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Background: Bite mark identification is based on the individuality of a dentition and helps in identifying the perpetrator. The use of three-dimensional (3D) analysis of forensic evidence is highlighted in comparison with traditional methods. CBCT has been used in registering bite mark on food material. To our knowledge this is the first study where CBCT is used to register bite mark from human forearm. Aims and Objective: To signify the potential of CBCT in registering and analysing the bite mark on human skin and to analyse various identifying parameters. Materials and Method: 60 subjects of either sex were asked to bite their own forearm and alginate impression of the maxillary and mandible dentition was taken and cast was poured. Both bitemark and cast was subjected to CBCT scanning and parameters like arch shape, inter canine width, mesio distal dimension of anterior teeth, and individual characteristics like rotation, buccal/lingual tilting of teeth was noted and compared and assigned a score using simplified version of ABFO scoring system. Results: Highly significant result with 56.6% definite match, 26.66% probable match and 16.66% possible match were obtained using CBCT. Conclusion: CBCT is a non-destructive, accurate, efficient, objective and reproducible method. Out of all parameter mesio-distal dimension of teeth is the best parameter to judge the bitemark on skin.

Aim: To analyze the occurrence and correlation of oral manifestations of patients affected by gastro-esophageal reflux disease (GERD), especially with dental erosion. Materials and Methods: With a simple randomization method, a total of 120 patients, GERD-diagnosed patients (group 1, n = 60), based on complaints and reviewed by gastroenterologists through proper history, clinical pictures, and established investigations, and healthy individuals (group 2, n = 60), were enrolled in the study. Oral manifestations such as xerostomia, oral acid/burning sensation, subjective halitosis, dental sensitivity, and dental erosion were evaluated in both groups. The Chi-square test and continuous variables were compared by the Mann–Whitney test and the Kruskal–Wallis test (P value < 0.05, significant). Results: The Mann–Whitney U test on the distribution of the gastric complaints between two groups revealed a significant difference in all the variables. A significant difference was found in the distribution of all the oral manifestations except halitosis and dentinal hypersensitivity between both groups. The Chi-square test between the heartburn and dental erosions revealed a significant association (c2 = 293.761, df = 1, P < 0.001), whereas there was no significant association between heartburn and dentinal hypersensitivity. Conclusion: GERD and dental erosions had no significant correlation, whereas other oral manifestations and mucosal changes were found significant with GERD.

Vascular malformation consists of a group of tumors that emerge from the vascular origin caused by vascular or lymphoproliferation. Arteriovenous malformations (AVMs) contribute high-flow, creating direct vein artery contact without regular capillary network. AVMs are present at birth or in congenital. Acquired AVMs occur later in life due to hormonal changes or trauma. AVM of the head and neck is a rare vascular anomaly but when present is persistent and progressive in nature and can represent a lethal benign disease and an incomplete resection frequently leads to recurrence of the lesion. Here, we present a series of three cases of AVM reported during 2019–2022 involving the orofacial region.

Background: Oral submucous fibrosis (OSMF) is a premalignant condition with a chronic, debilitating, and resistant nature. Various treatment modalities have been proposed for this condition including steroid injections and surgical interventions. In literature, there are very few studies signifying the role of therapeutic ultrasound in OSMF and this still remains a hidden field which needs to be explored further. Aims and Objectives: To evaluate and compare the clinical efficacy of ultrasound therapy with and without physical exercise with intralesional injection (I/L) of 2 ml dexamethasone (4 mg/ml) + hyaluronidase 1500 IU with physical exercise in patients with OSMF. Materials and Method: A total of 30 patients with OSMF were selected irrespective of age and gender and were allocated into groups A, B and C randomly. Group A: 10 patients treated with I/L injection of dexamethasone and hyaluronidase with physical exercise. Group B: 10 patients treated with therapeutic ultrasound and soft tissue mobilization with physical exercise. Group C: 10 patients treated with therapeutic ultrasound and soft tissue mobilization without physical exercise. All the patients were evaluated weekly for 1 month and findings were compared with those at the beginning of treatment. Result: Ultrasound in combination with exercises leads to more improvement in mouth opening compared to ultrasound alone. Improvement in mouth opening of ultrasound with exercise was almost similar to intralesional injection of steroids. Conclusion: Ultrasound therapy interventions definitely show a significant improvement in the patient's condition with no reported side effects; hence it should be included in the treatment protocol for patients with OSMF.

Solitary Plasmacytoma (SP) is a rare disease characterised by a localised proliferation of neoplastic monoclonal plasma cells, without evidence of systemic disease. The aetiology of SP remains unknown, but chronic stimulation, overdose irradiation, viruses, and gene interactions in the reticuloendothelial system have been suggested as the aetiologic factor. While pain is the most common symptom of osseous mandible SP, it is usually painless in the maxilla and may manifest orally with paresthesia, swelling, soft tissue masses, mobility and migration of teeth, haemorrhage, or pathologic fracture due to cortical destruction of bone. Because the amount of haemopoitic bone marrow in the maxilla is decreased, oral involvement of the maxilla is less common than that of the mandible. Here, authors reported a case of 46-year-old male patient presented with the chief complaint of mobility of his upper left back teeth and swelling over his left-side palatal area. Clinical examination was suggestive of benign odontogenic tumors and salivary gland tumors, while two-Dimensional (2D) and three-Dimensional (3D) imaging were suggestive of malignant tumors arising from either alveolar bone or maxillary sinus. The laboratory investigations and biopsy revealed solitary plasmacytoma of maxilla. There were clinical symptoms of paresthesia and mobility, but no other signs of malignancy were observed. As the case report concludes, all necessary investigations need to be conducted to exclude all other pathologies, so that treatment can begin as soon as possible.

Malignant melanoma arises from melanocytic cells. Oral mucosal melanoma is a rare malignancy with the tendency to metastasize and locally invade tissues more readily than other malignant tumors of the oral cavity. Here, a very rare entity of the pigmented nodular variety of the oral malignant melanoma of maxillary buccopalatal gingiva with regional lymph node involvement and distant metastasis to the lungs is reported. A new proposed clinical classification of oral malignant melanoma is explained. Early detection is very important for a better prognosis.

Aim: To evaluate the applicability of the method by Lamendin et al. for adult dental age estimation using extracted single-rooted mandibular first premolar in the Western Indian population and to develop a new regression equation. Materials and Methods: Ninety-seven extracted mandibular first premolars were collected from patients in the age range of 15–75 years. The root height, root translucency, and periodontosis parameters were measured. Lamendin's formula was tested on 77 randomly selected specimens. The regression formula was applied to the remaining 20 specimens to validate the same. The data were analyzed using the Interclass Correlation Coefficient (ICC), paired t-tests, and Pearson's correlation tests. Results: The mean estimated age using Lamendin's original formula was 44.75 years (±10.52) for the overall sample (N = 77). There was an overestimation of the age of the study sample by 0.11 year (SD = 11.14; df = 76; P > 0.05). The regression equation based on the data of the mandibular first premolar was Age (Yrs.) =18.423 + 0.441 (P) +0.423 (T) with a SEE = 11.07; r2 = 0.540; Sig. P 0.05) by applying the new premolar formula and Lamendin's original formula, respectively. Conclusion: A strong positive correlation was found between the actual age and the estimated age using Lamendin's method, and there was no significant difference between the actual age and the estimated age of the study population using Lamendin's original and new premolar formula.

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.

Objective: To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder. Methods: In the perinatal stage, the rats were either isolated or administered with lead acetate to establish an animal model of attention deficit hyperactivity disorder. Atomoxetine served as the reference standard. Animals’ behaviours were assessed through Y-maze, novel object preference, fear conditioning and resident-intruder aggression tests. Oxidative stress parameters, bioamine concentration (dopamine, noradrenaline and 5-hydroxytryptamine), nerve growth factor, interleukin-6, nuclear factor-κB, and tumour necrosis factor (TNF)-α were estimated. Synaptophysin immunohistochemical assay was performed. Results: Celastrus paniculatus oil significantly improved behavioural parameters in Y maze, novel object preference, discrimination index, fear conditioning and resident intruder aggressive tests. The treatment groups showed a decrease in malondialdehyde level. Changes in the levels of dopamine, noradrenaline, and serotonin were restored by Celastrus paniculatus oil. Celastrus paniculatus oil increased nerve growth factor and decreased interleukin-6, nuclear factor-κB, and TNF-α. Synaptophysin immunoreactivity was also improved by Celastrus paniculatus oil with alleviated reactive gliosis, degeneration, and vascular proliferation. Conclusions: This research shows the therapeutic potential of Celastrus paniculatus oil for the treatment of attention deficit hyperactivity disorder.

Salivary Duct Carcinoma (SDC) is a rare typically high grade, aggressive malignancy arising from the ductal epithelium of salivary glands characterised by ductal formations and central necrosis having pathomorphological resemblance to ductal breast carcinoma. Parotid and submandibular salivary glands are the most commonly affected while very few cases involving the minor salivary glands of the palate, labial mucosa, floor of mouth have been reported. This high grade malignancy must be treated aggressively by complete local excision with radical neck dissection and postoperative radiation therapy seems to offer maximum benefit for the patients. This article highlights a case of a 80-year-old male patient having an intraoral ulcer over a swelling which was since five years on the left side of upper lip with left submandibular lymph nodes enlargement is reported. An immunohistochemical analysis of the biopsy specimen was carried out which concluded a SDC. The swelling was surgically excised followed by postoperative radiotherapy and adjuvant chemotherapy. The patient was on a regular follow-up for two and a half years without any local recurrence or distant metastasis.

Objectives: This study was aimed at determining the specific signs of close relationship between impacted mandibular third molar (IMTM) root and inferior alveolar nerve (IAN) canal as visualised on digital panoramic radiograph or orthopantomograph (OPG) which should indicate as well as contraindicate the need for cone beam computed tomography (CBCT) imaging based on hierarchical model of Fryback and Thornbury. Materials and Methods: The sample consisted of 120 individuals (200 IMTM) who had undergone OPG as well as CBCT imaging as preoperative radiographic evaluation before surgical extraction. On panoramic radiographs; Rood and Sheehab's radiographic signs of IMTM root and IAN canal, impacted third molar position based on Winter's classification and depth of impaction based on Pell and Gregory's classification were evaluated. On CBCT; presence/absence of corticalization and the status of the buccal and lingual cortices (thinning/perforation) were evaluated. These findings of OPG were compared to CBCT findings to determine the better modality based on hierarchical model of Fryback and Thornbury. Results: Statistically significant association was found between radiographic signs of Rood and Sheehab such as 'no relation' and 'superimposition' on OPG and presence of corticalization between IMTM root and IAN canal on CBCT. Statistically significant association was also found between 'mesioangular' and 'vertical' positions of Winter's classification as well as 'class 1A' of Pell and Gregory's classification of IMTM on OPG and presence of corticalization on CBCT. CBCT was found to be having lesser variance and greater F value as compared to OPG for evaluation of IMTM. Conclusions: On OPG; Rood and Sheehab's radiographic signs such as 'no relation' and 'superimposition', Winter's 'mesioangular' and 'vertical' and Pell and Gregory's 'Class 1A' are not indicative for CBCT examination before surgical extraction is attempted. On OPG; Rood and Sheehab's radiographic signs such as interruption of white line, darkening of root, darkening of canal, deflection of root, narrowing of canal as well as diversion of canal are all frequently associated with absence of corticalization between IMTM root and IAN canal and hence require CBCT examination before surgical extraction is attempted so that post-operative neurological complications can be minimised. Also, Winter's horizontal, distoangular and others as well Pell and Gregory's classes 1B,1C,2A,2B,2C,3A,3B,3C are indicative for CBCT examination before surgical extraction is attempted. Fryback and Thornbury model-based comparison proves that CBCT is a better radiographic modality as compared to OPG for evaluation of IMTM relation with IAN canal.

Aim: To estimate the age by evaluating the length of dentin translucency in ground sections of extracted teeth using digital scanner and tools of GIMP 2.8 software for dental age estimation. Materials and Methods: Fifty extracted single-rooted permanent teeth from 50 different individuals and their 0.25-mm thick sections were prepared. Each tooth section was scanned and the length of dentin translucency was measured in GIMP 2.8 software. Results: A linear relationship was observed between dentin translucency and age in the regression analysis. Pearson's correlation analysis showed that there was positive correlation (r = 0.93, P = 0.001) between dentin translucency and age, and the difference between the chronologic age and real age is ± 4.88 years. Conclusion: Dentin translucency in the apical part of the tooth can be used for estimating the age of an individual. A method to digitally select and measure translucent root dentin length was used here. This software method is easy to use and less time-consuming. The measurements obtained using this method are more precise and thus help in more accurate age estimation. Considering these benefits, this study recommends the use of digital method to assess translucency for forensic purpose.

Background and Aims: Replacing missing teeth is one of the most common challenges faced by the dental surgeon. The invention of dental implants has brought about a great change in successfully delivering a fixed prosthesis to the patient. Precise radiographic assessment of available alveolar bone is of prime importance for dental implant placement. Panoramic radiograph provides an overview of the jaw bones and is considered adequate in the initial evaluation of the implant site; however, they do not provide the buccolingual dimension of the implant site. CBCT provides volumetric imaging with the ability to visualize the imaged region in virtually any plane. The objective of this study was to compare panoramic radiography (OPG) with cone-beam computed tomography (CBCT) for pre-surgical implant site evaluation. Materials and Methods: A total of 150 potential implant sites in 94 patients who were subjected to OPG and CBCT imaging previously were selected for the study. The height, width, and length of the available bone were measured for all the implant sites (except bone width which was measured on CBCT alone). Out of these, OPG & CBCT findings of 60 potential implant sites were evaluated by comparison with the surgical gold standard dimensions of actual dental implant placed. A comparison of all the values obtained with the two imaging modalities was done and the data was tabulated for statistical analysis. Results: The mean value of bone height using OPG and CBCT were found to be 12.15 mm and 11.99 mm, respectively. The mean value of the length of the edentulous jaw segment using OPG and CBCT was found to be 8.10 mm and 8.98 mm respectively. The mean value of the width of the crestal bone below the height of the crest using CBCT was found to be 5.46 mm. Conclusion: The overall results suggested that CBCT is better in depicting the bone height and bone width as compared to OPG; however, the length of the edentulous jaw segment is better depicted by OPG as compared to CBCT.

Pyogenic granuloma is a misnomer, as in reality it arises in response to various irritating factors such as low-grade local irritation or hormonal factors, traumatic injury as well as presented as inflammatory hyperplasia that is not related to infection. Oral pyogenic granuloma is a lobulated or smooth exophytic lesion with pedunculated or sometimes sessile base, haemorrhagic in tendency. Although excisional surgery is the treatment of choice for it, some other treatment protocols such as laser therapy, sclerotherapy with 3% polidocanol, cryotherapy and steroid therapy have also been proposed. Here, Authors present a case series of gingival as well as extra gingival pyogenic granulomas which were diagnosed and treated by various therapies i.e., surgical excision, Carbon Dioxide (CO2 ) laser therapy and sclerotherapy. Regression period of lesion with different therapies was evaluated in detail. Maximum patients were female in the age group of 26-50 years in present case series. Almost all cases of pyogenic granuloma had typical clinical characteristic without bony alteration. Amongst all therapies sclerotherapy had the biggest advantage of less regression period for any case of pyogenic granuloma i.e., 7-8 days only.

Background: The distance from the inferior border of mental foramen (MF) to lower border of mandible remains constant throughout the life. Considering this fact the present study was carried out to determine role of MF in age and gender estimation and also its importance in planning various treatments. Aims and Objective: (1) To determine the most common type and shape of MF 2) To measure the height of the mandibular body (H), the distance between the superior margin of the MF to the alveolar crest (SM-AC), the distance between the superior margin of the MF to the inferior border of the mandible (SM-IB), the distance between the inferior margin of the MF to the inferior border (IM-IB) on the right side and left side. (3) To compare the above measurements for age and gender determination. (4) To determine effect of various factors on above measurements (5) to evaluate whether any significant difference in measurement occurs on right and left side. (6) To derive a regression equation for age estimation. Materials and Methods: A total of 300 Orthopantomogram were studied. Measurements such as H, SM-AC, SM-IB and IM-IB were carried out on both sides on type II MF in males and females in all the six age groups. Statistical analysis was carried using IBM SPSS version 24 to determine differences in measurements and linear regression analysis was carried out to determine age of individuals. Result: The most common appearance of MF was type II and shape was oval. Statistically significant differences occurred in measurements using which regressive equation for age estimation was derived for males & females. Conclusion: MF, being a stable landmark in mandible, serves as a good indicator for the determination of age and gender. Hence, using certain measurements related to MF, it can help in determining the age of the individual. Further, its position and distance from the alveolar crest serve as a guide for orthognathic surgeries, implant placement, and pre-prosthetic surgery.

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.

Background: Ultrasonography is well-known for its application in medicine, and has been recently gaining importance for its use in the orofacial region. Aims and Objective: The present study aims to determine the efficacy of ultrasonography in diagnosing soft tissue swellings of the head and neck. Materials and Methods: Thirty patients with the head and neck soft tissue swelling were included in the study and all were subjected to ultrasonography. Various findings were recorded such as shape, boundary, echo-intensity, ultrasound architecture, presence of necrosis, posterior echoes, ultrasound characteristic of lesion, and vascularity, and an ultrasonography diagnosis was made. After obtaining final diagnosis sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the test was calculated in various types of swelling. Results: In case of an inflammatory swelling, ultrasonography had a sensitivity of 100%, specificity of 89.5%, PPV of 84.6%, NPV of 100%, and accuracy of 93.3%. In cystic swellings, ultrasonography had a sensitivity of 85.7%, specificity of 100%, PPV of 100%, NPV of 95.8%, and accuracy of 96.67%. In nonodontogenic benign tumor, ultrasonography had a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. In malignant swellings, ultrasonography had a sensitivity of 80%, specificity of 100%, PPV of 100%, NPV of 96.2%, and accuracy of 96.67%. Conclusion: From the present study, it can be concluded that ultrasonography is highly accurate in diagnosing benign neoplasms, followed by soft tissue cystic swellings and malignant neoplasms, followed by inflammatory swellings of the head and neck region.

Hay-Wells syndrome is a rare autosomal dominant disorder characterized by ankyloblepharon, ectodermal dysplasia, and cleft palate and/or cleft lip [ankyloblepharon-ectodermal dysplasia-clefting (AEC) syndrome]. Initially described by Hay and Wells in 1976, it is a rare form of ectodermal dysplasia with varying forms of expression featuring congenital abnormalities of the skin, hair, teeth, nails, and sweat glands. Recently, mutations in the p63 gene have been shown to be etiologic in the majority of cases of Hay-Wells syndrome. The present report describes the case of a 6-year-old boy who presented with ankyloblepharon, ectodermal dysplasia, and a cleft palate at birth, which are considered cardinal signs of this syndrome by most authors. The purpose of this article is to throw light on differentiating various ectodermal dysplasia syndromes associated with cleft palate and/or cleft lip and to highlight the importance of implementing multidisciplinary follow-up of patients with Hay-Wells syndrome.

Acute febrile neutrophilic dermatosis or Sweet′s syndrome (SS) is characterized by painful, erythematous plaques of rapid onset accompanied by fever. The etiology of SS is unknown and it may be associated with antecedent infections, malignancies, autoimmune diseases, drugs and vaccines, upper respiratory or gastrointestinal infection, pregnancy, inflammatory bowel disease as well as chemotherapy or idiopathic. The standard therapy for SS is systemic corticosteroids. We report a rare case of 19-year-old young male patient with complaint of severe ill-defined type of pain in both jaws associated with plaques and papules on extensor surfaces of upper and lower extremities with bodyache and myalgia. Histopathological examination suggested perivascular neutrophilic infiltration with scattered eosinophils. Sweet syndrome has rare oral manifestations secondary to hematological changes. It can also present as a paraneoplastic syndrome (malignancy-associated form of condition, which is most commonly related to acute myelogenous leukemia), which leads to poor prognosis and thus it requires careful examination, early diagnosis and long-term follow-up.

Trigerninal neuralgia is a relapsing and remittent disorder is best symptomatically treated by medical treatment out of which carbamazepine thought to be a diagnostic drug marker of trigeminal neuralgia, has often undesirable side effects and sometimes ineffective, limiting its usage, thus search for more effective drug with lesser side effect is still on. Recently two newer anticonvulsant oxcarbazepine (OXC) a ketoderivative of carbamazepine and gabapentin (GBP) has been trailed in trigeminal neuralgia in different open clinical trial as monotherapy with encouraging results. These drugs have convenient dosage and surprisingly fewer side effects. These facts that trigeminal neuralgia responds to newer anticonvulsant (oxcarbazepine, gabapentin) in a better perspective, enabled me to conduct the present clinical trial on 54 patients (both in newly diagnosed TN patient and refractive patient) of trigeminal neuralgia who were made two randomized group for separate monotherapy study for a period of six months. The therapeutic effect of OXC and gabapentin (GBP) in relation to reduction in number of attacks of pain and severity of pain were evaluated. All the scoring data showed OXC is more therapeutic efficacious cost-effective and well-tolerated profile than gabapentin and an emerging as a drug for treatment of TN in both new and refractive patients.

Regional Odontodysplasia is a rare developmental anomaly with unknown cause affecting ectodermal and mesodermal dental layers, affecting segment of jaw more commonly maxilla. A case of regional Odo-todysplasia was reported in a 13 year old patient in whom maxillary right segment was affected. Teeth affected were central incisor, canine, first & second premolar with different grades of severity & lateral incisor appeared to be nonnal. Affected teeth were having irregular, rough & discolored surfaces, localized gingival enlargement, periapical pathosis, radiographically "ghost. tooth" appearance &. short roots. Additional features noted were impacted permanent canine & overretained deciduous canine in the affected segment.

Two cases with the typical features of Pyknodystosis have been described with characteristic clinical and radiographic features. The patients with this syndrome should be differentiated from other closely related syndromes as cleidocranial dysostosis and osteopetrosis. Such patients should be managed conservatively to prevent complications like iatrogenic fractures and development of osteomyelitis which is difficult to control.