Neurofibroma is a benign peripheral nerve sheath tumor, which is one of the most frequent tumors of neural origin. The diagnosis of type 1 neurofibromatosis (NF-I) can be made if there is presence of a neurofibroma. Neurofibromatosis type 1 occurs due to an alteration in the long arm of chromosome 17 and is an autosomal dominant inherited disease. There is no family history of the disease in about 50% of the NF-I patients. NF-I is characterized by the presence of skin lesions (café-au-lait spots and neurofibromas), bone malformations, and central nervous system tumors. A series of clinical criteria decide the diagnosis of NF-I. This article reports a case of NF-I in a 61-year-old male patient with classical features.

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Context: This study intends to assess the data on the prevalence and types of ameloblastoma reported in the Outpatient Department retrospectively, so that the distribution of ameloblastomas among this geographic area can be reported. Aims: To retrospectively analyze and evaluate the distribution and frequency of ameloblastoma cases based on the gender and histopathological types. Settings and Design: Retrospective study. Materials and Methods: Radiographs and biopsy records of all histologically diagnosed cases of ameloblastoma archived from January 2010 to December 2012 were retrieved from the Outpatient Department. Statistical Analysis: Descriptive statistics were performed to calculate the frequency and percentages of these variables. Age was stratified into various groups at 15-year intervals. The chi-square test for differences between two groups and the analysis of variance (ANOVA) test for differences among three or more groups were used. The level of statistical significance was set at P < 0.05. Results: From the data of ameloblastoma patients, about 30 cases were short-listed and their data was analyzed. It was found that the 15-30 year old age group had the highest percentage of occurrence (about 46.6%) among all cases. Frequently the posterior segment and vertical ramus of the mandible was involved. Radiographically, unilocular appearance was noted in 50% of the cases and unicystic ameloblastoma was the most frequently encountered histological subtype (49.9%). Conclusion: Studies on the incidence of ameloblastoma among the Indian population is rare. By performing a meta-analysis at the level of societies and geographic places, we can identify the demographic distribution of common odontogenic lesions like ameloblastoma among the various populations.

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Aims: The purpose of this study is to determine, through a questionnaire, the prevalence of oral premalignant lesions and conditions in the population of Aurangabad city, having adverse oral habits of using tobacco and tobacco-related products in various forms, to analyze the adverse health effects of these habits with respect to the duration and frequency of consumption, and to analyze the patient motivation toward the cessation of this habit. Materials and Methods: The study was conducted in the form of a questionnaire, comprising 13 questions, to gather the sociodemographic data, information on habits of using various forms of tobacco and areca-nut (Q.1-5), symptoms associated with various habits and the treatment taken for the same (Q.6-9), and the attempt toward tobacco cessation (Q.10-13). The subjects who were diagnosed with premalignant lesions or other conditions, based on the clinical examination, underwent this questionnaire survey. Seven hundred and thirty-five subjects were included in this study during a period of 12 months. The obtained data was subjected to statistical analysis using the Epi Info™ 3.5.3. The mean percentage proportion was used for data analysis. Results: The results showed that areca nut was the most popular product among young adults. The survey data suggested that only few of the patients had tried to stop these adverse habits at some point in their lives. The most common reason for this was, advice given by the dentist after the patients were made aware of these lesions. Conclusion: The authors conclude that although the number of cases due to adverse oral habits is rising, if awareness is created by a dentist among such patients, it can bring a ray of hope in changing these malevolent trends.

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Juvenile ossifying fibroma is considered a unique entity occurring primarily in children and adolescents. Although a benign neoplasm of bone origin, it is an aggressive variant of ossifying fibroma of the jaws. On account of the variable clinical behavior, a highly aggressive nature, and a high tendency for recurrence, early detection and prompt treatment is required. This report presents a case of juvenile ossifying fibroma in an eight-year-old girl, who reported to our institution with a gradually progressive swelling on the left side of her face since nine months, with typical clinical, radiological, and histopathological features.

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Background: In recent times, transcutaneous electrical nerve stimulation (TENS) therapy and placebo drug therapy have been studied widely in the management of temporomandibular joint (TMJ) pain; but at the individual level. Thus, it was required to compare the efficacy of TENS and placebo drug therapy in patients with TMJ pain disorders. Aims: To determine the effectiveness of TENS therapy and placebo drug therapy in the treatment of TMJ pain disorders and to compare the efficacy of both. Settings and Design: A comparative study was done with 40 subjects reporting with the chief complaint of TMJ pain by dividing them into two groups through randomization. Materials and Methods: Subjects of either sex in the age group of 18-60 years and diagnosed with TMJ pain disorders were considered and divided into two equal groups of 20 patients each as Group I and Group II. Group I patients were advised TENS therapy once in a week for 4 weeks and were followed up in the fifth week. In Group II, placebo was given once daily for 4 weeks and follow-up was done in the fifth week. TMJ pain before, during, and at the completion of the treatment was measured in terms of Visual Analogue Scale (VAS). Statistical Analysis: Z-test for proportion and one-way analysis of variance (ANOVA) were used. Results: A significant improvement in the tenderness of muscles and TMJ and for maximum mouth opening bilaterally was observed in Group I during different visits. It was also observed that the average values for pain and tenderness of the muscles and TMJ in TENS therapy for the different visits including follow-up were less compared to the values in placebo drug therapy. Conclusion: TENS therapy proved to be one of the widely and most effectively used treatment modalities with its multifaceted approach toward the treatment of the TMJ pain disorders as compared to placebo therapy.

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Plasma cell gingivitis (PCG) is a rare condition of the gingiva, characterized by infiltration of plasma cells. The etiology is largely unknown, but it is thought to be due to a hypersensitivity reaction to an allergen. We report an interesting case of plasma cell gingivitis in a 28-year-old male patient, suffering from muscular dystrophy type II, diagnosed by histopathological examination of the excised gingival tissue, which was necessitated due to the refractory nature of the lesion to conventional treatment. The patient responded to topical 0.1% triamcinolone acetonide and 5 mg Levocetirizine.

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Binder's syndrome or nasomaxillary hypoplasia or maxillonasal dysplasia is an uncommon developmental disorder predominantly affecting the maxillary anterior region and the nasal complex. A concave profile, broad and flat nose, short columella, convex upper lip, and malocclusion are the major clinical findings. The characteristic features of this syndrome are developmental failure in the premaxillary area, with concomitant defects of the nasal skeleton. We present two cases showing the characteristic features of this rare syndrome.

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Invasive cervical resorption is a rare form of root resorption, characterized by destruction of the cervical region of teeth resulting from the action of tooth resorbing cells. Being an asymptomatic condition, it is often discovered on routine radiographic examination. This multifactorial disease process can most commonly occur as a sequel to orthodontic treatment, dental trauma, bleaching procedures, and less commonly, as an outcome of segmental orthognathic surgery, periodontal root planning, tetracycline conditioning of the root canal, bruxism, transplantation of tooth, guided tissue regeneration, cementoenamel disjunction. In the absence of these predisposing factors, it can be labeled as 'idiopathic multiple cervical resorption'. This article describes the case of a medically fit Indian male, who displayed idiopathic invasive cervical resorption in multiple teeth.

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Objective: The purpose of this study was to determine whether localization is achievable with a single panoramic radiograph. Materials and Methods: A total of 40 patients were studied, in varying age groups and were assessed clinically for impacted or erupted malpositioned maxillary canines. In 20 patients with erupted malposed canines, a panoramic radiograph was compared with the clinical visual method; and in the remaining 20 patients with impacted maxillary canines, a panoramic radiograph was compared with the buccal object rule, for localizing the canine. Results: In our study, the patients were in the age group of 11-52 years, with a mean age of 23.47 ± 8.63 years (SD). Kappa statistics revealed good agreement for localization by using panoramic radiographs when compared to the visual method (value-0.684), and they revealed moderate agreement for localization when using panoramic radiographs, as compared to the buccal object rule (value-0.630). A coefficient correlation for reliability of a panoramic radiograph gave a predictive value of P < 0.0001, thus proving that using panoramic radiography for localizing the object is highly significant. Conclusion: Our study suggested that panoramic radiography is a moderately reliable tool for localizing maxillary impacted canines.

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Psychoneuroimmunology characterizes a disease entity that combines psychological components, central nervous system regulation, and immunology, to explain the etiological complexity of a disease. Temporomandibular disorders (TMDs) include a heterogeneous group of painful conditions that involve the temporomandibular joint (TMJ), muscles of mastication, and the adjacent anatomic structures. This review focuses on the psychoneuroimmunological diseases and disorders that mimic the symptoms of TMDs. The differentiation of these disorders is of great significance to the oral physician - differentiating and diagnosing the cause of TMJ pain and treating it effectively to benefit the patient.The literature for this review was taken from Medline/PubMed, other indexed journals, standard text books, and online material.

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Unilateral pure trigeminal motor nerve neuropathy is an extremely rare and unique condition, characterized by atrophy of the muscles, innervated by the motor branch of the trigeminal nerve. We report such a case in a 25-year-old male patient. The diagnosis was made on the basis of clinical and radiological examinations. Magnetic Resonance Imaging (MRI) proved to be the key for establishing the diagnosis, which showed atrophy and fatty infiltration over the affected side of the muscles of mastication. We were unable to establish the cause of the condition even after performing a brain MRI.

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Ameloblastoma is the most common clinically significant odontogenic tumor. Its relative frequency equals the combined frequency of all other tumors. Ameloblastoma is one of the most significant odontogenic tumors because of its incidence and clinical behavior. Unicystic ameloblastoma refers to those cystic lesions that show clinical, radiographical or gross features of a mandibular cyst, but on histological examination show a typical ameloblastomatous epithelium lining of the cyst cavity, with or without luminal and/or mural tumor growth. We present a case of unicystic ameloblastoma in a 25-year male patient, with its management.

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Odontomas are the most frequent hamartomatous lesions involving the oral cavity. The complex variant is an agglomerate of all dental tissues characterized by abnormal morphodifferentiation despite normal histodifferentiation. These are usually asymptomatic and are frequently associated with eruption disturbances. We report an unusual case of erupting complex odontoma associated with an impacted maxillary second molar.

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The aim of this review is to evaluate the expression of cytokeratin 18 and 19 in oral potentially malignant disorders (OPMD). Systematic review was performed using Medline and PubMed. Hand searches were taken from the back references. Articles published till 15 July 2014 were included in the search. The search yielded a total of 20 articles, out of which 16 articles were eliminated, as they did not fulfill the inclusion criteria and 4 articles were included for the final analysis. The available literature showed that cytokeratin 18 and 19 were expressed in all OPMDs. The level of expression varied among different oral, potentially malignant disorders and among different studies.

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Cleidocranial dysplasia is a disease that occurs secondary to a dominant autosomal inheritance. There is no predilection for any genre or ethnic group. As there is a delay in the eruption and/or absence of permanent teeth, the patients usually report to a dental surgeon for replacement of the missing teeth. This condition is characterized by several cranial malformations and underdevelopment, absence of clavicles, and multiple impacted supernumerary and permanent teeth. The diagnosis of the condition is usually based on the presence of the above-mentioned main features and on clinical and familial evidence. Here we report a rare case of cleidocranial dysplasia in a male patient, having most of the characteristic features of this syndrome.

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The peripheral cemento-ossifying fibroma (PCOF) is an osteogenic neoplasm and is believed to arise from the periodontal ligament. It accounts for 3.1% of all oral tumors and 9.6% of all gingival lesions. It frequently occurs in the maxillary anterior region in teenagers and young adults, and has a female predilection. Trauma, local irritation due to calculus, ill-fitting dentures and faulty restorations, and hormonal disturbances are the known predisposing factors. An early diagnosis and surgical excision is required to prevent its recurrence. Here we present a case of PCOF with a history of just two months, occurring in an elderly female involving the edentulous mandibular posterior region.

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Introduction: The gap between the integration of medical and dental care in our country is quite evident, and requires the attention of both the faculties. Postgraduate training in Oral Medicine and Radiology is available in our country since many years. However, unlike other specialists in dentistry, it is not routine for a medical practitioner to refer patients to a specialist in Oral Medicine and Radiology. An introspection regarding the present situation is essential to improve the accessibility and availability of comprehensive oral healthcare. Objective: This survey was conducted to assess the perceived need and availability of dentists and specialists in Oral Medicine and Radiology by medical practitioners in Pune, Maharashtra. Materials and Methods: A questionnaire was sent by post to 200 randomly selected medical practitioners. Personal interviews were conducted among 41 medical practitioners in private practice and 25 working at a local teaching hospital. Hence, a total of 266 medical practitioners were approached for participation in the study. Results: Ninety-six percent of the practitioners have mentioned seeing patients with oral complaint(s) other than toothache in their practice. Thirty-four percent of the medical practitioners referred patients with dental or other oral problems directly to the dentists, 60% referred them after prescribing medicines, whereas, 6% of the medical practitioners treated such patients on their own. Sixty percent referrals were made to a general dental practitioner rather than a dental specialist. Seventy-two percent of them were not even aware of the presence of any Oral Medicine and Radiology specialists in their vicinity or city. Conclusion: Medical practitioners do perceive a need of dental practitioners for referring various oral problems. However, there seems to be little awareness among the medical practitioners regarding the expertise and availability of specialists in Oral Medicine and Radiology. Very few referrals of oral mucosal lesions are done to the dentists, as a majority of them are done to general dental practitioners rather than to an Oral Medicine and Radiology specialist.

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The Parry Romberg syndrome (PRS) is a rare neurocutaneous disorder characterized by progressive facial hemiatrophy. Parry Romberg syndrome is characterized by a slow progressive atrophy that appears in the early stages of life, primarily affecting the subcutaneous tissue and subjacent fat on one side of the face. Dental findings include delayed tooth eruption, retarded root formation, root resorption, oligodontia, microdontia, dilacerations, pulp stones, reduction in the height and width of the ramus and body of the mandible, and delayed mandibular angular development. We describe the case of a 24-year-old female patient with stabilized, moderate, facial hemiatrophy on the right side of her face with a varied presentation.

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Adenomatoid odontogenic tumor (AOT) has been described as an uncommon benign odontogenic tumor mostly encountered in young patients, especially in the second decade of life. It is uncommon in patients older than 30 years of age. Adenomatoid odontogenic tumor shows a female predilection. Maxilla is the major site of occurrence, almost twice as often as the mandible, and the anterior part of the jaw is more frequently involved than the posterior part. An unerupted maxillary canine is the tooth most commonly associated with AOT. Clinically, AOT presents as a slowgrowing symptom-free lesion and is frequently discovered during routine radiographic examination. This article features the AOT cases reported at Government Dental College, Kozhikode, Kerala, India over a period of 5 years from January 2009 to January 2014. This case series is diverse with respect to the anatomic site of the tumor and its radiographic features, and all the three clinico-topographic variants are reported.

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Ameloblastomas are an enigmatic group of tumors affecting different parts of the body, namely, the pituitary gland (craniopharyngioma, Rathke's pouch tumor), long bones, jaws, and soft tissues of the oral cavity. These are slow-growing benign tumors of the jaw, where patients usually present late, after the tumor achieves considerable size and causes facial disfigurement. Ameloblastomas show wide morphological spectra and may pose diagnostic difficulties. Of the different histological variants, acanthomatous type is a rare variant that has distinct features. The challenges in the management of this tumor lie in achieving complete excision, as recurrence is common with incomplete removal, and also to reconstruct the bony defect, to give a reasonable cosmetic and functional outcome to the patient. We report one such rare case of a large acanthomatous ameloblastoma affecting the mandible that has caused gross facial disfigurement.

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Cone beam computed tomography (CBCT) is a relatively new gadget in the field of clinical CT technology. CBCT has been projected as a low-dose alternative to medical CT, with a wide range of applications, and it is said to have paved the way for a paradigm shift in the role of imaging in dentistry from diagnosis to image guidance. However, several questions remain regarding the applicability of CBCT in dentistry, as some of the applications suggested appear to be applications for the sake of an application. This article attempts to look into the hype and facts of cone beam CT.

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Cone-beam computed tomography (CBCT) is an advanced imaging modality, with its application in all branches of dentistry. Of all the imaging modalities available, CBCT, with minimum required exposure, provides the best image quality and helps in arriving at a correct diagnosis and in treatment planning. An odontogenic keratocyst, reclassified as a keratocystic odontogenic tumor (KCOT), has an aggressive behavior, is prone to recur, and thus, has been classified as a tumor. Here, we discuss a rare case of a keratocystic odontogenic tumor occurring in the maxilla, with an ectopic tooth position mimicking a dentigerous cyst.

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Desmoplastic fibroma (DF) is a rare, locally aggressive benign fibrous tumor of the bone that has been reported in the maxillofacial skeleton. In this case report, we present imaging findings of a histopathologically proven desmoplastic fibroma involving the left mandibular body region in a 27-year-old male patient. We have also discussed epidemiological data, clinical, radiographical, and histopathological features, along with the prognosis and treatment of DF.

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Primary intraosseous carcinoma (PIOC) is a very rare, but well-recognized entity, which is locally aggressive with quite poor prognosis. It may arise within the jaws either from a previous odontogenic cyst or de novo, rather than from a pre-existing epithelial lesion. A case of PIOC arising in the mandible of a 63-year-old male patient is reported in this article, with the clinical, radiological, and histological features described. This rare lesion must be considered in any differential diagnosis of jaw radiolucency.

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