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Introduction: Tobacco and areca nuts release carcinogens, which cause alterations in saliva. Evaluation of these changes through estimation of salivary flow rate and pH was performed in tobacco and areca nut chewers and apparently healthy subjects. Material and Methods: The study group for this comparative study comprised 60 subjects with 20 areca nut chewers (group 1), 20 tobacco chewers (group 2), and 20 non-tobacco and areca nut chewers (group 3) in the ages between 18 and 75 years. After collection of saliva from each subject, the salivary flow rate (SFR) was measured by using graduated tubes, whereas salivary pH was measured using a digital salivary pH meter. Tukey HSD post hoc test was performed for comparison of mean SFR and mean pH between study group subjects. Analysis of variance (ANOVA) test was used to find the mean difference in SFR and pH in duration, intensity, and frequency among various types of areca nut and tobacco users. A "P" value of less than 0.05 was considered as statistically significant. Results: The mean age among groups 1, 2, and 3 was 37.70 ± 10.44, 39.75 ± 10.16, and 37.90 ± 10.52 years, respectively, with a statistically insignificant difference. The mean salivary flow rate (ml/20 min) was maximum in group 3 (13.23), followed by group 2 (11.75) and group 1 (10.48), with the statistically significant difference as P < 0.05. The mean salivary pH was maximum in group 3 (7.07), followed by group 2 (6.86) and group 1 (6.49), with the statistically significant difference as P < 0.05. Conclusion: Long-term use of tobacco and areca nuts in a chewable form can significantly reduce the salivary flow rate and salivary pH. Hence, these measurements can be used as chair side, non-invasive measures for assessing pathological changes in oral mucosa linked to vulnerable effects among people addicted to these adverse habits; thereby, early re-organization can prevent mobility and mortality. [ABSTRACT FROM AUTHOR]

Ranula is a cyst-like growth that occurs in the oral cavity beneath the tongue. It consists of saliva from a ruptured salivary gland or duct. Rather than just flowing directly from the glands into the oral cavity, saliva permeates the nearby connective tissues and creates a bubble. A ranula could indeed appear at any time span in a person’s life for inexplicable reasons. A trauma such as an oral operation, a facial blow or nibbling the lower lip may possibly start one. The following is a case study of an early childhood boy who reported with a swelling in the floor of the mouth with unknown aetiology from the last 6months. [ABSTRACT FROM AUTHOR]

Cysticercosis is a rare disease caused by the ingestion of the parasite Cysticercus cellulosae, a larval stage of Taenia solium. The definitive host is human who harbors the adult worm and may accidentally or incidentally become the host. The larval form of cyst is commonly seen in the brain, meninges and eyes. Cases in the maxillofacial region including oral cavity and cheek muscles are rarely reported. Cysticercosis is not commonly considered in the diagnosis of swellings of the head and neck and a diagnostic and therapeutic dilemma for clinicians. Hence, they are of utmost interest to the practitioner and have to be studied. We present an unusual case of cysticercosis presenting as a solitary cystic nodule in the upper left vestibule of the oral cavity in an 18 year male and the diagnosis was made on histopathological examination.

Background: Children dental trauma is a significant oral health issue worldwide; accidents involving falls in school are extremely common; they are the main etiological factor of traumatic tooth injury. Children around the age of 8-11 years are the most affected with these injuries. Aim: The purpose of the study is to assess the level of knowledge and attitude of Makkah government female school teachers regarding the emergency management of dental trauma. Materials and Methods: This was a cross-sectional study where participants were 378 teachers of 6-12 years old children in primary schools who were randomly selected from primary public schools in Makkah city and were invited to fill in a self-administered questionnaire. Teachers' knowledge was assessed using their answers on the appropriate action in given imaginary cases; their personal profile information was also obtained from the questionnaire. Results: A total of 378 female teachers participated in the study. Of these, 35.7% had first aid training and 6.3% had dental emergency training. However, teachers' knowledge of dental emergencies was severely lacking. The relation between teachers' knowledge and their age, educational level, years of experience, first aid training, dental emergency training, and the number of emergency dental cases experienced was tested; however, the results found no significant difference. Conclusions: This study concluded that female primary school teachers in Makkah were drastically lacking knowledge in dental trauma management. Accordingly, awareness programs focused on how teachers at primary school understand the basic management of emergency dental trauma is needed. [ABSTRACT FROM AUTHOR]

Russell-Silver syndrome is a unique disorder characterised by intrauterine growth retardation before and after birth, large-sized head, a triangular facial appearance, a protuberant forehead, asymmetry and feeding difficulties. This extensive spectrum of features varies in both occurrence and gravity from one individual to another. Congenital muscular torticollis or commonly known as wry neck is one of the common presenting complaints in the outpatient department. It is characterised by rotational deformity of the cervical spine and consequently secondary tilting of the head. [ABSTRACT FROM AUTHOR]

Background: Developmental dental anomalies are seen as abnormalities in tooth size, shape, position, and structure due to multiple reasons during various stages of tooth development. These anomalies can create disturbances in dental arch lengths and occlusions. Hence, it is very important to treat, recognise and perform proper treatment. The purpose of this study was to find out the prevalence and distribution of selected developmental anomalies in shape, size and position of teeth in the Saudi population of Taif Region. Design and methods: The study was based on the clinical examination of 2481 adults who are Saudi nationals came for dental treatment from September 2019 to February 2020, at Taif University Dental Hospital, Saudi Arabia. These patients were examined clinically for developmental dental anomalies affecting shape, size and position. Results:We found that a total of 512 individuals (20.63%) had developmental anomalies and out of which 386 persons (15.56%) had at least one developmental dental anomaly. The frequency and distribution of anomalies of shape and size, number and position were 46.8%, 26.9% and 42.9% respectively. In the present study, 15.56% individuals exhibited at least one anomaly, 8.54% subjects had more than one anomaly and 79.36%.did not any developmental anomaly. On comparison, statistically significant results were seen between different groups of anomalies. Conclusions: The present study had varying results for the prevalence rate of selected dental anomalies. This variation in results might be due racial differences or discrepancy in sample size or/and diagnostic or inclusion criteria. Treatment of developmental anomalies necessitates a multidisciplinary approach and mostly may comprise of orthodontic correction or prosthetic replacement. [ABSTRACT FROM AUTHOR]

Background: Oral cancer is a major public health issue worldwide and it remains a highly lethal and disfiguring disease. Squamous cell carcinoma is the most common malignant neoplasm of the oral cavity and represents about 90% of all oral malignancies. Increase in incidence and mortality rates is a Global health problem. Squamous cell carcinoma is known to show geographical variation with respect to the age, site, sex and habits of the population. It is a malignant tumor of epithelial origin, with varied regional distribution involved in the biological activity of the neoplasm. Each anatomic site has its own particular spread pattern and prognosis. Hence this study was undertaken to present a comprehensive data on the trends of squamous cell carcinoma of oral cavity. Material and Methods: The study included a total of 127 previously diagnosed cases among a period of 5 years from January 2005 to December 2009. Results: It occurred in an age range from 17 to 86 years and male to female ratio of 3:1. Most commonly affected site was buccal mucosa with ulceroproliferative growth and large number of cases in the 4th and 5th decades of the life. According to histopathological grading 83% cases were well differentiated, 16% were moderately differentiated and only 1% case was poorly differentiated. Conclusion: Thus squamous cell carcinoma of the oral cavity shows geographical variations with respect to the age, site, sex and habits of the population. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is a metabolic disorder characterized by abnormal secretion and action of insulin on metabolism of carbohydrate, protein and lipids. Diabetes mellitus alters the cellular microenvironment in multiple organ systems and oral cavity is not an exception. It alters the oral health to a great extent and periodontitis most common oral complication of this disease. Aim: To evaluate the interrelationship between diabetes mellitus and dental health status such as the prevalence of caries, periodontal condition of teeth and any endodontic/restorative treatment of teeth. Materials and Methods: A total of one hundred type 2 DM patients (68 Uncontrolled diabetics and 32 controlled diabetics) among the age group of 35-60 years were included in the study. Relevant information regarding age, oral hygiene habits and personal habits was obtained from patients reporting to our hospital. Results: Gingivitis and Periodontitis were most frequent oral signs and symptoms observed in both controlled and uncontrolled diabetic patients. No statistically significant differences are found between control and uncontrolled diabetic patients for number of teeth, prevalence of caries, endodontically treated teeth, periapical lesions and restorations. Conclusion: Growing evidence of complications of diabetes on oral structures especially periodontium, demands dental care as one of main health care in these patients. The objective of treatment is to encourage a good oral health in patients with diabetes. [ABSTRACT FROM AUTHOR]

Dentigerous cysts are benign odontogenic cysts that are accompanying with the crown of permanent teeth. They are typically single in incidence and are situated in the mandible. They are usually associated with impacted mandibular third molar and maxillary canines. Here we report a very rare presentation of dentigerous cyst in anterior maxilla accompanying with ectopically impacted maxillary second premolar. The cyst was enucleated along with extraction of premolar. [ABSTRACT FROM AUTHOR]

Background: Oral Squamous cell carcinoma (OSCC) results from genetic damage, leading to uncontrolled cell proliferation of damaged cells and the cell death. In the course of its progression, visible changes are taking place at the cellular level (atypical) and the resultant at the tissue level (epithelial dysplasia). Objectives: The Aim of the present study was to evaluate and compare the expressions of intensity of p21 and Bcl- 2 in Leukoplakia, oralsubmucous fibrosis (OSMF) and oral squamous cell carcinoma. Materials and Methods: Total 60 cases, 30 cases of oral squamous cell carcinoma, 15 cases of oral submucous fibrosis and 15 cases of Leukoplakia were evaluated immunohistochemically for p21 and Bcl-2 expression. Results: p21 showed positive expression in 13 (86.67%) cases out of 15 cases of OSMF, 12 (80%) cases of leukoplakia out of 15 cases and 24 (80%) cases out of 30 cases of OSCC. The Bcl-2 expression was positive in 13 (86.67%) cases of OSMF, all cases of Leukoplakia and 25 (83.33%) cases of OSCC. l\lo statistical significance was noted in the expression of p21 and Bcl-2 positive expression between OSMF, Leukoplakia and OSCC. Statistical analysis for comparison of intensity of p21 expression in different grades of OSCC showed no significance. Statistical significance difference was found between the expressions of Bcl-2 in moderately and poorly differentiated SCC. Conclusion: The intensity of p21 and Bcl-2 expressions in different grades of OSCC indicates a key role in progression of oral neoplasia. [ABSTRACT FROM AUTHOR]

Background: Collagen is a part of structural connective tissue in every organ of the body. Study of collagen brings into focus the current knowledge of biosynthesis and degradation as a complex mechanism. One of the major aspects of tumor cell invasion and metastasis is the interaction between cancer cells and extracellular matrix component. Property of picrosirius red to enhance the birefringence is the result of basic protein nature of collagen molecules. There exists a direct relationship between the presence of type IV collagen and degree of differentiation in squamous cell carcinoma (SCC) cells as they lose their capability to form the basement membrane. Materials and Methods: Thirty cases of oral SCC (OSCC) were evaluated for standard staining protocol of picrosirius red to analyze collagen fibers in different grades of OSCC under polarizing microscopy. Results: In this study, moderately to poorly differentiated OSCC cases showed a gradual change in polarizing colors from yellowish orange to greenish yellow particularly in the vicinity of invading tumor islands. Thick collagen fibers forming bundles in parallel disposition were found around the neoplastic areas in discontinuous fashion. Type I collagen fibers of different lengths were strongly birefringent and swirl pattern, parallel orientation was evident. Conclusion: An observable stromal change with the progression of neoplasm was evinced with picrosirius red stain in different thickness of collagens with a significant change in the arrangement from the early stage to the advanced stage according to tumorogenesis. [ABSTRACT FROM AUTHOR]

Lymphomas are diverse group of neoplasm affecting the lymphoreticular system. Diffuse large B cell lymphoma is the most frequently diagnosed type of non-Hodgkin lymphoma and is the fifth most frequent malignancy, accounting for about 40% of cases reported. In the present case report a 40 year old female patient complains of swelling on right side of face since 45 days and gradually increased to present size. Intra-orally an ulcero-proliferative growth was present on the right side of hard palate. Incisional biopsy was suggestive of Lymphoproliferative disorder. Panel of immunohistochemical antibodies were used; which showed positivity for CD45, PAX5, Bcl2, Ki67, CD138 and negativity for CD3, CD10, CD20 and CD30. Therefore through routine standard hematoxylin and eosin staining a clear cut diagnosis of specific lymphoma was difficult to obtain and thus immunohistochemistry plays an important role in confirming the pinpoint diagnosis. [ABSTRACT FROM AUTHOR]

Background: Biopsy is an important diagnostic tool used in the diagnosis of lesions ranging from simple non-neoplastic, tumor-like lesions to malignancies, and is often the only way to diagnose oral lesions and diseases. The gingiva is the most common site for some kind of irritation or low-grade injury, resulting in localized overgrowths that are considered to be reactive and non-neoplastic lesions. This aim of this study is to analyze the frequency and distribution of gingival lesions in the Gujarati population. Materials and Methods: In this retrospective study, gingival biopsies submitted for a period of five years were included. Microscopic slides of all the cases were reviewed by two observers for confirmation of the diagnosis. Results: Among the 106 cases of gingival biopsies, the most frequent category of lesions encountered was the non-neoplastic category, which accounted for 73.58% of the cases. Both benign and malignant neoplasms constituted 26.42% of the cases. Among the non-neoplastic lesions, Pyogenic granuloma was the most frequent lesion (38.46%), followed by fibrous hyperplasia (20.51%), inflammatory hyperplasia (19.23%), and Epulis (8.97%). Neoplasms accounted for 26.42% of the gingival biopsies (92.85% benign and 7.15% malignant). Among the benign neoplastic lesions, Fibroma (30.76%) and Fibrolipoma (26.92%) were the most frequent, followed by peripheral ossifying fibroma (23.08%) and peripheral giant cell granuloma (11%). Conclusion: It is difficult to compare studies carried out in various countries due to differences in people's attitudes toward oral health and the accessibility of various population groups to biopsy services. Nevertheless, this study has provided some information about the frequency and distribution of biopsied gingival lesions in the Gujarati population over a period of five years. [ABSTRACT FROM AUTHOR]

Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. Recently, the WHO classification of odontogenic tumors has been revised and few changes have been made. According to WHO, the AOT is reclassified as an epithelial odontogenic tumor. Very few cases of AOT associated with a dentigerous cyst have been reported in the available literature. We present an additional case of an AOT arising from a dentigerous cyst around the crown of an unerupted lower canine in a 12-year-old boy, which was clinically diagnosed as a dentigerous cyst. Histologically, our case showed 'odontoma-like' areas which have been described in only two other previous case reports. We believe that this case represents an odontogenic cyst with neoplastic change containing both epithelial and mesenchymal components. Further studies to determine whether the AOTs derived from an odontogenic cyst could represent a distinct 'hybrid' variant (different from the three variants described so far) are to be done. [ABSTRACT FROM AUTHOR]

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Osteochondroma (OC) is one of the most common benign condylar tumours having both chondroma and osteoma. However, this tumour is most frequently found on the metaphyses of long bones and is unusual on the skull. When it affects the mandibular condyle, the cause could be due to trauma to the tempero mandibular joint (TMJ). Here, in this report we present a rare case of osteochondroma of left condyle region in a 36-year-old man. The patient had noticed pain in the left TMJ for six months. The lesion is surgically removed and histologically evaluated which composed of chondrocytes dispersed in hyaline matrix along with a rim of calcified bone at one end. [ABSTRACT FROM AUTHOR]

Ranula is a cyst-like growth that occurs in the oral cavity beneath the tongue. It consists of saliva from a ruptured salivary gland or duct. Rather than just flowing directly from the glands into the oral cavity, saliva permeates the nearby connective tissues and creates a bubble. A ranula could indeed appear at any time span in a person's life for inexplicable reasons. A trauma such as an oral operation, a facial blow or nibbling the lower lip may possibly start one. The following is a case study of an early childhood boy who reported with a swelling in the floor of the mouth with unknown aetiology from the last 6 months., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: According to the American Dental Association, temporomandibular disorders (TMD) refer to a group of disorders characterised by pain in the temporomandibular joint (TMJ), the periauricular area, or the muscles of mastication. TMJ noise/sounds, and any deviations or restriction during jaw movements. Many oral habits are common and usually do not harm the TMJ and associated structures. However, these habits may result in TMJ disorders, if the activity goes beyond someone's physiological tolerance. The causes of degenerative changes of TMJ are believed to be multifactorial and controversial too., Objectives: This study aims to evaluate the prevalence of oral habits and its relationship with temporomandibular disorders in the Saudi population of Taif city., Materials and Methods: This questionnaire-based cross-sectional study was conducted from March 2021 to July 2021 at Taif city, Kingdom of Saudi Arabia (KSA). The Arabic version of a standardized questionnaire (recommended by the American Academy of Orofacial Pain) was used and distributed randomly among 441 citizens of Taif city., Results: Our study showed that many respondents had different TMJ disorders, such as pain during eating, sound in jaw joint, pain around ear, temples, and cheek, headache and neck pain, change in bite, and pain during opening and closing of the mouth. On the other hand, many respondents answered that they had TMD, pain associated with nail biting/object biting, lip biting, clenching teeth, and chewing gum., Conclusion: In the present study, a relationship between harmful oral habits and the development of signs and symptoms of TMDs among adolescents who lived in Taif city, KSA was noted. In the present study, no clinical examinations were conducted and only consisted of closed-ended questions, all of which may have a lower the validity rate. An effort was made to overcome these limitations by using a well-designed standardized questionnaire by the American Academy of the Orofacial Pain. We conclude that further studies are required and using of clinical examination to measure the severity of the signs and symptoms for better understanding the association of oral habits with TMJ disorders., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Oral and Maxillofacial Pathology.)

Brown tumor is one of the lesions that develop in patients with hyperparathyroidism (HPT) and represents the terminal stages of bone remodeling process. Any of the skeletal bones can be affected including the craniomaxillofacial ones. Many a times, brown tumor was detected after a final diagnosis of HPT is made. However, on occasions, brown tumor can be the first clinical sign of the disease. Primary HPT is an uncommon systemic disease usually caused by hyperplasia or adenoma of the parathyroid glands. It causes overproduction of parathormone, which may affect the entire skeleton, causing bone resorption appear as cyst-like lesions called osteitis fibrosa cystica or brown tumors. Here, we report such a rare case in which multiple radiolucent lesions were noticed in the ramus part of the mandible and premolar region bilaterally, as the initial signs of primary HPT are presented in this report., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Oral and Maxillofacial Pathology.)

Objective: Lymphomas are diverse group of neoplasm affecting the lymphoreticular system. Diffuse large B cell lymphoma is the most frequently diagnosed type of non-Hodgkin lymphoma and is the fifth most frequent malignancy, accounting for about 40% of cases reported. In the present case report a 40 year old female patient complains of swelling on right side of face since 45 days and gradually increased to present size. Intra-orally an ulcero-proliferative growth was present on the right side of hard palate. Incisional biopsy was suggestive of Lymphoproliferative disorder. Panel of immunohistochemical antibodies were used; which showed positivity for CD45, PAX5, Bcl2, Ki67, CD138 and negativity for CD3, CD10, CD20 and CD30. Therefore through routine standard hematoxylin and eosin staining a clear cut diagnosis of specific lymphoma was difficult to obtain and thus immunohistochemistry plays an important role in confirming the pinpoint diagnosis.

Dentigerous cysts are benign odontogenic cysts that are accompanying with the crown of permanent teeth. They are typically single in incidence and are situated in the mandible. They are usually associated with impacted mandibular third molar and maxillary canines. Here we report a very rare presentation of dentigerous cyst in anterior maxilla accompanying with ectopically impacted maxillary second premolar. The cyst was enucleated along with extraction of premolar., (© 2016 Old City Publishing, Inc.)

Background: Dental identification has been used since long time for disaster victim identification protocol. There is a difference of opinion regarding whether ethnicity influences dental morphology or not. Few studies have shown the associations between these dental features and crown traits in humans using quantitative methods. The present study is an attempt to find correlation of occlusal morphology of Gujarati population with forensic Odontology., Aim: To study different occlusal morphology of permanent mandibular first and second molars in Gujarati Population., Materials and Methods: This study comprised of a total of 100 participants of Gujarati origin, selected by random sampling method. Total number of cusps and groove patterns of mandibular first and second molar were examined clinically and photographs of the same were taken. A descriptive statistics, Chi-square test and Student t-test were used for analysis of data., Results: Mandibular first molar with 5 cusps in 71%, 4 cusps in 18% and 6 cusps in 11% were noted in the study. Mandibular first molars with "+" groove pattern in 39.5% and "Y" groove pattern in 60.5% were recorded. Mandibular second molar with 5 cusps in 6.5% and 4 cusps in 93.5% were recorded in the study. Mandibular second molars with "+" groove pattern in 93.5% and "Y" groove pattern in 6.5% were recorded., Conclusion: The most common occlusal morphology in permanent mandibular first molar is "5 cusp" and "Y" groove pattern in about 47% and for second molar is "4 cusp" and "+" groove pattern in 88.5% of Gujarati population. It may be concluded that variation in degree of expression and frequency of teeth in dentitions of different populations is different, which may help in forensic identification.

Vascular neoplasms, other than benign are characterized as intermediate or malignant. They are often enshrouded in controversy, because the same neoplasm could show variability in biologic behavior that may not be correlated with microscopic features. The intermediate grade vascular neoplasm is named as epithelioid hemangioendothelioma (EHE). Epithelioid hemangioendothelioma of the oral cavity has been infrequently reported. To the best of our knowledge, the review of the English literature revealed a total of 30 cases of intraoral EHE reported till today. We report such a rare case in a 20 year old male, presented with a growth in lower anterior lingual gingiva since five months before the diagnosis with a history of similar swelling, twice in the same area. The differential diagnosis and brief review of literature is also discussed in the current article.