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2009| January-March | Volume 21 | Issue 1
November 14, 2009
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Central hemangioma of mandible presenting as massive radiolucency
Simi Thankappan, Valsa Thomas, Nileena R Kumar, KP Sharafudeen, Sherin Nair
January-March 2009, 21(1):42-45
A hemangioma is a proliferation of blood vessels that creates a mass resembling a neoplasm.
Some regard it as a true neoplasm while others state that it is a hamartoma resulting from proliferation of mesodermal cells that undergo endothelial differentiation and subsequently are canalized and vascularized. A central hemangioma rarely develops in the jaws. This case report deals with a low flow hemangioma in the ramus of the mandible, which despite its large size proved to be innocuous and lacked most of the characteristics of a conventional central hemangioma.
Discoid lupus erythematosus: A case report with review of the literature
CK Sreejan, R Gopakumar, Subhas Babu, RK Roopashri
January-March 2009, 21(1):37-41
Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus. Classic DLE lesions begin as red-purple macules, papules or small plaques and rapidly develop a hyperkeratotic surface. Most patients with untreated classic DLE lesions suffer indolent progression to large areas of cutaneous dystrophy and scarring alopecia that can be psychosocially devastating. A 68-year-old male patient presented with non-healing ulcers of the mouth since 6 months and skin lesions since 2 months. Examination revealed erythematous, disc-like, scaly plaques over the face, nose and scalp, showing signs of healing accompanied by scarring and hypopigmentation. Histopathologic examination verified a diagnosis of DLE. Topical steroids and antifungals were applied to the lesions twice daily for 2 weeks. After 2 weeks of application, all lesions regressed significantly. Follow-up is important and necessary every 6 months because DLE is considered as a pre-cancerous condition and for the early detection of systemic lupus erythematosus and to minimize scarring. The recent advances in the diagnostic criteria and treatment have also been highlighted.
Antioxidants: Enhancing oral and general health
Arvind Shetti, Vaishali Keluskar, Ashish Aggarwal
January-March 2009, 21(1):1-6
Free radicals and antioxidant therapy have attracted a great deal of attention in recent years. Antioxidants are compounds that destroy the free radicals in the body, thereby preventing harmful oxidation-reduction reactions. Antioxidants are critical for maintaining optimum health and well-being. The best sources of antioxidants are fruits and vegetables, which provide a variety of antioxidants such as Vitamins A, C, E, and carotenoids. Currently available data are compatible with the notion that these vitamins act as chemopreventives against some important cancers, e.g., carotenoids for lung cancer, ascorbic acid for salivary gland cancer, tocopherols for head and neck cancers, etc. Thus, a greater consumption of fruits and vegetables should be encouraged as they are the natural sources of these chemopreventive antioxidants along with other protective factors packaged by nature.
Utility of ultrasonography as adjunct to diagnosis in certain orofacial lesions over the clinical and radiological evaluation: A comparative study
Vinod Vijay Chandar, M Venkateswarlu
January-March 2009, 21(1):12-16
: This study was aimed at evaluating the utility of ultrasonography in the diagnosis and treatment plan of certain orofacial lesions over the clinical and radiological evaluation of patients and to visualize advantages and disadvantages, if any, over conventional diagnostic methods.
: The study consisted of 35 patients and according to the requirement, all these patients were clinically and radiologically diagnosed and then subjected to ultrasonographic evaluation.
: Following the evaluation when the lesions were measured and compared, it was noticeable that clinical measurement was found to be relatively larger in all classes. Not many characteristics are found to be specific to any particular pathological lesions and it is not possible to establish the diagnosis of lesion by sonographic evaluation alone. The statistical analysis (ANOVA
) and post Hoc test revealed statistical significance with regard to inflammatory and neoplastic conditions; others did not show significant values.
: Ultrasound can be used as a diagnostic tool in the diagnosis of certain orofacial lesions in the maxillofacial region, as this method is quick, widely available, relatively inexpensive, and easily reproducible without causing inconvenience to patients. However, careful analysis with through anatomical knowledge, could give an effective, early, and accurate diagnosis.
Evaluation of the effects of transcutaneous electrical nerve stimulation on whole saliva flow: A clinical study
Saraf Kedar Vilas, MC Shashikant, IM Ali
January-March 2009, 21(1):7-11
Background and Objectives
: Xerostomia and salivary gland hypofunction are associated with advancing age, autoimmune diseases such as Sjφgren's syndrome, head and neck radiation, smoking and recreational drug usage. Palliative management of xerostomia includes topical agents such as ice chips, saliva substitutes, increasing water intake, paraffin and citric acid containing lozenges. Systemic agents have been used, but some drugs have been found to have unfavorable side effects. Therefore, this study was undertaken to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) on whole salivary flow rate in healthy adult subjects.
: One hundred healthy adult subjects (50 males and 50 females), with no history of salivary gland disorder, were enrolled in this study. TENS electrode pads were placed externally on the skin overlying the parotid glands. Unstimulated whole saliva was collected for five minutes in a graduated tube, using a standardized collection technique. The TENS unit was then activated and stimulated saliva was collected for an additional five minutes.
: Eighty five of the 100 subjects demonstrated increased whole salivary flow when stimulated via the TENS unit. Eleven experienced no change and four experienced a decrease in the salivary flow. The mean unstimulated salivary flow rate was 0.36 ml/min (SD 0.16) and there was a 21% increase in the salivary flow following TENS application. Statistical analysis of flow rates utilizing the paired 't' test showed the difference to be statistically significant (
Interpretation and Conclusion
: The TENS unit was effective in increasing whole salivary flow in 85% of the healthy adult subjects. A further study in patients with xerostomia, secondary to various local and systemic causes, is required.
Grade V cherubism: A rare and aggressive entity
Karthikeya Patil, VG Mahima, S Sudhakar
January-March 2009, 21(1):17-20
Cherubism is a non-neoplastic, rare, hereditary childhood disease of bone characterized by bilateral enlargement of the jaws caused by bone degradation and replacement by fibrous tissue. The affected child is reminiscent of the cherub portrayed in Renaissance art. We report the clinicopathological and radiographic features of cherubism and review of literature.
S Sujatha, Namita Raghav
January-March 2009, 21(1):21-24
Papillon-Lefevre syndrome (PLS) is a very rare syndrome of autosomal recessive inheritance characterized by palmar-plantar hyperkeratosis and early onset of a severe destructive periodontitis, leading to premature loss of both primary and permanent dentitions. The palmar-plantar keratoderma typically has its onset between the ages of 1 and 4 years and severe periodontitis starts at the age of 3 or 4 years. The exact pathogenesis of these clinical events remains mainly speculative. An early diagnosis of the syndrome can help preserve the teeth by early institution of treatment, using a multidisciplinary approach. This paper describes a case of PLS with classic clinical features and briefly reviews the relevant literature.
Multiple intraoral neurofibromas: Case report and review of the literature
C Krithika, Ashwini Deshpande, D Koteeswaran, Saraswathy Gopal
January-March 2009, 21(1):32-36
Neurofibromatosis type I (NF I) is an autosomal dominant disease transmitted with a high degree of penetrance. The disease is expressed in different forms. NF I accounts for almost 90% of the cases although nine types have been described to date. We report one such case of a 40-year-old male who presented with multiple nodules on the body and multiple intraoral soft tissue swellings. He was diagnosed to have NF I, having satisfied the diagnostic criteria for the same. This paper highlights the clinical features and diagnostic criteria of NF, the prevalence and the significance of intraoral neurofibromas and the need for the general practitioner to be aware of this condition.
Transmigration of mandibular canine: A case report and review of literature
January-March 2009, 21(1):46-49
Transmigration of mandibular permanent canine is a rare event, the etiology of which is not clear. Pre-eruptive migration of a tooth across the midline is termed "transmigration. Here we present a case report. The literature on this rare condition is reviewed, its etiological possibilities are discussed.
Benign osteopetrosis with secondary osteomyelitic changes in the mandible: A report of two rare cases
S Jayachandran, S.S.A Mohamed Riyaz, L Kayal
January-March 2009, 21(1):25-31
Osteopetrosis is a name given to a group of diseases that affect the growth and remodeling of the bone. It is characterized by overgrowth and sclerosis of bone, with a resultant thickening of bony cortices and narrowing of marrow cavities throughout the skeleton. Osteopetrosis is an uncommon disease of unknown cause, although a failure of bone resorption related to defective osteoclasts is at the root of the problem. Herewith, we present two cases of benign osteopetrosis with secondary osteomyelitic changes in the mandible with description of dental considerations and review of the literature.
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