Search

Objective: The objective of the study is to assess the effects of adjunctive use of hyaluronic acid (HA), clinically and microbiologically in smokers and nonsmokers, in the management of chronic periodontitis. Material and Methods: 48 sites from 24 chronic periodontitis patients, including smokers and nonsmokers with probing depth >5 mm, were selected for the study. A split-mouth design was followed. Scaling and root planing (SRP) was performed for all the patients. The test sites received 0.8% HA gel whereas the control site received placebo gel. The clinical parameters plaque, gingival and bleeding indices, Pocket Probing Depth (PPD), and clinical attachment level (CAL) were evaluated at baseline, 1 and 3 months. Microbiological parameters were evaluated at baseline and 1 month. Results: The results showed reduction in PPD and gain in CAL in both smokers and nonsmokers at the end of 3rd month. The improvements in the test sites were statistically significant when compared with that of control sites. The microbiological analysis showed a significant reduction in Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at the test sites when compared to the controls in both the groups. Conclusion: The findings in both groups suggest that the use of locally delivered 0.8% HA gel may be valuable as an adjunct to SRP in the treatment of chronic periodontitis. [ABSTRACT FROM AUTHOR]

Aim: To study the expression of Epithelial Glycoprotein (EGP40) in various grades of Oral Epithelial Dysplasia namely mild, moderate and severe epithelial dysplasia and in various grades of Oral Squamous Cell Carcinoma (OSCC) namely well, moderate & in poorly differentiated squamous cell carcinoma.Material and Methods: This laboratory study comprised of 47 samples in which 27 samples were of three different grades of OSCC, Well (n=10), Moderate (n=10) and Poorly differentiated (n=7) and remaining 20 samples were of three different grades of dysplasia [Mild (n=7), Moderate (n=8), Severe dysplasia (n=5)]. All the 47 cases were subjected to immunohistochemical staining to evaluate the expression of EGP40. Chi square was used to analyze the significance of differences in different grades of oral epithelial dysplasia & in different grades of OSCC.Results: The percentage of EGP40 immuno positivity was increased from mild to severe dysplasia and the percentage of EGP40 immuno positivity was increased from well to poorly differentiated carcinoma No statistical significance was observed in the immunoreactivity and in the intensity of expression between various grades of oral epithelial dysplasia and oral squamous cell carcinoma.Conclusion: The epithelial cell adhesion molecule can be considered as an early marker for predicting malignant transformation of dysplastic epithelial lesions and used as a marker in predicting the OSCC prognosis. [ABSTRACT FROM AUTHOR]

Background: Health-care workers (HCWs) are at increased risk of acquiring tuberculosis (TB) than the general population. While national-level data on the burden of TB in general population is available from reliable sources, nationally representative data on latent tuberculosis infection (LTBI) burden in HCWs in the high burden countries is lacking. Methods: A prospective study was carried out to assess the risk of TB infection among HCWs who directly engage in medical duties. HCWs were recruited between January 2014 and December 2015. A structured questionnaire was used for risk assessment of TB infection among HCWs, including sociodemographic characteristics (e.g., age, gender, period of professional work, and employed position), knowledge of TB prevention and control, and history of professional work. A single-step tuberculin skin test (TST) using 5 international units (IU; 0.1 ml) of tuberculin (purified protein derivative from Mycobacterium bovis Bacillus Calmette-Guérin [BCG]). TB infection was determined using a TST induration ≥10 mm as a cutoff point for TST positivity. TST-positive participants were further subjected to detailed clinical evaluation and chest radiography to rule out active TB. The associations between TB infection and the sociodemographic characteristics, duration of possible exposure to TB while on medical duties, BCG vaccination, and knowledge about TB were estimated using Chi-square test. A two-sided P < 0.05 indicated statistical significance. Results: A total of 206 eligible HCWs signed the informed consent and completed the questionnaires between January 2014 and December 2015. The age of the participants ranged from 18 to 71 years, with a mean age of 27.13 years. TST induration size (mean 6.37 mm) the TST results suggested that 36.8% (76/206) were infected with TB using a TST induration ≥10 mm as a cut-off point. All 76 TST-positive HCWs showed no evidence of active TB in clinical evaluation and chest radiography. However, during the study, two HCWs developed pulmonary TB (both TST baseline test negative). Statistical analysis suggested that age, duration of employment as a health-care professional, literacy status, and working in medical wards/OP/Intensive Care Unit were significantly associated with TB infection. Conclusions: Many studies propose serial tests of LTBI as effective occupational protection strategies. However, practically, it is not feasible because it has to be done at frequent intervals, but how frequently to be done is not clear. Another concern is even if found to have LTBI, there are no clear consensus guidelines about the treatment in high prevalence settings. The prevalence of LTBI is so high in countries like India that affected HCWs could not be exempted from working in high-risk areas. The depth of knowledge of TB prevention and control among HCWs should be improved by regular infection control training. [ABSTRACT FROM AUTHOR]

Background: India is facing an epidemic of diabetes mellitus (DM). Effective management of complications of DM is a challenge in resource-poor areas of India. This study addresses the need to explore low-cost methods to manage diabetic ketosis (DK) and diabetic ketoacidosis (DKA). Objectives: To demonstrate the use of intramuscular (IM) regular insulin as a safe alternative method to control DK and DKA in a family practice setting. Materials and Methods: A retrospective chart review was done for 34 patients admitted with DK and DKA in a family medicine unit for the urban poor over 5 years. Data on age, sex, precipitating factors, blood pressure, number of days of hospitalization, amount of insulin, and time required to control blood glucose (BG) and to correct acidosis were entered into EpiData version 3.1 and analyzed using SPSS software version 17. Results: Administration of IM regular insulin was effective in reducing the BG to <250 mg/dL in patients with DK and DKA. The mean time required for this in the ketosis group was 3.8 h and in the ketoacidosis group was 3.9 h. The mean amount of insulin required for correction of acidosis in the ketoacidosis group was 72.3 units and the mean time to achieve this was 33 h. Of the 34 patients, only one in the ketoacidosis group had hypoglycemia. There was no fatality or referral of any patient. Conclusion: This study demonstrates that IM regular insulin is a safe alternative method in managing DK and DKA in a family medicine setting. [ABSTRACT FROM AUTHOR]

Fusion is a developmental anomaly of shape of the tooth seen in developing primary or permanent teeth. Etiology is not exactly known, but the physical pressure or force generated during growth causes contact and fusion between adjacent tooth buds. The genetic foundation for the anomaly is possibly autosomal dominant with reduced penetrance. The bilateral type of fusion in the primary dentition is very rare and is usually 0.02%. Till now, only 18 cases have been previously reported in dental literature since 1940, and in the Indian population, only few cases have been reported. In bilateral fusion of primary lateral incisor and canine, 75% chance of lacking the succedaneous lateral incisors have been reported. The anomalies of the permanent dentition are strongly associated with anomalies in the primary dentition. The potential clinical problems associated with fusion require orthodontic, prosthetic, cosmetic and periodontal intervention also. Thus, to establish a right treatment to this anomaly, the early proper examination and knowledge to recognize the anomalies associated between primary teeth and permanent teeth is a prerequisite. [ABSTRACT FROM AUTHOR]

Aim: To Quantify the DNA single-stranded breaks in the peripheral blood leukocytes (PBLs) of tobacco-habituated individuals with clinically normal mucosa and patients with oral carcinoma. Objectives: To evaluate DNA damage levels in PBLs of tobacco-habituated individuals with clinically normal mucosa and patients with oral carcinoma and compare with a control group of healthy volunteers. To evaluate the extent of DNA damage in PBLs using Single Cell Gel Electrophoresis (SCGE) in the above groups. Materials and Methods: Patients who were attending the outpatient department were enrolled in this study. A control group of 30 healthy volunteers included in Group I were selected from various age groups who are not tobacco users in any form. Thirty patients with tobacco habituation but with clinically normal mucosa were included in Group II, while 30 tobacco-habituated patients with oral squamous carcinoma were included in Group III. A biopsy was taken from the representative area and confirmed histologically. Intravenous blood samples were collected from all the groups for evaluation of the extent of DNA damage using ethidium bromide-stained slides under fluorescent microscope. The DNA tail length was calculated by subtracting the diameter from the total length. Twenty-five randomly selected cells per slide were analyzed and mean calculated. Results: The mean DNA damage levels in patients with tobacco habits were compared with that of the control group and the results were found to be statistically significant. The mean DNA damage level in PBLs between tobacco-habituated patients with normal mucosa and oral cancer patients was found to be statistically significant. The DNA damage in cancer patients was compared with the control group and the results were found to be statistically significant. Conclusion: DNA damage evaluation in PBLs by SCGE technique is a sensitive and reliable indicator of tobacco insult. [ABSTRACT FROM AUTHOR]

Background: Syndecan-1 is abundant in normal tissues and reduced in squamous cell carcinomas. Leukoplakia and oral submucous fibrosis (OSF) are oral pre-cancerous disorders that have potential for malignant transformation. The aim of this study was to evaluate the expression of syndecan-1 in leukoplakia and OSF and to identify its role as a reliable marker for predicting malignant changes. Materials and Methods: Expression of syndecan-1 was examined immunohistochemically in 42 cases of oral leukoplakia with or without epithelial dysplasia, 28 cases of OSF and 10 cases of normal oral epithelia as control. Mann-Whiteny 'U' test was used for statistical analysis and the level of significance was fixed at P < 0.05. Results: Intense syndecan-1 expression was observed in nine cases with normal epithelium. Immunopositivity was lost gradually as the extent of epithelial dysplasia increased. The significant reduction in syndecan-1 expression was observed in leukoplakia as epithelial dysplasia progressed from moderate or severe. Similarly, significant reduction was observed in staining intensities in OSF with dysplasia. Conclusion: The results reveal that down-regulation of syndecan-1 expression is associated with dysplastic changes in leukoplakia and OSF. Thus syndecan-1 can be considered as marker for predicting malignant changes. [ABSTRACT FROM AUTHOR]

Cancer is a disease involving complex multiple sequential irreversible dysregulated processes showing metastasis that results in morbidity and mortality. Metastasis is a complex biological course that begins with detachment of tumor cells from the primary tumor, spreading into the distant tissues and/or organs, invading through the lymphovascular structures followed by their survival in the circulation. Metastatic tumors to the oro-facial region are uncommon and may occur in the oral soft tissues or jawbones. The clinical presentation of metastatic tumors can be variable, which may lead to erroneous diagnosis or may create diagnostic dilemma. Therefore, they should be considered in the differential diagnosis of inflammatory and reactive lesions that are common to the oral region. Most of the literature on oral metastases involves either single case reports or reviews of these reported cases from scattered geographical areas. Hence this present article is an attempt to provide a detailed review of pathogenesis, epidemiological details including clinical and radiographic presentations, microscopic features and treatment of metastatic tumors to the jaws and oral cavity. [ABSTRACT FROM AUTHOR]

Background: Cyclin D1, a member of G1 cyclins, controls the cell-cycle transit from the G1 to S phase. The deregulation and overexpression of cyclin D1 has been revealed in many tumors of diverse histogenesis. Ameloblastoma is the most frequently encountered odontogenic tumor known for its local invasiveness and a high tendency to recur. The adenomatoid odontogenic tumor is a benign, nonaggressive tumor with a limited growth and no tendency to recur. Aim: The aim was to investigate whether the immunohistochemical expression of cyclin D1 as a proliferation marker in ameloblastoma and adenomatoid odontogenic tumor correlates with the known clinical behavior of these two benign neoplasms. Materials and Methods: Ameloblastoma cases consisted of follicular, plexiform, and unicystic subtypes. The positive staining was assessed based on intensity of staining, localization of staining, and in different cell types in both the tumors. Two cases of follicular ameloblastoma and one case of plexiform ameloblastoma showed intense staining, but the predominant staining intensity was overall mild in both ameloblastoma and adenomatoid odontogenic tumors. The immunoreactivity was found both in nucleus and cytoplasm in ameloblastoma and only nuclear in adenomatoid odontogenic tumors. The peripheral columnar and central stellate reticulum-like cells of ameloblastoma showed immunoreactivity with squamous and granular cells being negative. In adenomatoid odontogenic tumors, the whorls showed predominant localization of staining. Statistical comparison with a Mann--Whitney U-test showed no significant difference in staining intensities between different histologic subtypes of ameloblastomas and also between ameloblastoma and adenomatoid odontogenic tumors (P>0.005). Conclusion: The marked expression of cyclin D1 in these tumors suggested its participation in proliferation of both the tumors and its expression patterns were irrespective of their known biologic behavior. [ABSTRACT FROM AUTHOR]

Odontogenic cysts and tumors are distinct entities and quite a common occurrence in the jaw bones. The lining of odontogenic cysts shows a potential for neoplastic transformation to non odontogenic malignancies like squamous cell carcinoma and mucoepidermoid carcinoma, and odontogenic tumors like ameloblastoma and adenoamatoid odontogenic tumor (AOT). AOT is a benign, epithelial odontogenic tumor, common site being the anterior maxilla. Its origin from a dentigerous cyst and in the mandible is rare. A case of an AOT arising from a dentigerous cyst associated with an impacted permanent mandibular left lateral incisor is reported. [ABSTRACT FROM AUTHOR]

Glandular odontogenic cyst (GOC) is a rare developmental cyst of the jaws. The most common site of occurrence is the anterior mandible, and it is most commonly seen in middle-aged people. It is a destructive lesion with a high rate of recurrence. A predilection for men is observed. Clinical and radiographic findings are not specific, and it can mimic as any other destructive lesion of the jaw. The histopathological features of GOC and those of low-grade central mucoepidermoid carcinoma (MEC) are similar. Often, they are misdiagnosed as MEC. We present a case of GOC in the posterior maxilla, which is a rare site. The similarities and differences between GOC and central MEC are also discussed. [ABSTRACT FROM AUTHOR]

Vegetable granuloma (VG) or pulse granuloma (PG) results from the implantation of food particles of plant or vegetable origin. It is usually seen in the periapical or in the sulcus areas. These lesions have been described as a distinct entity and classified into central and peripheral lesions according to the location. Central lesions are asymptomatic, whereas peripheral lesions present as painless sub-mucosal swellings. Many authors have postulated that food particles in VG or PG get implanted and are rapidly digested, and sometimes partly get altered by host responses. The cellulose part of plant foods being indigestible persists in the form of hyaline material, whereas the starch matter gets digested. This cellulose moiety invokes chronic granulomatous response. [ABSTRACT FROM AUTHOR]

Myiasis is an opportunistic infestation of human and vertebrate animals with dipterous larvae. Oral myiasis is a rare condition associated with poor oral hygiene, mental disability, halitosis and other conditions. We present a case report of an adult mentally challenged woman with extensive necrotic oral lesion burrowing into the hard palate through which three live maggots (larvae) were seen emerging out. The larvae were removed using forces and the patient was treated with oral ivermectin. The maggots were identified as larvae of the Chrysomya bezziana fly. [ABSTRACT FROM AUTHOR]

Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in infants or children younger than 2 years. Herein, we present a case of recurrent cystic hygroma in a 22-year-old woman. History revealed that she had a similar lesion in the left submandibular region when she was 2 years old and in the thyroid region seven years back. This case has been reported for its unusual occurrence in an adult, showing recurrences at different sites and presence of calcification. [ABSTRACT FROM AUTHOR]

A 27-year-old man suffered a relatively minor trauma. He developed signs of raised intracranial pressure three days after injury. Investigations revealed superior sagittal sinus and torcular thrombosis. [ABSTRACT FROM AUTHOR]