Karthikeya Patil

Stature estimation using odontometry and skull anthropometry

OBJECTIVE To investigate the possibility of estimating height from odontometry and anthropometric data of the skull for the positive identification of height in forensic investigations concerned with fragmentary human remains. MATERIALS AND METHODS The study was carried out on 100 Mysorean patients, 50 males, and 50 females. Measurements of mesiodistal widths of the six maxillary anterior teeth, circumference of the skull, and height were made directly on each patient. Anteroposterior diameter of the skull was obtained on the lateral cephalograph. The data collected were subjected to statistical methods. The known heights of the combined data, data for males, and females were regressed against the odontometric and anthropometric variables using linear regression analysis. RESULTS Significant sexual dimorphism was observed for the parameters studied ( P 0.05). Highly significant correlation was found between height and other parameters when combined data and data for males were regressed. The equation relating height to the combined mesiodistal width of maxillary anterior teeth was derived as height = 982.421 + 13.65 x combined mesiodistal width of maxillary anterior teeth ( P 0.0001). Similarly equations were obtained by regressing height to head circumference and skull diameter ( P 0.0001 for both). The above findings may hence provide reliable method of estimation of height from skeletal remains in the forensic setup.

Extragingival pyogenic granuloma

Pyogenic granuloma is a well-known localized granulation tissue overgrowth in reaction to mild irritation. Although it is known to show a striking predilection for the gingiva, it can be found extragingivally with varying clinical features that sometimes may mimic more serious lesions such as malignancies. The clinical diagnosis of such an uncommon extragingival pyogenic granulomra can be quite challenging. The purpose of this article is to report an unusual case of extragingival pyogenic granuloma occurring on the lower lip, which presented as a cutaneous horn.

Localization of impacted permanent maxillary canine using single panoramic radiograph

BACKGROUND AND OBJECTIVES The objective in localization is selection of a suitable technique which has minimal radiation dose, cost and maximum details. Panoramic radiograph, being a screening radiograph, can satisfy the above needs. Taking this into consideration, the present study was done to evaluate the reliability of panoramic radiograph in localization of impacted permanent maxillary canines by applying the criteria suggested by Chaushu et al. and by comparing it with Clarks rule. MATERIALS AND METHODS The study comprised of 114 subjects in the age group of 13-30 years of both the genders with 150 impacted canines visiting Department of Oral Medicine and Radiology during the study period. The study subjects were examined for clinically missing canine, and then confirmed with intra-oral peri-apical radiograph (IOPAR). Panoramic radiographs (for application of Chaushu et al. criteria) and IOPARs (for application of Clarks rule) of the subjects were made and interpreted for parameters pertaining to the impacted canines. The data obtained was tabulated and subjected to statistical analysis using the statistical package for social sciences (SPSS) software. RESULTS Determination of the bucco-palatal position from panoramic radiographs, by applying Chaushu, et al. criteria, showed that localization in bucco-palatal position was possible for 96 of the 102 impacted canines placed in the middle and coronal zones. The remaining six impacted canines, three each in the middle and coronal zones, could not be localized as they showed overlapping in their range. By excluding them, the overall agreement worked out to be 94.11%. Localization was not possible for 48 impacted canines that lied in the apical zone. CONCLUSION A single panoramic radiograph can serve as a reliable indicator for determining the bucco-palatal position of the impacted canines when they lie in the middle and coronal zones. When they lie in the apical zone it is recommended to explore their presence with other conventional or advanced imaging modalities.

Malignant peripheral nerve sheath tumour: an elusive diagnosis.

Malignant peripheral nerve sheath tumour (MPNST) also termed as spindle cell malignancy of the peripheral nerve Schwann cells or neurogenic sarcoma, represents approximately 10% of all soft tissue sarcomas. This tumour is usually found in the lower extremities and only 10-12% of all lesions occur in the head and neck region, which makes it a rare entity. The diagnosis of MPNST has been described as one of the most difficult and elusive diagnosis in the soft tissue diseases because of its non-specific presentation both clinically and histopathologically. This was overcome by the use of immunohistochemistry. A case of MPNST of the left maxillary antrum in a 45 -year -old male patient is reported.

Bucco-lingual dimension of teeth - An aid in sex determination

Background: Bucco-lingual (B-L) dimensions of permanent teeth are known to exhibit sexual dimorphism. Objectives: Sexual dimorphism of B-L dimensions is known to be population specific. This study involves the measurement of B-L dimensions of all teeth except third molars of 99 native residents of Mysore district, Karnataka in the age group of 19-30 years. Materials and Methods: The B-L dimensional measurements of 28 teeth, except third molars, of 50 males and 49 females in the age group of 19 to 30 years were made on the study casts using vernier calipers with a resolution of 0.02 mm. The distance between the highest points on the buccal / labial and lingual / palatal surfaces were measured and analyzed using discriminant function analysis. Results: Males showed greater B-L dimensions of teeth in comparison to females with eight maxillary teeth exhibiting statistically significant dimorphism. However, discriminant function analysis showed an overall accuracy of classification of sex of 78%, among which 11 showed maximum dimorphism with a classification accuracy of 70.7% whereas both 23 and 26 showed an accuracy of 66.7%. Conclusion: Application of B-L dimensional variability among males and females in the population of Mysore can aid in sex determination in forensic scenario as the results of this study showed moderate magnitude of dimorphism in maxillary teeth with an accuracy rate of 78%. However, it is recommended to take this odontometric trait into consideration in combination with other skeletal and/or dental traits for sex determination.

Klestadt's cyst: A rarity

Klestadts cyst, more commonly known as the nasolabial cyst is an uncommon, non-odontogenic, soft tissue cyst characterized by its extra osseous location in the nasal alar region. Following its description first by Zukuerkandl in 1882, only 267 cases have been found in English literature. A case of nasolabial cyst in a 30-year-old female patient is presented.

Central schwannoma of mandible.

Intraoral schwannomas are uncommon and intraosseous ones are even rarer. The intrabony lesions account for less than 1% of the central neoplasms.According to the literature, there have been reports of 44 cases of intrabony neurilemmomas that occurred in either of the jaws. In theis case report. we report a case of central schwannoma of the mandible in a 23-year-old female, who presented with a swelling involving the right body of the mandible. Radiographs revealed a well defined, unilocular radiolucency with bicortical expansion. Histopathology and immunohistochemistry confirmed the diagnosis of schwannoma arising from right inferior alveolar nerve. The lesion was treated by segmental resection and reconstructed with autogenous iliac bone graft.

Eruption times and patterns of permanent teeth in school children of India

AIM To study the eruption pattern of permanent teeth excluding third molars in school children of Mysore, South India. OBJECTIVES To compare the eruption times determined with previous studies. To determine range of variation of the eruption time of each tooth and evaluate if any preponderance exists in the eruption timings of maxillary and mandibular teeth and between boys and girls. MATERIALS AND METHODS This was a descriptive cross sectional study. A random sample of 5007 school children in the age group of 5-14 years was selected. The mean age of eruption of individual permanent teeth was recorded and results were analyzed using Probit analysis. RESULTS The study population included 2371 boys constituting 47.26% and 2636 girls constituting 52.65% of the total sample. In the age group of 5 years, one of the permanent teeth was found to be erupted. In the age group of 14 years, all the permanent teeth except third molar had erupted. Girls showed early tooth eruption compared to boys. Mandibular teeth erupted earlier than maxillary teeth in both the sexes. Right and left sided teeth erupted at the same time in both the arches. CONCLUSION The mean ages of eruption obtained from the present study are strikingly comparable with those of other investigators in different populations across the world. Since the current study involves a large sample of children, the data reported in this study could be used as standards when assessing permanent tooth eruption in Indian children.

Radiomorphometric analysis of frontal sinus for sex determination

Context: Sex determination of unknown individuals carries crucial significance in forensic research, in cases where fragments of skull persist with no likelihood of identification based on dental arch. In these instances sex determination becomes important to rule out certain number of possibilities instantly and helps in establishing a biological profile of human remains. Aims: The aim of the study is to evaluate a mathematical method based on logistic regression analysis capable of ascertaining the sex of individuals in the South Indian population. Settings and Design: The study was conducted in the department of Oral Medicine and Radiology. Methods and Material: The right and left areas, maximum height, width of frontal sinus were determined in 100 Caldwell views of 50 women and 50 men aged 20 years and above, with the help of Vernier callipers and a square grid with 1 square measuring 1mm2 in area. Statistical analysis used: Students t-test, logistic regression analysis. Results: The mean values of variables were greater in men, based on Students t-test at 5% level of significance. The mathematical model based on logistic regression analysis gave percentage agreement of total area to correctly predict the female gender as 55.2%, of right area as 60.9% and of left area as 55.2%. Conclusion: The areas of the frontal sinus and the logistic regression proved to be unreliable in sex determination. (Logit = 0.924 - 0.00217 × right area).

Recurrent oral angioleiomyoma.

Angioleiomyomas are vascular variant of leiomyomas which are benign tumors of smooth muscle. They are exceedingly rare in the oral cavity. Malignant transformation of these tumors has also been reported occasionally which warrants knowledge of this soft tissue tumor. A 57 year old male patient reported with a 15 day history of an asymptomatic growth that had started insidiously in his lower left back tooth region. Clinical examination revealed a solitary, oval, sessile growth in the mandibular left retro molar region. Excisional biopsy was suggestive of Angioleiomyoma. A recurrence of the same was noted two months later which was also histopathologically reported as Angioleiomyoma. The same was confirmed using special stains. This case reports an unusual presentation of Angioleiomyoma with regards to both recurrence as well as rapid growth. It is important to be well aware of this uncommon entity as these tumors often can mimic or transform into malignancy. Precise clinicopathological examinations are therefore invaluable in establishing an accurate diagnosis and delivering suitable treatment.