The mucocele or mucus retention phenomenon is a salivary gland lesion possibly due to a traumatic origin, which is formed when the main duct of a minor salivary gland is torn with subsequent extravasation of the mucus into the fibrous connective tissue such that a cyst like cavity is produced. Mucoceles most commonly occur on the lower lip, followed by the floor of the mouth, with buccal mucosa being the next most frequent site.

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Introduction: Oral health is often neglected by pregnant females, and physicians should evaluate and educate pregnant women regarding the routine dental checkups to prevent complications. Periodontitis is associated with preterm birth and low birth weight babies, and high levels of cariogenic bacteria in the oral cavity of the mother leads to dental caries in infants. Most of the pregnant women are unaware of periodontal diseases during pregnancy because of lack of knowledge. Aims and Objectives: The aim of the study was to assess the oral health-related awareness and practice among pregnant women in Bilaspur city. In addition, we assessed the knowledge of mothers towards nutrition during pregnancy because adequate prenatal nutrition is one of the most important environmental factors affecting the health of pregnant women and their babies. Materials and Methods: The study was a cross-sectional study. A total of 446 samples were selected by convenience sampling technique. A questionnaire containing 12 questions related to knowledge and practices pertaining to oral health and 12 questions related to diet and nutrition along with sociodemographic data were used for collecting information. Analysis were conducted using the Statistical Package for the Social Sciences (SPSS) for Windows (version 20.0, SPSS Inc., Chicago IL, USA). Results: Majority of women (74%) were not aware about periodontal diseases, which is common during pregnancy. Only 44.9% were aware which period was safe for dental treatment, and 33.4% were aware that exposure to high dose radiation is dangerous to the baby. A total of 50.1% experienced bleeding from gums during pregnancy; 99.8% maintained their oral hygiene by brushing twice daily and 96.8% visited dentist twice yearly. Concerning nutritional awareness, pregnant patients were aware of the meaning of food (40.1%) and the importance of food (45.5%), balanced (47%), and healthy diet (43.9%). They had adequate knowledge regarding requirement of food for proper functioning of the body (59.9%) as well as for fighting infections (67.2%). Knowledge regarding sources of carbohydrates/proteins, iron, zinc, vitamin A and iodine was low in our patients. Conclusion: The results suggest that knowledge and practices of pregnant women should be improved for better pregnancy outcomes. It requires proper coordinated effort between oral health and prenatal communities for maternal and child's oral health outcomes. Nutritional education programs should be carried out by medical centres, which should be directed towards women in rural areas.

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Fibrous dysplasia is a benign bone disorder where normal bone gets replaced by fibrous connective tissue. Although histopathology is a gold standard in the diagnosis of any pathology, radiology remains an important investigation. This is attributed to the fact that it not only helps in the diagnosis and treatment planning but also is an indispensible tool for follow up of such patients.

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Introduction: Cone beam computed tomography (CBCT) has been recognized as a reliable method for the examination of the osseous components of the temporomandibular joint (TMJ). Aims and Objectives: The aim of this study is to assess the joint space and arthritic changes in TMJ, as visualized on the CBCT scan. Materials and Methods: The study comprised 60 patients attending the outpatient department (120 joints) with temporomandibular dysfunction. All the patients were subjected to CBCT scan using Planmeca Promax 3D Mid machine. TMJ evaluation included bony changes (flattening, erosion, osteophytes, sclerosis, Ely's cyst and joint mice) and measurement of joint space (normal, increased, reduced, bony contact) between the condyle and the mandibular fossa. Results: No statistically significant differences were found between symptomatic and asymptomatic joints and radiographic arthritic changes (P = 0.437) and distribution of osseous changes in condyle among the symptomatic and asymptomatic joints (P = 0.428). Statistically significant difference was found between diminution in joint space with increased mean age (P = 0.001). Conclusion: The radiographic findings may not truly reflect the clinical signs and symptoms. Asymptomatic joints may present with radiographic changes and few of the symptomatic joints may fail to reveal radiographic changes. Radiographically manifested osseous changes, i.e., flattening, osteophyte, sclerosis, erosion etc., had no significant correlation with the symptomatic and asymptomatic joints. In older age groups, patients are expected to have severe progressive degenerative bony changes than those in patients of younger age groups.

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Cementoblastoma is considered to be a rare odontogenic neoplasm of mesenchymal origin. The World Health Organization classified benign cementoblastoma and cementifying fibroma as the only true cemental neoplasms. This is a case of cementoblastoma which has shown an unusual local aggressiveness causing lingual cortical plate perforation, which is a rare presentation of this lesion. Radiographic and histologic findings along with the treatment plan are described in detail.

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Introduction: The most important prognostic factor in oral squamous cell carcinoma (OSCC) is the presence or absence of clinically involved neck nodes. Appropriate diagnosis of the metastatic lymph node is very important for management of OSCC. Aim: The aim of the present study was to evaluate the diagnostic accuracy of metastatic cervical lymph nodes through clinical examination, ultrasonography (USG) and computed tomography (CT), and to compare them with each other. Materials and Methods: Twenty individuals with histologically proven OSCC were selected for the study. The selected individuals were clinically examined by a single trained investigator and further investigations were advised. USG and contrast enhanced CT was performed for each patient with cervical lymphadenopathy to evaluate the findings. The results of each modality were analyzed for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Pathological analysis of the surgical specimen served as the reference standard. Results: Considering pathological analysis of the surgical resection as the baseline, data obtained from clinical, USG and CT examinations were compared. We found that the cases which showed negative results in clinical evaluation showed positive results in both CT and USG; on comparing the specificity and sensitivity, USG had 93% specificity and 92% sensitivity whereas CT had 84% specificity and 81% sensitivity. Conclusion: This study concludes that one should not rely solely on clinical evaluation; other diagnostic methods should be evaluated. Although CT is better than clinical evaluation, USG was found to be superior to both clinical and CT examinations.

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Adenomatoid odontogenic tumor (AOT) is a relatively uncommon benign odontogenic tumor which affects females in the second decade of life, with a predilection for the anterior region of the maxilla, usually associated with impacted canine. In this paper, we present a case of follicular AOT associated with dentigerous cyst affecting the anterior mandible in a 12-year-old male with review of the cases reported in literature till date.

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Sialolithiasis or salivary gland duct calculus or salivary stones are the most common pathologies of the salivary gland. Sialolithiasis accounts for more than 50% of the major salivary gland diseases. Sialoliths are deposits obstructing the ducts of major or minor salivary glands or its parenchyma. Salivary stones larger than 15 mm are classified as giant sialoliths. Giant sialoliths measuring 35 mm or more are extremely rare, with approximately 18 cases published in literature all reported in male patients. The aim of this article is to present a case of a giant sialolith occurring in an old female patient and to communicate the results of a literature search on giant sialoliths.

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Odontogenic myxoma is a benign, locally aggressive/destructive neoplasm arising from the mesenchymal portion of tooth germ, dental papilla, follicle, or periodontal ligament with an exclusive presentation in the tooth-bearing areas of the jaws. They usually present as an asymptomatic swelling in the second or third decade of life. This case report brings to the fore a classical presentation of odontogenic myxoma, with a brief review on its diverse features and diagnostic dilemmas.

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Introduction: Many times fractures go undetected, if not examined properly. For initial diagnosis and proper treatment plan of facial injuries, diagnostic images play a crucial role in providing necessary information. Aims and Objectives: To compare the diagnostic accuracy of conventional digital radiography and inverted digital panoramic imaging in detecting maxillofacial fractures. Materials and Methods: A total of 50 orthopantomographs were collected from the archives of dental and maxillofacial radiology. High quality radiographs with maximum sharpness, ideal contrast, and density were only included which were made using a digital OPG machine. The digital data were saved as jpeg files. Both conventional radiographs as well as inverted digitized images were evaluated by 3 expert radiologists twice with an interval of 10 days. The presence of a radiolucent line in conventional digital radiographs and radiopaque line in inverted digital image which depicted the fracture line was classified according to a 3 point confidence scale. Statistical Analysis Used: Intra observer variation was calculated using Student t test. Inter examiner agreement was calculated by kappa statistics by point (κ). Results: All the examiners showed poor to fair agreement for mandibular fractures and displacement of fracture line in both direct digital and inverted panoramic radiograph. Conclusions: Both the imaging modalities were reliable and there was no significant difference in the diagnostic accuracy.

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Gardner's syndrome is a hereditary autosomal dominant disorder with complete penetrance and variable expression. The disease is characterized by multiple intestinal polyps, osteomas and supernumerary teeth. Gardner's syndrome is linked to mutations on the long arm of chromosome 5 (5q21-q22) referred to as the adenomatous polyposis locus. It has 100% potential for malignant change. Increase in loss of heterozygosity percentages of chromosome 18q21 have suggested that 'Deleted in Colon Cancer' (DCC) gene may be involved in the progression of benign adenomas to malignant carcinomas. We report a case of Gardner's syndrome with similar findings along with presence of multiple epidermal inclusion cysts. The patient's father had died of intestinal cancer. An oral physician may be the first person diagnosing the condition based on orofacial manifestation. Early recognition of this disease can be lifesaving to the patient.

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Ameloblastomas are benign epithelial odontogenic tumors. The World Health Organization (2005) classified ameloblastomas into solid/multicystic, extraosseous/peripheral, desmoplastic and unicystic types. Unicystic ameloblastoma (UA) is a less frequently occurring tumor and accounts for 10 to 15% of all the intraosseous ameloblastomas. Ninety percent of the UAs are found in the mandible with predominance towards molar-ramus region. Approximately 50–80% of UAs are associated with impacted tooth (dentigerous variant). This case report is an effort to bring forth a case of UA in a 35-year-old female who presented with an asymptomatic swelling involving the right and left parasymphsis region through the midline, which is uncommon for UA and is not associated with an impacted tooth (nondentigerous variant). The lesion was confirmed by histopathological evaluation, treated by complete enucleation and curettage with extraction of teeth number 31 to 35 and 41 to 45, followed by chemical cauterization with 5% Carnoy's solution, and rehabilitated with fixed partial denture after 7 months.

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Aims and Objectives: Purpose of this study was to evaluate the reliability and clinical usefulness of ultrasonography (USG) and magnetic resonance imaging (MRI) in temporomandibular joint (TMJ) imaging. Materials and Methods: By USG and MRI the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (lateral capsule-condyle distance) was measured, and both the values were compared in normal asymptomatic volunteers as well as in patients with temporomandibular disorders (TMDs) in both open and closed mouth positions. A total of 40 joints were analysed in which 19 were asymptomatic and 21 were joints with TMD. Capsular width of TMJ was measured and compared in normal and joints with TMD joints using unpaired t test. Widths were also compared in images obtained with MRI and USG. Karl Pearson's correlation coefficient was calculated to find out if there exists any relationship between the capsular width measured with MRI and USG. Results: Results show that both the modalities viz. MRI as well as USG are effective in differentiating the capsular width of normal joints to that of joints with TMD joints. Although capsular widths obtained with MRI and USG are not equal, they are positively correlated. Conclusion: USG can be used for the preliminary investigation of patients with TMD.

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Osteoid osteoma is a benign lesion accounting for 3% of all primary bone tumors and approximately 10% of benign bone tumors. Approximately 80% of osteoid osteomas occur in the long bones, whereas less than 1% occur in jaws. Osteoid osteoma is most frequently observed in the second and third decades of life, more commonly in males than females, in a ratio of approximately 2:1. In this case report, we discuss the case of a 13-year-old female patient having a painful bony lesion in the anterior border of the ramus of the mandible, which is a rare site of occurrence.

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Introduction: The role of human dentition in gender dimorphism can be investigated owing to its resistance against peri and postmortem insults. Hence, it forms an excellent tool for forensic, genetic, odontological and anthropological investigations. Among all the teeth, the mandibular canines are found to exhibit the greatest gender dimorphism. Aim: To determine a method of diagnosing gender from the dentition in a population of Ghailla village, Lucknow, Uttar Pradesh, India. Materials and Methods: Intercanine distance and widths of both right and left mandibular canine were measured intraorally and on the dental casts of the same individuals followed by mandibular canine index calculation. Results: In the female group, the mesiodistal (MD) width was less than 7 mm in the majority of individuals. It was also interpreted that the left canine was found to exhibit greater gender dimorphism. The reliability with regards to gender was 76.6% for males and 73.3% for females. The standard value of mandibular canine index was (0.35); hence, numerical quantities above this value belonged to the masculine sex and below this value belonged to the feminine sex. Conclusion: The left canine was found to exhibit greater gender dimorphism. Whenever the width of either canine was greater than 7 mm, the probability of gender being male was 100% in the present study.

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Unicameral bone cysts are encountered commonly in the proximal metaphyseal region of the long bones in children and adolescents. Identical lesions with similar etiology are found mostly in the mandible. Clinically, these lesions are usually asymptomatic, and the majority of cases are diagnosed fortuitously by chance as radiographic findings. Normally, they are empty cavities sometimes having a thin lining of connective tissue without epithelium containing serosanguinous fluid, clots, erythrocytes, fibrin and giant cells. Symptoms include swelling, pain, and rarely, labial paresthesia. Over half of the patients give a history of significant trauma to the area. Here, we present a case of unicameral cyst in an 8-year-old patient who presented with pain, swelling, and both buccal and lingual cortical plate expansion with no significant history of trauma.

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Introduction: Oral medicine and radiology (OMR) as a subject requires in-depth knowledge for its application in every wake of academic and clinical life. It becomes the duty of teachers in this field to continuously appraise the subject for its betterment. Ironically the subject of OMR is becoming less popular among the students. Aims and Objectives: To assess undergraduate curriculum by obtaining feedback evaluation from interns and to evaluate the utility of this curriculum in clinical practice. Materials and Methods: A sample size of 220 students was selected among interns. They were asked to fill up the questionnaire given to them for the evaluation of the curriculum. Results: 25% respondents found the subject interesting whereas 46% of them thought it stimulated further reading. 62.72% found it easier to understand. Temporomandibular joint (TMJ) disorders were considered as the most difficult topic. Extra-oral radiography along with panoramic radiography were considered as topics which required in-depth explanation. 72.72% did not feel the need for inclusion of any other topics in the curriculum and felt that it was sufficient for them. 81.36% were completely satisfied by the audio-visual content as well. Conclusion: The curriculum should be designed to accommodate more of clinical skills and have a formative educational role. These modifications according to the needs of the students can actually enlighten the path towards betterment of the subject and acceptability from the student's perspective.

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Introduction: Lipids are essential for various biological functions, including cell growth and division of normal and malignant tissues. Changes in the lipid profile have long been associated with malignancies. Aims: The aim of this study was to evaluate the alterations in lipid profile in patients with oral submucous fibrosis (OSMF), leukoplakia and lichen planus. Materials and Methods: This is a hospital-based study conducted among a total of 80 patients; 20 patients in the control group and 20 patients with histopathologically confirmed cases of OSMF, leukoplakia, and lichen planus group. Serum cholesterol, triglyceride, low density lipoprotein (LDL), very low density lipoprotein (VLDL), high density lipoprotein (HDL) and Apo A₁were analyzed among the included patients. Statistical Analysis Used: Analysis of variance and post hoc tests were performed. Results: Serum total cholesterol, HDL and Apo A₁levels were significantly decreased in OSMF patients, and HDL and Apo A₁levels were also significantly decreased in leukoplakia patients. There was no difference in lipid profiles in lichen planus patients. Conclusions: The findings of the present study warrant in depth investigation of lipids and their mechanism of transportation through cell membranes as well as the role of receptors in maintaining cell integrity and their association with different precancerous lesions and conditions.

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Imaging has a crucial role in the treatment of head and neck cancers as it discloses hidden foci of metastases, especially when it is located outside of the planned treatment field. Metastasis to oral cavity is a rare chance and may involve either soft tissue or jaw bones. Their early and accurate detection is critical and also a real challenge for the clinician. Therefore, pre-, per- and post-treatment imaging in diagnosis is critical. Radiography, computerized tomography, magnetic resonance imaging, followed by positron emission tomography, advancements in ultrasonography, and nuclear medicine along with sentinel node lymphoscintigraphy has greatly added to the diagnostic accuracy of metastases.

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A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. In this paper, we report one such case of hybrid odontogenic tumor composed of calcifying cystic odontogenic tumor and unicystic ameloblastoma in the left maxillary anterior region of a 30-year-old Indian male. Calcifying cystic odontogenic tumor (CCOT) is a benign cystic neoplasm of odontogenic origin, which involves association of a cyst (calcifying odontogenic cyst) with an odontogenic tumor, a finding which is a rare event in other types of odontogenic cysts or tumors. CCOT associated with unicystic ameloblastoma is a rare entity with very few cases being documented in literature. Preoperative diagnosis of such hybrid lesions can be difficult or sometimes impossible because it shares significant clinical and radiographic similarities with odontogenic cysts and tumors.

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Plasma cell granuloma (PCG) is an exceedingly rare non-neoplastic lesion. The pathogenesis of the PCG remains unclear. It manifests as a localized, benign proliferation of polyclonal plasma cell population. It occurs primarily in the lungs but may also occur on other anatomical structures including the oral cavity, with gingiva being the rarest site. Here, we report the case of a 55-year-old female with two nodular growths seen on the left maxillary and mandibular posterior gingiva, which gave an impression clinically as pyogenic granulomas and histopathologically as nonspecific pathological entities. Advanced investigations such as immunohistochemistry was done, which ruled out other potential plasma cell neoplasms and confirmed the diagnosis of PCG.

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Langerhans cell histiocytosis (LCH) is characterized histologically by a monoclonal proliferation of large mononuclear cells accompanied by a prominent eosinophil infiltrate. The pathogenesis of LCH is unknown. Hand–Schüller–Christian (HSC) disease is a rare proliferative disorder in which pathological Langerhans cells (LCs) accumulate in various organs. The clinical manifestations arise as a result of accumulation and infiltration of the Langerhans cells in organs and tissues. HSC is characterized by a classic triad of exophthalmos, diabetes insipidus, and lytic lesions in the skull. It is usually manifested in children but can also affect adults. Here, we present a case of HSC disease in a 12-year-old boy with oral manifestations.

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Neurilemmomas are relatively uncommon lesions most commonly encountered in the nerve sheath originating from Schwann cells. They are rarely found in the oral cavity and are characterized by solitary occurrence, slow, persistent growth and smooth surface, along with inconsistent clinical aspects depending on the nerve origin. Microscopically, the lesion typically comprises of alternating regions of hypercellularity and hypocellularity such as Antoni A and Antoni B arrangements, respectively. Here, we present a case of a benign spindle cell tumor of the mandible reflecting a case of intraosseous neurilemmoma in a 33-year-old female patient. Immunopositivity with S-100 and vimentin clearly indicates the lesion to be a spindle cell tumor with neural involvement. The prognosis was favorable; complete surgical removal was the treatment of choice with no recurrence noted. The present case further magnifies the importance of neurilemmoma and further aids in the differential diagnosis of several other benign soft tissue tumors in the oral cavity.

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Myoepithelioma (ME) is a rare benign neoplasm of salivary gland, which commonly originates from parotid gland. Limited number of cases originating from the minor salivary gland tissue have been reported. MEs have characteristic histopathologic and immunohistochemical features, helping in its definitive diagnosis. Here, we present a case of plasmacytoid ME of the palate with review of literature. To the best of our knowledge, only 19 such cases have been reported in literature till date.

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Introduction: The styloid process is a long slender and pointed bony process projecting downwards, forwards and slightly medially from the temporal bone. Elongated styloid process is being more often seen in panoramic radiographs which are commonly used in dental practice. Aim: To assess the styloid process on digital panoramic radiographs. Materials and Methods: It is a cross-sectional study based on the panoramic radiographs of 2000 patients who reported to the department. The panoramic radiographs were available in the archives of our department as soft copies. These panoramic radiographs were obtained using Orthoralix DDE (GENDEX, USA) digital panoramic system. The length of the styloid process was measured radiographically on both sides of the maxillofacial region using the measurement toolbars on the accompanying analysis software. For statistical analysis, we used the unpaired t-test, Chi-square test, and one-way analysis of variance test, as necessary. Results: The average length of the right and left styloid process in males was 26.96 ± 8.748 and 26.76 ± 8.33 in females; right and left average length were 26.02 ± 5.86 and 26.59 ± 7.00 in males and females, respectively. The length of the styloid process on both sides increased with age; males had longer styloid process than females. Elongated styloid process was present in 26.5% of the patients. Langlais type I elongated styloids and type D calcification pattern were more common than others. Conclusion: Panoramic radiography is useful for the detection of an elongated styloid process in patients with or without symptoms, and helps avoid misdiagnosis of tonsillar pain or pain of dental, pharyngeal, or muscular origin.

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