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   2021| October-December  | Volume 33 | Issue 4  
    Online since December 27, 2021

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Oral manifestations in diabetes mellitus- a review
Subham Kumari, N Gnanasundaram
October-December 2021, 33(4):352-356
This article deals with the characteristic of clinical findings of diabetes mellitus (DM) in the mouth and teeth. Identification of these findings in the examination of the mouth will help to diagnose DM. Symptoms such as dryness of the mouth (xerostomia), burning sensation, painful gingival swelling, and mobility of teeth due to uncontrolled DM are explained. Signs such as gingivitis, periodontitis, multiple periodontal abscesses, and fungal lesions such as Candidiasis are explained. Oral symptoms and signs may enable medical and dental specialists to diagnose diabetes. Proper diagnosis will ensure proper treatment. “Diabetes is a good disease with bad companions” quoted Dr. Sam G. P. Mosses, a renowned diabetologist in India. It is true. Diabetes is a biochemical disorder where there is a failure of peripheral utilization of sugar in cells due to insulin deficiency or defectiveness causing accumulation of excess sugar in the tissues, thus leading to hyperglycemia, glycosuria, polyuria, polyphagia, and polydipsia. It is difficult to find out when exactly the disease develops with a hyperglycemic state and how to identify the disease in the early stages. Diabetes is a reversible disease and can be controlled by restoring sugar metabolism by correcting insulin deficiency or defectiveness. Thus, the complications are considered as the bad companions of this disease. DM is a disease with systemic involvement affecting various structures and organs. The mouth is also affected by DM. If a medical or dental specialist is fully familiarized with Oral changes in DM, they can diagnose the undiagnosed diabetes through the examination of the mouth. Further confirmation of diagnosis can be made by a biochemical study of blood and urine. This article elaborates and explains the various mouth changes in diabetics for diagnosis and management.
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Efficacy of tea tree, sesame, and cumin extracts against oral Candida species – An in Vitro study
Keerthana Selvam, Suman J Lakshmi, Elangovan Somasundaram, Senthil Kumar Balasubramanian, Bakiyalakshmi Balasubramanian
October-December 2021, 33(4):357-363
Background and Objective: Oral cavity ports have diverse, abundant, and complex microbial communities. Candida is (a genus of yeast) and is the most common cause of oral fungal infection. The standard treatment of oral candidiasis is the use of antifungal agents, which cause different adverse effects. To combat this, herbal drugs can be considered as an alternative to allopathic drugs. The literature has reported that these herbal products are a rich source of antimicrobial agents. The present study determined the antifungal efficacy of tea tree, sesame, and cumin extracts against oral candidiasis in comparison to clotrimazole. Material and Methods: An in vitro study was carried out on 30 patients, wherein saliva and swab samples were collected and subjected to culture on chromagar and incubated at 37°C for 24 to 48 hours. The cultured Candida species were subjected to an antifungal susceptibility test. Clotrimazole (Group I: positive control), tea tree extracts (Group II–Group VI), sesame extracts (Group VII–Group XI), and cumin extracts (Group XII–Group XVI) were inoculated in wells and incubated. Zones of inhibitions were measured and subjected to statistical analysis. Results: Antifungal efficacy of tea tree (Group II–VI), sesame (Group VII–IX), cumin (Group XII–XIV), and clotrimazole (Group I) were compared and proven to be statistically significant with a P value < 0.05. Conclusion: Clotrimazole had a higher antimicrobial activity compared to medicinal plants. The extracts of tea tree, sesame, and cumin had significant antimicrobial activity and they might prove to be promising alternatives as a therapeutic agent for oral candidiasis.
  922 269 -
Disruptive Technologies: 3D Printing
Bharat M Mody
October-December 2021, 33(4):350-351
  914 215 -
From the desk of editor in chief
Dipti Bhatnagar
October-December 2021, 33(4):349-349
  896 203 -
Anti-inflammatory and antioxidant activity of lycopene, raspberry, green tea herbal formulation mediated silver nanoparticle
Mukundh V Chaithanya, TN Uma Maheswari, S Rajeshkumar
October-December 2021, 33(4):397-400
Aim: To assess the anti-inflammatory and antioxidant effects of a formulation containing lycopene, raspberry, green tea herbal, and silver particles. Materials and Methods: In this study, a formulation of lycopene (10%), raspberry (25%), green tea (95% polyphenols), and silver nanoparticles was subjected to anti-inflammatory testing using bovine serum albumin (BSA) assay and antioxidant testing by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) assay. Results: Anti-inflammatory and antioxidant assays showed that the highest inhibition was seen at 50 μL concentration. Conclusion: From the above results, it can be concluded that the combination of herbal extracts along with silver nanoparticles has better anti-inflammatory and antioxidant activities.
  920 171 -
Evaluation of dentition status and temporomandibular joint disorders in patients with chronic neck and/or back pain – A cross-sectional study
Pradnya Chandanshive, Avinash Kshar, Raghavendra Byakodi, Arati Paranjpe, Sunil Awale, Manish Kumar Shete
October-December 2021, 33(4):414-420
Background: The stomatognathic system (SS) is a functional unit of the body formed by the orofacial structures, together with peripheral sensory and motor neuronal connections to perform different functions like mastication, speech, and deglutition. Stomatognathic system consists of skeletal components (maxilla and mandible), dental both maxillary and mandibular arches, soft tissue (salivary glands, their nervous and vascular supplies), and temporomandibular system, that is, temporomandibular joints (TMJ; which connects the mandible to the base of the skull), muscles of mastication and their ligaments and nerves (III, IV, V, XI) which regulates and co-ordinates all its structures. The stomatognathic system also plays an important role in postural control. In balance of imbalance stomatognathic system components such as occlusion may cause temporomandibular joint disorder (TMD), TMDs may affect neck and back muscles. Aims and Objectives: To evaluate the dentition status and TMDs in patients with chronic neck and/or back pain and to correlate dentition status and TMDs in both neck and back pain patients. Material and Methods: A cross-sectional study was carried out on 300 patients. Patients were selected according to inclusion and exclusion criteria. Findings were noted in specialized case history proforma. Results: Out of 300 patients, 116 (38.67%) were males and 184 (61.33) were females. The mean age of patients referred for the study was 38.09 years. The most common dental finding in both chronic neck and/or back pain patients was flat curve of Wilson's (90%) whereas the least finding found was Grade III tooth mobility (0.04 ± 0.31 teeth). In TMDs most common finding was deviation of jaw (79.3% in neck and 100% in back pain) whereas the least finding found was deflection of jaw (50% in neck and 48.2% in back pain). Statistical analysis: The result was found highly significant (p-value <0.05). Conclusion: There was an association between disturbed dentition status, temporomandibular joint disorders, chronic neck and back pain.
  736 186 -
Awareness towards forensic dentistry - A questionnaire-based cross-sectional study
Sneha R Sharma, Freny R Karjodkar, Kaustubh P Sansare, Mohd Saalim, Ankit H Sharma, Samiksha A Chavan
October-December 2021, 33(4):385-390
Background: Forensic odontology is a vital branch of dentistry which applies the knowledge of dentistry mainly for age and gender estimation, person identification and the identification from human remains. The role of a general dentist towards forensics is crucial for medicolegal cases. Aim: The aim of the study was to scrutinize the awareness and approach of dental fraternity namely Interns, Postgraduate students and practicing clinicians towards forensic odontology. Methods and Material: A cross-sectional study was conducted in 1,860 participants, divided according to age and educational qualifications. Data was collected digitally using Google forms. Descriptive analysis were performed to describe frequencies and percentages. Chi-square test was used to analyze statistical significance. Results: 97% of the total participants maintained dental records, with only 13.4% maintaining complete records. Maximum participants were unaware of the duration for which patient records should be maintained. The significance of patient radiographs was known to 71.6% participants. 72% were vigilant of the implication of maintaining dental records in identification of the deceased. 57% knew about radiographic methods used for age estimation. 47.74% gave a response that DNA comparison has the maximum accuracy to ascertain the identity of an individual. 46.7% had the knowledge about formal training centers of forensic odontology in India. Conclusion: The present study revealed partial lack of knowledge, awareness and information of forensic odontology among the participants. Amongst all participants, the highest responses were noted amongst students and younger age group.
  756 165 -
Evaluation of genomic damage from buccal epithelial cells in patients subjected to cone beam computed tomography
Gutta Mounika, Koduri Sridevi, Buduru Krishnaveni, Nalli Prasanth Kumar, Harika Naidu, Bonthagarla Krishna Sahi
October-December 2021, 33(4):372-378
Background: Radiography forms an important and integral part in diagnosis which is used in the oral and maxillofacial region to give an appropriate diagnosis and treatment planning. But, diagnostic radiations also induce some amount of cell damage at cytogenetic levels, depending on the dosage of the radiation administered. The ionizing radiation which has been emitted during these procedures has deleterious effects on the DNA and induces cell death. Aim: To evaluate the genomic damage from buccal epithelial cells in patients subjected to cone-beam computed tomography (CBCT). Materials and Methods: Patients were divided into two groups with 30 subjects in each group. Group-1 included the subjects advised for single CBCT exposure and Group-2 included the subjects advised for double CBCT exposure. Exfoliated buccal epithelial cells were collected immediately before the exposure, 15 days, and 30 days after the CBCT exposure. The cytological smears were examined to detect the micronucleus and pyknotic nucleus. Results: The mean of the micronucleus and pyknotic nucleus obtained from group-2 (double exposure) subjects was significantly higher in males than group-1 (single exposure) subjects with a P value of 0.0001 during pre-exposure, 15 days, and 30 days after exposure. Conclusion: Genomic damage does take place due to cone-beam computed tomography. So, CBCT should be cautiously used when necessary and it cannot be considered as a risk-free procedure.
  722 184 -
Stem cells application in oral mucosal disorders: Awareness and knowledge of indian oral and maxillofacial diagnosticians – A cross-sectional study
Ashwini Nerkar Rajbhoj, Vikram V Khare, Amita Aditya, Suhas Pande, Daisy Happy, Nayana Anasane
October-December 2021, 33(4):379-384
Background: Regenerative medicine, tissue engineering, and surgery coupled with advances in materials science form an alliance of emerging interdisciplinary fields that combines the principles of cellular and molecular biology and biomedical engineering to support intrinsic healing and replace or regenerate cells, tissues, or organs, with the restoration of impaired function. The present-day treatment modalities for oral mucosal lesions are not satisfactory. Various studies have shown the successful role of stem cell therapy in the treatment of precancerous conditions, oral ulcers, wounds, and mucositis. The awareness among and knowledge of oral medicine and radiology (OMR) specialists regarding the therapeutic application of stem cells for the treatment of oral mucosal disorders is a relatively unexplored arena. Aim and Objectives: The present study was conducted to assess the awareness among and knowledge of OMR specialists regarding the application of stem cells for the treatment of oral mucosal disorders and compare the results based on age, area of work, and years of experience of the participants. Materials and Methods: The present study included a rapid, short, cross-sectional online survey. It was conducted using a web-based survey platform called Google Forms. A total of 203 OMR specialists were selected by simple random method for participating in the study. A self-administered, 10-point questionnaire in the form of an online survey was used to assess the awareness and knowledge of OMR specialists. A Chi-square test was used for statistical analysis. Results and Conclusions: Overall, awareness and knowledge were found to be more in the participants below 29 years of age, doing specialty practice, and with an experience of fewer than 5 years. A significant association of age, and area of work with awareness and knowledge was observed.
  691 172 -
Comparative evaluation of the efficacy of co2 and diode laser in the treatment outcome of oral homogeneous leukoplakia
Amrita Gupta, Sandeep S Pagare, Sunanda Bhatnagar, Mandavi Waghmare, Sonal Vahanwala
October-December 2021, 33(4):447-452
Background: “L.A.S.E.R” an acronym for “Light Amplification by Stimulated Emission of Radiation” works as an alternative to conventional surgical systems. It has many advantages and is widely used in the treatment of both oral hard and soft tissues. One of the most popular uses of lasers in the field of dentistry is in the treatment of precancerous lesions and conditions. Aim: This paper is based on the comparison of two laser techniques, carbon dioxide and diode lasers to assess the efficacy in the treatment outcome of oral homogeneous leukoplakia. Setting and Design: The study is a prospective pilot study and the study design is a hospital-based randomized clinical trial. Method and Material: The study compared two treatment groups; carbon dioxide laser on group A and diode laser on group B. The patients were assessed on the basis of postoperative signs and symptoms. Also, the rate of recurrence of oral homogeneous leukoplakia following two techniques was assessed. Statistical Analysis: One-way analysis of variance (ANOVA) test was applied and P value was measured. Study showed statistical significance with P value >0.05 for evaluation parameters such as pain, erythema, swelling, burning, and rate of recurrence. Result and Conclusion: The study concludes that carbon dioxide and diode lasers can be used as alternative treatment modalities for the excision of oral soft tissue lesions. Intraoperative and postoperative complications are rare, with minor bleeding being the only complication observed during the surgeries.
  696 155 -
Role of areca nut and smokeless tobacco-related habit in altering physical properties of saliva – A comparative study
Roseline A Patel, Jigna S Shah, Bhavin B Dudhia, Purv S Patel
October-December 2021, 33(4):421-427
Context: Saliva performs multiple functions and is of paramount importance for the maintenance of oral health. Hence, alterations in its physical properties like salivary flow rate, buffering capacity and pH can be deleterious to the oral cavity. Areca nut and smokeless tobacco products are known to alter the mucosa as well as the saliva. Aims and Objectives: The study is aimed to compare the alteration in the salivary properties like stimulated salivary flow rate, pH, and buffering capacity between subjects with areca nut and smokeless tobacco habit and without in subjects without habit. A correlation between the habit frequency, duration, and exposure on the same parameters was also ascertained. Settings and Design: It is a comparative study using purposive sampling, comprising of 100 subjects within age group 18–50 years of any gender. The sample size constituted of 50 subjects (group A) with a habit of areca nut and smokeless tobacco and 50 subjects (group B) without any habit. Salivary properties like salivary flow rate, buffering capacity, and pH were analyzed in both groups to test a hypothesis that the habit results in changes in the salivary properties and that there is a correlation between the changes and the frequency, duration, and exposure of the habit. Materials and Methods: Saliva samples were collected from these subjects for analysis of salivary flow rate (SFR), pH, and buffering capacity using the GC Saliva Check Buffer Kit. Statistical Analysis Used: Data were analyzed by using the SPSS software program, version 27.0. Results: The mean stimulated salivary flow rate among group A was 3.34 ± 1.32 and pH was 6.50 ± 0.54. The mean stimulated salivary flow rate among group B was 4.42 ± 1.48 and the pH was 7.04 ± 0.47. The difference in these values was found to be statistically significant. Conclusion: Alterations in SFR and salivary pH and buffering capacity are observed in habitual chewers of areca nut alone and areca nut with other products. The alteration is dependent on the type of habit and the habit exposure frequency and duration.
  650 186 -
Association of dental implants success in bone density classification of postmenopausal women with osteoporosis - a clinical and radiographic prospective study
Wasim Alsadi, Ali AbouSulaiman, Mohammad Monzer AlSabbagh
October-December 2021, 33(4):428-434
Introduction: Osteoporosis according to postmenopausal women is a major health problem increasing yearly. Thus, there is a growing need to assess the success of dental implants among these patients. Aim: Evaluation of dental implants success between 6 and 12 months follow-up on postmenopausal women with osteoporosis by means of clinical and radiographic assessment. Materials and Methods: A total of 30 female patients aged between 46 and 65 years were diagnosed with osteoporosis and treated with Vitamin D3 and Calcium (Vit D3 and Ca). The sample was divided into two groups: Group 1- 15 female patients diagnosed with osteoporosis (bone density of D2) and treated with (Vit D3 and Ca) and group 2- 15 female patients diagnosed with osteoporosis (bone density of D3) and treated with (Vit D3 and Ca). A total of 60 dental implants were placed in the mandibular posterior area. Implant loading was done after 6 months. Follow up intervals were 6 to 12 months after loading. Results: According to the study, compromised survival was in two implants in the osteoporosis group with a bone type of D2 with a rate of 3.3%, and compromised survival in the osteoporosis group with bone type of D3 was 11 implants with a rate of 18.3%. The success was in 52 implants, with a rate of 86.7%. Conclusion: Placing dental implants in postmenopausal female patients with osteoporosis and treating with (Vit D3 and Ca) is a safe treatment option for missing teeth, despite the bone density type. More researches about implant with osteoporosis patients are recommended.
  615 206 -
Assessment of correlation between bone quality and degenerative bone changes in temporomandibular joint by computed tomography -A retrospective study
Neha Koshal, Deepa Jatti Patil, Sanjeev Laller, Mamta Malik, Ramandeep Singh Punia, Hemant Sawhney
October-December 2021, 33(4):364-371
Objectives: This study was performed to assess the correlation between bone quality and degenerative bone changes in temporomandibular joints on computed tomographic images. Methods: Temporomandibular joints of 100 patients who underwent computed tomography were analyzed retrospectively. Sagittal and coronal images of the joint (condyle and articular eminence) were assessed for bone quality type 1 to 4 and degenerative bone changes. A Chi-square test was used to assess the descriptive statistics. One-way ANOVA was used to compare the degenerative changes in different age groups and gender. The post hoc Tukey honesty significance test was used to assess the presence of a statistically significant difference between the degenerative changes and bone quality. A value P < 0.005 was considered statistically significant. Results: The retrospective analysis included 48 women and 52 men with ages ranging from 17 to 85 years (mean age 52 years). D3 quality of bone was most commonly observed in the condyle and articular eminence. Osteophytes were the most common degenerative changes observed in the condyle and no significant degenerative changes were seen in the articular eminence. There was a correlation between degenerative changes and bone quality of condyle with respect to age. There was no correlation between the bone quality of the condylar head and its degenerative changes. Conclusion: There was no correlation between the type of bone quality and degenerative bony changes of the condyle and articular eminence, but most of the patients with degenerative changes had a poor-quality bone.
  596 218 -
Estimation of serum creatine phosphokinase and serum lactate dehydrogenase levels in oral leukoplakia and oral cancers – A clinicopathological study
Harsha Bhayya, Geetha Paramkusam, Swetha Kardalkar, ML Avinash Tejasvi, Pavani Donempudi, Namrata Patil
October-December 2021, 33(4):409-413
Aims: Evaluation of total serum creatine phosphokinase and serum lactate dehydrogenase levels as a biochemical parameter in the diagnosis of oral cancer, oral leukoplakia by the case-control method. Settings and Design: A hospital-based, case-control study was conducted at the Department of Oral Medicine, Diagnosis, and Radiology. Materials and Methods: The study included clinically and histopathologically diagnosed oral leukoplakia and oral cancers with 20 patients in each group. The control group consisted of 20 healthy patients without lesions or tobacco-related habits or any systemic diseases. The blood samples were collected from the study and control groups, centrifuged, and serum was analyzed for serum creatine phosphokinase and serum lactate dehydrogenase (CK and LDH) levels using an autoanalyzer. Statistical Analysis: Comparison of three groups with respect to each biochemical parameter was done by one-way ANOVA. Comparison between the groups was done by Tukey's multiple post hoc test. Results: It was found that total serum CK levels were statistically significantly decreased in both oral leukoplakia and oral cancer when compared with that of the control group. Total serum LDH levels were statistically significantly increased in both oral leukoplakia and oral cancer when compared with that of the control group. Conclusion: Although the results of the present study showed increased levels of LDH in both oral leukoplakia and oral cancer, and CK levels statistically decreased but they were within normal limits. Further. studies with a greater number of samples, different grades of epithelial dysplasias, and assessment of individual isoenzymes has to be carried out to evaluate the exact role of CK and LDH in the etiopathogenesis of oral cancer.
  606 186 -
A comparative study of alternative therapies and mandibular advancement device in the management of obstructive sleep apnea
Deeptanshu Daga, Mohit Pal Singh, Prashant Nahar, Hemant Mathur, Anshit Babel, Apoorva B Daga
October-December 2021, 33(4):391-396
Introduction: Patients suffering from obstructive sleep apnea (OSA) face the challenge of getting the correct diagnosis and treatment. Snoring is the most common giveaway. Aim: The aim of the study was to evaluate the quality of sleep before and after the use of the appliance and while practicing yoga based on the STOP-BANG questionnaire for sleep quality, Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Methodology: A total of 100 patients visiting the outpatient department (OPD) were divided into two groups of 50 each. The first group who fulfilled the criteria for the device was given a mandibular advancement device (MAD) and the second group was assigned yoga and pranayamas. Results: The first group showed a significant increase in the airway space on lateral cephalogram also with more immediate overall scores in all three questionnaires compared to the second group. Conclusion: MAD offers an inexpensive, comfortable treatment option for patients requiring immediate relief but has poor appliance compliance. However, yoga and pranayama yielded very good results although took a long time. On follow-up, the recurrence of OSA was negligible. MAD would provide immediate relief in OSA but for sustained overall benefit yoga and pranayama should be practiced.
  636 141 -
Impact of oral health factors on quality of life of geriatric population - A systematic review
Shalu Rai, Deepankar Misra, Akansha Misra, Ankit Jain, Suman Bisla
October-December 2021, 33(4):453-465
The innumerable special needs and challenges faced by geriatric patients in healthcare has attracted the attention of the modern world. Various basic oral functions contribute to good physical and psychological health and are likely to deteriorate with frailty. The aim of the study was to examine effects of aging on oral health related quality of life (OHRQoL) and assess importance of dental care amongst older persons. An electronic search in PubMed Central's database was performed. The search strategy was limited to human studies (single and double-blinded trials, cross-sectional and case-control studies), full-text English articles published from first of January 2010 until the end of April 2021. Irrelevant articles or articles with inadequate information were omitted. Data was searched and analyzed using following MeSH terms/keywords: Geriatric Assessment, Oral Health Related Quality of Life. 43 studies were included. In most of the studies it was identified geriatric assessment is essential to avoid comorbidities in such patients. Furthermore judicious use of polypharmacy is advocated in such patients. An association between OHRQoL and dental care of older people was found. This indicates prevention and early intervention with treatment modalities in the increasing elderly population with an apparent solicitousness of their health needs
  623 150 -
Assessment of artifacts induced by various dental restorative materials on cone- beam computed tomography- An in vitro study
Laboni Ghorai, ML Asha, Jigna V Raja
October-December 2021, 33(4):401-408
Objectives: The aim of this study was to assess and compare quantitatively and qualitatively the artifacts induced by various commonly used dental restorative materials in different sections of CBCT image and to characterize the pattern of artifact. Material and Methods: Thirty dental plaster blocks, each with one of each of mandibular second premolar, first molar and second molar teeth with crowns aligned as in the natural dentition were scanned by CBCT device and analyzed using CS 3D imaging software, before and after the first molar was prepared and restored with dental amalgam, composite resin or glass ionomer cement (GIC), 10 plaster blocks being randomly selected for each restorative material. The reformatted axial, coronal and sagittal scans were then quantitatively assessed for artifact by two calibrated dento- maxillofacial radiologists by comparing the control and restored scans of each plaster block in a blinded manner and documented the slice numbers from which the image became diagnostic. Then, the slice numbers were converted into millimeters away from the restoration. Results: Paired t test, ANOVA and post hoc Tukey tests were used for statistical analyses. The level of significance was set at α = 5%. Depending on the extent, the majority of artifacts produced were as follows: Dental amalgam >Composite resin >GIC. The artifact was most extensive in the coronal section. Streaks and scatter artifacts, linear artifacts extending outward from tooth surface and hypodense halo were predominant. Conclusion: Different dental restorative materials cause various amounts of artifacts in different planes of projection of CBCT image due to differences in density and atomic number.
  574 139 -
Actinomycotic osteomyelitis of maxilla in a diabetic patient- “A rare case report & review of literature”
Basavaraj T Bhagawati, Manisha Solanki, Hemlata Solanki, Manish Sharma
October-December 2021, 33(4):487-489
Actinomycosis may be a relatively rare infection caused by saprophytic bacteria of the mouth and alimentary canal which will become pathogenic. The chronic hyperglycemia in Diabetes Mellitus induces events that promote structural changes in various tissues and are related to problems in wound healing. This infection remains largely unknown to most clinicians due to its different presentations, and palatal involvement is extremely rare. This report describes the case of a 50-year-old man who was diagnosed with actinomycosis involving mucosal surface. The main clinical, histopathologic, and therapeutic characteristics and diagnosis of actinomycosis are reviewed. Till date, 4 cases of actinomycosis involving the palatal surface are reported.
  546 156 1
Comparative estimation of serum levels of vitamin A, vitamin B12, vitamin D and vitamin E in patients with recurrent aphthous stomatitis and normal individuals – A case-control study
Subhasish Mustafi, Rupam Sinha, Soumyabrata Sarkar, Debanti Giri, Anindya P Saha, Priyanka Yadav
October-December 2021, 33(4):442-446
Background: Recurrent aphthous stomatitis (RAS) is a recurrent acute ulcerative lesion of oral mucosa. Till now, the exact cause and mechanism of this condition isn't very much clear; it is however believed to be multifactorial. Various studies indicate that genetically mediated disturbances of the innate and acquired immunity play an important role in the disease development. Vitamins and micro-elements deficiencies are one of the principal factors that modify the immunologic response in RAS. Aim: To probe for correlation between serum levels of Vitamin A, B12, D3, E, and RAS. Methods and Materials: The cross-sectional clinical study was conducted on persons seeking dental service at some private dental college in West Bengal, India between January 2017 and June 2018. Forty patients suffering from RAS were compared to forty normal individuals. Applying ELISA method, serum concentration of vitamins A, vitamin B12, vitamin D3 and vitamin E were measured in two groups. Statistical Analysis: The means between two groups were compared by Student's unpaired 't' test. A value of P < 0.05 was considered as statistically significant. Results: RAS patients had a significantly lower serum level of vitamin A, B12, D3 and E than normal individuals; and there were a positive relation between the serum level of vitamin B12 and vitamin E in RAS patients. Conclusion: Vitamin A, B12, D3 and E deficiency have a significant bearing on RAS; and serum level of vitamin B12 and E of RAS patients have a significant interrelationship.
  512 153 -
Hybrid tumour of central ossifying fibroma and complex odontoma in the mandible – A rare case with review of literature
Vasavi K Santosh, Shweta Hinduja, Anindya K Debnath, Mandavi Waghmare
October-December 2021, 33(4):472-475
Central ossifying fibroma is a rare, benign fibro osseous lesion that arises from the periodontal ligament. Odontoma is one of the most common odontogenic tumors containing enamel, dentin, cementum, and pulpal tissue. A 15-year-old boy came to our department with the chief complaint of missing teeth and malocclusion. On complete clinical and radiological investigations, we suspected a fibro osseous lesion and an odontoma occurring in the same site in the mandible, which was confirmed histopathologically to be complex odontoma and central ossifying fibroma. The patient was treated with en bloc resection and iliac crest graft. Such hybrid tumors where there is a synchronous occurrence of two tumors have been rarely reported in literature. There has been no established correlation in such cases but reporting more such cases may help in the establishment of a relationship.
  474 133 -
Frey's syndrome: A misdirected reflex action!! – A case report
Anuradha Ganesan, Bounika E Rao
October-December 2021, 33(4):484-486
The incidence of Frey's syndrome after parotidectomy greatly varies in the literature. It is a sequelae of any surgery near the pretragal region like parotidectomy or condylar surgeries which might cause embarrassment and considerable social discomfort and may further result in disruptions and disturbances in daily life. Hence, frequent follow-ups after the surgeries, early diagnosis, and proper management of Frey's syndrome may help to alleviate symptoms and improve quality of life for the patient. This case report highlights a case of Frey's syndrome followed by the surgical management of condylar fracture and also highlights the management of the syndrome.
  469 126 -
Unilateral mandibular coronoid osteoma-An unusual cause for pseudoankylosis
Karthikeya Patil, CJ Sanjay, M Meghana, S Viveka
October-December 2021, 33(4):476-479
An osteoma is a benign osteogenic tumor characterized by compact or cancellous bone proliferation with unknown etiology, but it may arise from cartilage or embryonal periosteum. Osteomas are rare, slow growing, usually asymptomatic until their size and position interferes with functioning. This is a report of a 53-year-old male patient who complained of difficulty in opening his mouth, which was diagnosed as an osteoma of mandibular coronoid producing pseudo ankylosis, a very unusual condition. Surgical excision of the tumor was performed, followed by physiotherapy and no recurrence was observed. This case report highlights the rare causes of pseudo ankylosis with significance to early diagnosis and intervention which can prevent further complications to the patient.
  482 110 -
Usefulness of demirjian's comprehensive dental chart for age estimation in dental practice – A pilot radiographic study
MunBhawni Bagga, Ramandeep S Punia, Thippeswamy S Halappa
October-December 2021, 33(4):468-471
Demirjian 7-teeth method is a gold standard for dental age estimation (DAE) so it has been simplified to a comprehensive chart (DAEcc) to make it user-friendly. This pilot study aimed to assess applicability and usefulness of DAEcc. 250 OPGs (130 men, 120 women, 5–15 years) were evaluated for DAE in the North Indian population using DAEcc and compared it to chronological age. Results showed a positive correlation between chronological age and estimated age (Correlation = 0.9; P < 0.001). However, like the original Demirjian 7-teeth method here also a slight overestimation of age was there but DAEcc is a more time-efficient method.
  468 95 -
An ambiguous clinical presentation of a gingival plasma cell granuloma – A case report
Areeba Shahid, Priya Singh, Neeta Misra, Deepak Umapathy
October-December 2021, 33(4):480-483
Plasma cell granuloma (PCG) is a rare localized benign proliferation of polyclonal mature plasma cells. The etiopathogenesis of the PCG remains inexplicit. Although it primarily occurs in the lungs, intraoral variants, involving the gingiva, tongue, buccal mucosa, have been reported too. Here we report a case of a 19-year-old female patient with mandibular anterior gingival exophytic growth that gave an impression of pyogenic granuloma clinically. The overgrown tissue was excised and histological examination revealed inflammatory cell infiltrate containing sheets of plasma cells. This case highlights the presence of a PCG having a periodontal origin. As intraoral occurrences of PCG are uncommon, such observations should be well documented and added to the existing literature. Advanced investigations such as immunohistochemistry can be done, which rule out the possibility of any malignancy, as seen in cases of plasmacytoma that mimic PCG (no malignant potential).
  454 108 1
Detection of mandibular canal in human dry mandibles with cone beam computed tomography using 270° and 360° protocols under continuous and pulse modes – A comparative study
Karishma , AG Annaji, N Rakesh, L Upasana, MS Abhinetra
October-December 2021, 33(4):435-441
Background: Cone beam computed tomography (CBCT) enables practitioner to accurately localize and mark the nerve canal. The rotation of the X-ray tube and the detector around the patient's head produces multiple projection images. A high number of projections is associated with increased radiation dose to the patient, higher spatial and contrast resolution. Shorter scan arc results in reduced scan time, reduced dose and smaller file sizes. The pulsed X-ray beam reduces the actual exposure time than the scanning time and the patient radiation exposure. Aim: (1) To assess and compare the diagnostic efficacy between pulse mode and continuous mode (2) To assess and compare the diagnostic efficacy between 270° and 360° CBCT rotational protocols Subjects and Methods: A total of 30 Intact Dentate or Partially dentate dry human mandibles consisting first, second, and third molars were subjected to a total of 4 CBCT scans: 270° rotation scans under continuous and pulse mode, 360° rotation scans under continuous and pulse mode using two CBCT units. Distance from the inferior cortical border of mandible (ICBM) to the roof of the inferior alveolar nerve canal (IANC) was measured at four locations: mental foramen, first, second and third molar. The results were then compared. Results: Comparison of the IANC length measurements for the two modes revealed no significant difference. Conclusion: Shorter scan arc and pulse mode can be adopted in patients finding it difficult to remain stable for prolonged periods of time, while maintaining appreciable clarity and quality of image. This could apply to geriatric patients, children, mentally challenged, in patients with trauma, neurological diseases, anxiety, claustrophobia, wherein the patient's movements might need re-scanning, which would lead to an extra radiation dose to the patient.
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Need for regulation of pan masala advertisements in television media
A Winnifred Christy, T Jones Raja Devathambi, B Deepikalakshmi
October-December 2021, 33(4):466-467
Tobacco industries have resorted to brand stretching to keep their brands visible through sale of non-tobacco products like elaichi (cardamom) and paan masala, as seen in television advertisements aired during Indian premier league matches. The direct and indirect forms of advertisements of tobacco products in digital media remains unchecked. Strict ban should be enforced as these advertisements lure children and the youth into consumption of tobacco products later in life. In addition to providing tobacco cessation services to patients, oral health professionals should be aware of the marketing strategies of tobacco companies so that we can advise governing authorities to enact new laws and enforce existing laws in order to curtail tobacco consumption in our country.
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