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2018| July-September | Volume 30 | Issue 3
Online since
October 18, 2018
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REVIEW ARTICLES
Classifying giant cell lesions: A review
Vikash Ranjan, Sambuddha Chakrabarty, Pallak Arora, Trisha Rastogi
July-September 2018, 30(3):297-301
DOI
:10.4103/jiaomr.jiaomr_81_18
Multinucleated giant cells are often encountered in oral lesions. Traditional classifications have placed a little importance on the type or histogenesis of multinucleated giant cells in grouping these lesions. The classification of giant cell lesions of the maxillofacial skeleton is the one that remains controversial. Classifying giant cell lesions of the jaw as granulomatous based solely on its location seems inappropriate. Giant cells lesions were classified based on the etiopathogenesis, origin, etiology, type, radiographic appearance and pathology of giant cells present. The rationale for this classification was based on the recent research findings regarding the histogenesis of giant cells. Multinucleated giant cells are morphologically characterized by the presence of multiple nuclei dispersed in cytoplasm. Multinucleated cells are commonly encountered in oral and maxillofacial lesions. An epidemiological study by Mohajerani
et al
. has reported that 6.36% of the oral biopsies received in their laboratory were multinucleated giant cells containing lesions. Classifying oral lesions with giant cells has always been problematic. However, accurate identification and categorization of these lesions based on nature, distribution and origin of giant cells is necessary. Correlation of histopathological features in relation to giant cells is required. The aim of this article is to review both the earlier and recent classification of giant cell lesions in order which would enable pathologists and oral physicians to ascertain the behavior and diagnosis of such lesions.
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ORIGINAL ARTICLES
“Frank Sign” – A clinical indicator in the detection of coronary heart disease among dental patients: A case control study
Praveenkumar Ramdurg, Naveen Srinivas, Surekha Puranik, Abhijeet Sande
July-September 2018, 30(3):241-246
DOI
:10.4103/jiaomr.jiaomr_90_18
Background:
The diagonal earlobe crease (DELC) has been proposed to be a marker of coronary heart disease (CHD), but this association remains controversial. Data available in Indian population seeking dental treatment are limited.
Objective:
The aim of this study was to evaluate the association between DELC and CHD.
Methods:
This case–control study investigated 118 cases with CHD and 50 controls without CHD. Characteristic differences and the relation of DELC to CHD were assessed by Chi-square and Student's
t
-tests. Multivariate logistic regression analysis was done to estimate the risk of various factors between cases and control.
Results:
The prevalence of DELC was 63.21% in cases and 26.79% in controls (<0.001). There was a significant correlation between DELC and coronary risk factors, such as advancing age, hypertension, male gender, and no correlation among DELC, diabetes mellitus, hyperlipidemia, and smoking.
Conclusion:
The association between DELC and CHD patients was high in our study. The data suggest that the DELC sign may be a useful marker for early detection of CHD in dental patients.
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Evaluation of the efficacy of carbamazepine and gabapentin in the management of trigeminal neuralgia: A clinical study
Bhawandeep Kaur, Preeti Dhir
July-September 2018, 30(3):253-256
DOI
:10.4103/jiaomr.jiaomr_75_18
Background:
Trigeminal neuralgia (TN) is a syndrome of unilateral, paroxysmal, stabbing facial pain, originating from the trigeminal nerve. Carbamazepine still remains as the gold standard drug in terms of efficacy in TN. Over the time, several other drugs are also used as alternatives for TN such as oxcarbazepine, baclofen, lamotrigine, levetiracetam, gabapentin, valproate, botulinum toxin A injection.
Objective:
To Evaluate the efficacy of Carbamazepine and Gabapentin in the management of Trigeminal Neuralgia.
Materials and Methods:
A total of 42 patients with a mean age of 52.78 years included in the study were randomly divided into two groups A and B and were given the tablets of carbamazepine in the dose range of 400mg to 1200 mg and gabapentin in the dose range of 600mg to 1800mg and recalled after 3
rd
day, 15
th
day, 1 month and 3 month period to evaluate the response to the drugs. The collected data was subjected to statistical analysis.
Results:
The therapeutic effectiveness of carbamazepine recorded as good response in 52.38% of patients of group A after 72 hours of recall while 28.57% patients had an average response and 19% patients had not relieved off pain attacks at the dose of 400mg of carbamazepine. The therapeutic effectiveness of gabapentin recorded as good response in 52.38% of group B patients after 72 hours of recall while 42.8% patients had an average response at the dose of 600mg of gabapentin.
Conclusion:
The study suggests that gabapentin can be effective as first or second line treatment of trigeminal neuralgia, even in cases resistant to traditional treatment modalities.
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CASE REPORTS
A giant tonsillolith: An incidental finding
Abhay S Kulkarni, Rajendra S Birangane, Abdullah Zakaria Kazi, Rashmi C Channe
July-September 2018, 30(3):324-327
DOI
:10.4103/jiaomr.jiaomr_53_18
Tonsilloliths are infrequent calcified concretions that develop in tonsillar crypts within the parenchyma of the tonsils or surrounding it. They are typically single and unilateral, but rarely may be numerous or bilateral. Large tonsilloliths can mimic many conditions including abscesses or neoplasms. It is difficult to diagnose tonsilloliths unless there is a considered emphasis on thorough history taking, careful inspection, and a detailed characterization of the lesion through digital palpation. This may be further supplemented with investigations such as plain film radiography and/or 3D imaging. Here, we present a case of asymptomatic tonsillolith where the patient presented for a painful tooth in mandibular anterior region and was incidentally diagnosed as having with a large tonsillolith on right side of posterior mandible.
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FORENSIC ODONTOLOGY: ORIGINAL ARTICLES
Body height from tooth size: A novel study on stature estimation by odontometric parameters
Yesha Jani, Shilpa Parikh, Bhavin Dudhia, Parul Bhatia, Purv Patel, Roseline Patel
July-September 2018, 30(3):275-280
DOI
:10.4103/jiaomr.jiaomr_105_18
Introduction:
Stature is the height of a person in the upright posture. Based upon the principle that the various long bones correlate positively with stature, stature correlation to skull and jaw dimensions has been frequently reported among various populations.
Objective:
The study was conducted to investigate the possibility of predicting the height of an individual using selected odontometric parameters as a forensic tool.
Materials and Methods:
The study sample consisted of 100 randomly selected subjects. Measurements of maxillary intercanine width (IC), maxillary interpremolar width (IP), and mesiodistal width of six permanent maxillary anterior teeth (CW) were made directly on the subject by means of a digital vernier caliper. Height (H) of patients was measured with anthropometer.
Results:
Significant correlation was observed between height and maxillary IC width (
P
< 0.05), whereas correlation between height and the combined width of six anterior teeth as well as IP width was found to be nonsignificant.
Conclusion:
The maxillary IC width can be used successfully to calculate the stature of an individual from fragmentary remains.
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SHORT COMMUNICATIONS
A new artifact!! – In life of a dental radiograph: A rare radiographic finding! Or a rare finding on a radiograph!!
Vela D Desai, Nitin Agarwal
July-September 2018, 30(3):331-333
DOI
:10.4103/jiaomr.jiaomr_64_18
Radiograph play as an important adjunct, in addition to history and clinical evaluation for the diagnosis of pathologies in head and neck region. A good and ideal diagnostic radiograph is essential for this purpose. An ideal radiograph is one that provides a great deal of information, the image exhibits proper density and contrast, have sharp outlines, and are of the same shape and size as the object being radiographed. Dental radiographs are subjected to various phases (procedures) right from the manufacturing and packaging until it is been exposed and processed. The diagnostic quality of a dental radiograph may be affected during any of these procedures and even after that. The authors here have noticed an interesting fault which is seldom mentioned in the literature.
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ORIGINAL ARTICLES
Sclerotherapy in pyogenic granuloma and mucocele
Jigna S Shah, Ashish F Ranghani
July-September 2018, 30(3):230-234
DOI
:10.4103/jiaomr.jiaomr_118_18
Aim and Objective:
To evaluate the effect of intralesional injection of polidocanol for treating pyogenic granuloma and mucocele that commonly in the oral cavity. This study also aimed to analyze the effect of polidocanol in both lesions of various sizes.
Materials and Methods:
Fifteen clinically diagnosed cases of oral pyogenic granuloma (8 cases) and mucocele (7 Cases) were included in the study. After topical anesthesia application, 0.5–1 ml of polidocanol was injected using an insulin syringe into the lesion till the solution leaked out. Each patient was recalled after 1 week and evaluated; if the lesion did not resolve, second and third injections were given consecutively.
Results:
All 15 patients showed complete regression of the lesion after 1–3 consecutive injections in a weekly interval. Recurrence of one case of mucocele occurred.
Conclusion:
Sclerotherapy is simple, minimally invasive, economical, and of minimal discomfort to the patient; there is negligible blood loss, and less surgical expertise is required. Size of the lesion determines the number of weekly injections of sclerotherapy required for complete resolution of the lesion; however, numbers of injections do not depend on age, sex, and site of the lesion.
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FORENSIC ODONTOLOGY: ORIGINAL ARTICLES
Age estimation using comprehensive chart for dental age estimation in Haryana population: A pilot study
Cheena Singh, Kusum Singal, Priyanka Kapoor
July-September 2018, 30(3):281-285
DOI
:10.4103/jiaomr.jiaomr_112_18
Background:
Dental age estimation by radiographic methods for forensic rationale is routinely applied to serve the judicial system. Of these, Demirjian system is most widely used, but its applicability in the Indian population, specifically Haryana population, is still lacking.
Aim and Objective:
This is a pilot study to evaluate Demirjian method in Haryana population using a comprehensive chart for dental age estimation (DAEcc) and establish a correlation between the chronological age (CA) and estimated age.
Materials and Methods:
Sample comprised 100 subjects (49 males and 51 females) 7–16 years of age. Orthopantomograms of these patients were traced and evaluated for Demirjian dental age computation using DAEcc and compared with CA.
Results:
A positive correlation was observed between CA and estimated age (
R
2
= 0.82 in males,
R
2
= 0.78 in females, and
R
2
= 0.80 in combined population). The paired
t
-test between CA and estimated age demonstrated that Demirjian method underestimates the dental age by 5.1 months, that is, 153 days in males (
P
= 0.04) and by 7.9 months, that is, 237 days in females (
P
= 0.01). There was an overall underestimation by 6.3 months (
P
= 0.001) in the entire study population.
Conclusion:
This pilot study supports the applicability of Demirjian method for age estimation in Haryana population and paves way for further studies in a larger sample in the same population to accurately establish the association between CA and dental age.
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ORIGINAL ARTICLES
Comparative evaluation of the efficacy of topical amlexanox 5% oral paste and triamcinolone acetonide 0.1% oral paste in the treatment of Recurrent Aphthous Stomatitis (RAS)
K Shrivastava, G Naidu, A Deshpande, H Handa, V Raghuvanshi, M Gupta
July-September 2018, 30(3):235-240
DOI
:10.4103/jiaomr.jiaomr_40_18
Background:
A double-blind randomized control trial was conducted to compare the clinical efficacy of topical triamcinolone acetonide 0.1% and amlexanox 5% in recurrent apthous stomatitis (minor).
Materials and Methods:
Forty adult patients were assessed for erythema, ulcer size, pain scores, and ulcer healing on three evaluation visits within 24 h of ulcer formation, third day, and fifth day. All participants were monitored for compliance with treatment protocols of four times daily application of calibrated quantity of medication.
Results and Discussion:
Ninety percent of controls when compared with 65% of the participants in the amlexanox group showed complete improvement of peri-ulcer erythema. Pain reduction was marked from the first to the fifth day (
F
= 15.249,
P
= 0.000). The control participants showed 90% reduction in pain in comparison to 70% in the amlexanox group. The mean ulcer size was shown to reduce from the first to fifth day in both groups (
F
= 18.611,
P
= 0.000). Completely healed ulcers were seen in 70% of the participants in the control group compared with 75% of the participants in the amlexanox group.
Conclusion:
The data suggest that the clinical efficacy of topical amlexanox 5% is comparable to topical 0.1% triamcinolone acetonide and may be considered a substitute except in pain control, which was marginally less for the treatment for recurrent apthous stomatitis (minor).
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The relationship between the roots and furcation of the maxillary first molar to the maxillary sinus: A cone-beam computed tomography study
Girish Katti, Syed Shahbaz, Chandrika Katti, Mohd Sabyasachi Rahman
July-September 2018, 30(3):260-264
DOI
:10.4103/jiaomr.jiaomr_130_18
Introduction:
Pneumatization of maxillary sinus leads to posterior root displacement into the sinus cavity associated with potential complications following extraction of these teeth, or planning an implant in case of missing ones. Thus the relation of the maxillary sinus to the maxillary posterior teeth is of utmost importance. Hence the study was taken up to evaluate the relation of maxillary first molar to the maxillary sinus.
Objectives:
Assessing the relationships between the roots and furcation of the maxillary first molar to the floor of the maxillary sinus.
Materials and Methods:
A retrospective study where 50 CBCT scans of maxillary first molars of 36 patients were taken and the vertical relationship of the roots and furcation with the floor of the sinus were analyzed and classified.
Results:
Totally 14 (28%) mesio buccal roots, 8 (16%) disto buccal roots and 5 (10%) palatal roots were in Class 3, which is perforating into the sinus and total of 18 scans had furcations whose distance from the sinus floor was less than 5mm with Mean ± SD as 3.64 ± 1.14 and rest had more than 5mm with Mean ± SD as 6.19 ± 2.63
Conclusion:
Our study concluded that though most roots were not in touch with the maxillary sinus, a notable amount were either in touch or penetrating into it. Thus any pathology assessment or treatment plan in the first molar region must be dealt with proper three dimensional images to understand the approximation of the sinus and plan out procedure best suited for the patient.
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CASE REPORTS
Discoid lupus erythematosus
Anilkumar L Bhoweer, Sudarshan G Ranpise
July-September 2018, 30(3):302-305
DOI
:10.4103/jiaomr.jiaomr_107_18
Oral ulcerative lesions are very common and a proper diagnosis is required of the nonresponsive lesions to common antiseptic and analgesic creams which do not work on those ulcers. Specific local potent steroids work faster with given soft trays to apply, which holds the medicine for local action, as it does not get washed away with the mouth saliva. Lupus Erythematosus lesions respond slowly with medicine as this is an autoimmune disease. Systemic lupus erythematosus, it occurs, is a cutaneous autoimmune disease and can affect the skin and various internal organs. Thus, proper observation of oral ulcers is important and if there are any indications of such skin infections, then it requires a Dermatologist to handle for life-saving management as the disease is sometimes fatal. A general warning signal of recurrence can help the patient with history of oral lesion for the proper management even later in life by a Dermatologist. Oral lesions are very important in diagnosing systemic disease in many cases. Oral lesions are thus the mirror of general health.
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Drug induced erythema multiforme: Reporting 2 cases
Kamala Rawson, R Usha Rani, Sonia Susan, Gigi Roy, Neha Gupta
July-September 2018, 30(3):306-309
DOI
:10.4103/jiaomr.jiaomr_73_18
Erythema multiforme (EM) is a rare, acute, inflammatory mucocutaneous condition caused by a hypersensitivity reaction with the appearance of cytotoxic T lymphocytes in the epithelium that induce apoptosis in keratinocytes, which leads to satellite cell necrosis. Reactions to drugs are quite common and are generally mild, hence not reported. However, occasionally life-threatening reactions including EM major (Steven–Johnson syndrome) and toxic epidermal necrolysis may occur. A wide spectrum of drugs can sometimes give rise to EM. We report two cases of EM following administration of non-steroidal anti-inflammatory drugs.
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ORIGINAL ARTICLES
Ultrasonographic evaluation of oral submucous fibrosis patients: A noninvasive diagnostic approach
Aditya Dupare, Apeksha Dhole, Mukta Motwani
July-September 2018, 30(3):247-252
DOI
:10.4103/jiaomr.jiaomr_102_18
Background:
Oral submucous fibrosis (OSMF) is one of the most common premalignant conditions seen in the Indian population. It affects all parts of oral cavity including buccal and labial mucosa, tongue, and soft and hard palate. Ultrasonography is a noninvasive, nonionizing technique, readily available, cost effective, and better accepted by patients. In USG, OSMF shows alteration in submucosal thickness and vascularity overlying the bands leading to reduced peak systolic velocity (PSV). These changes cannot be assessed during clinical and histological examination. In advanced cases, OSMF can be diagnosed based on the typical clinical picture but to assess prognosis and to monitor the response to treatment; USG can be a better diagnostic tool of choice.
Aim:
To evaluate the submucosal thickness and PSV using USG in OSMF patients.
Materials and Methods:
In total, 40 OSMF patients were selected from departmental OPD divided into four groups (OSMF stages I, II, III, and IVA) equally. They were subjected to ultrasonographic evaluation for submucosal thickness and PSV of buccal and labial mucosa bilaterally.
Results:
On statistical analysis, the results were found highly significant (
P
-value < 0.05). There is significantly increase in the submucosal thickness and decrease in PSV among the OSMF stages I, II, III, and IVA, respectively.
Conclusion:
USG is found to be very effective tool for the diagnosis of OSMF as it is noninvasive modality which does not cause any discomfort to the patient and provides qualitative and quantitative information of the condition.
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CASE REPORTS
Central ossifying fibroma in old female: A case report and review of literature
Hanaa Hezam Algadi, Widad Murajia Alqasi, Omer Mohammed Jamali
July-September 2018, 30(3):315-317
DOI
:10.4103/jiaomr.jiaomr_116_18
Central ossifying fibroma is a benign, non-odontogenic tumor of the jaw, a type of fibro-osseous lesion characterized by slow growth and proliferation of fibrous cellular tissue, bone, cement, or a combination. This lesion tends to occur in the second to fourth decades of life, with predilection for women and for the mandibular premolar and molar areas. The following article reports a case of a 49-year-old female patient, who presented with large ossifying fibroma in the mandible and brief literature review of these uncommon lesions is also conducted.
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REVIEW ARTICLES
SWIFT: Sweep imaging with FOURIER transformation
Harshavardhan Talla, Vijayalakshmi Nimma, Tejaswi Bathina
July-September 2018, 30(3):286-288
DOI
:10.4103/jiaomr.jiaomr_35_18
Oral cavity is prone to a variety of diseases starting from simple tooth decay to life-threatening carcinomas. Injudicious use of ionizing radiation may increase the exposure of a patient and this has been overcome with the use of magnetic resonance imaging. A newer modality sweep imaging with Fourier transform is fast, quiet, and identifies tissues with ultra-short relaxation times. A literature search has been done in main databases such as PubMed and Google Scholar and 20 articles have been included in this review.
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CASE REPORTS
Angiofibrolipoma of the lower lip: A rare case report
Lisa Elizabeth Jacob, Sharlene Sara Babu, Sunil Sukumaran Nair, Sujeesh Koshy
July-September 2018, 30(3):318-320
DOI
:10.4103/jiaomr.jiaomr_94_18
Lipomas are commonly occurring benign tumors consisting of mature white adipocytes surrounded by a thin fibrous capsule. It is the most common type of soft tissue mesenchymal neoplasm. Angiofibrolipoma is a rare subtype of lipoma. The most common site of angiofibrolipoma is in the back, the neck, or the shoulders. Only a few cases have been reported to occur in the oral region. This article reports a case of a 34-year-old male patient with a chief complaint of a swelling in the lower lip for the past 2 years and was diagnosed as an angiofibrolipoma. A thorough search of the literature was carried out using Pubmed, Sciencedirect, Google Scholar, and Medline until 2018 using angiofibrolipoma as a keyword. To the best of our knowledge, this is the first case reported in the literature involving the lower lip.
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ORIGINAL ARTICLES
An electromyographic evaluation of orbicularis oris and masseter muscle in pretreatment and posttreatment patients of oral submucous fibrosis: A prospective study
Gunjan Sinha, Manisha Lakhanpal Sharma, CS Ram
July-September 2018, 30(3):210-215
DOI
:10.4103/jiaomr.jiaomr_109_18
Background:
Oral submucous fibrosis (OSMF) is a chronic disease of insidious onset featuring the deposition of fibrous tissue in the submucous layer of the palate, fauces, cheek, lips, pharynx, and esophagus. The underlying muscles of mastication may be affected resulting in trismus and disability due to muscle hypertrophy.
Aims and Objectives:
To evaluate the electromyographic activity of masseter and orbicularis oris muscles in patients with OSMF and to compare pretreatment and posttreatment activity of masseter and orbicularis muscles in patients with OSMF and with healthy control.
Materials and Method:
The study comprised 60 individuals. They were divided into two groups. One group was experimental/study group comprising 30 clinically and histopathologically diagnosed patients with OSMF and control group included another 30 healthy age- and sex-matched individuals. The electromyographic activity was evaluated among study group and control group, pre- and posttreatment patients with OSMF. The results were statistically evaluated using Student's
t
-test, paired
t
-test, analysis of variance test, and Bonferroni test.
Results:
The results showed that electromyographic activity of both the muscles in control group showed statistically significant decreased activity when compared with patients with OSMF. Patients with OSMF posttreatment showed statistically significant decreased activity when compared with pretreatment patients.
Conclusion:
Electromyography can serve as a useful aid in detecting the involvement of the muscles of mastication and muscle of facial expression in patients with OSMF and effect of the treatment on the muscular activity in patients with OSMF.
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Prevalence of retromolar canal and foramen: A cone beam computed tomography study
Suruchi Bajaj Ahuja, Neelkamal Sharda Bhardwaj, Vishal Dang, Ravjot Ahuja, Hemant Mathur
July-September 2018, 30(3):216-222
DOI
:10.4103/jiaomr.jiaomr_79_18
Introduction:
The retromolar fossa is a triangular area posterior to the third mandibular tooth. An opening called the retromolar foramen (RMF) and a canal called retromolar canal (RMC) are known to be present in this area. The RMF is an anatomical structure on the alveolar surface of the retromolar triangle. The contents of the RMC have been reported to consist of branches of the inferior alveolar vessels and nerves. Retromolar area is related to surgical procedures that may lead to unexpected bleeding or paresthesia.
Aims and Objectives:
(1) To determine the prevalence of RMF and RMC in the mandible using cone-beam computed tomography (CBCT). (2) To observe variations, if any, in the appearance of the same. (3) To determine the length of the RMC, diameter of RMF, and proximity (distance) of the RMF from the cementoenamel junction (CEJ) of the mandibular molars. (4) To propose a classification for the presentation of the RMC.
Materials and Methods:
A retrospective analysis was carried out for the presence and characteristics of the RMC and RMF. The retromolar region of the mandible on both sides (right and left) was examined in 80 CBCT scans (
N
= 80).
Results:
The RMCs traversed in different directions – horizontal, vertical, and angular. Based on a subjective assessment, each of these canals was further subclassified into either a straight or curved canal. In the present study, RMF was found in 3 cases unilaterally (3.8%), out of which 2 were males (2.5%) and 1 was female (1.2%), and distance from the midpoint of the same to the CEJ of first, second, and third molars were determined.
Conclusion:
The prevalence of RMC and RMF showed that all RMC may or may not end into RMF. The three different varieties of RMC observed were classified into horizontal, vertical, and angular typeswhich were further subclassified based on a subjective assessment of each of these into either a straight or a curved canal.
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Betel-nut-induced oral lichenoid lesion in oral submucous fibrosis and its relation with liver enzymes and hepatitis C virus-ribonucleic acid
Shashwati H Choube, Rahul R Bhowate
July-September 2018, 30(3):265-270
DOI
:10.4103/jiaomr.jiaomr_48_18
Introduction:
Reticular, annular, and pigmented lichenoid lesionsare associated with oral submucous fibrosis (OSMF). Both, betel-nut alkaloid and aflatoxin are responsible for hepatic damage. Occurrence of hepatic disorder with hepatitis C infection is associated with lichen planus. Considering the co-relation of oral lichen planus (OLP) with hepatitis C infection and similar lichen-planus-like lesion in OSMF probe to investigate the co-relation of liver enzymes and hepatitis C virus and OSMF associated with oral lichen-planus-like lesion.
Methods:
A cross-sectional case–control study was conducted on total 60 patients. Out of 60 patients, 20 were with lichen-planus-like lesions with OSMF, 20 with OSMF, and 20 healthy individuals. The sera of the patients and controls were tested for HCV (RNA) using Mini Vidas and liver function tests (bilirubin, transaminases, and alkaline phosphatase).
Results:
Among the total 60 patients, OLP-like lesions with OSMF patients had higher serum bilirubin, transaminases, and alkaline phosphatase level as compared with control patients.
Conclusions:
Increased titer of HCV-RNA with increased liver enzymes was found in OSMF with betel-nut-induced lichenoid lesions. This demonstrates the dual action of betel-nut alkaloids with plausible role of aflatoxin in liver damage in OSMF.
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CASE REPORTS
Epithelioid hemangioma: A rare entity to report
Mukta Motwani, Tapasya Karemore, Kunal Omprakash Sarate
July-September 2018, 30(3):321-323
DOI
:10.4103/jiaomr.jiaomr_93_18
Epithelioid hemangioma (EH) or angiolymphoid hyperplasia is an uncommon benign vasculoproliferative neoplasm. We are reporting a case of EH involving the gingiva in a 12-year-old male patient who reported to the outpatient Department of Oral Medicine and Radiology with the chief complaint of gingival growth in the lower mandibular gingiva involving both buccal and lingual gingiva and facial asymmetry due to enlarged left submandibular lymph nodes. Histopathological features diagnosed the case definitive of EH.
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ORIGINAL ARTICLES
Unintended and unexpected incidental findings on cone beam computed tomography: A retrospective study of 1500 scans
Shalu Rai, Deepankar Misra, Mukul Prabhat, Mansi Khatri, Priyank Mallick, Ayush Dhawan
July-September 2018, 30(3):223-229
DOI
:10.4103/jiaomr.jiaomr_72_18
Introduction:
Cone beam computed tomography (CBCT) has revolutionized the field of oral radiology. With the detailed three-dimensional views of dental tissues, incidental findings which were once considered abnormalities present outside the area of interest can now be recognized. Here, we report various incidental findings found on CBCT.
Materials and Methods:
This retrospective study consisted of 1500 CBCT scans. Different fields-of-view ranging from 5 × 5 to 11 × 13 were selected. Age group of the subjects included in the study was 5 to 89 years. All incidental findings were categorized in seven groups according to the area and nature of pathology – dento-alveolar region, cysts and tumors, nasal and sinus pathologies, supernumerary and impacted teeth, artifacts, temporomandibular joint (TMJ) region, and miscellaneous.
Results:
Out of 1500 patients, 723 (48.2%) were males and 777 (51.8%) were females. Mean age of patients referred for CBCT was 47.08 years. Most frequently referred patient age group was 60–69 years (19.75%). Eighty-nine percent of the subjects showed incidental findings. Total number of incidental findings was 2734. The most common area showing incidental findings was dento-alveolar area (44.3%), the least number of findings were seen in the TMJ area (0.4%). Most common finding was mucositis/mucous retention cyst (83.4%) whereas the least finding found was odontogenic keratocyst cyst and coronoid hyperplasia (0.6%).
Conclusion:
The full CBCT dataset should be fully examined and interpreted by Oral Maxillofacial Radiologists. Correct identification of various potentially pathological lesions outside the area of interest on CBCT scan should be reported and documented.
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REVIEW ARTICLES
Oral health of children and adolescents infected with human immunodeficiency virus and impact of highly active antiretroviral therapy on quality of life
Ravleen Nagi, Deepa J Patil, Shashikant Sahu
July-September 2018, 30(3):289-296
DOI
:10.4103/jiaomr.jiaomr_64_17
Human immunodeficiency virus (HIV) is global pandemic disease with progression of HIV infection to acquired immunodeficiency syndrome (AIDS) varying considerably among individuals, it is faster and more severe in children, due to the immaturity of the immune system. It may lead to various oral manifestations thus compromising nutrition and oral health of patients. Due to increasing frequency of pediatric HIV infection, all dental health-care providers should familiarize themselves with the early diagnosis of pathological conditions of the oral cavity and recommend management strategies for the treatment of such children. With the introduction of successful highly active antiretroviral therapy (HAART), oral health-care providers are now more likely to encounter children and adolescents who live longer with HIV/AIDS. This review would discuss the role of oral health-care provider in management of HIV infection especially in children and adolescents and would also highlight the effect of HAART on the quality of life on pediatric patients.
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CASE REPORTS
An interesting case of malignant paraganglioma of the mandible with calvarial metastasis
Ravi Prakash Sasankoti Mohan, Neha Agarwal, Swati Gupta, Vivek Kumar Sidhu
July-September 2018, 30(3):310-314
DOI
:10.4103/jiaomr.jiaomr_61_18
Paraganglioma is a rare neuroendocrine tumor arising from the neuroectodermally derived paraganglionic cells scattered throughout the body. Other neuroendocrine tumors include carcinoids, islet cell tumors, medullary carcinoma of thyroid, melanoma, mastocytoma, merkel's cell tumor of the skin, neurocytomas, oat cell carcinoma, pinealoma, and pituitary adenoma. Very few cases have been reported intraorally. Only few cases of neuroendocrine tumor of mandible have been reported till date. This is an interesting case of malignant paraganglioma of the mandible in a 30-year-old male patient with metastasis to the calvarium.
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GUEST EDITORIAL
The enigma of central sensitivity syndrome in dentistry
Ramesh Balasubramaniam
July-September 2018, 30(3):199-200
DOI
:10.4103/jiaomr.jiaomr_148_18
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FORENSIC ODONTOLOGY: ORIGINAL ARTICLES
Variations in dermatoglyphic patterns in oral submucous fibrosis and leukoplakia patients with and without adverse oral habits
Devashree Awasthy, Varsha J Maheshwari, Rajkumar Maurya, Chandresh Shukla
July-September 2018, 30(3):271-274
DOI
:10.4103/jiaomr.jiaomr_85_18
Introduction:
The present study was conducted to determine the comparative variations in dermatoglyphic patterns in patients without oral submucous fibrosis (OSMF) and leukoplakia and those having lesions, as well as to predict the occurrence of these diseases and initiate preventive measures in these high-risk patients.
Materials and Methods:
Dermatoglyphic patterns were collected from randomly selected 120 patients using 3M™ CSD200i. Single-digit Optical Scanner (3M™, Canada, 2015) with automatic capture mechanism was applied to capture finger prints of all the 10 fingers of patients, who were divided in control and test group with respective subgroups of leukoplakia and OSMF. Qualitative analysis of dermatoglyphic patterns in the different groups showed loops, arches, and whorls.
Results:
The collected data was subjected to analysis using Chi-square test for comparison between the groups; significant difference in
P
value was observed on comparison between dermatoglyphic patterns in patients with leukoplakia and those with adverse oral habits but without oral lesions (
P
= 0.00005), patients with OSMF and individuals with adverse oral habits but without oral lesions (
P
= 0.03), patients with OSMF and individuals without adverse oral habits and without oral lesions (
P
= 0.004), leukoplakia and OSMF (
P
= 0.007). Quantitative analysis including total finger ridge count was done by counting the number of ridges in all 10 fingers for all the patients in all the groups.
Conclusion:
The present study showed weak association in the loop pattern of patients with OSMF than leukoplakia, whorl pattern with adverse oral habits, without oral lesions, and arch pattern with OSMF. More controlled prospective trials are needed to affirm the association, if any, at larger homogeneous Indian sample in future to validate the finding.
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ORIGINAL ARTICLES
Down regulation of serum protein expression in oral submucous fibrosis: A proteomic study
Nimi Susan Mathew, Prashanth Shenoy, Laxmikanth Chatra, KM Veena, Rachana V Prabhu, Tashika Kuttappa
July-September 2018, 30(3):207-209
DOI
:10.4103/jiaomr.jiaomr_66_18
Background:
Oral submucous fibrosis (OSMF) is a potentially malignant condition, which affects the oral cavity and the oropharynx. Despite the high prevalence rates of the disease and the morbidity and mortality related to the malignant transformation of 3%–19%, that is, OSMF into oral squamous cell carcinoma, there are fewer methods to identify the malignant transformation associated with OSMF. Dissecting the molecular aspects of these disorders will significantly contribute to improved prevention, early diagnosis, and clinical management. The complementary process involved in decreasing of the cellular components is called downregulation and the vice versa is known as upregulation.
Materials and Methods:
To predict the malignant transformation of OSMF, a study was conducted for quantitative proteomic profiling on the serum of histopathologically proven patients with OSMF to identify the candidate protein biomarkers. Among the differentially expressed proteins, only the downregulated proteins are included in the scope of this article.
Results:
During the study, 133 proteins were identified from the plasma of the case samples who histopathologically confirmed OSMF. These proteins were identified using mass spectrometric analysis. During the analysis, 14 proteins were differentially expressed. A fold change of more than 1.5 indicates upregulated proteins and less than 0.6 indicates downregulated proteins when compared with the control group.
Conclusion:
This study depicts the scope of the candidate protein biomarkers that can aid in definitive diagnosis of OSMF through a minimally invasive technique and help in the early detection and better treatment planning to reduce the morbidity of the disease in the future.
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SHORT COMMUNICATIONS
Squamous papilloma treated with diode laser
Bhavna Barthunia, Neeral Barthunia, Shaik Mohammed Asif
July-September 2018, 30(3):328-330
DOI
:10.4103/jiaomr.jiaomr_16_18
Oral squamous papilloma is a benign tumor of unknown origin which arises from stratified squamous epithelium and appears as a cauliflower-like growth with finger-like projections seen on the tongue, palate, and other parts of oral cavity. The treatment modalities include surgery, cold steel excision, cryosurgery, and laser ablation. Here, we report a case of squamous papilloma on buccal mucosa treated with a diode laser.
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ORIGINAL ARTICLES
Assessing field change through the expression of cytokeratin 18 and 19 in areas of erosive oral lichen planus and adjoining normal mucosa
Sam Prasad Prabakaran, Arvind Muthukrishnan
July-September 2018, 30(3):201-206
DOI
:10.4103/jiaomr.jiaomr_117_17
Introduction:
Oral lichen planus (OLP) is a potentially malignant disorder. Of its seven different clinical forms, erosive is most prone for malignant transformation. The concept of field cancerization postulates that the mucosa of upper aero-digestive tract has a potential for developing malignancy due to genetic abnormalities and migration of transformed cells. Cytokeratins (CKs) are intermediate filament proteins that are specifically expressed in epithelial tissues and used as tools in diagnostic pathology, particularly in the detection of tumors.
Aim:
To identify field change through the expression of CK 18 and 19 in areas of erosive OLP and adjoining normal mucosa (ANM) and assess whether CK 18 and 19 could predict malignant transformation.
Materials and Methods:
Tissue samples from 19 patients with erosive OLP were subjected to immunohistochemical analysis for CK 18 and 19.
Results:
CK 18 was expressed in 11 out of the 19 samples of erosive OLP, of which nine samples showed expression in ANM as well. CK 19 was expressed in 10 out of the 19 samples of erosive OLP, of which eight samples showed expression in ANM as well.
Conclusion:
Expression of CK 18 and 19 could be used to predict malignant transformation of erosive OLP and also aids in assessing field change.
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Morphometric analysis of infraorbital canal using digital panoramic radiograph and proposing new classification
Chandramani B More, Palak H Shah
July-September 2018, 30(3):257-259
DOI
:10.4103/jiaomr.jiaomr_82_18
Background:
The infraorbital canal is one of the important anatomic structures present in the panoramic radiographic image which shows different radiographic presentations.
Aim:
To study the morphology of infraorbital canal on digital panoramic radiograph.
Materials and Methods:
The total of 1000 digital panoramic radiographs were selected from archives of the department after fulfilling the inclusion and exclusion criteria. Each radiograph was then analyzed for morphological study based on Scarfe
et al
. classification. The collected data were statistically analyzed by using descriptive statistics and the Chi-square test.
Results:
The participants' age ranged from 11 to 85 years with the mean age 37.72 + 15.89 years. There were total 583 males and 417 females with ratio of 1.4:1. The infraorbital canals were detected in 96.8% of the radiographs. The Type I, II, and III infraorbital canals were 43.45%, 18.95%, and 34.4% of radiographs, respectively. No significant difference was noted according to sex and side (
P
> 0.05).
Conclusion:
The radiographic patterns of infraorbital canal were analyzed and a modification into Scarfe
et al
. classification was proposed.
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EDITORIAL
Wisdom begins in wonder
Prashanthi Reddy
July-September 2018, 30(3):197-198
DOI
:10.4103/jiaomr.jiaomr_146_18
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© Journal of Indian Academy of Oral Medicine and Radiology | Published by Wolters Kluwer -
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Online since 23
rd
July , 2014