Renita Lorina Castelino

Drug induced xerostomia in elderly individuals: An institutional study.

Introduction: With better health care facilities and nutritional levels the average life expectancy of Indian population has been on the rise over the years. Most of the geriatric population is under long-term medication. Aim: The aim of this study was to evaluate the synergistic effect of multiple xerostomia drugs. Materials and Methods: Unstimulated saliva was measured in 60 geriatric patients, and xerostomia questionnaire and quality-of-life scale were also administered. Results: There was a very highly significant reduction in the salivary flow rates of patients under multiple xerostomia-inducing drugs. Conclusion: The synergistic effect of the xerostomia inducing medication could be the possible factor responsible for reduced salivary flow in elderly individuals using such drugs

Status of salivary lipid peroxidation in oral cancer and precancer.

Introduction: Lipid oxidation gives rise to number of secondary by-products. Malondialdehyde (MDA) is the principal and most widely studied product of polyunsaturated fatty acid peroxidation. This aldehyde is a highly toxic molecule and should be considered as more than just a marker of lipid peroxidation in oral carcinogenesis. Materials and Methods: Salivary malondiadldehyde was evaluated in 65 healthy controls (HC), 115 subjects with oral, potentially malignant disorders (PMD) and 50 subjects with oral squamous cell carcinoma (OSCC) using the Thiobarbituric-Trichloroacetitic acid (TBA-TCA) method. Results: A consistent elevation in the levels of salivary MDA was observed in HC with tobacco related habits, subjects with PMD and subjects with OSCC. The elevation in the salivary MDA was significant (P = 0.001) in the groups PMD and OSCC and group OSCC when compared to HC. Conclusion: The significant and encouraging findings of this study thus validate and reinforce that salivary malodialdehyde analysis can be used as an efficient, noninvasive tool for the early diagnosis of PMD and OSCC for planning comprehensive treatment protocol.

Co-Occurence of Florid Cemento-Osseous Dysplasia and Simple Bone Cyst: a Case Report

ABSTRACT Background The purpose of this report is to present a rare case of co-occurrence of florid cemento-osseous dysplasia with simple bone cyst in a middle aged Asian woman. Most of the reported cases are isolated cases of simple bone cyst or florid cemento-osseous dysplasia, but co-occurrence of these two entities is extremely rare. Methods The authors report a 41 year old female patient with co-occurrence of mandibular florid cemento-osseous dysplasia with simple bone cyst. A thorough clinical and radiological examination was carried out. Results It was diagnosed mandibular cyst with possible co-occurrence of florid cemento-osseous dysplasia. Surgical exploration of the multilocular lesion was applied. Since, the patient was symptomatic at the time of presentation utmost caution was taken during the surgical procedure as florid cemento-osseous dysplasia is associated with hypo-vascularity of the affected bone. Based on histopathological, as well as supporting clinico-radiological findings a confirmative diagnosis of florid cemento-osseous dysplasia co-occurring with simple bone cyst was made. Patient was followed-up for a period of six months and was reported to be asymptomatic. Conclusions Timely diagnosis and well planned treatment is important to obtain a good prognosis when a rare co-occurrence of two or more bone lesions affects the jaws.

Candida Carriage Rate and Growth Characteristics of Saliva in Diabetes Mellitus Patients: A Case-Control Study.

Background and aims. The aim of this study was to establish a relationship between salivary glucose levels and Candida carriage rate in type 2 diabetes mellitus patients and assess the growth characteristics and acid production of Candida in glucose-supplemented saliva. Materials and methods. A total of 90 subjects, 30 with controlled type 2 diabetes, 30 with uncontrolled type 2 diabetes and 30 without diabetes (control subjects), aged 30‒60 years, participated in the study. Unstimulated saliva was collected and investigated for glucose levels (GOD-POD method), colony-forming units (CFU) of Candida and salivary pH, using Indikrom paper strips). Analysis of statistical significance of salivary glucose and PH levels was carried out using post hoc Tukey HSD test. Correlation of Candida carriage rate with salivary glucose and salivary PH in the study groups and control group was made using Pearson’s correlation. Results.Candida CFUs were significantly higher in diabetic subjects, with a significant and positive correlation with salivary glucose levels. There was a negative correlation between salivary PH levels and Candida carriage rate. Conclusion. Increased salivary glucose was associated with increased prevalence of oral Candida in diabetic subjects. The growth of Candida in saliva was accompanied by a rapid decline in PH, which in turn favored their growth.

Can saliva offer an advantage in monitoring of diabetes mellitus? – A case control study

Objectives: Diabetes Mellitus is emerging as a major health problem over these years. Present method of blood glucose monitoring by venepuncture is invasive leading to reduced patient compliance and thereby ineffective judicious monitoring. The need of the hour is to direct research in the direction of establishing painless and more acceptable blood glucose analysis method.The objective of the study is to conduct a comparative analysis of the concentrations of salivary glucose and blood glucose in type 2 diabetes mellitus patients. Study Design: This study assessed glucose levels using the glucose oxidase method in blood and unstimulated saliva in 90 subjects who were divided into 3 equal groups of controlled type 2 diabetes, uncontrolled type 2 diabetes and those without diabetes. Statistical analysis was carried out using one way ANOVA, Post hoc Tukeys tests and Pearson’s correlation coefficient test. Results: Salivary glucose levels were significantly higher in patients with diabetes than controls. There was a significant positive correlation between salivary and plasma glucose levels in patients with diabetes. Conclusions: Glucose concentration in saliva is higher in diabetics but hyperglycemia does not influence salivary glucose levels. Further clarification is required to claim the diagnostic potentials of saliva in diabetes. Key words:Salivary glucose, type 2 diabetes mellitus, blood glucose.

Osteoradionecrosis of the Mandible and Mastoiditis after Radiotherapy for Parotid Mucoepidermoid Carcinoma

Osteoradionecrosis of the mandible in conjunction with mastoiditis is an extremely rare occurrence following irradiation of salivary gland malignancy in the orofacial region. We report one such case of a patient who presented to us with trismus, jaw pain, and ear discharge. Imaging of the jaws revealed classical features of osteoradionecrosis and mastoiditis. This case is important because presenting features like trismus and dental infection led us to investigative procedures that revealed extensive bone involvement including mastoiditis. Trismus progressively increased over a period of 8 years. In this case, we would like to emphasize the importance of good oral hygiene in the postradiotherapy stage for head and neck cancer.

Evaginated odontome on maxillary lateral incisor and #8212;a reverse and a rare presentation

Evaginated odontome or talon cusp is an uncommon dental anomaly with accessory cusp-like projection arising from the cingulum area of the maxillary or mandibular anterior teeth. This anomalous cusp resembles an eagles talon and hence the name. It occurs in both the primary and the permanent dentition. The presence of talon cusp on the lingual surfaces of primary permanent teeth is considered to be pathognomic, but the case reported here is an unusual case which is present in the facial aspect in a female patient. As per the existing literature only seven case reports of facial talon in permanent maxillary teeth have been reported.

Oromandibular-limb Hypogenesis Syndrome Type II C: A Rare Case

The oromandibular-limb hypogenesis syndrome comprises a group of anomalies which simultaneously affect the mandible, tongue, and maxilla with or without reductive limb anomalies. It is characterized by failure of development of the intraoral region and distal extremities. Multiple and variable deformities of the mandible, maxilla and tongue may occur in combination with a variety of limb defects. The wide range of presentation and combination of anomalies make classification difficult. They usually feature primarily in sporadic case reports because of their low incidence. The genetic origin of this syndrome is uncertain. It is congenital and there seems to be no sex predilection. The key radiographic features are retruded mandible, impacted teeth and malformed phalanges. When compared to available literature, frequently reported features like hypodontia, hypoglossia, microstomia, protruded maxilla and limb anomalies were present in our case. The case presented here is one of the rarest subtypes of this rare syndrome.

A rare co-occurrence of facial talon's cusp on fused maxillary permanent central and lateral incisor

Fusion is a developmental anomaly of dental hard tissues characterised by the union of two adjacent teeth. It can be complete or incomplete and commonly seen in deciduous than in the permanent dentition with higher frequency in anterior maxillary regions. Talon’s cusp is an unusual cuspal projection from the lingual aspect of the tooth with normal enamel and dentin and varying degree of pulp tissue. It commonly affects the permanent maxillary lateral incisors followed by central incisors and canines. Talon cusp is mostly found on the lingual aspect of teeth and rarely it projects from the facial aspect. We hereby report a case of fusion of permanent left central and lateral incisor with facial talon cusp which is rarely reported.

A Rare Case of Oral Erythema Multiforme: A Case Report with a Literature Review

Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction characterized by skin eruptions with or without oral or other mucous membrane lesions. The main two variants are erythema minor and erythema major. Oral disease with typical EM lesions has been suggested as a third variant of EM. Known as oral EM, it is reported less and has no target lesions unlike the other two types, in its primary presentation. Objective: To report a manifestation of a rare case of oral EM and discuss various forms of EM including its management. Case report: A 22-year-old male patient reported with a complaint of oral and lip ulcers and severe pain for the past 7 days. The patient reported spontaneous onset of the lesions in the form of vesicles after consuming unknown artificially colored food items. The vesicles ruptured within two days leaving ulcers on the lips and the intraoral mucosa, with blood encrustations. The patient was unable to take food, was admitted for hydration, and was kept on corticosteroids. It took around three weeks for the patient to completely recover. Conclusion: The positive history of artificially colored food intake followed by the sudden onset of lesions and eruptions on the lips and oral mucosa led us to the diagnosis of oral EM. Early recognition and timely intervention benefits patients because the lesions associated with EM and related disorders can compromise life.