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   Table of Contents - Current issue
Coverpage
October-December 2018
Volume 30 | Issue 4
Page Nos. 335-441

Online since Thursday, January 17, 2019

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EDITORIAL  

Making difference as a teacher Highly accessed article p. 335
Ajay Parihar
DOI:10.4103/jiaomr.jiaomr_10_19  
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IAOMR NEWS Top

Tribute to a legend: Dr. BK Venkataraman p. 336
KS Nagesh
DOI:10.4103/jiaomr.jiaomr_184_18  
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Tribute to a legend: Dr. B. K. Venkataraman: A perfect teacher p. 337
N Gnansundaram
DOI:10.4103/jiaomr.jiaomr_201_18  
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EDITORIAL Top

President's message p. 338
Vishal Dang
DOI:10.4103/jiaomr.jiaomr_202_18  
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Necessity is the mother of innovation p. 339
Freny R Karjodkar
DOI:10.4103/jiaomr.jiaomr_200_18  
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ORIGINAL ARTICLES Top

Root canal morphology variation in mandibular posteriors: A cone beam computed tomography study p. 342
Christine Roy, Sandeep Pagare, Sonal Vahanwala, Mandavi Waghmare
DOI:10.4103/jiaomr.jiaomr_119_18  
Introduction: Cone beam computed tomography (CBCT) is a noninvasive method which has gained broad acceptance in dentistry in 10 years. CBCT has been designed as an improvement of the diagnostic tools available for dental applications. It aids in the diagnosis of variations of root canal morphology, endodontic and nonendodontic pathosis, assessing vertical root fractures, analysis of root resorption defects, and presurgical assessment of apicoectomy procedures. Methods: CBCT images of 400 mandibular second premolars, 400 first molars, and 400 second molars were collected from 200 patient's (bilaterally) using their CBCT images. The images were acquired retrospectively and studied for anatomy of root canals and their number. Results: In the present study type IV (89.7%) and type I (77.8%) canal configurations were the most commonly seen in the mesial and distal roots of first and second molars. They were seen in both males and females. Bilateral symmetry was noted in most of the mandibular second premolars for the males and females. They did not show any significant variations in their roots and root canal morphology; however, rare variations were noted in some cases. Conclusion: Present study indicated that we are able to provide more accurate diagnosis and treatment planning with this imaging modality, thereby limiting out any sort of missed canals and overlapping of anatomical structures.
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Efficacy of therapeutic ultrasound with soft tissue mobilization in patients of oral submucous fibrosis p. 349
Himani Tyagi, Manisha Lakhanpal, Manu Dhillon, Apala Baduni, Anchal Goel, Akansha Banga
DOI:10.4103/jiaomr.jiaomr_142_18  
Aims: To study the effect of adjuvant therapeutic ultrasound with soft tissue mobilization in the management of patients suffering from oral submucous fibrosis (OSMF). Settings and Design: This study was conducted on OSMF patients visiting the outpatient department of Oral Medicine and Radiology, ITS-CDSR, Muradnagar, Ghaziabad, in collaboration with Physiotherapy Department ITS CDSR. Materials and Methods: Thirty patients diagnosed clinically and histopathologically with OSMF were enrolled in the study. They were divided into two groups consisting 15 patients each in group A and group B.Both A and B groups were given lycopene (12mg/day) and intralesional (I/L) injection (biweekly) for 3 months. Therapeutic ultrasound with soft tissue mobilization was used only in group B. Statistical Analysis Used: An independent t-test was done for intergroup comparison for group 1 and group 2. Results: Two groups show that the difference in the treatment in both the group was highly significant at >0.01 to very highly significant at 0.001. Itshowsthat in group A, the effect is steady, and in group B, the effect is substantialwithin the first 15 days; nevertheless, the total clinical effect after 3 months is similar in both the groups. Conclusions: Therapeutic ultrasound when used as an adjuvant shows a significant improvement in the patient's condition with no reported side effects. Hence, should be incorporated in the treatment protocol for patients with OSMF.
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Role of soft occlusal splint therapy in the management of temporomandibular disorders: A 6-month follow-up study p. 355
Abhishek Soni, Panjab V Wanjari, Ashish Warhekar
DOI:10.4103/jiaomr.jiaomr_133_18  
Objective: To analyze the effectiveness of soft occlusal splint therapy in patients presenting with temporomandibular disorders (TMDs) in each diagnostic category based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) criteria. Materials and Methods: In this study, 50 consecutive patients (20 males and 30 females) with TMDs received soft occlusal splint therapy. All the patients were evaluated for temporomandibular joint (TMJ) pain on visual analog scale (VAS), maximum comfortable mouth opening or interincisal distance (IID), and joint sounds at the time of diagnosis and after every month for the next 6-month period. Pre- and post-treatment clinical parameters were compared using paired and unpaired t-tests, and Kruskal–Wallis test. Results: At 6 months' follow-up examinations, there was a progressive decrease in pain and tenderness as indicated by VAS scores and significant improvement in mouth opening (mean IID) after treatment with soft occlusal splint therapy. The joint sounds were either ceased completely or reduced in intensity. Conclusion: Within the limitations of this study, we can conclude that soft occlusal splint therapy is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders.
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Saliva as a diagnostic tool for evaluating oxidative stress in periodontitis and its correlation with tobacco habits: A cross sectional study p. 361
Margee Desai Sharma, Prashant Nahar, Mohit Pal Singh, S Bhuvaneshwari, Saurabh Goel, Hemant Mathur
DOI:10.4103/jiaomr.jiaomr_124_18  
Aims: The aim of this study was to assess oxidative stress (OS) caused by tobacco habits in the initiation and progression of periodontitis by evaluating the salivary uric acid (UA) and albumin (ALB) levels, which are indicators of antioxidant activity, and to compare their values with normal and healthy individuals with no tobacco habits. Settings and Design: A total of 75 subjects were divided into three study groups and were asked to collect unstimulated whole saliva in sterile plastic containers. Subjects and Methods: Groups A, B, and C comprised 25 subjects each, according to their respective inclusion and exclusion criteria. Subjects from all the three groups were asked to collect unstimulated whole saliva in sterile plastic containers, which were then sent for laboratory assessment of UA and ALB levels to determine the levels of OS in the saliva samples of each subject. Statistical Analysis Used: Independent student's t-test was used for statistical evaluation of the results of the present study. Results: Levels of salivary AOs, UA, and ALB were remarkably reduced in subjects having periodontitis, thereby exhibiting higher levels of OS. The levels of these AOs were further reduced with the use of tobacco in subjects already diagnosed with periodontitis. Conclusions: Significant OS occurs in periodontitis with tobacco being a probable risk factor. Thus, saliva can be used as a noninvasive diagnostic fluid with UA and ALB being promising biomarkers in monitoring periodontal disease and OS.
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Evaluation of human papillomavirus as an independent risk factor in known patients of oral squamous cell carcinoma using immunohistochemistry p. 367
Himadri Verma, Siddharth K Singh, Tushar Phulambrikar, Anjali Gupta
DOI:10.4103/jiaomr.jiaomr_122_18  
Introduction: Oral cancer (OC), ever since its discovery has not failed to claim lives of many. However, in between 1960s and 1980s, some astonishing trends started to emerge pertaining to OC, which almost entirely changed the face of this ailment. Almost a fourfold ascent in the number of patients diagnosed with OC was seen in the age group of 30–39 years! Authors, after several studies and meticulous observations got a clear picture of the phenomenal changes. These changes, which were almost entirely attributed to a rise of human papillomavirus (HPV) after few years became a global issue and did not leave Asian countries, including India unscathed. Rigorous studies were conducted in India, although each one yielded different and somewhat contrasting results. While some authors could not demonstrate a single OC case with HPV, some concluded otherwise. Aims: 1. To identify the role of HPV as an independent risk factor for oral squamous cell carcinoma (OSCC). 2. To calculate the prevalence of HPV in local population. Settings and Design: Biopsy specimens of 100 patients were analyzed in the study. They were tested for the presence of surrogate marker p16 to predict the involvement of HPV. Materials and Methods: OC samples with already proven histopathological diagnosis of (of all grades) without habits were taken as cases and were subjected to immunohistochemistry. Statistical Analysis Used: Descriptive statistics were taken in use along with inferential statistics. Results: Out of 100 patients, 6 patients showed positive results for the presence of p16 or HPV. The P value was P = 0.012, which was statistically significant. Conclusions: It can be concluded that despite the absence of any other risk factors, HPV can result in OSCC even in a developing and conservative nation like India.
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Study of salivary flow rate in type II diabetics: A case–control study p. 372
Arpita Srivastava, BN Padmavathi, Rahul Shrivastava, Rajeev Srivastava, Setu Mathur
DOI:10.4103/jiaomr.jiaomr_159_18  
Context: Diabetes mellitus is one of the most common chronic metabolic disorders, which may cause irreversible complications. It affects the salivary glands and thereby affects oral health. Among physical and chemical alterations, changes in the salivary flow rate are particularly important. Hyposalivation is one of the main problems caused due to altered flow rate of stimulated and unstimulated whole saliva in type II diabetic patients. Aim: The aim of this study was to measure the salivary flow rate in type II diabetic patients and to compare with healthy sex- and age-matched controls. Materials and Methods: Whole unstimulated and stimulated saliva was collected from 30 patients with type II diabetes and 30 healthy controls, using the spitting method after it had been pooled for 5 min in the oral cavity. Statistical Analysis: Results were subjected to statistical analysis using Student's t-test and Chi-square test. Results: The results of the study suggested that diabetic patients had significant reduction in salivary flow rate when compared with healthy individuals. Conclusion: The salivary flow rate decreases in patients with diabetes type II in comparison to healthy individuals. Further investigations with larger sample sizes are needed to substantiate the findings of this study.
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Evaluation of the role of a mouth rinse containing turmeric, triphala, and honey in the treatment of oral submucous fibrosis: An open label clinical study p. 376
Ritesh Aich, Soumi Ghanta, Anirban Das, Debanti Giri, Madhumita Majumdar, Simantini Bhattacharjee
DOI:10.4103/jiaomr.jiaomr_87_18  
Background: Oral submucous fibrosis (OSMF) is a chronic disease affecting any part of oral mucosa. A proper cure of this disease is of utmost requirement. Our aim of this study is to explore the effectiveness of a novel herbal mouth rinse containing curcumin, triphala and honey in the treatment of OSMF. Methods: Subjects were included in this study from the outpatient department of Dr. R Ahmed Dental College and Hospital. Clinical assessments of the oral condition were done at subsequent follow up visits (at entry, end of 30 days and end of 60 days). Results: Out of 12 females and 28 males included in the study, all showed significant reduction in regards to difficulty in mouth opening, blanched mucosa, pain at rest and lesion size. Results were analyzed using ANOVA Friedman test followed by Dunn's multiple comparisons test to observe the statistical significance. Conclusion: Efficacy and safety of mouth rinse containing curcumin, triphala and honey in relieving symptoms associated with OSMF was established in this study.
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Logicon: A third eye for caries detection Highly accessed article p. 380
Mohammed Najmuddin, Girish Katti, Syeda Arshiya Ara, Safeena Abdul Khader Saheb, Amit Byatnal, Mohammed Wahajuddin
DOI:10.4103/jiaomr.jiaomr_83_18  
Objectives: To evaluate and compare the diagnostic value of computer-assisted caries detector Logicon with other diagnostic methods. Materials and Methods: This study was conducted on 300 proximal surfaces corresponding to 150 posterior teeth. The diagnostic techniques employed comprised an ORIx 65 kV intraoral radiodiagnostic apparatus, Trophy RVG system in normal mode, and in combination with a caries diagnosis assisting program by Logicon. The same X-ray source was used for the entire study, followed by comparison with histological sections of the teeth used which were observed under light microscope. The positive and negative predictive values, sensitivity, specificity, and probability ratio were calculated. Results: Application of computer-assisted caries detector Logicon increased sensitivity for the cases where caries was extending into the dentin. In contrast, conventional radiography showed a higher specificity and positive predictive value, whereas the negative predictive values were the same for both techniques. Conclusion: This study has demonstrated that Logicon Caries Detector can enable dentists to find 49% more cases of caries penetrating the dentin than they were able to find without it.
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Oral manifestations in diabetic patients under treatment for ischemic heart diseases: A comparative observational study p. 385
Myla Swathi, T Ramesh, R Sudhakara Reddy, Md Rezwana Begum, N Rajesh, T Reshmi
DOI:10.4103/jiaomr.jiaomr_123_18  
Objective: To assess the oral and dental manifestations in the nondiabetic and diabetic groups who were under treatment for ischemic heart disease (IHD) patients. Materials and Methods: A total of 167 IHD patients who were under treatment for IHDI s were considered for the study. After seeking permission from various hospitals in and around Bhimavaram, both inpatients and outpatients-files were screened-for presence of IHD from the available data. After selecting the study population, patients were checked for absence of diabetes and grouped accordingly. Subjective symptoms such as dry mouth, taste changes, and tongue or mucosal pain were evaluated and recorded as present or absent in the pre – prepared proform and dental assessment consisted of decayed, missing, filled, teeth (DMFT) index and Community Periodontal Index (CPI). Results: Subjective oral manifestations of dry mouth, taste changes, and tongue or mucosal pain showed statistically higher score in the diabetic group with a P value of <0.001. The overall DMFT index score was statistically higher in the diabetic group with a P value of <0.001. The overall CPI index score was statistically higher in the diabetic group with a P value of <0.001. Conclusion: From the study it is concluded that the subjects with IHD are at higher risk for developing periodontal disease, dry mouth, taste changes, and tongue or mucosal pain. The dental and periodontal health status of IHD patients in this study in the diabetic and nondiabetic groups is nearly comparable. Thus, oral health maintenance is of utmost importance in this diabetic group. It is recommended that subjects should be regularly examined by dentists for proper care.
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FORENSIC ODONTOLOGY: ORIGINAL ARTICLES Top

Digitized radiovisiographic analysis of dental pulp of permanent mandibular first molar and second premolar for age estimation using tooth coronal index method p. 392
Supreet Jain, Shweta Hegde, Salona Kalra, Ravleen Nagi, Prasoon Goyal, Stuti Shukla
DOI:10.4103/jiaomr.jiaomr_98_18  
Background: Teeth have become a valuable index to estimate age of an individual in forensic odontology. The advent of radiovisiography (RVG) has led to accurate calculation of dental age, which may be due to more precise RVG images than other radiographic techniques. Objectives: The study aimed at estimating the age of an individual from mandibular premolar and molar through tooth coronal index (TCI) measured from digital intraoral radiographic images (RVG). Materials and Methods: Using RVG 176 periapical radiographs of mandibular second premolar and first molar of individuals of either sex aged 20–70 years residing in Chhattisgarh were taken by paralleling angle technique for the study. The RVG images of selected teeth were analyzed and height of the crown, i.e., coronal height and the height of the coronal pulp cavity, i.e., coronal pulp cavity height of each tooth were measured in millimeters using KODAK software to calculate TCI. The real age of a subject was compared with TCI of tooth and the acquired data was subjected to Pearson's correlation test. Bland and Altman regression analysis was carried out to estimate limit of agreement between the two measurements (real and calculated age). Results: Negative correlation was observed between the real age and TCI of mandibular first molar (r = −0.149, P = 0.166) and second premolar (r = −0.20, P = 0.061). The difference between real age and calculated age for premolar ranged from − 38.11 to 23.51 years (mean difference 7.30) and for first molar it was from − 34.82 to 25.22 years (mean difference 4.799), which suggested acceptable agreement. Conclusion: TCI method provides accurate estimation of age from RVG images of teeth. RVG is convenient to use, has low radiation dose, and produces sharper images than other imaging methods.
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Craniometric measurement by jug handle view: An aid for gender determination p. 398
Sunira Chandra, Neha Chaturvedi, Kunal Sah, Shruti Sinha, Ali Hamza
DOI:10.4103/jiaomr.jiaomr_121_18  
Introduction: Dental identification can be done on the basis of “sexual dimorphism,” which refers to the differences in size, stature and appearance of males and females. The most reliable bony structures for sex determinations are pelvis and skull. Zygomatic arch and vault area as being part of skull can be considered most reliable and accurate for their objectivity and reproducibility. Among the various skull radiographs, jug handle radiograph provides the best view of zygomatic arches and vault area. Hence the present study has been undertaken to measure bizygomatic and intervault distance on the jug handle radiograph for gender determination. Aim and Objectives:(i) To assess the efficacy and reliability of craniometric measurement using bizygomatic distance for gender determination. (ii) To assess the efficacy and reliability of craniometric measurement using intervault distance for gender determination. (iii) To determine the most appropriate and reliable craniometric method for gender determination among bizygomatic and intervault distance. Methodology: Sixty individuals (30 males and 30 females) between age group of 18 to 25 years were included in the study. Jug handle radiographs were taken under standardized manner. Bizygomatic and inter vault distances were measured, and the results obtained were later subjected to statistical evaluation (independent Student's t-test). Result: The average bizygomatic distance of male was found to be 72.594 and for female was 65.3583, and intervault distance for male was 63.8693 and for female were 59.664, which was found to be statistically significant. Conclusion: It was observed that males have more bizygomatic distance and intervault distance when compared to females. Also, bizygomatic distance gave better result as compare to intervault distance. Thus, based on the observations from the present study we can conclude that craniometric measurement can be considered as a reliable tool for gender determination.
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REVIEW ARTICLES Top

Resurrecting the antique system: Unraveling prolotherapy p. 402
Sundar Shreenivas, Sankaran Sudhakar, Balasubramani Senthil
DOI:10.4103/jiaomr.jiaomr_127_18  
Proliferation therapy, or “prolotherapy,” is a simple, natural technique that stimulates the body to repair chronically damaged ligaments and tendons. Since 1930s, this technique has been used to stabilize injured joints and to relieve joint pain. Recently, it has also been used to treat temporomandibular joint (TMJ) dysfunction and considered as an effective therapeutic modality that reduces TMJ pain. Injection of prolotherapy agents into the joint space causes cells to grow and produces an increase in the growth factors with additional antibacterial effect. It is considered as a long-term solution rather than a palliative measure and should be considered before the use of long-term drugs or surgery. This article reviews the history and scientific literature regarding prolotherapy and its application in TMJ disorders.
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Oral submucous fibrosis: Current concepts on aetiology and management – A review p. 407
Sadiya Khan, Abhishek Sinha, Shiva Kumar, Haider Iqbal
DOI:10.4103/jiaomr.jiaomr_89_18  
Oral submucous fibrosis (OSF) is the chronic debilitating and crippling condition of oral mucosa. It is well recognised as potentially malignant disorder which is associated mainly with the use of arecanut in various forms. It is characterised by inflammation and progressive fibrosis of the submucosal tissue. The pathogenesis of the disease includes various factors like arecanut chewing, chillies, nutritional deficiencies and genetic processes. The management of OSF has been the subject of controversy ever since Schwartz first described the condition in 1952. Through this article, an attempt is made to update the knowledge regarding aetiology and its therapeutic and surgical management which improves the life expectancy of patients suffering from OSF.
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HIV negative aids-idiopathic CD4 lyphocytopenia p. 412
Ashima Bali Behl, Puneeta Vohra, Vikram Bali
DOI:10.4103/jiaomr.jiaomr_103_18  
Idiopathic CD4+ T-cell lymphocytopenia (ICL) is a rare disorder of immune system with heterogeneous clinical manifestations and immunologic profile. This is a rare condition, which was first defined in 1992 by the Centers for Disease Control and Prevention. It is marked by a CD4 count that is <300 cells/mm3 without human immunodeficiency virus (HIV) infection. Its course differs from that of acquired immunodeficiency syndrome (AIDS), although patients with this disorder may develop opportunistic infections. Hence, the clinicians should be aware of this rare immunologic disorder and that a decrease in the CD4 count is not a hallmark for HIV infection, but could be due to other idiopathic causes as well.
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CASE REPORTS Top

Intra muscular hemangioma of masseter: A rare case scenario p. 417
Kandasamy Murugan, E Gracelin Ranjitha, D Angeline Deepthi, Chinnappa Saravana Bharathi
DOI:10.4103/jiaomr.jiaomr_21_18  
Intramuscular hemangioma (IMH) is a rare congenital benign vascular tumour occuring in the skeletal muscles. Mostly they occur in the muscles of lower extremity and rarely in the muscles of oral cavity. This is a case report of a 37 year old female patient with a Chief complaint of painless dependent swelling in the left middle third of the cheek region for the past 4 years. Clinical examination supported by the findings of Ultrasonography [USG] and Magnetic resonance imaging [MRI] leading to the diagnosis of intramuscular hemangioma of masseter. The diagnosis is later confirmed after Excisional biopsy followed by histopathologic evalution of the biopsied section. The masseter muscle is most frequent muscle accounting for 5% of all intramuscular hemangiomas. Due to the fibro vascular nature IMH have a rubbery, firm texture and vascular bruits or thrills are infrequent. The management has ranged from steroids to injection of sclerosing agents, radiation therapy, and surgical excision.
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Oral cenesthopathy – the psychological malady: Report of two cases p. 421
Pritesh B Ruparelia, Bharvi A Shukla
DOI:10.4103/jiaomr.jiaomr_113_18  
Cenesthopathy is characterized by bizarre or strange sensations at various parts of body, and it is common to occur at the oral area (oral cenesthopathy). In such cases, the patients seek dentists for medical care, but will mostly fail to find any causes of the disease. The nosography of oral cenesthopathy has been discussed in some case reports and reviews but is overlooked in mainstream medicine. Thus the aim of this article is to focus review on the various aspects of oral cenesthopathy with report of two cases.
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Triple mental foramina: CBCT findings of an unusual anatomical variant p. 423
J John Hearty Deepak, A Nelson, C Saravana Bharathi, D Angeline Deepthi
DOI:10.4103/jiaomr.jiaomr_149_18  
The mental foramen is an important anatomic landmark located on the buccal aspect of the mandible. Evaluation of anatomical variants in the mental foramen (MF) is an important prerequisite for implant and surgical procedures involving the anterior part of the mandible body to avoid mental nerve branches injury. The most frequent variation is the presence of double mental foramen, ranging from 1.4% to 12.5%. The incidence of triple mental foramen is extremely rare ranging from 0.7% to 1.2%. Cone beam computed tomography (CBCT) is the diagnostic tool of choice for imaging the maxillofacial region, which allows accurate three-dimensional analysis of mental foramen variations. The present report describes an unusual case of triple mental foramina of the right side of the mandible in a 39-year-old south Indian male detected by CBCT.
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Drug-induced bullous pemphigoid – a case report with review p. 427
Kamala Rawson, Sankar Vinod, B Sreenivasan, Gigi Roy
DOI:10.4103/jiaomr.jiaomr_126_18  
Bullous pemphigoid (BP) is an acquired autoimmune disease that affects mainly the elderly and is characterized by subepidermal blistering. The drug-induced variant of BP follows the oral or (sometimes) topical administration of specific drugs. More than 50 different drugs have been associated with the appearance of BP, and as new therapies emerge, this number is very likely to increase. Drug-induced BP is difficult to differentially diagnose from its idiopathic counterpart, as the clinical picture and histopathological findings in both conditions may have only subtle differences. After withdrawal of the suspect medication, most patients respond rapidly to treatment and do not experience relapses. We report a case of BP following administration of certain medication.
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Oral bullous pemphigoid – a rarity among vesiculobullous lesions p. 432
P Venkatalakshmi Aparna, S Kailasam, Narmatha Namachivayam, Jayashree Gopinath
DOI:10.4103/jiaomr.jiaomr_150_18  
Bullous pemphigoid (BP) otherwise known as parapemphigus is a chronic autoimmune subepidermal blistering disease with tense bullae that rupture and become flaccid. It commonly affects the skin and is rare in oral mucous membrane. Considering its rarity, we are presenting a case report of a 45-year-old female diagnosed with BP that had occurred predominantly in the oral cavity prior to the minimal presentation of skin lesions, along with satisfactory management, thereby stressing the role of dentists in prior diagnosing the lesion.
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Keratocystic odontogenic tumour: A diagnostic dilemma? p. 436
Jyothirmayi Mandla, Satheesha Reddy Bandalore Hanumantha, Ramamurthy Thyganadoddy Kempegowda, Neenu Udayalal
DOI:10.4103/jiaomr.jiaomr_100_18  
The keratocystic odontogenic tumours (KCOTs) are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, KCOTs present as well-defined radiolucent lesions with smooth and usually corticated margins. They may be either multilocular or unilocular on radiography. We present the case of a 26-year-old man with KCOT associated with an impacted mandibular third molar. The cyst was initially diagnosed to be a dentigerous cyst based on the clinical and radiographic features. The histological examination of the specimen finally confirmed it to be a KCOT.
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SHORT COMMUNICATION Top

Oral myiasis in brain hemorrhage p. 439
Ekta Parmar, Hemant Shakya, Anshuman Jamdade, Neeraj Yadav
DOI:10.4103/jiaomr.jiaomr_115_18  
Myiasis is a rare condition which arises from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies. Oral myiasis is seen especially in individuals with neurologic deficit, secondary to oral wounds, suppurative lesions, and extraction wounds. The halitosis and neglected oral hygiene attracts flies to lay eggs in oral wounds which results in oral myiasis. We present a case of oral myiasis in a 63-year-old female patient who was medically compromised since 6 months.
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