the mandibular condyle and the second, a metastatic CS with the primary in the clavicle.

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