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The results of present study proved that the mandibular ramus plays an important role in sex determination due to its unique high sexual dimorphism, so does the gonial angle, which is linear to studies done previously with a smaller sample size. [8, 9, 13] The mandible also possesses resistance to damage and disintegration process. Hence, we conclude that the use of mandibular ramus and gonial angle is recommended as an aid for gender determination in forensic anthropology.

Oral submucous fibrosis is a chronic insidious oral mucosal condition causing trismus and reduced mouth opening and it is affecting predominantly Indian and other Asians. The treatment of trismus requires combination of pharmacological agents, surgical therapy and physiotherapy, the latter is essential for preventing relapse due to postoperative inactivity and scarring as well as for improvement of mouth opening. Computerized literature search was performed from 1993 till 2021 to select eligible articles from the following databases: PUBMED [MEDLINE], SCOPUS, SCIENCE DIRECT, and COCHRANE DATABASE using specific keywords. The search was limited to articles published as full text in English, which were screened by two reviewers for eligibility.This article describes in depth about various appliances, devices used in oral submucous fibrosis. The devices can be used along with pharmacological and surgical treatment modalities or can be used alone. Mouth exercise is also well-established method to improve mouth opening and also to prevent postsurgical relapse. This article is one of the rare article that describes all the appliances together either directly used or indirectly used for the case of microstomia due to oral sub mucous fibrosis.

Introduction: Tobacco is the single most important avoidable cause of premature morbidity and mortality in the world. Tobacco dependence is a chronic condition that often requires repeated interventions. Since oral medicine experts are the first to note any changes that can occur in the oral cavity, they can play a major role in its prevention and intervention. There are well-tried and cost-effective methods for interventions. An oral medicine expert can play an effective role in tailoring a special and specific cessation programme for every individual to improve quit rate and prevent relapse. Objective: This review is prepared with the objective to help Oral Medicine Experts to guide differential prescribing practices and tailoring pharmacotherapy for tobacco cessation. Conclusion: Interventions by Oral Medicine Experts have been found to be effective in helping people to quit tobacco. Keywords: Tobacco dependence, tobacco cessation, oral medicine expert, nicotine replacement therapy.

Dentistry has witnessed tremendous advances in all its branches over the past three decades. With these advances, the need for more precise diagnostic tools, especially imaging modalities, has become mandatory. Many advanced imaging modalities like CT, MRI, CBCT, PET imaging are available which has made diagnostic imaging very accurate. Some of these modalities give a very good anatomic location and extent of the pathology, while others are able to image the pathology when the organ is in function. But, when both ie the precise anatomic location and functional imaging are required, than fusion of images made by more than one advanced imaging modality is required. This is where fusion imaging plays a significant role. “Fusion Imaging is the process of registering and combining multiple images from single or multiple imaging modalities to improve the imaging quality and reduce randomness and redundancy to increase the clinical applicability of medical images for diagnosis and assessment of medical problems”. It was designed to overcome the disadvantages of anatomic and functional imaging modalities and attempts to provide inputs that improve the image quality by combining the advantages of anatomic and functional imaging modalities for improvising treatment plans. The fusion imaging information is ultimate and it allows not only better understanding of various physiological and disease process but also helps in monitoring & predicting the course of the treatment and predicting the prognosis. Keywords:Fusion Imaging, PET-CT, PET-MRI, F18-FDG

Introduction – Age assessment is an essential part of forensic odontology. It is of importance in medico-legal areas and in mass disasters. Age estimation methods show variation in the reported results. Aim and Objectives - To evaluate and compare the dental age from orthopantomogram using Demirjian’s and Nolla’s method in residents of Pune city and to compare the dental age with the chronological age. Methodology - The study was carried out in the Department of Oral and Maxillofacial Pathology and Oral Microbiology, Bharati Vidyapeeth Deemed to be University, Dental College and Hospital, Pune. A total of 100 subjects were enrolled in the study. The diagnostic orthopantomograms (OPGs) were evaluated as per the Demirjian’s and Nolla’s method. Statistical methods - The pair-wise statistical comparison of distribution of means of continuous variables was tested using paired t-test. Results – The results of our study suggest that the Demirjian’s method is applicable to higher age groups in both genders with a better accuracy than Nolla’s method. Nolla’s method has a better accuracy in the lower age group than the Demirjian’s method.

Introduction: Aloe vera has various pharmacological actions due to which it has been selected as an alternative treatment modality in treating various oral diseases. It has antibacterial, antifungal, antiinflammatory, antioxidant, antitumor, and immune boosting. It has been used for the management of oral lesions such as oral lichen planus, oral submucous fibrosis, radiation-induced mucositis, burning mouth syndrome, xerostomia, recurrent aphthous ulcers. Aim: The aim of this study is to the compare the effects of the topical aloe vera gel and triamcinolone acetonide 0.1% in patients with minor ulcers of aphthous stomatitis. Materials and Methods: Thirty-four patients presenting with clinical signs and symptoms of aphthous stomatitis were included for the randomized single blinded study after informed consent. Group A patients received topical aloe vera gel (Forever Bright Aloe vera Gel), and Group B patients received topical triamcinolone acetonide 0.1% (kenacort oral paste) three times a day for 7 days or till the ulcer heals completely. The parameters such as the size of the ulcer, burning sensation, and pain were recorded at each visit. Results: In this study, kenacort oral paste was found to be effective than aloe vera in wound healing (measured by the diameter of ulcer). In contrast, aloe vera gel had a better response in terms of pain and burning sensation. Conclusion: Aloe vera has a wide spectrum of unique properties and uses. It is a promising agent in treating oral lesion in the field of oral medicine. It can be used as an alternative medicine and in patients who are allergic to steroid medication.

Aims and Objectives: To substantiate the use of ultrasonography in diagnosis of cervical lymphadenopathy in oral malignancies and to assess if ultrasonographic examination done prior to lymph node (LN) biopsy can yield important information regarding the diagnosis. Materials and Methods: Twenty subjects with histopathologically confirmed oral malignant lesions with clinically palpable and untreated cervical LNs included into study. These patients were subjected to clinical examination (number of LNs, shape, size, location, overlying temperature, overlying skin, tenderness, consistency, and fixity to the underlying structures), and ultrasonographic evaluation (number of LNs, shape, size (mm), location, borders, matting, peripheral halo, hilum, calcification, necrosis, reticulation, and echogenicity) of the LNs, and finally, histological assessment was done after surgical excision during the course of treatment. Results: Predominantly male (65%) patients were having with malignant LN involvement with age group of 60–69 years, i.e., 35%. Ultrasonogram is superior to clinical examination as it detected additional 49 nodes. Malignant nodes tend to have longest axial diameter (17 mm with standard deviation of 8.7 mm). Over all 52 malignant nodes were round, whereas 35 nodes were oval in shape. Most of the nodes were detected in submandibular region. Around 61 (70.9%) nodes had sharp borders and 26 (29.9%) had smooth borders. Loss of echogenic hilus is a common feature of malignancy showing 70% sensitivity and 67% specificity. Most of malignant nodes were hypoechoic. Around 51 (58.6%) of nodes showed intranodal necrosis, whereas it was absent in 36 (41.4%) nodes. Matting and edema were present 25 (28.7%) nodes. Intranodal calcification was present in 37 nodes. Sensitivity of USG was 90%, whereas specificity was 100%. Conclusion: Ultrasonographic examination of cervical LNs can yield important information regarding the diagnosis. Ultrasound examination should be done prior to FNAC and ideally an ultrasound-guided FNAC.

The final portion of the inferior alveolar nerve (IAN), the mental nerve (MN), is a general somatic afferent nerve that provides sensation to the lip, chin, and gingival tissue. Three patterns of MN have been observed - straight, perpendicular or vertical, and anterior loop (AL) of MN. The interforaminal region of the mandible possesses a MN with a path that creates an AL before entering the mental foramina. The aim of the study is to evaluate the presence of AL of MN using cone-beam computed tomography (CBCT) and to measure the length of the AL of MN, if present, also to evaluate the prevalence of other anatomical patterns of MN - straight and vertical patterns.Mandible CBCT of 400 patients with the age of 20 years onward was included in the study. The images obtained were assessed for the different patterns of MN - straight, vertical, and ALs. The statistical analysis was done using the Chi-square test, pairedOut of 400 CBCT scans comprising 800 hemimandibles, straight pattern was observed in 67.1%, vertical pattern in 26%, and Anterior Loop in 6.9%. The prevalence of AL pattern was 6.9%. AL length was found to be in a range of 2.4-6.6 mm.Surgical trauma or injury to the AL of MN is possible during implant surgery in the interforaminal area of the mandible if AL is not assessed preoperatively.

Enlargements of soft tissue of the oral mucosa often present a diagnostic challenge because a diverse group of pathologic processes can produce such lesions. Lobulated capillary hemangioma of oral mucosa is a well-known benign lesion occurring most commonly on gingiva. Diagnosis of such lesions becomes difficult many times as an enlargement may represent a variation of normal anatomic structures, inflammation, cysts, developmental anomalies, and neoplasm. Some of these lesions are reactive in nature. This article focuses on a series of three similar cases on gingiva, clinically diagnosed as “pyogenic granuloma” and histopathologically as “lobulated capillary hemangioma.”

Coronavirus disease-2019 (COVID-19) caused by zoonotic virus severe acute respiratory syndrome coronavirus-2 was first reported in Wuhan, China, in December 2019, in 41 patients with a perplexing pneumonia. Ever since, it has wreaked havoc in the entire world and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. According to the WHO, 2019-nCoV principally spreads through respiratory droplets and saliva, thus making dental care and other aerosol-generating practices precarious in nature. Saliva is a bio mixture secreted from major and minor salivary glands which plays a vital role in prompt diagnosis and close contact transmission of the disease. In this article, we discuss the role of saliva in the diagnosis and as a potent transmitter of COVID-19 infection.

Aim: To compare the efficacy of combination therapy (low level laser therapy [LLLT] and topical steroids) with topical steroid therapy alone in individuals with symptomatic oral lichen planus. Materials and Methods: The study was conducted on 30 patients who reported to our department with clinically and histologically proven symptomatic oral lichen planus (OLP). All the patients were assessed for the criteria of outcome—pain, burning sensation, size of the lesion, clinical resolution, and recurrence. The patients were randomly assigned into two groups each comprising of 15 patients. Group I (study group) patients received a combination of topical steroid and LLLT while Group II (control group) patients received only topical steroid therapy. Results: A significant pain and burning sensation reduction were found in the patients who were given LLLT (P: 0.05). There was a decrease in the size of the lesion which was statistically significant. A complete clinical resolution was achieved and only 11% recurrence occurred in the study group. This therapy appears to be effective in patients with symptomatic OLP. Conclusion: The LLLT therapy appears to be useful in relieving pain and burning sensation, reduction in the size of the lesion, with complete clinical resolution and minimal recurrence, and hence, can be considered as a valuable aid in managing symptomatic OLP. Thus, the LLLT therapy serves as a potent and independent therapeutic modality in symptomatic OLP.

Introduction Evaluation of the position of mental foramen aids in forensic, surgical, endodontic, as well as diagnostic procedures. Thus, in view of this, the present study was conducted among the population of Pune, a central part of India, to determine the most regular location of the mental foramen and to estimate difference in position of mental foramen based on gender. Materials and methods The present retrospective study was commenced on 200 digital panoramic radiographs of dentate patients. The location of the representation of the mental foramen was traced. Measurements for evaluating distance of superior and inferior borders of the foramen in relation to the lower border of the mandible were made using the reference lines drawn from anatomical landmarks. The data so obtained were statistically analyzed using chi-square test. Results The most common position of mental foramen among Pune population in horizontal plane in both male and female patients was in line with second premolar followed by position in between first and second premolar, whereas in the vertical plane, most common position was at or in line with apex of second premolar followed by in between apex of first and second premolar. The variation in length of superior and inferior border of the foramen in relation to lower border of the mandible with respect to gender was found to be significant, with p-value Conclusion There was no difference in position of mental foramen in horizontal and vertical planes based on gender. Clinical significance The stability of location of mental foramen and significant difference in length of superior and inferior border of the foramen in relation to lower border of the mandible with respect to gender offer its application in forensic identification of gender. How to cite this article Thakare S, Mhapuskar A, Hiremutt D, Giroh VR, Kalyanpur K, Alpana KR. Evaluation of the Position of Mental Foramen for Clinical and Forensic Significance in terms of Gender in Dentate Subjects by Digital Panoramic Radiographs. J Contemp Dent Pract 2016;17(9):762-768.

Verrucous hemangioma (VH) is an uncommon, congenital, vascular malformation that involves dermis and subcutaneous connective tissue of skin. VH lesions are initially present at birth, and therefore, the diagnosis in the elderly may be difficult. Review of literature reveals that VH lesions are commonly located unilaterally on the lower extremities. VH may clinically present as keratotic, papular, nodular, or plaque-like lesions that are reddish-blue in color. VH does not resolve spontaneously and has a tendency to relapse. The diagnosis of VH is generally done on the basis of histopathology. Early diagnosis is important to get a better cosmetic result. VH requires a large, deep excision to avoid recurrence because of frequent extension into subcutaneous fat planes. Intra-oral lesions of VH have rarely been reported in the literature. We present an extremely rare case of VH occurring in the retromolar triangle area of oral cavity.

Plasmablastic lymphoma (PBL) is an aggressive type of large B-cell lymphoma as stated in the WHO classification of 2008. It is a rare form of non-Hodgkin's lymphoma, generally seen in human immunodeficiency virus (HIV)-acquired immunodeficiency syndrome affected individuals. A case of a 42-year-old female patient is presented here. The patient complained of swelling in the lower right back tooth region and presented with a history of extraction of molars. The underlying HIV status was detected after the oral examination. The diagnosis of PBL was confirmed with immunohistochemical analysis.

Osteoma is benign neoplasm with slow growth characterized by deposition of compact lamellar cortical or cancellous bone creating a tumour mass. It is still unclear whether osteomas are benign neoplasms or hamartomas. They have typical clinical presentations and are easily diagnosed with the help of radiographs. We present a rare case of non-syndromic multiple osteomas in the craniofacial region which are typically restricted to the midline and presents radiographically as craniofacial fibrous dysplasia causing a diagnostic dilemma.

Background Oral submucous fibrosis (OSMF) is a wellestablished precancerous condition affecting the oral mucosa. It is a disease that causes significant morbidity (in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult) and mortality (when transformation into squamous cell carcinoma occurs). Aim The aim of the study is to compare the efficacy of Aloe vera with antioxidant when given along with physiotherapy in the management of OSMF. Materials and methods Forty patients presenting with clinical signs and symptoms of OSMF were included for the study after informed consent. Group A included 20 patients who received Aloe vera gel (forever living gel) along with physiotherapy. Group B included 20 patients who received antioxidant capsules twice daily for 3 months along with physiotherapy exercises four times in a day. The following parameters, that is, burning sensation, mouth opening, tongue protrusion and cheek flexibility were recorded at each visit. Results Majority of the participant enrolled were in the age range of 30 to 35 years. Improvement in all the parameters was seen with the individuals receiving Aloe vera gel in comparison to antioxidants. Conclusion So, Aloe vera being a soothing, simple and safe mode of treatment along with proper habit restriction can be considered to be an effectual protocol in the management of OSMF. The analgesic effects of Aloe vera with the physiotherap exercises provide better results in reducing burning sensation and improving mouth opening, tongue protrusion and cheek flexibility in comparison to antioxidants. How to cite this article Singh N, Hebbale M, Mhapuskar A, Ul Nisa S, Thopte S, Singh S. Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis. J Contemp Dent Pract 2016;17(1): 78-84.

Context: Gender determination of skeletal remains is part of archeological and medicolegal examination. In forensic investigations mandibular canines provide excellent material to identify gender as they are more likely to survive in disaster. Dimorphism in mandibular canines is of immense use in forensic investigation. Aim: The aim of study was to establish mandibular canine index (MCI) for gender determination in general population for age group of 18--30 years and to find out efficiency of MCI in establishing gender identity of individual. Setting and Study Design: Patients reporting to Department Of Oral Medicine and Radiology are selected for study after applying inclusion and exclusion criteria. Materials and Methods: The study was conducted on 200 subjects in general population; (100 males and 100 females). Following parameters were considered in study; mesiodistal width of right and left mandibular canine, intercanine arch width and right and left MCI. All measurements were taken intraorally and then on dental casts of same individuals followed by MCI calculation. Statistical Analysis Used: In the entire study the P –value less than 0.05 was considered to be statistically significant. The entire data were statistically analyzed by using (SPSS ver 16, IBM corporation, USA). Results: Using the MCI value, gender can be correctly predicted up to 81% in females and 85% in males. Overall, percentage accuracy of MCI in prediction of gender was 83%. The standard MCI value was 0.2661. Also, right canine was found to exhibit more dimorphism than left canine. Conclusion: It was evident from this study that MCI is a good tool for determining gender. It is quick, reliable, and inexpensive method. Along with other parameters it increases percentage accuracy of predicting gender.

Central giant cell granuloma (CGCG) of the maxillofacial region is generally present as an asymptomatic slowly growing localised disease to aggressive neoplasm-like rapid expansive progression typically present with localised disease. It is an uncommon benign lesion with a low incidence that occurs in the craniofacial region especially in jaw bones. It is a localised osteolytic lesion with varied biologic behavior of aggression which affects the jaw bones. There is much controversy regarding it arising as a result of trauma and its connection with the giant cell lesion seen in the long bones. As it is uncommon, it does not possess any characteristic clinical or radiologic features and resembles neoplasms; the diagnosis is initially some odontogenic or non-odontogenic neoplasm till a definitive histologic diagnosis of CGCG is made. We report five cases of an aggressive form of CGCG at different sites of involvement in the jaw bones.

Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination.

Oncocytoma is a rare benign tumor of salivary gland origin, most often seen in the parotid gland. Oncocytoma is characterized by presence of large epithelial cell (oncocytes) with eosinophilic, finely granular cytoplasm and a rounded, centrally placed nucleus. They are most often encountered after the 6th decade of life. The clinical presentation of oncocytomas is essentially identical to other benign salivary gland tumors—a slow growing, nontender mass. They are firm, may be multilobulated and mobile on examination. Oncocytic neoplasms should be considered as a possible diagnosis in patients with parotid enlargement. This article describes a case of oncocytoma of parotid gland which was present in the 4th decade of life, with a brief review of the relevant literature. Due to the lack of large series, assiduous study of the cases reported in the literature may lead to better understanding of this rare disease.

Malignant melanomas represent one of the most life-threatening forms of cancer. Arising from melanocyte precursors, they have the ability to invade or readily metastasise to any organ. Intra-oral melanomas represent 1-2% of all oral malignancies, and 0.2-8% of all melanomas. Prognoses and eight-year survival rates for intra-oral malignant melanomas are poorer than for cutaneous malignant melanomas (20% and 60% survival, respectively) because of: the absence of symptoms in the early stage of the disease delaying diagnosis; difficulty in determining the width of the radical surgical excision due to anatomic limitations; and the rich blood supply to the region, which may facilitate haematogenic propagation. We report a case of a 65-year-old man with malignant melanoma of the anterior maxillary gingiva. Considering the poor prognosis associated with oral melanomas, it also emphasises the fact that suspicious pigmented lesions should be surgically removed and investigated further.

In the recent years, numbers of suspected bite mark cases examined by forensic odontologist are increasing. Human bite mark analysis is most demanding and complicated part of forensic dentistry, involving identification of assailant by comparing record of their dentition with record of bite mark left on a victim. Like fingerprints and DNA, bite marks are unique to individual such as distance and angles between teeth, missing, and teeth fillings. This type of impression evidence can be left in the skin of a victim and also in food, chewing gums, pens, pencil, etc., In some crimes, bite mark evidence is the only evidence on which conviction has been achieved, particularly alleged rape and child abuse cases. The current protocol for collection, management, preservation analysis, and interpretation of evidences should be employed if information is to be obtained for the court. The aim of this article is to give brief overview of bite mark analysis, its clinical applications, and limitations.

Hansen et al first described proliferative verrucous leukoplakia (PVL) in the year of 1985. It is a rare form of oral leukoplakia which occurs as a slow growing and becomes multifocal and as the time progresses it becomes exophytic, wart like and ultimately transforms to squamous carcinoma. It has a high recurrence rate and also high malignant transformation rate. Etiology is still under the sheets. Though there has been association of human papilloma virus with its occurrence. The diagnosis and the management is still unclear.

Epidermoid cyst is a rare developmental cyst of the oro-facial region which results from entrapped epidermal elements without adnexal appendages. Dermoid and epidermoid cysts occur in orofacial region with an incidence of 6.9–7%. Teratomas always refered to as dermoid cysts. Epidermoid dermoid cyst is also used to describe inclusion cysts of face, neck, and floor of the mouth. These cyst also also shows epidermal tissues and even hair follicles, sweat and sebaceous glands in the cyst wall and keratin and sebum in the cyst cavity.

Although Dens invaginatus and fusion are well-known and well established dental anomalies, they are rarely seen in supernumerary teeth. In this article, simultaneous occurrence of Dens invaginatus and fusion between maxillary lateral incisor and a supernumerary tooth is described. Dens invaginatus is clinically significant due to the possibility of the pulpal involvement; pulpitis, necrotic pulps and chronic periapical lesions are often associated with this anomaly without clinical symptoms. Fusion has a negative impact on the aesthetics, especially when it occurs in maxillary anterior teeth. It is difficult to clinically make differential diagnosis between fused teeth and geminated teeth, especially when these anomalies take place together with hypodontia or supernumerary tooth. It has been found that sequel of such teeth may result in delayed eruption, ectopic eruption or even impaction of permanent teeth; hence proper diagnosis by clinical and radiographic methods and intervention at appropriate time is of paramount importance. The accurate knowledge of variations in morphology of tooth and pulp cavity greatly assists the dentist in planning successful treatment options.