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CASE REPORTS
Oral Submucous Fibrosis – The Indian Scenario: Review and Report of Three Treated Cases
Kamala Rawson, Ruchika K Prasad, Admaja K Nair, Juliet Josephine
October-December 2017, 29(4):354-357
DOI:10.4103/jiaomr.jiaomr_60_17  
Oral submucous fibrosis (OSF) is a premalignant condition mainly associated with the practice of chewing betel quid containing areca nut, a habit common among south Asian people. It is characterized by inflammation, increased deposition of submucosal collagen, and formation of fibrotic bands in the oral and paraoral tissues, which increasingly limit mouth opening. In this paper, we review literature on OSF and the different stages of the disease to help dentists make an early diagnosis and reduce the morbidity and mortality associated with this condition. We also present three cases after treatment with biweekly intralesional injections which resulted in improvement of the subjective symptoms.
  17,362 695 -
REVIEW ARTICLE
Nikolsky's sign - A clinical method to evaluate damage at epidermal-dermal junction
Abhishek G Soni
January-March 2018, 30(1):68-72
DOI:10.4103/jiaomr.jiaomr_95_17  
Soft tissues of the oral cavity are often affected by various mucocutaneous disorders of variable etiology, affecting both the skin and mucosae, with severe clinical manifestations such as blisters involving the tissues; and therefore their appropriate management relies on their correct diagnosis. Clinical signs to elicit characteristics of blisters are a crucial part of the examination of patients with such disorders. It is therefore essential for clinicians to be familiar with, or rather be expert at eliciting these signs to frame an accurate diagnosis, since proper treatment and follow-up will depend on which disease is involved. The Nikolsky's sign is one such sign that can be helpful in the clinical diagnosis of pemphigus group of disease and differentiating it from other blistering dermatoses. This review gives an overview of sign of Nikolsky and other related sign, its clinical presentation and their diagnostic implications, using PubMed and Medline databases searching for articles written in English. Peer-reviewed articles were targeted using the keywords “Nikolsky's sign”, “mucocutaneous disorders” and “pemphigus”. Available full-text articles were read, and related articles were also scrutinized and finally the search was subsequently refined to articles concerning to “Nikolsky's sign”. It was concluded that early recognition of these signs are necessary to prevent delayed diagnosis and for early institution of appropriate treatment of these potentially serious mucosal and dermatological diseases.
  15,646 943 -
REVIEW ARTICLES
Wilhelm Conrad Röntgen and the discovery of X-rays: Revisited after centennial
Arati S Panchbhai
January-March 2015, 27(1):90-95
DOI:10.4103/0972-1363.167119  
Every healthcare professional should be aware of Wilhelm Conrad Röntgen's discovery of X-rays over 100 years ago, which had an interesting, eventful, and dramatic history. The physicist from Germany won the first Nobel Prize in physics in 1901 for this discovery. Röntgen was one of the outstanding physicists of the nineteenth century, even without considering his best-known discovery, which opened up new vistas in research. In addition to the discovery of X-rays, Röntgen is credited with three standard components that are currently used in X-ray analysis: The fluorescent screen, the photographic plate, and a prototype of the ionization chamber method. This paper is a wordy tribute to a great scientist and presents a simplified picture of Röntgen's great discovery of X-rays.
  14,294 898 -
CASE REPORTS
Benign migratory glossitis: A rare presentation of a common disorder
Tarun Kumar, Gagan Puri, Konidena Aravinda, Neha Arora
January-March 2015, 27(1):112-114
DOI:10.4103/0972-1363.167128  
Benign migratory glossitis, also known as geographic tongue, is a recurrent condition of unknown etiology characterized by loss of epithelium, particularly of the filiform papillae on the dorsum of the tongue. Clinically, it appears as multifocal, circinate, irregular erythematous patches bounded by slightly elevated, white-colored keratotic bands. The condition is very common in adults and older age groups. The present article describes a rare presentation of geographic tongue in a 2.5-year-old child.
  12,983 631 -
Oral manifestations in neurofibromatosis type I: A case report
Ashwinirani Suragimath, Shobha Channabasappa Bijjargi, Abhijeet R Sande, Veerendra S Patil
April-June 2014, 26(2):241-244
DOI:10.4103/0972-1363.143717  
Neurofibroma is a benign peripheral nerve sheath tumor, which is one of the most frequent tumors of neural origin. The diagnosis of type 1 neurofibromatosis (NF-I) can be made if there is presence of a neurofibroma. Neurofibromatosis type 1 occurs due to an alteration in the long arm of chromosome 17 and is an autosomal dominant inherited disease. There is no family history of the disease in about 50% of the NF-I patients. NF-I is characterized by the presence of skin lesions (café-au-lait spots and neurofibromas), bone malformations, and central nervous system tumors. A series of clinical criteria decide the diagnosis of NF-I. This article reports a case of NF-I in a 61-year-old male patient with classical features.
  1,768 11,064 -
REVIEW ARTICLES
Psychosomatic disorders: An overview for oral physician
Nerella Narendra Kumar, Mamatha Gowda Panchaksharappa, Rajeshwari G Annigeri
January-March 2016, 28(1):24-29
DOI:10.4103/0972-1363.189979  
A psychosomatic disorder involves both the body and mind. These diseases have physical symptoms originating from mental or emotional causes. Most common causes are stress, anxiety, and depression. When these psychological entities are not perceived properly, it may result in somatic disease due to conversion hysteria. Even the oral and paraoral structures show manifestations of these psychosomatic disorders. The present review has been done from text books and articles relevant to psychosomatic disorders. Relevant articles have been selected and filtered from databases using MeSH terms psychosomatic diseases, oral mucosal diseases, stress, etc., with boolean operators from 1990 till date. This review highlights the important aspects of the psychosomatic diseases affecting oral cavity.
  10,872 1,137 -
ORIGINAL ARTICLES
Recent advances in diagnostic oral medicine
Venkatesh G Naikmasur, Atul P Sattur, Sunil Mutalik, Arpita R Thakur
July-September 2009, 21(3):99-104
DOI:10.4103/0972-1363.58748  
Oral medicine is an area of dentistry which is constantly changing. Over the past several years Oral medicine has expanded in both scope and complexity. Oral medicine involves the diagnosis and management of complex diagnostic and medical disorders affecting the mouth and jaws. Current decade has witnessed enormous advances in the diagnostic oral medicine, which have moved from the laboratory to the dental clinics and hospitals. It is important that these advances do not remain as domain of the specialists in this field. Every general dental practitioner should be aware of recent advances in diagnostic oral medicine in order to provide a high level of care. This paper discusses the recent technological advances in the field of oral medicine that have made an impact on clinical dental practice.
  8,197 1,899 -
Dental age estimation by Demirjian's and Nolla's method: A comparative study among children attending a dental college in Lucknow (UP)
Shruti Sinha, Deepak Umapathy, Mathod C Shashikanth, Neeta Misra, Anshul Mehra, Ashish Kumar Singh
July-September 2014, 26(3):279-286
DOI:10.4103/0972-1363.145005  
Introduction: Estimation of age is an important aspect of forensic science. The assessment of age is useful in forensic odontology and in treatments plans of orthodontic and pedodontic patients. Aims and Objectives: The aim of the study was to determine dental age from orthopantomograph using Demirjian's method and Nolla's method. It was also to evaluate the interrelationship between chronological and dental age according to both these methods and to evaluate which technique was better. Materials and Methods: The study was conducted in the Department of Oral Medicine and Radiology of Babu Banarasi Das College of Dental Sciences (UP, Northern India). A total of 300 subjects (150 girls and 150 boys) of age group from 6 years to 15 years were enrolled. These subjects were grouped by a difference of 1 year into 10 groups (each group comprised of 30 subjects: 15 males and 15 females). For every individual included in the study a panoramic radiograph was taken, with standard parameters and adequate protective measures. Results: The results imply that Demirjian's method is applicable to all age groups and for both genders with better accuracy than Nolla's method, which had a limited utility in younger age group. Thus Demirjian's method is a better method when compared to Nolla's method in Northern Indian population.
  8,457 1,221 -
CASE REPORTS
Oral hemangioma or vascular malformation: Different entities!
Ujwala Rohan Newadkar
July-September 2015, 27(3):497-499
DOI:10.4103/0972-1363.170480  
The confusing and often misleading terminology used to define oral vascular tumescences along with the generic use of the term hemangioma has led to inappropriate grouping of a number of entities that are known to be biologically distinct. In many cases, the differential diagnosis between hemangioma and vascular malformation cannot be made on the basis of routine analysis. Hemangiomas were differentiated from vascular malformations by their clinical appearance, histopathologic features, and biologic behavior. However, the term hemangioma is still overapplied by clinicians and pathologists without regard to etiology or clinical behavior. Thus, a critical approach toward vascular tumescence represents the first step to reach a correct diagnosis, understand the disease pathogenesis, and provide better therapy. Here, a case report of arteriovenous malformation in the oral cavity is presented.
  8,057 966 -
Lesion on palate: A diagnostic dilemma
Swati N Chavan, Jitendra K Rathod
April-June 2016, 28(2):223-226
DOI:10.4103/0972-1363.195145  
A non-ulcerated mucosal swelling on hard palate presents a challenge to the clinicians. Thorough clinical, radiographic and histopathological evaluations are mandatory. Here, we report a case of mucosal swelling on the hard palate of a 52-year-old male patient. On clinical examination, there was a dome-shaped, firm swelling seen on the left side of the posterior hard palate. On computed tomography (CT), the lesion appeared as round homogenously enhancing mass/lesion epicentered over the mucosa overlying the posterior part of the half of hard palate extending into the adjacent soft palate. When biopsy was performed, the histopathology report was suggestive of pleomorphic adenoma of palate. Pleomorphic adenoma is the most common tumor of the salivary glands; it accounts for approximately 60% of all salivary gland tumors. CT or magnetic resonance imaging should be considered when assessing for the presence of bony erosion or soft tissue and nerve involvement. Ultimately, complete surgical excision provides the definitive diagnosis and treatment for this noteworthy salivary gland neoplasm. Pleomorphic adenoma is commonly encountered in the parotid gland and other major salivary glands. At times they can also develop in minor salivary glands of the palate.
  7,928 816 -
Compound-complex odontoma: A case report of a rare variant
Nishath Khanum, Mahesh Mysore Shivalingu, Naresh Lingaraju, Srisha Basappa
October-December 2014, 26(4):463-466
DOI:10.4103/0972-1363.155668  
The odontoma is a benign tumor containing all the various component tissues of the teeth. It is the most common odontogenic tumor representing 67% of all odontogenic tumors. Odontomas are considered to be developmental anomalies (hamartomas) rather than true neoplasms. Based on the degree of morphodifferentiation or on the basis of their resemblance to normal teeth, they are divided into compound and complex odontomas. The compound odontoma is composed of multiple, small tooth-like structures. The complex odontoma consists of a conglomerate mass of enamel and dentin, which bears no anatomic resemblance to a tooth. They are usually diagnosed on routine radiological examinations in the second decade of life and are often slow growing and non-aggressive in nature. Here, we report a case of rare, unusually large, compound-complex odontoma, located in the left anterior maxilla of a 13-year-old male patient.
  7,874 438 -
STUDY
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
DOI:10.4103/0972-1363.52827  
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. Results: 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.
  6,720 1,116 3
REVIEW ARTICLES
Classifying giant cell lesions: A review
Vikash Ranjan, Sambuddha Chakrabarty, Pallak Arora, Trisha Rastogi
July-September 2018, 30(3):297-301
DOI:10.4103/jiaomr.jiaomr_81_18  
Multinucleated giant cells are often encountered in oral lesions. Traditional classifications have placed a little importance on the type or histogenesis of multinucleated giant cells in grouping these lesions. The classification of giant cell lesions of the maxillofacial skeleton is the one that remains controversial. Classifying giant cell lesions of the jaw as granulomatous based solely on its location seems inappropriate. Giant cells lesions were classified based on the etiopathogenesis, origin, etiology, type, radiographic appearance and pathology of giant cells present. The rationale for this classification was based on the recent research findings regarding the histogenesis of giant cells. Multinucleated giant cells are morphologically characterized by the presence of multiple nuclei dispersed in cytoplasm. Multinucleated cells are commonly encountered in oral and maxillofacial lesions. An epidemiological study by Mohajerani et al. has reported that 6.36% of the oral biopsies received in their laboratory were multinucleated giant cells containing lesions. Classifying oral lesions with giant cells has always been problematic. However, accurate identification and categorization of these lesions based on nature, distribution and origin of giant cells is necessary. Correlation of histopathological features in relation to giant cells is required. The aim of this article is to review both the earlier and recent classification of giant cell lesions in order which would enable pathologists and oral physicians to ascertain the behavior and diagnosis of such lesions.
  6,601 956 -
CASE REPORTS
Hypercementosis: Review of literature and report of a case of mammoth, dumbbell-shaped hypercementosis
Vijay Raghavan, Chandan Singh
January-March 2015, 27(1):160-163
DOI:10.4103/0972-1363.167154  
Hypercementosis is a non-neoplastic condition in which excessive cementum is deposited in continuation with the normal radicular cementum. Although some cases of hypercementosis are idiopathic, this condition is associated with several local and systemic factors such as supra-eruption of a tooth, inflammation at the apex of a tooth, traumatic occlusion, Paget's disease, etc. Hypercementosis may be isolated, involve multiple teeth, or appear as a generalized process. Posterior teeth are more commonly involved. The radiographic appearance of hypercementosis is an altered shape of the root with maintenance of normal relationship of the shadows of the periodontal membrane and lamina dura. The histologic study of teeth with hypercementosis shows that the cementum formed is usually osteocementum (acellular cementum). The differential diagnosis may include any radiopaque structure that is seen in the vicinity of the root, such as a dense bone island or mature cemento-osseous dysplasia. Patients with hypercementosis require no treatment. Because of a thickened root, occasional problems have been reported during the extraction of an affected tooth. Herein, an interesting case of a mammoth, dumbbell shaped hypercementosis associated with maxillary third molar is reported.
  6,794 659 -
ORIGINAL ARTICLES
Simplified zygomatic arch radiographic technique to overcome the drawback of jug handle view
Siddana Gouda Siddana, Manjunath Muniraju
October-December 2014, 26(4):390-392
DOI:10.4103/0972-1363.155677  
Introduction: The imaging of the zygomatic arch is very important in the diagnosis and management of zygomatic arch fractures. It is accomplished by jug handle radiography (a variation of the submentovertex view) and sometimes with modifications like the tangential or tea cup projection. For these techniques, the patient has to be positioned in a way which makes it non-applicable in cases having cervical injuries or suspected cervical injuries. Aims and Objectives: To devise a new approach with which the image of the zygomatic arch can be obtained with normal head position, in either sitting or supine position, using a dental X-ray machine and an occlusal film, which can even be used in patients with cervical injuries or suspected cervical injuries, without any complications. Materials and Methods: The present approach requires a dental X-ray machine and an occlusal X-ray film thereby eliminating the need for additional equipment like a general X-ray machine and extraoral film cassette. This approach can be carried out in a conventional dental setup to rule out zygomatic arch fractures. Conclusion: This technique can be applied in patients having cervical injuries or suspected cervical injuries, thus overcoming the drawback of the jug handle view, and is easy to master. This technique can be used in a conventional dental setup and holds good with the ALARA (as low as reasonably achievable) principle of radiation protection and safety.
  6,249 464 -
Evaluation of efficacy of turmeric in management of oral submucous fibrosis
Nitin Agarwal, Devika Singh, Abhishek Sinha, Sunita Srivastava, Ruchika K Prasad, Govind Singh
July-September 2014, 26(3):260-263
DOI:10.4103/0972-1363.144998  
Aim: The aim of this study was to evaluate the efficacy of turmeric in oral submucous fibrosis (OSMF) patients. Objectives: To check the treatment efficacy of turmeric in terms of burning sensation on Visual Analog Scale (VAS) and mouth opening, and to evaluate the group which showed the maximum improvement. Materials and Methods: 30 subjects diagnosed with OSMF were included in this study. The patients were administered commercially available turmeric; their mouth opening and burning sensation on VAS scale were evaluated at regular intervals, and the data was then compared. Results: The improvement in mouth opening was not significant; however, the change in burning sensation on VAS was significant. Conclusion: Treatment of OSMF with turmeric is an affordable and effective treatment methodology; however, further research needs to be done.
  5,247 1,125 -
CASE REPORTS
Central ossifying fibroma of mandible: A case report and review of literature
Anand N Swami, Lata M Kale, Sunil Surendraprasad Mishra, Sneha H Choudhary
January-March 2015, 27(1):131-135
DOI:10.4103/0972-1363.167134  
Ossifying fibroma (OF) is a benign, non-odontogenic tumor of the jaw, a type of fibro-osseous lesion. Traditionally, this type of lesion was subclassified histologically into ossifying fibroma and cementifying fibroma according to the hard tissues formed, but both types are now known by the unified term, ossifying fibroma. It is generally accepted that the histological subclassification of these two lesions is of academic interest only since differential diagnosis is often arbitrary and their biological behaviour seems to be identical. The present article discusses the case of central ossifying fibroma in a 35-year-old female patient who presented with a swelling in premolar-molar region of left mandible which was symptom-free and present since last 6 months. The diagnosis was confirmed by histopathology.
  5,821 527 -
ORIGINAL ARTICLES
Pulp polyp - A periapical lesion: Radiographic observational study
Kandagal V Suresh, Nidhi Bajaj, Ajay G Nayak, D Mounesh Kumar Chapi, Snehal Patil, Ashwini Rani
January-March 2015, 27(1):68-71
DOI:10.4103/0972-1363.167085  
Introduction: Pulp polyp (PP) is a chronic hyperplastic condition resulting in formation of granulation tissue and proliferative mass. The radiographic appearance of PP has innumerable presentations. Diagnosing and treatment planning of periapical lesions, heavily relies on the radiographic changes surrounding the root structures. Objective: To evaluate different radiographic periapical changes in clinically detected PP patients. Materials and Methods: Patients reporting to Department of Oral Medicine and Radiology and who were clinically diagnosed with PP by an oral diagnostician were subjected to radiographic examination. Digital intraoral periapical radiographs of 50 patients with PP were taken. Various periapical changes in the digital radiographs were recorded by a skilled oral radiologist. The data obtained was subjected to statistical analysis using SPSS ver 17.0 and P-value was set at <0.05 as significant. Result: Periapical changes like periodontal space widening (PDLW), loss of lamina dura, periapical abscess, periapical granuloma, hypercementosis, condensing osteitis and root resorption were noted. Periodontal space widening was seen in all patients (100%), loss of lamina dura was noted in 72%, periapical rarefying osteitis in 56%, condensing osteitis in 8%, hypercementosis, periapical granuloma, and root resorption were seen in 4% of PP patients. Majority of PP were asymptomatic (66%). Pulp polyp was commonly seen in mandibular first molar followed by mandibular second molar and maxillary first molar. Statistically significant difference was noticed between periapical changes in PP patients (P value <0.0001). All PP patients showed definite periapical changes suggesting it to be a periapical lesion. Conclusion: Pulp polyp is confined to the pulpal portion of the tooth which, may or may not cause changes in periapical region. The results of the present study showed that majority of the PP patients were associated with definite periapical changes. This observation suggests that clinically detected PP are radiographically associated with definite periapical changes suggesting it to be a periapical lesion.
  5,636 608 -
CASE REPORTS
Squamous papilloma: A report of two cases with review of literature
Abhishek Kumar Singh, Upender Malik, Sourav Malhotra, Abhishek Kumar
January-March 2016, 28(1):102-104
DOI:10.4103/0972-1363.189978  
Squamous papillomas are common lesions of the oral mucosa with predilection for mucosa of hard and soft palate. As an oral lesion, it raises concern because of its clinical appearance, which may mimic an epithelial malignancy such as verrucous carcinoma or condyloma acuminatum. Pathogenesis of this lesion though largely unknown can be attributed to human papillomavirus infection, however, slight controversy regarding its viral origin exists. In this compilation, two cases of oral squamous papilloma are presented along with a review of literature.
  5,806 437 -
REVIEW ARTICLE
Hand-held X-ray device: A review
D N S V Ramesh, Mahalakshmi Wale, R Thriveni, Amit Byatnal
April-June 2018, 30(2):153-157
DOI:10.4103/jiaomr.jiaomr_36_18  
This is an era of digital revolution where the world is shifting from analogue to digital electronics. This revolution has led to the invention miniaturization of devices and one such invention is hand-held X-ray devices. With the introduction of new technology in dental radiology, there is a need to change or update old guidelines that many states use to regulate the use of ionizing radiation. Currently, there are voluntary guidelines promulgated by the NCRP for dental radiation protection. Many states use the Conference of Radiation Control Program Directors Suggested State Regulations for the Control of Radiation to regulate the use of X-ray equipment. Hand-held portable X-ray devices are increasingly used for intraoral radiography. This development introduced new challenges to operator and patient safety, for which new or revised risk assessments must be made and acted upon prior to use.
  5,546 503 -
REVIEW ARTICLES
Eagle syndrome: A review of current diagnostic criteria and evaluation strategies
Vishlesh Arora, Arvind Shetti, Vaishali Keluskar
January-March 2008, 20(1):1-5
DOI:10.4103/0972-1363.44352  
The mineralized and elongated styloid process and Eagle's syndrome are similar processes of elongation in which mineralization of the stylohyoid ligament leads to styloid process of the temporal bone. The mineralized and elongated styloid process and Eagle's syndrome differ significantly in terms of the symptoms displayed and the treatment modalities that are sought. The mineralized and elongated styloid process refers to unilateral or bilateral elongation of the styloid process that does not result in any significant pain, discomfort, or limitation of neck movement. It often remains asymptomatic until it is discovered on extraoral radiographs. Eagle's syndrome refers to pain and discomfort in the cervicofacial region resulting specifically from the elongated styloid process. Surgical shortening may be the only treatment that will alleviate the patient's symptoms.This article reviews the entire process of elongation pertaining to the styloid process and discusses the associated syndromes, including current knowledge of the theories of elongation, diagnostic criteria and treatment strategies.
  5,536 469 -
ORIGINAL ARTICLES
Lycopene and intralesional betamethasone injections in the management of oral submucous fibrosis
Dipti Singh, Mathod C Shashikanth, Neeta Misra, Sudhanshu Agrawal
July-September 2014, 26(3):264-268
DOI:10.4103/0972-1363.145000  
Aims and Objectives: This study was conducted to determine the efficacy of lycopene in the management of oral submucous fibrosis (OSMF) and to compare its efficacy with intralesional betamethasone injections. Materials and Methods: Forty-four patients were divided randomly into two groups. Group I subjects were treated with 10,000 mcg of lycopene (Lyconex) daily, in two equally divided doses, for two months. Group II subjects were given intralesional injections of betamethasone. Both the groups were assessed in terms of mouth opening and burning sensation. Results: A significant improvement in mouth opening was seen in both the groups and the improvement was better in Group I. The mean improvement in mouth opening in Group I was 37.62% (12 mm) at the end of the study, which was statistically highly significant and weekly evaluation revealed that this high significance was from the third week onward, and Group II patients (only intralesional steroids) showed an average improvement of 13% (3.9 mm) at the final follow-up visit. Conclusion: Lycopene (Lyconex) is better than intralesional betamethasone injections in improving mouth opening and decreasing burning sensation.
  5,133 654 -
REVIEW ARTICLES
Steroid sparing regimens for management of oral immune-mediated diseases
Arti Agrawal, Mariappan Jonathan Daniel, Subramanian Vasudevan Srinivasan, Vannathan Kumaran Jimsha
January-March 2014, 26(1):55-61
DOI:10.4103/0972-1363.141857  
Immune-mediated mucocutaneous disease may present oral symptoms as a first sign of the disease. The primary etiology could be the cellular and/or humoral immune responses directed against epithelial or connective tissue, in a chronic and recurrent pattern. Lichen planus, pemphigus vulgaris and bullous pemphigoid are the most frequent immunologically mediated mucocutaneous diseases. More often than not, patients present with complaints of blisters, oral ulcers, pain, burning sensation, and bleeding from the various oral sites. Steroids, whether topical or systemic, are the treatment of choice as they have both anti-inflammatory and immune-suppressant properties; however, challenges in the treatment of autoimmune diseases are the complexity of symptoms, the need to manage long-term medications for preserving organ function, and the long-term adverse effects of steroids. In such situations steroid sparing agents, such as, tacrolimus, dapsone, azathioprine, cyclosporine, and so on, may be helpful. Here an attempt is made to review various treatment regimens that could be used as alternatives to steroids for management of such diseases.
  4,747 1,024 -
ORIGINAL ARTICLES
Prevalence of soft tissue calcifications on digital panoramic radiographs: A retrospective study
Janisha Vengalath, Jaishankar Homberhalli Puttabuddi, Balakrishnan Rajkumar, Ganiga Channaiah Shivakumar
October-December 2014, 26(4):385-389
DOI:10.4103/0972-1363.155676  
Aims and Objectives: To determine the prevalence of visible calcifications in soft tissues of the orofacial region in digital panoramic radiographs. Materials and Methods: Panoramic radiographs of 1615 adult male and female dental outpatients who had visited the dental college for various dental treatments were scrutinized for calcifications. Soft tissue calcifications were recorded according to gender, age, and site. Results: Patients identified with soft tissue calcifications comprised 63.41% arteriosclerosis, 45.29% calcified atherosclerotic plaques, phlebolith in 11.7%, sialolith of submandibular salivary gland in 4.3%, calcified stylomandibular and stylohyoid ligament in 4.2%, tonsillolith in 3.2% and lymph node calcification in 2.1% of the radiographs. The association of presence of calcification with age was analyzed with the Chi-square test (P<0.05). Women showed an increased prevalence of soft tissue calcifications (P<0.001). Mean age of participants with calcification and without calcification was assessed (P<0.05) using Mann-Whitney U test. Conclusion: Carotid artery calcifications were found to be high among the soft tissue calcifications and women after menopause showed an increase in the carotid artery calcifications.
  4,818 912 -
CASE REPORTS
Pleomorphic adenoma of the parotid gland with cystic degeneration: A rare case report
Preeti Dhir, Chaya M David, Keerthi G Dhaduti
October-December 2014, 26(4):450-453
DOI:10.4103/0972-1363.155661  
Pleomorphic adenoma, also called benign mixed tumor, is the most common tumor of the salivary glands. Usually they are found as solitary, unilateral, firm and mobile, painless, slow growing masses. Only 10% of them occur in the minor salivary glands and 90% of them occur in the parotid gland. The incidence of parotid tumor is about 2.4 in 100000/year of all neoplasia of head and neck region, the right side being commonly involved and seen more often in males. Management involves surgical resection by superficial or total parotidectomy. This case report illustrates clinical features, imaging characteristics and histopathological features in a case of pleomorphic adenoma.
  5,324 368 -