Keratocystic odontogenic tumor (KCOT) has been identified as a "tumor" after observation of its biological behavior and genetic abnormalities consistent with neoplastic progression. In 2005, the World Health Organization (WHO) working group considered odontogenic keratocyst (OKC) to be a tumor and recommended the term KCOT, distinguishing the lesion from the orthokeratinizing variant, which is now considered an OKC or orthokeratinized odontogenic cyst. Very rarely, KCOTs can transform into more aggressive lesions such as ameloblastoma and primary intraosseous carcinoma (PIOSCC). In this paper, we present a case of KCOT involving the angle and ramus of the mandible, with histopathologic evidence of ameloblastomatous changes. We also discuss about the evolution of this lesion from a cyst to a tumor along with the latest updates of the entity.

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Senile purpura is the clinical condition where purpuric spots and ecchymosis develop at the site of minimal injury. It occurs due to laxity of the connective tissue. Oral manifestation of this disease is rare and when one encounters such a case, proper examination with extensive differential diagnosis should be considered along with appropriate investigations. A case of senile purpura in an elderly patient who had developed oral ecchymosis secondary to denture injury is being reported.

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Pyknodysostosis is a rare autosomal recessive disorder characterized by the postnatal onset of short limbs, short stature, and generalized hyperostosis along with acro-osteolysis with sclerosis of the terminal phalanges, a feature that is considered essentially pathognomonic. Other features include persistence of fontanelles, delayed closure of sutures, wormian bones, absence of frontal sinuses, and obtuse mandibular gonial angle with relative mandibular prognathism. Here, we report a case of pyknodysostosis found to be having the classical features during intraoral examination and general physical examination.

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A painless, bluish, submucosal swelling on one side of the floor of the mouth usually indicates the presence of a ranula. Rarely, such a swelling may be caused by an inflammatory disease process in a salivary gland, a neoplasm in the sublingual salivary gland, hemangiomas, a lymphatic nodular swelling, amyloidosis, or embryologic cysts/dermoid cyst. We report a 35-year-old female patient with swelling in the floor of her mouth that was clinically diagnosed as a ranula due to negative diascopy, the site of swelling, and the age of patient. Because of a strong clinical suspicion of a ranula, diagnostic methods such as angiography and magnetic resonance imaging (MRI) were not used in our case. A preoperative diagnosis was not truly established. We report a case of hemangioma in the floor of the mouth masquerading as a ranula. Although a rarity, vascular malformations should always be ruled out by using digital subtraction angiography and MRI studies before going for surgical intervention.

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Basal cell carcinoma is the most common skin cancer, accounting approximately for 70% of all skin malignancies. It develops most frequently on the exposed surfaces of the skin, middle third of the face, and the scalp. Though it is a slow-growing tumor that rarely metastasizes, it can cause significant local destruction with disfigurement if neglected or treated inadequately. We present one such interesting case of a 70-year-old female patient with a non-healing ulcer involving the left ear and the retroauricular area since 2 years. An incisional biopsy was performed from the left pinna, which was conclusive of nodular basal cell carcinoma. The clinical presentation, differential diagnosis, along with appropriate review of literature are presented in the context that dental surgeons might often be the first health care professionals to come in contact with patients suffering from abnormalities in the orofacial region.

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Taenia solium , the larvae of pork tapeworm, can cause the parasitic infection known as cysticercosis. It is commonly seen in developing countries. The World Health Organization estimates that over 50,000 deaths per year are caused by neurocysticercosis worldwide. It can occur anywhere in the body. Cysticerci in the muscles generally do not cause symptoms; they present as nodules and can be felt as lumps under the skin or they can present as muscular pseudohypertrophy. The condition rarely involves musculature of the orofacial region and presents a difficulty in clinical diagnosis. Here, we present a case report of a healthy middle-aged female patient who had a painless swelling below the lower lip. The ultrasound examination revealed an intramuscular cysticercosal cyst. The diagnosis was confirmed using magnetic resonance imaging and by histopathology. The case was managed by conservative enucleation of the cyst.

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Objective: To investigate the presence of sexual dimorphism by studying the size of the teeth among males and females in Chennai population, which aids in sex determination. Materials and Methods: Incisocervical length, mesiodistal and buccolingual diameters were measured in teeth of 60 subjects (30 males, 30 females) in the age group of 18-22 years from Chennai population. The differences in the mean values of parameters in males and females were calculated using independent t-test. Discriminant functional analysis was performed to determine the accuracy of sex. Results: Significant differences were found in mean incisocervical length which were found to be larger in males with P < 0.05 in 11, 12, 14, 17, 21, 22, 24, 26, 27, 31, 32, 33, 34, 41, 43, and 45 and with P < 0.001 in 13, 23, 32, 42, 43, and 44, with the exception of 37 and 47 which were larger in females. Mean mesiodistal diameter was larger in males with P < 0.05 in 11, 12, and 21 and with P < 0.001 in 13, 23, 33, and 43. Mean buccolingual diameter was larger in males with P < 0.05 in 12, 21, 31, 33, and 41 and with P < 0.001 in 11, 13, 23, and 43. Accuracy rate of predicting sex based on incisocervical length (17, 23, 47) and mesiodistal diameter (13, 33) was 78.3% and based on buccolingual diameter (13) was 76.7%. Conclusion: Males showed greater sexual dimorphism than females. Application of incisocervical, mesiodistal, and buccolingual dimensional variability among males and females in the Chennai population can aid in sex determination in forensic odontology, as the results showed moderate extent of dimorphism with an overall accuracy rate of predicting sex to be 78%.

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Double lip is a rare dental anomaly affecting either upper or lower lip or concurrently. It may be congenital or acquired. This deformity can affect the facial esthetics as it gets exaggerated while speaking, smiling, or chewing food. When it interferes with speech, double lip may cause potential functional problems. The purpose of this article is to review the literature on double lip and present a case series of maxillary double lip.

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One of the rarest developmental malformations of the lip is congenital lip pits. They are usually seen as bilateral depressions in the vermilion zone of the lip and occur on the paramedian portion of the vermilion border of the lip. They are extremely rare in the upper lip. Lip pits are due to the failure of complete union of embryonic lateral sulci of the lip/notching of lip at an early stage of development with fixation of tissues of the base of the notch. Lip pits have also been associated with a variety of other congenital disorders and other malformations. The clinical and pathologic picture and the therapeutic aspects of this condition are discussed in this paper.

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Hemangiomas are one of the most common neoplasms of infancy with an estimated prevalence of 1-3% among neonates and 10% among children of 1 year of age. It has a female predominance and occurs more frequently among Caucasians than other racial groups. Sixty percent of hemangiomas arise in the head and neck. In 80% of cases, hemangiomas occur as single lesions. They are probably developmental rather than neoplastic in origin. Despite their benign origin and behavior, hemangioma in the oral cavity is always of clinical importance to the dental profession and requires appropriate clinical management as sometimes it is associated with complications like bleeding and ulceration. Here, we report a case of hemangioma of tongue treated with sodium tetradecyl sulfate, a sclerosing agent.

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We report a case of a 15-year-old male who presented with a chief complaint of swelling in the maxillary anterior region of the jaw since 5 years. Patient gave a history of trauma to the same region 7 years back. On examination, a large intraoral swelling with multiple missing permanent teeth was noted. On radiographic examination, a large corticated radiolucency surrounding the maxillary left central and lateral incisors and canine was seen in the anterior maxilla. Surgical enucleation was carried out and histopathologic examination confirmed diagnosis of an infected dentigerous cyst. The present case report is unique as the cyst enclosed the three permanent maxillary teeth: Central incisor, lateral incisor, and canine.

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Objective: The purpose of the study was to compare high-resolution ultrasonography (HR-USG) with magnetic resonance imaging (MRI) in the diagnosis of temporomandibular joint (TMJ) internal derangements. Materials and Methods: The study was conducted on 11 subjects with a chief complaint of TMJ discomfort, who were diagnosed as having TMJ internal derangement according to clinical diagnostic criteria (CDC) for temporomandibular disorders (TMD). A control group of eight subjects who had no sign of TMJ internal derangement were also examined. Imaging modalities (MRI and HR-USG) were performed on all the subjects (cases and controls). Results: Strong agreement was found between MRI and HR-USG in the diagnosis of TMJ internal derangements (k = 0.918, P < 0.001). Conclusion: MRI and HR-USG can be used to define the disc and its displacement.

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Dental education came into existence in the early 20 ^th century in India and is at a critical juncture at present. Dental education, as we know it today, evolved from the Gies Report in 1926, i.e., university-housed and scientifically based shortly after Flexner made his landmark report on the existing and proposed medical education system. Present-day education system is exam driven. This is compounded by compartmentalized approach to patient management as the present curriculum is not designed for either horizontal or vertical integration. Although graduates perform exceedingly well in the academic environment, it has been observed that they are not ready for practice. Many dental schools in the west are gradually undergoing a paradigm shift and transitioning to a competency-based education curriculum. Schools must become unburdened from departmental courses and move toward interdisciplinary integration. This paper highlights the need for shift in paradigm of dental education in the Indian context.

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Odontogenic keratocyst (OKC), now known as keratocystic odontogenic tumor (KCOT), is the most common cystic lesion occurring in the maxillofacial region. Multiple occurrence of these cysts is less frequent and is usually associated with syndromes, the most common being the Gorlin Goltz syndrome or the nevoid basal cell carcinoma syndrome (NBCCS). We hereby report an unusual case of multiple OKCs in a healthy adult, associated with other dental anomalies. Management approach consisted of enucleation with curettage of the smaller lesions and decortication of buccal cortex in the large lesion. The condition in the present case may be because of the multifocal nature of OKC rather than its association with any syndrome. Concomitant occurrence of multiple OKCs with other dental anomalies may be coincidental. Impacted teeth or missing teeth must be radiographed to rule out the lesions associated with them.

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Introduction: The major immunoglobulin present in mucosal secretions (e.g. saliva) is secretory immunoglobulin A (IgA). The potential functions of this secretory IgA include prevention of microbial attachment to surfaces by agglutination, blockage of receptor-mediated attachment, and altering surface hydrophobicity. IgA in saliva is detected early in life as the mucosal immune system develops and the oral cavity is exposed to microbes that make up the normal ecology, as well as to potential pathogens. Lower concentration of IgA in saliva is associated with increased risk for periodontal disease and caries. The secretory IgA is the first line of defense against pathogens that invade the mucosal surfaces. The immune system exhibits profound changes with age and this fact has been well documented. Aims and Objectives: To investigate and re-confirm that salivary IgA concentration undergoes changes with advancing age, and further, to find if there is any probable difference in salivary IgA levels between men and women. Materials and Methods: Saliva samples were taken from 120 healthy subjects aged 1-60 years who were divided into the following age groups: 1-10 years, 11-20 years, 21-30 years, 31-40 years, 41-50 years, and 51-60 years. The salivary IgA concentrations were measured by use of single radial immune diffusion technique and analyzed using the paired and unpaired Student's t-test, and coefficient test as appropriate, and P values of less than 0.5 were considered significant. Results: The mean salivary IgA levels showed significant changes in each decade of the subjects selected. The mean salivary IgA levels were significantly higher in adults than those observed in children. Conclusion: These results showed that the salivary IgA levels exhibit age-related changes.

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Taurodontism is a morphologic alteration in the shape of the tooth, in which there is an enlargement of the pulp chamber with apical displacement of the pulpal floor and lack of the normal constriction at the level of the cemento-enamel junction. Although its developmental etiology is evidential and well documented, it occurs as a part of multiple syndromes as well as several developmental anomalies. This review compiles different facets of origin of taurodontism, rather than viewing it just as a developmental malformation, cited so far in the literature. A case report in which all the first permanent molars are being affected with taurodontism is also presented.

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Cemento-ossifying fibromas (COFs) are relatively rare, benign lesions affecting the jaws and other craniofacial bones and are included in the group of mesodermal odontogenic tumors by Gorlin. They have a predilection for females between the third and fourth decades of life, and about 60% of the lesions are seen most often in the mandibular arch, predominantly occurring in the premolar/molar region of the mandible. This report describes a case of central COF in a 49-year-old male involving the maxillary posterior region. The current case is reported because of the rarity of such lesions and the paucity of information concerning them in the dental literature. We believe that this case illustrates many of the clinical, radiographic, and histologic features associated with cemento-ossifying tumors.

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Though a clinical examination may reveal a deep fissure or pit on the surface of an anterior tooth, radiographic examination is a more accurate approach to diagnose an invagination. Dens invaginatus is one of the common dental deformities, but the defect involving the root and its association with radicular cyst is still very uncommon. The objective of this case presentation is to report a case of radicular dens in dente, which is a rare dental anomaly. This case report shows that dens invaginatus with an open apex and a radicular cyst can be treated successfully using currently available materials.

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Introduction: Panoramic radiograph is frequently prescribed by dentists for implant planning and, hence, accurate assessment of anatomical structures in panoramic radiograph is of utmost importance. Aims: The aim of the present study is to know the accuracy of panoramic radiograph in assessment of relationship between maxillary sinus floor and posterior teeth roots, and the distance from alveolar crest to nasal floor by comparing it with that of cone-beam computed tomographic (CBCT) image. Materials and Methods: Panoramic and CBCT images of 30 patients were analyzed. The topographic relationship of each root of posterior teeth to the maxillary sinus floor was evaluated and classified into three classes. The distance from the peak point on maxillary alveolar crest to nasal floor was measured in panoramic radiograph as well as in CBCT image. All the measurements were made by built-in measurement tools. Results: Class 1 roots in panoramic radiograph showed high agreement (86%) with CBCT image, followed by class 0 (76%). There was a significant difference in the measurements of alveolar bone height (ABH) in the nasal floor region with a P value of 0.018. Conclusion: Panoramic radiograph is reliable in assessment of nasal floor and maxillary sinus, provided position of the patient, distortion, and the inherent magnification factor are taken into consideration.

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People from many advanced countries are traveling to developing countries like India for medical and dental care along with their vacations, which is also known as medical tourism. Dental tourism means traveling abroad for affordable dental care, dental surgery, or dental procedures, which is generally expensive in their own country, while exploring the visiting country. Dental tourism forms 10% of the total Indian medical tourism, which is projected to grow to 30% by 2015. It has greatly developed overtime and it is likely to further expand more as international patients find it more and more advantageous due to affordable dental treatments in India from highly qualified and experienced professionals. The oral health professionals can arrange for travel and tours along with dental treatment at most competitive rates. The article focuses on the emergence of the dental tourism as a booming industry and the key management aspects that will help oral health professionals to establish India as a dental care destination.

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Gemination and fusion are anomalies which have close similarity. These anomalies may develop during tooth bud morphodifferentiation as a result of a developmental aberration of the ectoderm and mesoderm. The incidence of these anomalies was reported to be less than 1%, occurring predominantly in incisors and canines with equal distribution in the maxilla and mandible. Gemination and fusion are generally asymptomatic and do not require treatment. However, there could be poor aesthetics, periodontal destruction, or caries leading to pulp necrosis. This article reports a rare occurrence of fusion/gemination in the third molar region.

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Bean syndrome or blue rubber bleb syndrome is a rare disorder of vascular channels with mucocutaneous manifestations. The clinical severity varies among patients from being totally symptom free to fatal bleeding resulting in anemia. As the histopathologic findings are not pathognomonic, diagnosis is usually made from the clinical presentation, though the imaging techniques reveal extension of the lesion. We report an asymptomatic case of blue rubber bleb syndrome who reported for dental treatment with oral and cutaneous manifestations.

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Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the major and minor salivary glands, the lacrimal glands, the ceruminous glands and occasionally the excretory glands of the female genital tract. 30-40% of these carcinomas occur in the head and neck region. Approximately 50-70% of the cases have been reported in the minor salivary glands. The most common location is the palate, generally in the area of the greater palatine foramen. ACC is generally characterized by a slow growth rate, and it is often present for several years before the patient seeks treatment. Here we present a case of 42-year-old female who came to the department for the complaint of a swelling over the right side of palate since 2-3 months which was diagnosed as a benign tumor initially, but was confirmed as tubular ACC histologically.

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The odontogenic keratocyst (OKC) is a rare odontogenic cyst of epithelial origin. There are many types of cysts of the jaws, but what make the odontogenic keratocyst unusual are its characteristic features including its potentially aggressive behavior, high recurrence rate, and an association with the nevoid basal cell carcinoma syndrome. Odontogenic keratocysts, now reclassified as keratocystic odontogenic tumors (KCOTs) by the World Health Organization, are a clinical entity with a characteristic microscopic picture, kinetic growth, and biological behavior. The characteristic features are unique among all the different inflammatory and developmental cysts that occur in the jaws. In this report, we present a 35-year-old female patient with a massive KCOT with buccal cortical plate expansion and unusual anteroposterior extension extending from the premolar area up to the condyle.

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The immune-mediated oral mucosal lesions pose a challenge to the oral physicians owing to their preplexing diagnosis and management. Steroids are the first line of treatment for these diseases, but they have their limitations. With improved advancements and research being done to understand the pathogenesis behind these diseases, newer modalities of treatment are being introduced as a part of the treatment protocol for long-term remission. Some of the promising ones are plasmapheresis, extracorporeal photopheresis, intravenous immunoglobulin therapy, and rituximab. Their therapeautic efficiency is yet to be established with randomized controlled trials.The purpose of this article is to focus on these novel therapies in the management of immune-mediated oral mucosal lesions and their feasibility in the Indian scenario. A PubMed search was done using the keywords plasmapheresis, extracorporeal photopheresis, immunoadsorption, rituximab, and immune-mediated oral mucosal disorders, which revealed 10,539 articles on plasmapheresis, 925 articles on extracorporeal photopheresis, 76,100 articles on immunoglobulin therapy, and 12,402 articles on rituximab. After a detailed screening, seven articles on plasmapheresis published from the year 2002 to 2012, three articles on extracorporeal photopheresis published from the year 2008 to 2011, three articles on immunoglobulin therapy published from the year 2005 to 2011, and two articles on rituximab published from the year 2006 to 2011 were identified based on their usage in immune-mediated oral mucosal disorders for inclusion in this review.

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Aim: The study was conducted to analyze the significance of dermatoglyphics in predicting the development of oral submucous fibrosis (OSMF) among gutkha chewers. Objective: To evaluate the finger tip patterns in OSMF patients. Materials and Methods: The study was conducted on 75 subjects selected randomly from the OPD of Oral medicine and Radiology, out of which 25 subjects were gutkha chewers with OSMF, 25 were gutkha chewers without OSMF, and 25 were healthy subjects who were used as controls. The fingertip patterns were recorded using duplicating ink on A3 size paper and analyzed for their configurations using a magnifying lens. Results: Statistical analysis showed significant increase in the percentage of loops among gutkha chewers with OSMF and controls, and significant increase in the whorl patterns among the control group. The distribution of finger tip patterns of all the digits showed statistically significant increase in whorl pattern in right index (RI) and right ring (RR) finger. Conclusion: The present study showed a significant increase in the loop pattern among gutkha chewers with OSMF in comparison to controls. Thus, it can be concluded that people with more number of loop patterns are more prone to develop OSMF as compared to those with other patterns. Hence, dermatoglyphics can be used in this modern era to forecast the future of gutkha chewers, without much intervention.

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Myxofibrosarcoma is one of the most common sarcomas in the extremities of elderly patients that rarely affect the oral cavity. In this article we describe a case of primary myxofibrosarcoma of maxilla in a 19-year-old boy. Microscopically the tumor showed loosely arranged spindle-shaped tumor cells with mild pleomorphic spindle-shaped nuclei, some with minute nucleoli in a fibromyxoid stroma. The cells were strongly immunoreactive for vimentin and negative for CD-68, S-100 protein and desmin. Based on clinical, histological and immunohistochemical findings, a final diagnosis of myxofibrosarcoma was established. It is an unusual aggressive variant that frequently recurs and metastasizes, reinforcing the importance of its correct diagnosis. We report a rare case of myxofibrosarcoma in maxilla, with emphasis on immunohistochemical findings.

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Introduction: The inferior alveolar canal is described as a dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone. Conventionally, preoperative assessment is performed by orthopantomogram (OPG). Spiral computed tomography (CT), allows the clinician to localize and determine the relation of the impacted tooth and the inferior alveolar neurovascular canal (IANC) in three dimensions. Objectives: To describe the anatomical and morphologic variation of IANC as it appears in digital OPG and to correlate its relation with IANC on the CT. Materials and Methods: 100 patients were subjected to OPG and were studied for anatomic and morphologic variation. Eleven patients with mandibular impacted third molar in close proximity to the IANC were further subjected to CT examination. Results: Linear type was the commonest on the left side (39.5% in females and 41.9% in males) and elliptical type on the right side (52.6% in females and 45.2% in males). Morphologic variation showed bifid canal present in only 1 (1.6%) male on the left side. On the left side, narrowing of canal was seen in 4 (100%) teeth on OPG, in which 3 (75%) teeth showed 0 mm with cortical break in the CT. Three (100%) teeth showing interruption of white line (superior radiopaque border of IANC) on the OPG also showed 0 mm with cortical break in the CT. On the right side, 2 (100%) teeth showing narrowing of canal on the OPG correlated with 0 mm with cortical break in the CT and 1 (100%) tooth showed interruption of white line which correlated with 0 mm with cortical break in the CT. Conclusion: The comparison between the OPG patients and the CT patients (selected using the Roods criteria from the OPG patients) showed statistically significant value for narrowing of canal and interruption of white line with 0 mm loss of cortication in CT.

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Sleep apnea is an entity characterized by repetitive upper airway obstruction resulting in nocturnal hypoxia and sleep fragmentation. It is recognized as a public health problem and shows detrimental effects on health, such as hypertension, cardiovascular disease, and death. The prevalence rate is 19.5% among men and 7.5% among women in India. Polysomnography remains the gold standard method for diagnosis of sleep apnea and assessment of sleep apnea. Positive pressure therapy is the mainstay therapy of sleep apnea. Other treatment modalities include lifestyle modification, upper airway surgery, and use of an oral appliance. This article reviews the available data on management of sleep apnea.

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Calcifying cystic odontogenic tumor (CCOT) is an extremely rare clinical entity. It was considered as a cyst until 2005, when World Health Organization included it among the odontogenic tumors. It presents as a slow-growing, painless swelling of the jaw. Radiographically, it may be seen as a unilocular or multilocular radiolucency. Here, we present a case of a proliferative ameloblastomatous type of CCOT of the left mandible. Conventional radiography and cone beam computed tomography were performed, in which the lesion was found to be unicystic without any sign of calcification. The lesion was also associated with an impacted 37 tooth, which was displaced to the inferior border of the mandible.

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Aims and Objectives: To evaluate the effect of mobile phones on salivary flow rate and protein concentration in parotid saliva by comparing the dominant and non-dominant sides of prolonged mobile phone users. Materials and Methods: Parotid saliva was collected simultaneously from both the glands in 50 healthy volunteers by using sialographic cannula. The obtained results were statistically analyzed using paired t-test. Results: Salivary secretion rate was significantly less on the dominant side of mobile phone usage. There was no such significance in protein concentration on comparing the dominant side with the non-dominant side. Conclusion: It was concluded that there was a change in the functional activities of the parotid gland in prolonged mobile phone users.

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Introduction: Osteoporosis is a metabolic bone disease characterized by microarchitectural deterioration in bone tissue leading to fractures, and is essentially a preventable disease when detected in the early stages. Novel methods for early identification of osteoporosis can have a great impact in combating this otherwise progressive disease. Aims: The present study was conducted with the objectives of evaluating the precision of a radiomorphometric index [mental index (MI)] measured on a panoramic radiograph in early diagnosis of osteoporosis and finding its correlation with bone mineral density (BMD) measured by digital X-ray radiogrammetry method. Materials and Methods: The study consisted of 71 women who were in natural menopause. The MI was calculated by two investigators, with each investigator recording two sets of measurements. The BMD was assessed and the T-score was obtained by digital X-ray radiogrammetry method. Based on the T-score obtained, the patients were divided into three study groups of normal (n = 24), osteopenic (n = 30), and osteoporotic (n = 17). The values obtained were tabulated for statistical analysis. Results: In the present study, it was found that there was a statistically significant difference in the mean scores of MI among normal, osteopenic, and osteoporotic subjects. Normal subjects had significantly higher MI (P < 0.001) than the osteopenic subjects and, similarly, the osteopenic subjects had significantly higher MI (P < 0.001) than the osteoporotic subjects. The inter- and intra-investigator variability was found to be low. Conclusion: Based on the results of the present study, it was concluded that a simple radiomorphometric index (MI) which is relatively easier to measure on a panoramic radiograph can be an indicator of osteoporosis and may aid in early detection and treatment planning of one of the most prevalent metabolic bone diseases.

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Ameloblastic carcinoma is a rare odontogenic tumor exhibiting not only features of ameloblastoma but also features of carcinoma in either or both primary and metastatic lesions. Clinical features of this lesion are more aggressive and rapid than those of ameloblastoma. At times, it can metastasize to the lung or regional lymph nodes. Histologically, there is a picture of both ameloblastoma and carcinoma. Treatment is aggressive and has to be designed for each individual patient. English literature is sparse for this condition, as fewer cases have been reported till date. We report a series of four cases with different treatment modalities.

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Keratocystic odontogenic tumors (KCOTs) are one of the most frequent features of nevoid basal cell carcinoma syndrome (NBCCS). The condition is linked with mutation in the PTCH gene. Partial expression of the gene may result in occurrence of multiple recurring odontogenic keratocysts (OKCs). Although KCOTs are common in clinical practice, simultaneous occurrence of multiple cysts in both the maxilla and mandible of a patient is rare. These patients have early propensity to develop multiple neoplasms like basal cell carcinoma and medulloblastoma. Hence, early diagnosis and treatment is of utmost importance in reducing the severity of the long-term sequelae of NBCCS. We report a rare case of multiple KCOTs in a non-syndromic male patient, with emphasis on its diagnosis, radiographic features, and treatment.

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Human immunodeficiency virus (HIV) antibody testing of saliva has been successfully used to detect HIV infection for surveillance and screening studies of various populations since 1986. Many articles have been published reporting the sensitivity and specificity of saliva tests to detect antibodies produced against HIV. In spite of the difference between the type of collection device and laboratory methodology, the results found the sensitivity and specificity to be very high (around 98-100% and 99.5-100%, respectively). However, there is no data available about the usage of oral fluid in screening the HIV patients in our country. This article attempts to review various studies that used saliva as a sample to diagnose HIV infection for its known advantages when compared to blood, which is the current golden standard in investigating this disease.

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