The confusing and often misleading terminology used to define oral vascular tumescences along with the generic use of the term hemangioma has led to inappropriate grouping of a number of entities that are known to be biologically distinct. In many cases, the differential diagnosis between hemangioma and vascular malformation cannot be made on the basis of routine analysis. Hemangiomas were differentiated from vascular malformations by their clinical appearance, histopathologic features, and biologic behavior. However, the term hemangioma is still overapplied by clinicians and pathologists without regard to etiology or clinical behavior. Thus, a critical approach toward vascular tumescence represents the first step to reach a correct diagnosis, understand the disease pathogenesis, and provide better therapy. Here, a case report of arteriovenous malformation in the oral cavity is presented.

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In any mass disaster condition, identification of the person is most important. For this purpose, the forensic investigators use different methods for identifying the dead. They consider skeletal remains of the dead as the initial step in identification. Radiographs carry great evidence to act as antemortem records and also assist in identifying the person, age, gender, race, etc. Forensic dentistry is also emerging as a new branch in forensics. So, the forensic dentist must be aware of different techniques, developments, and resources to incorporate the technology in order to achieve success in human identification. So, our aim of the present review is to focus on different radiological techniques and new developments available for successful identification of the dead.

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Fibrous dysplasia (FD) is an idiopathic skeletal disorder in which the trabecular bone is replaced and distorted by poorly organized, structurally unsound fibro-osseous tissue. The lesion is classified into two forms: Monostotic (75-80%) and polyostotic. A distinct form of Polyostotic FD, known as McCune-Albright Syndrome, is accompanied by cutaneous pigmentation and sexual precocity, and this occurs almost exclusively in women. Typical radiographic appearance shows an expanded osseous lesion having poorly defined margins covered by a thin "eggshell" cortex and lacking periosteal new bone formation. Here, we are presenting two case reports of FD involving the maxilla.

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Introduction: Oral submucous fibrosis is a scarring progressive disease characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of the submucosal tissues, i.e., lamina propria and deeper connective tissues. An attempt was made in this study to evaluate the role of vitamin E in the treatment of oral submucous fibrosis by carrying out a comparative study between regular intralesional dexamethasone, hyaluronidase, and local anesthesia with and without oral vitamin E capsules. Materials and Methods: Twenty histopathologically confirmed oral submucous fibrosis cases were randomly selected and divided into two groups, with 10 cases in each group. Group A patients were given intralesional dexamethasone 2 ml (2 mg/ml), hyaluronidase (1500 IU), and 0.2 cc lignocaine (2%), every week. In addition, group B patients were given oral vit E capsules, 400 IU OD, for a period of 8 weeks. Weekly follow-ups were done. Results: Addition of vitamin E to the conventional treatment had synergistic effect with more improvement in the patient's condition in terms of burning sensation, vesiculation/ulceration, pigmentation, paleness of oral mucosa, tongue protrusion, and extent of mouth opening, which was confirmed histopathologically. Conclusion: Vitamin E has a significant role in the improvement of oral submucous fibrosis, which was proven in the present study.

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Introduction: Saliva is an important diagnostic biofluid and the salivary composition is affected by various systemic conditions including pregnancy. Aims: The study was conducted to evaluate the salivary flow rate and pH in pregnant and non-pregnant Indian women and, consequently, to compare and correlate the salivary flow rate, pH, and prevalence of dental caries in both groups. Settings and Design: A cross-sectional study was conducted in our institute on a sample of 30 pregnant and 30 non-pregnant women. Materials and Methods: The clinical findings for Decayed-Missing-Filled Teeth (DMFT) index were recorded. Unstimulated whole saliva was collected to determine the salivary flow rate and pH. Statistical Analysis Used: Data were statistically analyzed using Student's t-test. Results: Salivary flow rate was lower in pregnant women (0.63 ml/min) as compared to that in non-pregnant women (0.81 ml/min) (P < 0.05) and the pH was also lesser in pregnant women (6.56) than in non-pregnant women (6.86) (P < 0.05). DMFT index showed a strong negative correlation with pH in pregnant women and non-pregnant women (P < 0.05). Conclusion: A difference was observed between the salivary parameters of pregnant and non-pregnant women in this sample. However, all the values were within the normal range. A significant inverse relation was found between salivary pH and dental caries for both the groups.

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An aneurysmal bone cyst (ABC), usually considered a reactive lesion of bone rather than a cyst or true neoplasm, is believed to represent an exaggerated, localized, proliferative response of vascular tissue in bone. The case described here is of a 40-year-old female patient presenting with gradually increasing bilateral mandibular swelling of more than 1 year duration. The radiographic and cone beam computed tomography (CBCT) images showed bilateral, multilocular expansile radiolucent lesions in the mandible in the premolar-molar region. On considering the blood aspirate obtained and the histopathologic findings, the patient was diagnosed with bilateral aneurysmal bone cysts in the mandible, with probable pre-existing bone lesion.

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Aims and Objectives: Thalassemia is the most common gene disorder caused by mutations that decrease the rate of synthesis of α- or β-globin chains. Every year approximately 100,000 children with thalassemia major are born the world over, of which 10,000 are born in India. This study aimed to compare the radiographic findings of jaws and teeth, as well as crown body and root lengths of the mandibular first permanent molar in thalassemia major patients. Materials and Methods: Panoramic radiographs of 50 thalassemia major patients and 50 controls were made. The radiological changes in the jaws and teeth and the dimensional changes in the teeth were evaluated and compared between the two groups. Two observers were involved in evaluating the specific changes and findings were subjected to statistical analysis using chi-square test (χ² ) test. Differences in crown body height, root length, and crown:root (C:R) ratio were found using independent t-test. Results: A significant difference was found between the two groups in the occurrence of short spiky roots, taurodontism, faint lamina dura, large bone marrow spaces, obliteration of maxillary sinus (haziness), indistinct inferior alveolar canal, thin mandibular cortex (P < 0.001), nutrient canals (P < 0.02), and between mean crown body and root values of the two groups (P < 0.05). However, there was no statistically significant difference in prominent antegonial notch (P = 0.860) and C:R ratio (P = 0.989). Conclusion: Taurodonts, short spiky roots, thin mandibular cortex, enlarged bone marrow spaces, and obliterated maxillary sinuses were found to occur with high frequency in thalassemia major, followed by indistinct inferior alveolar canal and attenuated lamina dura.

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Aims and Objectives: To observe and compare the distribution of various palatal rugae patterns in western and northern Indian populations and to study the variations in male and female subjects respectively. Materials and Methods: The study consisted of 100 subjects, 50 each from the two groups of geographically different regions of western and northern India. After obtaining informed consent, an alginate impression of maxillary arch was made for interpretation. The number, type, and unification were followed according to Thomas and Kotze's classification and the shape was recorded according to Kapali et al.'s classification. Results: The shape of rugae was compared between the two study groups and was found to be highly significant between western Indian and northern Indian subjects. The number and shape of rugae differed significantly between the genders, with males having a highly significant difference as compared to the females. The western Indian group showed wavy shape predominantly in males and females had straight rugae. Similarly, the northern Indian male participants also had wavy shape; however, females in this group had more curved shaped rugae. Conclusion: The uniqueness of palatal rugae pattern can be utilized similar to fingerprints and when combined with other methods, it can help in the identification of a person.

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"Hydatid" is a Greek word which means "a drop of water." Hydatid cysts occur in hydatid disease or echinococcosis, which is one of the most geographically prevalent zoonosis. This zoonotic infection in humans is mainly caused by infection by the larval stage of the dog tapeworm Echinococcus granulosus. This tapeworm infestation is widespread in sheep, goats, cattle, and dogs. This chronic disease is present worldwide among herding populations who live in close proximity to dogs and herd animals. It is a serious and potentially fatal condition and symptoms may occur a long time after the early infection. The most frequently affected organs are liver, lungs, followed by bones and brain, and extremely unusual occurrence has been found in the oral cavity, which was noticed in the present case. So hereby, we reveal a very rare case of intraoral hydatid cyst in a 20-year-old female patient.

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Lesions of the gastrointestinal tract (GIT) run the gamut from the merely annoying heartburn that has affected many a partakers of a large and spicy meal to the highly lethal cancers. Distressing to the physician is that all disorders of the esophagus tend to produce similar symptoms, namely heartburn, dysphagia, pain, and/or hematemesis. The GIT plays a prominent part in the immune system. The pH (ranging from 1 to 4) of the stomach is acidic which proves fatal for a number of microbes which pass through it. Also, mucus in the stomach (containing IgA antibodies) and enzymes present in the saliva and bile neutralize many of these microorganisms. Lesions of the GIT also present with oral symptoms, which is of significance for an oral physician to recognize and treat them.

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Schwannomas, also known as neurilemmoma, are benign, slow-growing nerve sheath tumors arising from Schwann cells. Approximately 25-40% of schwannomas occur in the head and neck region. However, schwannomas that present in the oral cavity are relatively rare, constituting around 1% of all described cases in the head and neck region. ^[1],[2] Here, we report a rare case of an intraoral schwannoma, in a 28-year-old male, with painless swelling located in the posterolateral aspect of the soft palate on the right side. Definitive diagnosis was obtained after histopathology examination. Surgical excision of the tumor was done with no complications or recurrences.

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Treacher Collins syndrome (TCS) or Franceschetti syndrome is an autosomal dominant disorder of craniofacial development with variable expressivity. It is named after Treacher Collins who described the essential components of the condition in 1900. Incidence of this syndrome is approximately 1 in 50,000 live births and it affects both genders equally. It affects structures which are derivatives of the first and second brachial arches. The most common manifestations of TCS are the antimongoloid slanting of the palpebral fissures, colobomas of the lower eyelids, hypoplasia of zygoma and mandible, and various ear abnormalities. This article describes the clinical and radiographic features of TCS in an 18-month-old female who had reported to the Department of Oral Medicine and Radiology.

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Introduction: Identification of an individual is a prerequisite for certification of death and for personal, social, and legal reasons. The study of lip prints (cheiloscopy) was thought of as a method of identification of a person. It is safe to assume that cheiloscopy, in its present stage of development, has become a means of criminal identification dealing with lip prints. Aims and Objectives: To evaluate the lip prints of different individuals in various parts of the lip, to find out the incidence of any particular pattern in relation to specific gender, to ascertain the authenticity of lip prints as a tool for identification of an individual and establish its evidentiary value. Materials and Methods: The study was conducted on 500 subjects, which included 250 males (4 twins) and 250 females, in the age group of 18-30 years. After application of lipstick evenly, the lip print of each subject was obtained on a simple bond paper. The lip prints of each individual were scanned using an image scanner set at a resolution of 600 dpi for better interpretation. Results: We had correctly matched the gender of 487 individuals out of 500 samples taken. We also found that no lip prints were similar among the 500 subjects and even in twins. Interpretation and Conclusion: Along with other traditional methods, cheiloscopy can also serve as a very important tool in the identification of a person based on the characteristic arrangement of lines and grooves appearing on the red portion of the lips. It can be used for sex determination and personal identification for forensic purposes.

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Introduction: This study was undertaken to assess the levels of malondialdehyde (MDA), superoxide distmutase (SOD), beta carotene, and vitamin E in oral submucous fibrosis (OSMF), oral leukoplakia (OL), and oral cancer patients. Though several studies have been done on the levels of antioxidants in these disorders, there are very few available reports in patients with various histological staging of these disorders. Materials and Methods: Blood samples were collected from 40 patients who were divided into three groups: Group I as control with 20 normal individuals, group II with histopathologically confirmed different stages of OSMF and OL, and group III with histopathologically confirmed different stages of oral squamous cell carcinoma (OSCC). Standard methods for estimation of serum values were used and statistical comparisons were performed using SPSS software 16.0 version and the level of significance was calculated. Results: The mean levels of vitamin E, beta carotene, MDA, and SOD among Group I subjects were 9.89 ± 0.75, 112.10 ± 11.97, 2.92 ± 0.36, and 189.45 ± 14.17, respectively. In group II patients with OL having mild dysplasia, serum vitamin E, beta carotene, MDA, and SOD levels were found to be 7.89 ± 0.87, 70.75 ± 2.82, 9.89 ± 0.92, and 119.63 ± 24.97, respectively. In moderate dysplasia, these values were 7.16 ± 0.55, 69.80 ± 5.54, 10.56 ± 0.46, and 115.20 ± 23.03, respectively. Serum vitamin E, beta carotene, MDA, and SOD levels were 7.70 ± 0.57, 70.50 ± 3.54, 9.81 ± 0.11, and 115.00 ± 8.49, respectively, in grade I OSMF and 7.32 ± 0.29, 69.67 ± 3.43, 9.76 ± 0.38, and 113.67 ± 8.32, respectively, in grade II OSMF. In group III patients with well-differentiated squamous cell carcinoma (WDSCC), serum vitamin E, beta carotene, MDA, and SOD levels were 7.01 ± 0.36, 64.32 ± 3.42, 12.98 ± 0.67, and 59.22 ± 4.01, respectively, and in patients with moderately differentiated squamous cell carcinoma (MDSCC), the values were 6.54 ± 0.41, 61.87 ± 2.03, 13.34 ± 0.42, and 58.43 ± 2.26, respectively. The P-value was calculated and the results were highly significant. Conclusion: A decrease in the levels of antioxidants like beta carotene, vitamin E, and SOD and an increase in MDA level in these disorders have been previously reported in the literature.

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Aims and Objectives: The aim of this study was to investigate various lesions involving the oral and maxillofacial region by using scintigraphy and to compare the findings with those of conventional radiograph. Materials and Methods: Nineteen subjects of all age groups and both sexes who reported to the outpatient department of Oral Medicine and Radiology and had been clinically diagnosed with diseases of oral and maxillofacial region were selected. Conventional radiography and scintigraphy were performed for all the subjects. Biopsy and histopathological investigations were preformed to confirm the diagnosis and on the basis of which sensitivity, specificity, positive predictive value, and efficiency of conventional radiography and scintigraphy were evaluated. Results: Conventional radiography was found to have 94.11% sensitivity, 50% specificity, 94.11% positive predictive value, and 89.47% efficiency. Scintigraphy was found to have 100% sensitivity, 14.28% specificity, 66.66% positive predictive value, and 68.42% efficiency. Conclusion: Scintigraphy is a very sensitive diagnostic aid, but lacks in specificity. Conventional radiography, on the other hand, has good sensitivity and relatively better specificity. For a proper diagnosis, scintigraphic findings must be correlated with clinical, radiological, and histopathological findings.

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Aim: The aim of the study was to assess the reliability of gingival crevicular blood (GCB) glucose level compared with finger capillary blood (FCB) glucose level using a glucose self-monitoring device (Contour ^® TS). Materials and Methods: One hundred randomly selected patients with gingivitis (45 subjects) and periodontitis (55 subjects) were included in the study. The mean age of the study group subjects was 35.39 ± 11.97 years (range 17-70 years). The blood glucose values obtained from GCB elicited during routine periodontal probing and those of peripheral finger stick blood glucose were recorded using a glucose self-monitoring device (glucometer) during fasting and postprandial phases. Statistical analysis was done using Student's "t" test and Karl Pearson's product moment correlation. The regression analysis was then performed to compare the GCB and FCB blood glucose readings using the approach of Bland and Altman. Results: There was no statistically significant difference (t = 1.443, P = 0.152) between the fasting GCB and FCB glucose values, but it was significant during postprandial measurement (t = 6.893, P < 0.001). Pearson's correlation showed a positive correlation between the two measurements (r = 0.893, P < 0.001). Bland-Altman regression analysis revealed sufficient agreement between the two values. Conclusion: The results suggest that GCB collected during diagnostic periodontal examination may be an excellent source of blood for glucometric analysis. Thus, it can be used as a chairside investigative procedure.

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Growth disturbances in the mandibular condyle region include aplasia, hypoplasia, and hyperplasia. Non-syndromic aplasia of the mandibular condyle is very rare, and may be due to congenital or acquired causes. The mandibular condyle is regarded as the center of mandibular growth. Therefore, regional disturbances during the growth phase may negatively impact mandibular growth. We present a case of unilateral condylar aplasia associated with severe hypoplasia of the posterior body and ascending ramus of the mandible.

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Aims and Objectives: The purpose of this study was to investigate whether dimorphism of permanent mandibular and maxillary canine teeth as well as intercanine and intermolar distance plays a role in establishing sex identity. Materials and Methods: Four hundred volunteers comprising 200 males and 200 females, with age ranging from 18 to 50 years, were selected. The greatest mesiodistal width of the canine teeth and the distance between the tips of canines of both arches and intermolar arch width were measured using vernier caliper with 0.02 mm resolution. All data were tabulated and analysis done by "t" test. Results: The widths of the mandibular and maxillary right and left canine teeth were almost bilaterally symmetrical in females and males. The mean values for left and right mandibular and maxillary canine widths were less in females than in males and the differences were statistically significant. The mean values for mandibular and maxillary intercanine and intermolar distances were less in females than in males and the differences were statistically significant (P < 0.001). Conclusion: The present study establishes a statistically significant sexual dimorphism in maxillary and mandibular canines and intermolar arch width. It can be concluded that standard canine index is a quick and easy method for sex determination.

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Introduction: Fractal analysis (FA) quantifies complex geometric structures by generating a fractal dimension (FD), which can measure the complexity of mucosa. FA is a quantitative tool used to measure the complexity of self-similar or semi-self-similar structures. Aim and Objective: The study was done to perform the FA of oral mucosa with keratotic changes, as it is also made up of self-similar tissues, and thus, its FD can be calculated. Results: In oral leukoplakia, keratinization increases the complexity of mucosa, which denotes fractal geometry. We evaluated and compared pretreated and post-treated oral leukoplakia in 50 patients with clinically proven oral leukoplakia and analyzed the normal oral mucosa and lesional or keratinized mucosa in oral leukoplakia patients through FA using box counting method. Conclusion: FA using the fractal geometry is an efficient, noninvasive prediction tool for early detection of oral leukoplakia and other premalignant conditions in patients.

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Aims and Objectives: The morphology of soft palate has variable presentations on lateral cephalometry. The aim of our study was to investigate the correlation between various shapes of soft palate and types of malocclusion in different gender groups among North Indian individuals. Materials and Methods: The study sample comprised randomly selected 250 healthy North Indian individuals (125 males and 125 females) seeking orthodontic treatment for malocclusion without any speech abnormality or any other syndromes or diseases and with age ranging from 14 to 28 years. Clinically, in all subjects, the type of malocclusion was examined and categorized according to Angle's classification of malocclusion. The morphological variants of soft palate were also assessed on digital lateral cephalogram and were allocated to one of the six patterns as described by You et al. The differences in the proportion of each type were studied and variation of malocclusion and soft palate morphology between gender groups was also assessed. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate and types of malocclusion in different gender groups. Results: In our study, the frequency of rat tail (37.2%) type of soft palate was seen in highest proportion, whereas the frequency of distorted S-shape (6.80%) was least in both the genders. Angle's class II malocclusion (51.2%) was the most common, followed by class I (43.2%), whereas class III (5.6%) was found to be the least prominent type in both the genders. Patients with Angle's class I malocclusion were most frequently found to have rat tail type soft palate, those with Angle's class II had leaf-shaped soft palate, and those with Angle's class III had crooked shaped soft palate. Angle's class II and class III malocclusions were significantly correlated with soft palate shapes, whereas Angle's class I malocclusion was highly significantly correlated with the shape of soft palate. Conclusion: It was found in our study that there was a significant correlation between variants of soft palate and types of malocclusion.

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Osteomyelitis is an acute or chronic inflammatory process that can involve cortical and trabecular aspects of bone or bone marrow. This case report describes an interesting presentation of chronic suppurative osteomyelitis in a 22-year-old male patient who visited the dental clinic with a chief complaint of facial asymmetry and esthetic concern only. The history, examination, radiographic and histopathological investigations contributed to the diagnosis of chronic suppurative osteomyelitis; however, the etiology remained a dilemma. Treatment included surgical debridement and curettage followed by antibiotics.

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Bifid mandibular canal could be an interesting variation in the mandible. This condition can pose complications during surgical procedures in the mandible, such as extraction of lower molars, placement of implants, and surgery. Therefore, identification of this variation is sometimes very crucial and can assist in minimizing postoperative complications. Hereby, we report the presence of bifid mandibular canal in the first molar region, an unusual presentation. The patient was evaluated for implant prosthesis using cone beam computed tomography (CBCT) that confirmed the bifid canal which was seen as an unusual radiolucency on intraoral periapical radiograph.

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Introduction: Oral health reflects overall well-being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in old age. Oral health evaluation should be an integral part of the physical examination, and dentistry is essential to qualify geriatric patient care. Aim: To determine the prevalence of oral soft tissue lesions and systemic diseases in institutionalized geriatric population in North India. Materials and Methods: Geriatric patients were clinically evaluated using a standard questionnaire and assessed for known medical illnesses and prevalence of oral soft tissue lesions. Four hundred patients (71% males and 29% females) with age ranging from 60 to 100 years were considered in the study group. Twenty-two (33.8%) patients were edentulous and seven patients (10.8%) were denture wearers. Forty-four (67.69%) patients reported with tobacco habits. Results: Most prevalent medical illness reported was diminished vision (15.5%), followed by hypertension (10%) and diabetes mellitus (6.25%). Several oral soft tissue lesions were reported among the study population. The most prevalent lesions were leukoplakia (12%), smoker's melanosis (10%), smoker's palate (9%), pigmentation on tongue (6%), frictional keratosis (5%), lichen planus (3%), denture stomatitis (2.5%), aphthous ulcers (2%), angular chelitis (1.5%), oral submucous fibrosis (1.5%), melanotic macule (1.5%), candidiasis (1.5%), irritation fibroma (1%), geographic tongue (1%), median rhomboid glossitis (1%), and traumatic ulcer (1%). Conclusion: The findings observed in this population are important and can have a determinant effect on the overall quality of life in this population. This information is a crucial prerequisite for health awareness programs involving the community health workers, oral physicians, and medical professionals.

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Proliferative verrucous leukoplakia (PVL) is a rare, unique type of oral leukoplakia, which is enigmatic in etiology and behaves in a far more aggressive fashion than other forms of leukoplakia. Diagnosis is often late with the disease in an advanced stage when it is especially refractory to treatment. There are no definite criteria that dictate how extensive the leukoplakic changes should be, how many or which oral subsites should be involved, or how many recurrences should have occurred, in order to qualify for the diagnosis of PVL. The lack of definitive diagnostic criteria is the prime reason for PVL not being treated appropriately and in a timely fashion, thereby leading to the very concept of PVL being questioned. This article discusses the various clinicopathologic diagnostic criteria for this enigmatic entity and also reports a case of PVL in a 73-year-old female.

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Hay-Wells syndrome is a rare autosomal dominant disorder characterized by ankyloblepharon, ectodermal dysplasia, and cleft palate and/or cleft lip [ankyloblepharon-ectodermal dysplasia-clefting (AEC) syndrome]. Initially described by Hay and Wells in 1976, it is a rare form of ectodermal dysplasia with varying forms of expression featuring congenital abnormalities of the skin, hair, teeth, nails, and sweat glands. Recently, mutations in the p63 gene have been shown to be etiologic in the majority of cases of Hay-Wells syndrome. The present report describes the case of a 6-year-old boy who presented with ankyloblepharon, ectodermal dysplasia, and a cleft palate at birth, which are considered cardinal signs of this syndrome by most authors. The purpose of this article is to throw light on differentiating various ectodermal dysplasia syndromes associated with cleft palate and/or cleft lip and to highlight the importance of implementing multidisciplinary follow-up of patients with Hay-Wells syndrome.

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Ectodermal dysplasias are a large hereditary group of disorders which are usually manifested as X-linked recessive disorders and have a full expression in males, whereas females show little to no signs of the disorder. The two most common types of ectodermal dysplasias are hypohidrotic ectodermal dysplasia (Christ-Siemens-Touraine syndrome) and hidrotic ectodermal dysplasia (Clouston syndrome). Hypohidrotic ectodermal dysplasia is characterized by hypodontia, hypotrichosis, and hypohidrosis. Here, we present two female sibling cases of hypohidrotic ectodermal dysplasia.

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Actinomycosis is a chronic infectious granulomatous disease caused by saprophytic Actinomyces species. The case discussed in this report is of an adult female patient with a large actinomycotic lesion in the region of the mandibular left second premolar, first and second molars. Provisional diagnosis was made as extragingival pyogenic granuloma. Definitive diagnosis was based on histopathological examination. Since actinomycotic infection has opportunistic characteristics, early diagnosis and proper management of the disease is mandatory to prevent further complications.

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Lipodystrophy is regarded as a functional disturbance of the hypothalamus. Typically, face is the first part to be affected, and its aspect in an advanced case is characteristic: hollowed temples, prominent zygomatic bones, and sunken cheeks. When the patient smiles, numerous wrinkles appear in the cheeks, giving the appearance of premature senility. Here is a report of a rare case of partial lipodystrophy with an atypical presentation which had alarmingly affected the patient's appearance. Our main purpose of presenting this rare case in oral medicine is an attempt to educate oral physicians about lipodystrophy and increase awareness about the presence of subtle forms that may be underdiagnosed.

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Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) usually arises in the long bones of extremities. It is uncommon to find ES in the head and neck region, particularly in gnathic bones. It comprises 6-8% of all primary bone malignancies. Only 1% of cases is reported with jaw involvement and has mandibular predilection. Even with early intervention, patients with metastasis have approximately 20% chance of 5-year survival. Here, we report a rare case of ES involving right maxillary alveolus.

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Osteomas are relatively rare in the jaws. The causes of these lesions are unknown, although trauma, infection, and developmental abnormalities have been suggested as contributing factors. To the best of our knowledge, only 13 cases of osteomas of the condyle have been reported in literature. Here we report a rare case of osteoma of the right condyle in a 35-year-old male. The patient presented with inability to open the mouth since 15 years, with a history of trauma to the chin. He had facial asymmetry, deviation of the mandible to the unaffected side, and reduced mouth opening. Considering the patient's history and clinical features, a provisional diagnosis of bony ankylosis was considered. This case highlights the importance of performing a detailed examination in patients presenting with limited mouth opening caused by uncommon conditions such as osteomas of the condyle.

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Lipoid proteinosis is a very rare, autosomal recessive disorder, characterized by hoarseness of voice, skin scarring, beaded papules along the eyelid margins, and an inability to protrude the enlarged tongue. Infiltration of hyaline material to various organs is found to be responsible for the various manifestations of this disorder. It is mainly prevalent in early infancy and childhood, and is rare in older adults. In this article, we report a 61-year-old patient with the skin and orofacial features of lipoid proteinosis, which is very rarely recorded in literature as far as age and oral manifestation are concerned.

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Oligodontia, a rare genetic disorder, represents the congenital absence of more than six teeth in primary, permanent, or both dentitions and is usually the feature of a syndrome. Its occurrence as an isolated entity is even rarer. This article reports non-syndromic oligodontia in two siblings. One case also had concurrent maxillary canine transmigration as one of the rarest associated entities.

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Aims and Objectives: Certain strains of human papillomavirus (HPV) have been shown to be etiologically related to the development of uterine, cervical, and other genital cancers, but their role in the development of malignancies at other sites is less well established. Previous studies have shown HPV in tumors of the head and neck, but its prevalence has varied depending on the detection methods and the types of tumor and/or tissue examined. This study was undertaken for the detection of high-risk HPV types 16 and 18 and human immunodeficiency virus (HIV) in oral squamous cell carcinoma. Materials and Methods: Twenty-five patients histologically diagnosed with oral squamous cell carcinoma and 10 apparently normal persons as controls were selected for the present study. Two biopsy specimens were removed surgically by incision biopsy for histopathological examination and polymerized chain reaction (PCR) study. Results: Out of 25 oral squamous cell carcinoma subjects, 8 were found to be HPV positive in PCR. Out of these eight subjects, four had HPV 16 and the other four had other genotypes, and one subject was HIV positive. Conclusion: The conclusion drawn from the present study was that well-defined risk factors like HPV may play a prominent role in the development of oral squamous cell carcinomas, in addition to other risk factors. Further studies with a larger sample size are necessary to arrive at conclusions and to explore the relationship of HPV and HIV in oral squamous cell carcinoma.

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Bisphoshonate-related osteonecrosis of the jaw (BRONJ) is an avascular osteo-chemonecrosis of the jaw which results after administration of the group of drugs called as bisphosphonates. Bisphosphonates are given to prevent bone resorption in osteolytic diseases such as Paget's, osteoporosis, osteogenic carcinoma, and other carcinomas where there could be metastasis and bone resorption. Incidence of BRONJ is reported to be high in western literature and is found to be more after intravenous route compared to oral route of administration. There are various clinical stages of BRONJ as per the American Association of Oral and Maxillofacial Surgeons (AAOMS). Here, we present a rare case of a 60-year-old lady who presented with a complaint of a painless swelling in the alveolus and gingiva in the left maxillary posterior region. This patient was on intravenous Zolendronate for more than 4 years. Thorough examination with detailed investigations revealed BRONJ along with a coexisting second primary tumor, plasmacytoma. Metastasis to distant site is a common feature of malignancy. A metastatic lesion usually occurs within 6 months to 1 year after treatment of a primary lesion. Any fresh neoplasm beyond 1 or 2 years after detection of a primary can be regarded as a second primary tumor. Solitary bone plasmacytoma is a localized form of plasma cell tumor. Diagnosis is based on the presence of the following: Malignant proliferation of plasma cells in biopsy, absence of osteolytic bone lesion, absence of Bence Jones proteins, low concentration of monoclonal proteins, elevated IgG and gamma globulin levels.

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Peripheral ossifying fibroma belongs to the group of reactive focal lesions occurring on the gingiva. It is usually solitary and tends to occur in teenagers and young adults with a female predilection. In this article, we have reported a rare case of peripheral ossifying fibroma occurring in a 60-year-old female in the maxillary anterior region, with superficial ulceration and pathologic migration of adjacent teeth.

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