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2008| October-December | Volume 20 | Issue 4
June 18, 2009
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Levamisole and antioxidants in the management of oral submucous fibrosis: A comparative study
Vasanti Jirge, MC Shashikanth, IM Ali, Nisheeth Anshumalee
October-December 2008, 20(4):135-140
Background and Objectives:
Oral submucous fibrosis (OSMF) is a chronic condition of the oral cavity which results in permanent disability. The pathogenesis is poorly understood and the disease is difficult to treat. OSMF is associated with immunological changes (altered levels of serum immunoglobulins) and the effect of treatment (especially antioxidants and levamisole) on serum immunoglobulins (Ig) is not known. This study was carried out to evaluate the clinical effects of levamisole (VERMISOL), and antioxidants (ANTOXID) and its effect on serum immunoglobulins IgG, IgA and IgM.
Meterials and Methods:
Forty-five study subjects were included in the study. Patients were randomly assigned into three groups. There were 15 patients in each group; group I patients received levamisole, 50 mg three times daily for three alternate weeks, group II patients received 2 capsules of antoxid daily for six weeks, group III patients received levamisole and antoxid. The results were analyzed with paired 't' test and unpaired 't' test.
The results indicated that levamisole, antoxid and the combination of levamisole and antoxid showed significant improvement in mouth opening and reduction in burning sensation. Significant reduction of serum IgG, IgA and IgM was seen in the levamisole group and combination group whereas in the antoxid group significant reduction was observed only in serum IgA and IgM.
Interpretation and Conclusion:
Levamisole can bring about clinical improvement and is better than antoxid and the combination regimen. The addition of antoxid to the treatment regimen does not seem to have an added advantage over levamisole alone.
Biohazards in dentistry
M Manjunath, TA Deepak, Sowmya Krishna, R Bhanushree
October-December 2008, 20(4):125-128
Dentists constitute a group of professionals who are likely to be exposed to biological health hazards in the course of their work. Relying on relevant literature, the present paper discusses selected occupational biohazards as well as baseline precautionary measures. A dentist can become infected either directly or indirectly as they deal with the potential carriers of these biohazards. So it is important and mandatory for every practitioner of dentistry to know about biohazards.
Burning mouth syndrome: Clinical dilemma?
Kanchan R Patil, RS Sathawane
October-December 2008, 20(4):129-134
Burning Mouth Syndrome (BMS) is a chronic orofacial burning pain condition usually in the absence of clinical and laboratory findings that affects many adults worldwide, yet its etiology and treatment remain poorly understood. Though it has been associated with numerous oral and systemic conditions, there has been no clear consensus on its etiology, pathogenesis and treatment. As a result, patients with inexplicable oral complaints are often referred from one health care professional to another without effective management having significant emotional impact on patients. As the dental profession expands its scope of care to oral medicine and geriatrics, BMS will be more effectively diagnosed and managed by these dental surgeons. Hence, they should be more involved in evaluation and management of these patients. The present article provides updated information on BMS including possible etiological factors and current treatment options, although data on the effectiveness of these treatment modalities remain limited. Recently researchers found that treatment with a familiar nutritional supplement- lipoic acid- is of remarkable benefit with minimal adverse effects. ALA (alpha-lipoic acid) may be the effective treatment modality in management of BMS.
Dentigerous cyst associated with a maxillary permanent lateral incisor: Case report and literature review
BK Ramnarayan, M Manjunath
October-December 2008, 20(4):141-145
Trauma to deciduous teeth can have severe consequences. Dentigerous cysts are common developmental odontogenic cysts of the jaws. They are associated with the crown of an unerupted/impacted or developing tooth. Reported cases most commonly involve mandibular third molars and maxillary canines. They rarely involve the incisors. The condition occurs predominantly in the second and third decades of life. We report a case of dentigerous cyst involving the permanent maxillary lateral incisor, which developed as a consequence to trauma to the deciduous predecessor. The pathogenesis and clinical and radiologic features are discussed.
Infantile malignant osteopetrosis: A case report with review of literature
Sunil Chaudhary, Arun Sharma
October-December 2008, 20(4):151-156
Osteopetrosis is a rare hereditary, generalized disorder of bone characterized by a significant increase in the density of the skeletal tissues usually manifesting in two basic forms: an autosomal dominant benign form (osteopetrosis tarda) and an autosomal recessive malignant form (osteopetrosis congenita). The present article documents an incidentally diagnosed case of malignant osteopetrosis in a 4-year-old child with periapical abscess. It is our belief that given the nature of this disease, its nosological confusion and lack of definitive treatment modalities, as oral physicians we can still manage such cases merely by timely preventive measures, early intervention and by avoiding complications. This was just a single case which was incidentally diagnosed; our focus must shift to the many cases which otherwise go unnoticed to ensure that timely intervention can be lifesaving.
Desmoplastic ameloblastoma of anterior mandible: Case report of a rarity
October-December 2008, 20(4):146-150
Ameloblastoma, one of the most common odontogenic tumors of the jaws, presents classical clinical, radiographic and histopathological diagnostic features exhibiting a benign but locally aggressive and destructive clinical course with a high rate of recurrence. A case of desmoplastic ameloblastoma of mandible is discussed in this article, which presents itself as a rare variant of ameloblastoma with unusual inconclusive clinico-radiographic features to be diagnosed as classical ameloblastoma and difficult to differentiate from other suspected multilocular benign odontogenic or reactive lesions of the jaws. It is the typical histopathological picture of the lesion exhibiting a blend of desmoplasia (collagenization) and ameloblastoma that leads to its final diagnosis and determines its management.
Anil Kumar Bhoweer, AP Chitre
October-December 2008, 20(4):157-161
Pain in the dental arches is a very common cause for patients to seek the dentist's advice. Persistence of pain following exclusion of dental causes by treatment and especially when the pain refers to the other areas of the jawbone makes the dentist think of neurologic causes. However, proper investigation and consideration of intracranial tumors as the cause of neuralgic pain around dental arches and jawbone is of utmost importance. A rare case of esthesioneuroblastoma (ENB) arising from naso-ethmoidal complex encroaching the posterior aspect of left maxilla causing neuralgic type of pain in the dental arches, and therefore primarily seeking advice of the dentist is described. It is common for these patients suffering from ENB to have classical symptoms with nasal cavity, maxillary sinus or vision. It is extremely rare to have dento-facial pain as the first clinical symptom seeking dental advice. Awareness of such rare cranial tumors causing dento-facial pain is important. Necessary investigations include radiographs, CT scan images, histological examination for accurate diagnosis and treatment modality.
Wolff-Parkinson-White syndrome with cleft lip and palate: A rare, previously unreported association
K Kannan, Rajendra Patil, Suresh Kumar
October-December 2008, 20(4):166-169
Wolff-Parkinson-White syndrome, also called Pre Excitation Syndrome, is characterized by an extra pathway that conducts the electrical impulses from the atria to the ventricles without the normal delay. We are reporting a case of WPW syndrome with a cleft lip and palate, which is a rare association and previously unreported in literature.
Oral non-Hodgkin's lymphoma as an initial diagnosis in a HIV positive patient
Elluru Venkatesh, Anjana Bagewadi, Vaishali Keluskar, Arvind Shetti
October-December 2008, 20(4):162-165
Patients with the acquired immunodeficiency syndrome (AIDS) present unique diagnostic challenges because of a propensity to develop unusual infections and neoplasms. Since the beginning of the AIDS epidemic, the number of documented clinical manifestations has considerably increased. Current estimates are that 40% of patients with AIDS have a malignant tumor at the time of initial diagnosis, and the percentage may increase to 70% over the course of the disease. It is generally recognized that Kaposi's sarcoma is the most common of these malignant conditions, but non-Hodgkin's lymphoma (NHL) is also being diagnosed in greater numbers. The purpose of this paper is to present one such case of oral NHL as initial diagnosis in a HIV positive patient.
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