Shruthi Hegde

Morphological and Radiological Variations of Mandibular Condyles in Health and Diseases: A Systematic Review

The appearance of mandibular condyle varies greatly among different age groups and individuals. Human mandibular condyles may be categorized into five basic types: flattened, convex, angled, rounded and concave. Morphologic changes of condyle occur due to developmental variations, remodeling, various diseases, trauma, endocrine disturbances and radiation therapy. Genetic, acquired, functional factors, age groups, individuals have a role in morphologic changes in shapes and sizes of condyle. Thus variability in the shapes and sizes of condyles should be an important factor in diagnosing the disorders of temporomandibular joint. Differentiating diseased conditions from anatomical variations of the condylar head possess a diagnostic challenge for the radiologist and surgeons on numerous occasions. The purpose of this review is to describe in detail about normal anatomical and morphological variations in condylar head, thus helping an investigator to distinguish between variations in form and pathologic condition.

The varying clinical presentations of peripheral ossifying fibroma: A report of three cases

PURPOSE: Gingival growths are one of the most frequently encountered lesions in the oral cavity. Most of these lesions are innocuous, but some do have malignant potential. Different lesions with similar clinical presentations make it difficult to arrive at a correct diagnosis. One of the infrequently occurring gingival lesions is peripheral ossifying fibroma (POF). Lesions with histological features similar to POF have been given various names, adding to the confusion. We report the varied clinicopathological features of 3 cases of POF, discuss the contentious nomenclature and investigate the possible etiopathogenesis of this disease. CASE DESCRIPTION: Three cases of gingival growths (POF) are reported. Two of the lesions occurred in the maxillary anterior region, while the third occurred in the mandibular posterior region. Two of the cases showed radiographic evidence of bone loss. An excision biopsy was performed in all three cases. CONCLUSION: Because the rate of recurrence for peripheral ossifying fibroma is 8% to 20%, close postoperative monitoring is required. It is also necessary to use consistent and specific nomenclature in the literature to avoid confusion and the loss of important data.

Status of trace elements in saliva of oral precancer and oral cancer patients

BACKGROUND Several studies in recent years have linked association between micronutrient levels and various forms of cancer. Copper and zinc have been the most researched micronutrients. AIM The aim of the study was to evaluate the levels of copper, zinc and iron in saliva of patients with oral leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma. RESULTS There was a highly significant increase in the level of salivary copper in oral submucous fibrosis patients when compared to controls (P = 0.001). Salivary copper levels were also elevated in oral leukoplakia and oral cancer patients (P = 0.01). There was a significant decrease in the salivary zinc levels in all three study groups when compared to controls (P = 0.001). A highly significant reduction in salivary iron levels was noticed oral submucous fibrosis group. The copper to zinc ratio significantly increased in all the study groups when compared to controls. CONCLUSION Results suggest that salivary copper zinc and iron could be used as biomarkers for oral precancer and cancer.

Human Papilloma Virus Associated Squamous Cell Carcinoma of the Head and Neck

Oral cancer is one of the commonest causes for mortality and morbidity with squamous cell carcinoma being the sixth most frequent malignant tumour worldwide. In addition to tobacco and alcohol, human papilloma virus (HPV) is associated with a proportion of head and neck cancers. As in cervical cancers, HPV types 16 and 18 are the cause of malignant transformation. HPV-positive cancers of head and neck have unique characteristics such as occurrence in a younger age group, distinct clinical and molecular features, and better prognosis as compared to HPV-negative carcinomas. They also possess the potential for prevention by using vaccination. The present review describes in detail the salient features of HPV associated oral squamous cell carcinoma (OSCC), its differences from HPV-negative OSCC, diagnostic features, and recent strategies in prevention and management.

Multiple unerupted teeth with amelogenesis imperfecta in siblings.

Amelogenesis imperfecta encompasses a group of inherited abnormalities that are generally considered to primarily affect the formation and/or calcification of enamel. This case report describes the unusual presentation of amelogenesis imperfecta in siblings as multiple unerupted teeth, multiple pulpal calcifications, and multiple dilacerations of roots along with the defect in the enamel. The intent of our report is to highlight a rare co-occurrence of amelogenesis imperfecta with multiple morphologic alterations in siblings.

Radiological features of familial Gorlin-Goltz syndrome.

Gorlin-Goltz syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocystic odontogenic tumors, and skeletal anomalies. This syndrome may be diagnosed early by dentist because keratocystic odontogenic tumors are usually one of the first manifestations of the syndrome. Early diagnosis and treatment are of utmost importance in reducing the severity of long term sequelae of this syndrome. This report presents a rare event of Gorlin-Goltz syndrome occurring in a 39-year-old male and his 8-year-old daughter. The clinical and investigative features of this familial disorder has been described in detail.

Rare features associated with Mobius syndrome: Report of two cases

Mobius syndrome is a rare congenital disorder with the preliminary diagnostic criteria of congenital facial and abducent nerve palsy. Involvement of other cranial nerves, too, is common. Prevalence rate of this syndrome is approximately 1 in 100,000 neonates. It is of unknown etiology with sporadic occurrence. However, data regarding the occurrence rate in India is limited. Features such as orofacial malformations, limb defects, and musculoskeletal, behavioral, and cognitive abnormalities might be associated. A thorough evaluation to identify the condition and establishing an adequate treatment plan is of utmost important in this condition. We are reporting clinical and radiographic features of Mobius syndrome in two cases along with unusual findings of limb and neck deformity.

The reverse claw: Report of an extremely rare facial talon cusp.

Talon cusp is a rare developmental anomaly that occurs most commonly on the lingual side of the incisors. Occurrence of the labial talon cusp is rare in the dental literature. Till date only seven cases of isolated nonsyndromic labial talon cusps have been reported in the maxillary permanent dentition. However, a few cases of syndromic labial talon cusps and faciolingual talon cusps have been reported. The aim of our report is to highlight clinical and radiological features of this rare anomaly.

Adenoid cystic carcinoma of the buccal mucosa: A case report and review of the literature.

Adenoid cystic carcinomas are deceptive malignancies that show slow growth and local invasion with recurrences seen many years after diagnosis. Upto 50% of these tumors occur in the intraoral minor salivary glands usually in the hard palate. Buccal mucosal tumors are relatively rare. We determined the incidence of buccal mucosal adenoid cystic carcinoma by reviewing the number of reported cases in the literature. This is the first article to analyze the occurrence of adenoid cystic carcinomas in the buccal mucosa through a review of 41 articles. Our review revealed 178 buccal mucosal adenoid cystic carcinomas among a total of 2,280 reported cases. We present a case of adenoid cystic carcinoma occurring in the left buccal mucosa of a 45-year-old female.

Serum folate levels among mothers of children with and without cleft lip and palate: A comparative biochemical study

Background: Cleft lip and palate is one of the major congenital malformations in the newborn. Folic acid or folate has been postulated to have a protective effect on the occurrence of cleft lip and palate if taken in the periconceptional period. Aims: The aim of this study is to evaluate and compare the serum folate levels of mothers of cleft children with that of mothers with healthy children and women of childbearing age. Materials and Methods: A total of 44 subjects were included in the study of which 28 formed the study group comprising of women who had delivered children with cleft lip and palate and 8 were women who had delivered healthy children and formed Control Group I. Control Group II consisted of 8 women of childbearing age. Serum folate levels were assayed using an automated chemiluminescence assay. Results: We observed no significant difference in the serum folate levels of the study group as compared with the control groups. However, the mean serum folate level in the study group was marginally lower than in Control Group I. Conclusions: Since, in our study, folic acid deficiency could not be demonstrated in the serum of women with cleft children, our results suggest that serum folate levels may not be the only reason for clefting. Furthermore, the range of folate in a population is usually narrow; therefore, a significant difference in the serum folate levels may not be demonstrable.