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   2010| October-December  | Volume 22 | Issue 4  
    Online since October 8, 2015

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Oral Field Cancerization: A Review
Raviraj Jayam
October-December 2010, 22(4):201-205
The concept of oral field cancerization (OFC) has been ever changing since its first description by Slaughter et al in 1953. The concept of OFC explains the mechanisms by which second primary tumors (OPTs) develop- OPTs are the tumor-, which develop in the oral cavity in succession to the primary malignant tumors, which might vary in duration ranging from few months to years. The "classical" mechanism, which was originally observed by Slaughter describes that in the individuals with adverse habits, large areas of the aerodigestive tissue are affected by long-term exposure to carcinogens. In this preconditioned epithelium, multifocal carcinomas can develop as a result of independent mutations, and thus would not be genetically related. Although this mechanism was accepted for a quite a long time, the controversies began with the advent of new mechanism called the "clonal theory-, which explains that a single cell, on exposure to carcinogens, is transformed and give- rise to one large extended premalignant field by clonal expansion and gradual replacement of normal mucosa. In this field of various subclones, two separate tumors can develop after accumulation of additional genetic alteration-. Both tumors have the same clonal origin, and would thus share at least one early genetic event, which occurred before the initial clonal expansion. Also, the molecular studies regarding OFC have been expanding exponentially since a few years. The need for chemoprevention and the management of OFC with its resultant effect of development of second primary tumors has been challenging till today. Hence, the article tries to explain the conflicting aspects of various mechanisms by which SPTs develop, the molecular techniques, chemoprevention and therapeutic implications for oral field cancerization.
[ABSTRACT]   Full text not available  [PDF]
  652 254 -
Review on Pulse Therapy: A Novel Approach in the Treatment of Pemphigus Vulgaris
Rachna Kaul, CJ Sanjay
October-December 2010, 22(4):211-214
Objective: Pemphigus vulgaris, a fatal autoimmune mucocutaneous disorder commonly seen involving the oral cavity, has since along time remained a topic of concern regarding its treatment modalities. Pulse therapy, introduced in 1984, employs high-dose corticosteroids along with certain immunosuppressive agents and has gained wide popularity since the last three decades due to its advantage of minimizing the adverse effects of conventional corticosteroid therapy. This article provides a detailed review about various studies conducted utilizing different regimens in pulse therapy and the outcome of these studies. Materials and methods: Information from various studies conducted over the last three decades was collected and a thorough analysis of the results of these studies has been provided in this article. Results: Extensive review of the existing data revealed that pulse therapy minimizes the adverse effects of long-term corticosteroid therapy, controls the disease process faster and has quicker and long-lasting remission rates. Conclusion: Pulse therapy appears to be successful in the treatment of pemphigus vulgaris. Various studies have proven the efficacy of pulse therapy along with reduced side effects of conventional corticosteroid therapy. However, long-term follow-up is necessary to compare the incidence of malignancy in patients receiving pulse doses of immunosuppressive agents with that in patients receiving continuous oral treatment
[ABSTRACT]   Full text not available  [PDF]
  475 248 -
Thermography: A New Diagnostic Tool in Dentistry
Sarbani Deb Sikdar, Anshul Khandelwal, Savita Ghom, Rajkumar Diwan, FM Debta
October-December 2010, 22(4):206-210
The various biochemical processes in the human body generate heat, which must be dissipated. Skin is the major route for heat dissipation using blood as the heat exchange fluid. Skin temperature is an indicator of aberrations in metabolism, hemodynamis or in neuronal thermoregulatory processes. Since most of the heat dissipation of skin is by infrared black body emission skin temperature should be measured without contact, by monitoring the emitted infrared radiation. This has been the basis of telethermography Thermography is being used to detect various pathological conditions in the medical field. There are also various orofacial conditions in which thermography can be used. This paper deals with the history of thermography and its various uses in dentistry.
[ABSTRACT]   Full text not available  [PDF]
  413 211 -
Estimation of Serum Copper and Zinc Levels in Patients with Oral Submucous Fibrosis
Savitha S Shettar, Mubeen
October-December 2010, 22(4):193-196
Background and objectives: The present study was conducted to estimate the serum levels of zinc, copper and copper/zinc ratio in patients with OSF, compare these values among patients with OSF and normal subjects, and to correlate the values among clinical and histological grades in OSF. Methods: The study consisted of 30 OSF patients and 30 normal subjects. Diagnosis of OSF patients was based on clinical and histopathologic findings. Khanna and Andrade grouping both clinically and histopathologically were followed for OSF patients. Serum levels of zinc and copper were estimated using semiautoanalyzer and data was statistically analyzed. Results: The mean serum levels of zinc and copper were decreased in patients with OSF, compared to normal subjects. The mean serum levels of copper and Cu/Zn ratio were increased in OSF patients compared to normal subjects. The mean serum levels of zinc showed no change through clinical and histological stages of OSF. The mean serum levels of copper and Cu/Zn ratio showed a gradual increase from clinical and histological grade I to IV in OSF patients. Interpretation and conclusion: Serum levels of these trace elements may be taken as prognostic markers of the disease progression in OSF patients
[ABSTRACT]   Full text not available  [PDF]
  367 153 -
Oromandibular Dystonia—Meige's Syndrome: Report of a Rare Case with Review
Siddharth Gupta, Basavaraj T Bhagwati
October-December 2010, 22(4):218-220
Meige's syndrome is a combination of two forma of dystonia; blepharospasm and oromandibular dystonia (OMD). Oromandibular dystonia (OMD) is a form of focal dystonia affecting head and neck region, including the lower face, jaw, tongue and larynx. It may be a factor contributing to muscle stiffness, degenerative changes in temporomandibular joint, mucosal lesions, damage to teeth, and dental prosthesis. We take this opportunity to present a patient with oromandibular dystonia associated with blepharospasm and spasmodic dysphonia.
[ABSTRACT]   Full text not available  [PDF]
  357 156 -
Ultrasonic Diagnosis of Masseteric Hypertrophy in Oral Submucous Fibrosis: A Preliminary Study
KA Kamala, Rajeswari G Annigeri, L Ashok
October-December 2010, 22(4):197-200
Background and objectives: Oral submucous fibrosis is a well-recognized and most prevalent premalignant condition of oral mucosa in India and Southeast Asia. Frequent and prolonged chewing of gutkha (readymade mixture of arecanut, tobacco, lime, catechu and sweetening agent) exerts undue pressure on muscles of mastication, which inturn may result in work hypertrophy of muscle. The present study was undertaken to measure thickness of masseter muscle at rest and at maximum clenching position by ultrasonography with masseter muscle hypertrophy in oral submucous fibrosis patient and in control group, and also to establish the normal value of masseter muscle thickness ultrasonographically and to prove that uttrasonography is reliable diagnostic technique for the evaluation of masseter muscle hypertropy in oral submucous fibrosis patient. Materials and methods: Ultrasonographic measurements (3-12 MHz) of masseter muscle thickness were performed for 40 subjects comprising 20 oral submucous fibrosis patients and 20 controls. Results: Study group showed higher thickness both on right and left side masseter muscle and also in relaxed and contracted state when compared to controls. The thickness of masseter muscle is more in contracted state than relaxed state which was highly significant.
[ABSTRACT]   Full text not available  [PDF]
  343 150 -
Maxillary Necrosis: A Sequelae of Fungal Osteomyelitis
K Anbarasi, S Sathasivasubramanian, N Malathy, N Nandakumar, F Massillamani
October-December 2010, 22(4):221-224
Osteomyelitis is designated to a variety of bone diseases having inflammation as a common denominator. Persistent infection progresses to inflammation of marrow space, haversian system and periostium of affected region. Thrombosis of endothelial vessels cause necrosis and sequestrum formation. Both pyogenic and nonpyogenic infections of jaw lead to this condition. Immunosuppressed patients are more prone to mycelial infections, whereas their occurrence in immunocompetent individuals are highly unusual.
[ABSTRACT]   Full text not available  [PDF]
  295 145 -
Albright's Hereditary Osteodystrophy: A Constellation of Clinical Features
L Ambika, Vaishali Keluskar
October-December 2010, 22(4):215-217
Pseudohypoparathyroidism (PHP) is an inherited metabolic disorder characterized by end-organ resistance to the action of PTH (Parathyroid Hormone). There are four types of PHPs namely Ia, lb, Ic and II. PHP Ia is associated with a constellation of clinical features referred to as Albright's Hereditary Osteodystroohy (AHO). The oral manifestation of AHO found in the literature includes aplasia and or enamel hypoplasia, late tooth eruption and enlarged radicular channels susceptible to caries. Here, we are reporting a rare case of a 14-year-old girl with Albrigt's hereditary osteodystrophy with disintinctive oral manifesitations.
[ABSTRACT]   Full text not available  [PDF]
  313 119 -
Comparing the Accuracy in Diagnosing Periapical Lesions by Conventional and Direct Digital Radiography
Ajay Parihar, Vaishali Keluskar, Anjana Bagewadi, Arvind Shetti
October-December 2010, 22(4):185-189
This study investigated the accuracy of diagnosing periapical lesions through conventional radiography (CR) and direct digital radiography (DDR) technique. A total of 170 patients with clinically suspected periapical pathosis and 30 normal subjects were included in the study. Both the conventional and digital images were taken with same exposure parameters keeping the film without lead foil and sensor simultaneously, to standardize the images. One endodontist and two oral radiologists evaluated all conventional and digital images and gave their final diagnosis for each technique separately. The diagnostic accuracy of each observer and image mode was calculated as the areas under receiver operating characteristic (ROC) curves. The mean values were statistically compared with the Wilcoxon's signed rank test. In results the intraobserver variation and interobserver variation were high with conventional radiographic technique in diagnosing initial periapical lesions. There was a slight increase in the mean values for digital technique and in the accuracy of diagnosing the periapical lesions but using wilcoxon signed rank test the z-value was 1.367 and p-value was 0-172. The results of this study suggest that for the diagnosis of initial periradicular pathosis, the difference between the conventional and Trophy RVG 5000 DDR systems is insignificant However, some advantages like elimination of chemical processing, immediate observation of radiographic images, ability to enhance images, and data storage make DDR preferable in comparison with CR for diagnosis of initial periapical lesions.
[ABSTRACT]   Full text not available  [PDF]
  289 129 -
Coronal Displacement of Cementum in Impacted Teeth and Its Correlation to Age: A Preliminary Study
Aparna Thombre Sharma, Minal Chaudhary, Vivek Thombre, Satyajit A Tekade, Pranoti Pradhan, Kriti Bagri
October-December 2010, 22(4):190-192
Structural changes occur throughout life in enamel, dentine, and cementum with continuous cementum apposition. Erupted teeth are directly affected by environmental and ageing process as opposed to impacted teeth. Cementum deposition on a healthy tooth is a continuous process and relationship may exist between age and cementum thickness. Cementum deposition may occur with coronal displacement due to erupted forces on impacted teeth. Aim: The present study was designed to investigate the extent of coronal displacement of cementum in impacted teeth as compared to erupted teeth, and to draw a probable correlation between age and coronal displacement of cementum in erupted and impacted teeth. Materials and methods: A morphometric analysis was performed using Leica DML B2 O-Win Lite image analysis system. Results: Our results suggested that there was a significant linear and positive correlation between age and coronal displacement of cementum in impacted mandibular third molars. Conclusion: This method can be applied in the arena of forensic odontology.
[ABSTRACT]   Full text not available  [PDF]
  273 127 -
Serum and Salivary Estimation of Dipeptidyl Peptidase IV, as a Prognostic Indicator in Oral Squamous Cell Carcinoma before and during Radiotherapy
Pranoti Pradhan, Anil Ghom, RN Mody
October-December 2010, 22(4):181-184
Increase in serum and salivary levels of Dipeptidyl peptidase IV (DPP IV) was reported earlier in the patients of oral squamous cell carcinoma. A study was conducted in the department to assess, the serum and salivary levels of Dipeptidyl peptidase IV in patients of oral squamous cell carcinoma before and after radiotherapy. The study was performed on 50 patients with different stages of oral squamous cell carcinoma as a study group and 50 control healthy group. The mean DPP IV activity in study group before radiotherapy in serum and saliva was significantly lower than control group. Amongst the study group, well differentiated carcinoma had the highest mean serum DPP IV activity than moderately and poorly differentiated carcinoma. There was an increase in mean DPP IV levels in study group after radiotherapy. We hence conclude that DPP IV activity in serum and saliva can be used as a prognostic indicator in oral squamous cell carcinoma patients.
[ABSTRACT]   Full text not available  [PDF]
  258 126 -
Apert's Syndrome: A Rare Case Report
Madhura Dalal, Naresh C Soni
October-December 2010, 22(4):232-235
Apert's syndrome /Acrocephalosyndactyly is a rare, congenital disorder characterized by craniosynostosis, midfacial malformations and symmetrical syndactyly. It is caused by a genetic mutation in the FGFR2 gene on chromosome 10. Although the syndrome has typical clinical features, the relative rarity of the condition still poses a diagnostic dilemma. Considering the general paucity of cases in the Indian literature, we present a case report of a 14-year-old female having all the features of classical Apert's syndrome.
[ABSTRACT]   Full text not available  [PDF]
  258 125 -
Johanson-Blizzard Syndrome: A Rare Case Report
R Sudarshan, Rajeshwari G Annigeri, Savitha S Shettar
October-December 2010, 22(4):225-228
Several of the anatomic malformations are difficult to diagnose. A group of population has characteristic anatomic changes but even in this group the diagnosis may not be considered, if one or more of the major features are present. The Johanson-Blizzard syndrome has distinctive craniofacial changes that should be easily recognized. It is an autosomal recessive condition characterized by typical facies, exocrine Pancreatic insufficiency, hypothyroidism and group of other features like oligodontia, growth retardation, bilateral hearing loss and midline scalp defects. A 9-year-old boy with Johanson-Blizzard syndrome is described in this article along with oral manifestation and less emphasized feature cafe-au-fait spots.
[ABSTRACT]   Full text not available  [PDF]
  249 128 -
Radiation Induced Hypoplasia of the Mandible and Retarded Tooth Development
Monica Tuteja, Shraddha Bahirwani, P Balaji, Bina Shah, Deepak Daryani, Rachna Kaul
October-December 2010, 22(4):229-231
Few cases of radiation-induced damage to the teeth and jaws, have been reported in the literature. Radiation therapy plays an important role in the treatment of patients affected with head and neck cancer. In spite of its recognized benefits in the treatment of malignant tumors, radiation therapy has several side-effects in the head and neck region. This paper highlights a case report where hypoplasia of the mandible, trismus and stunted permanent teeth roots were observed in an 18-year-old patient who was diagnosed with parameningeal rhabdomyosarcoma—embryonal type group III at the age of 5 years. He had received radiation therapy of 50 Gy to the nasopharynx for about 1 year and was reviewed for a period of 11 years. Full mouth periapical radiographs and panoramic radiograph revealed hypoplasia of the mandible and generalized hypoplasia of the roots of the permanent teeth.
[ABSTRACT]   Full text not available  [PDF]
  251 112 -
Prevalence of Candidal Carriage Rate in Denture Wearers and Evaluation of the effect of Whole Unstimulated Salivary Flow Rate and pH of Saliva on their Carriage Rates
Ashita R Kalaskar, Shirish Degwekar
October-December 2010, 22(4):177-180
Objectives: To assess the prevalence of Candida carriage rate in denture wearers and to evaluate the effects of local factors and habits of tobacco and betelnut on Candida carriage rate. Study design: 60 edentulous subjects and 60 dentulous subjects were evaluated. Standard methods for culture, salivary flow rates and pH determination were used. Statistically analysis was carried out using Students unpaired "t" test, 'Chi square test, z-test, ANOVA F-test and Tukey multiple comparison test. Results: Highest prevalence of Candida carriage rate was shown by group 1 (63.33%). The mean whole unstimulated salivary flow rate (p < 0-01) and pH (p < 0.05) were less in the subjects showing positive candida culture. Significant (p < 0.05) increase in prevalence of Candida carriage rate was found in subjects wearing prosthesis and having habits. Conclusion: The prevalence of Candidal carriage rate in healthy individuals increased in the presence of prosthesis and decreased salivary flow rate and pH.
[ABSTRACT]   Full text not available  [PDF]
  227 125 -
Rapidly Proliferating Nodular Fasciitis of the Maxillary Alveolus Extending into Antrum
V Naik, R Kini, A Shetty
October-December 2010, 22(4):236-238
Rapidly growing soft tissue masses of the oral and maxillofacial region are highly diverse in nature and mimic malignancy. Nodular fascidis (NF) being one such lesion. Its aggressive behaviour coupled with nonspecific histological features add to the difficulty in diagnose. NF is a benign, reactive proliferation of fibroblasts (myofibroblasts) in the subcutaneous tissues. They are common in upper extremities, forearm being involved quite frequently: involvement of oral cavity is extremely rare. Although it can occur at any age, it is quite common in 2nd to 4th decades. Both sexes appear equally affected. It presents as rapidly growing soft tissue mass of very short duration, ranging in size from 0.4 to 10.5 cm in diameter. Light microscopy and immunohistochemical examinations are means of confirming the diagnosis definitively. Surgical resection of the lesion is the treatment of choice. We report a case of NF of oral cavity involving maxillary sinus which enlarged alarmingly after an incisional biopsy. Immunohistochemisstry for 'Vimentin' marker was positive and confirmed the diagnosis.
[ABSTRACT]   Full text not available  [PDF]
  210 88 -
Incoming President's Message
RS Sathwane
October-December 2010, 22(4):0-0
Full text not available  [PDF]
  119 115 -