Srikant N

Demirjian's method in the estimation of age: A study on human third molars

Aim: The primary aim of the following study is to estimate the chronological age based on the stages of third molar development following the eight stages (A to H) method of Demirjian et al. (along with two modifications-Orhan) and secondary aim is to compare third molar development with sex and age. Materials and Methods: The sample consisted of 115 orthopantomograms from South Indian subjects with known chronological age and gender. Multiple regression analysis was performed with chronological age as the dependable variable and third molar root development as independent variable. All the statistical analysis was performed using the SPSS 11.0 package (IBM ® Corporation). Results: Statistically no significant differences were found in third molar development between males and females. Depending on the available number of wisdom teeth in an individual, R2 varied for males from 0.21 to 0.48 and for females from 0.16 to 0.38. New equations were derived for estimating the chronological age. Conclusion: The chronological age of a South Indian individual between 14 and 22 years may be estimated based on the regression formulae. However, additional studies with a larger study population must be conducted to meet the need for population-based information on third molar development.

Post-radiation changes in oral tissues - An analysis of cancer irradiation cases

Introduction: Radiation, commonly employed as neoadjuvant, primary, and adjuvant therapy for head and neck cancer causes numerous epithelial and stromal changes, prominent among which is fibrosis with its early and late consequences. Very little is known about the true nature of the fibrosed tissue and the type of fibers accumulated. Radiotherapy affects the supporting tumor stroma often resulting in a worsening grade of tumor post-radiation. Aim: To study epithelial, neoplastic, stromal, and glandular changes in oral cavity induced by radiation therapy for oral squamous cell carcinoma (OSCC) using special stains. Materials and Methods: The study included 27 samples of recurrent OSCC following completion of radiotherapy (recurrence within an average span of 11 months), and 26 non-irradiated cases of OSCC. Patients with a history of combined radiotherapy and chemotherapy were not included in the study. The epithelial changes assessed included epithelial atrophy, apoptosis, necrosis, dysplasia, and neoplasia. The connective tissue was evaluated for amount of fibrosis, quality of fibers (using picrosirius red staining), fibrinous exudate, necrosis, pattern of invasion, vessel wall thickening, and salivary gland changes. The aforementioned changes were assessed using light and polarizing microscopy and tabulated. Statistical Analysis: Epithelial and connective tissue parameters were compared between the irradiated and non-irradiated cases using chi square and t-tests. Results: Epithelial and connective tissue parameters were found to be increased in irradiated patients. Pattern of invasion by tumor cells varied from strands and  cords between the two groups studied. The effect of radiation was seen to reflect on the maturity of fibers and the regularity of their distribution.

Are teeth evidence in acid environment

Aim: Teeth are the most durable structures that resist destruction more than skeletal tissue Commercially available acids can be used to destroy the body or a part, to mask human identification. The present study examines the effect of caustic acids on human dentition. Materials and Methods: Ten upper anterior teeth each were immersed in 37% hydrochloric acid (conc. HCl), 65% nitric acid (conc. HNO3) and 96% sulfuric acid (conc. H2SO4). Teeth were retrieved, washed in distilled water, dried, photographed and radiographed at intervals of 15 min, 30 min, 1 hr, 3 hr, 5 hr and 8 hr. Results: Teeth placed in conc. HCl and conc. HNO3 dissolved completely after 8 hours, while that placed in conc. H2SO4 retained its morphology and radiographic dimension even after 8 hours. Conclusion: Hence teeth can serve as a tool in identification (age estimation and sex determination) of the victim when in contact with conc. H2SO4.

Lingual Cyst Lined By Respiratory Epithelium: A Case Report and Review of Literature

The present report describes a case of a lingual cyst lined by a respiratory epithelium occurring in a 1-year-old girl. The article also reviews the cases published in the literature under the heading of lingual cysts and segregates all the cases having predominant respiratory epithelium as the cystic lining. Reclassification, with more descriptive histologic terminology to name the lingual cysts, has been proposed.

Polarizing and Light Microscopic Analysis of Mineralized Components and Stromal Elements in Fibrous Ossifying Lesions

INTRODUCTION Fibro-osseous lesions, along with few reactive lesions of the jaws exhibit an overlapping histo-morphologic spectrum with respect to the nature of calcifications and stromal components. This causes difficulty in assessing the origin, pathogenesis and diagnosis of these lesions. AIM The present study analyses the mineralized components, cellularity, stromal density and stromal composition (nature of collagen, presence of elastic and oxytalan fibres) in cases of ossifying fibroma (OF), fibrous dysplasia (FD) and peripheral ossifying fibroma (POF). MATERIALS AND METHODS The study included a histochemical evaluation of six cases each of FD, OF and POF. Five consecutive sections of each case were stained with hematoxylin and eosin, picrosirius red (to assess maturation of fibres in polarizing light), van Gieson (for area fraction and collagen density) and aldehyde fuchsin (for elastic and oxytalan fibres) respectively. RESULTS Significantly higher amounts of mature bone were seen in FD while cementicles having microlamellar pattern were predominant in OF and POF (p < 0.001). Area fraction, collagen density and immature stromal fibre content was higher in POF followed by FD and OF (p= 0.039). Oxytalan and elastic fibres were absent in FD. CONCLUSION Higher cellularity of the stroma in OF was indicative of its neoplastic behaviour. Higher composition of oxytalan and elastic fibres in OF and POF supports their periodontal ligament origin. FD was distinct with more mature fibres in a lamellated bone and absence of oxytalan fibres.

Remineralizing effectiveness of calcium sucrose phosphate and fluoride dentifrices: An In vitro study

Context: Dentifrices-containing remineralizing agents are known to be effective in remineralization of early enamel lesions. Aims: This study aimed to compare and evaluate the changes in surface roughness, surface morphology, and mineral content of demineralized enamel lesion after treatment with dentifrices-containing sodium monofluorophosphate, amine fluoride, and Anticay® (calcium sucrose phosphate with inorganic amorphous calcium phosphate). Settings and Design: This was an in vitro study. Subjects and Methods: Eighteen extracted maxillary molars were decoronated and sectioned into four to obtain 72 specimens. Specimens were demineralized and randomly divided into four different test groups: Group A: no treatment (control), Group B: sodium monofluorophosphate dentifrice (Colgate), Group C: amine fluoride dentifrice (Amflor), Group D: Anticay® dentifrice (EnaFix) and subjected to pH-cycling for 4 weeks. After 4 weeks, they were assessed using a profi lometer and scanning electron microscope (SEM)-energy dispersive X-ray analysis (EDAX) for changes in surface roughness, surface morphology, and mineral content. Statistical Analysis Used: Intergroup comparison was done using repeated measures ANOVA. Results: Intergroup comparison revealed no significant difference in surface roughness and mineral content after remineralization between the groups. SEM images showed mineral deposition in all the dentifrice groups obliterating the defects caused due to demineralization. Conclusions: Sodium monofluorophosphate, amine fluoride-containing dentifrices, and calcium sucrose phosphate with inorganic amorphous calcium phosphate-containing dentifrice were found equivocal in their remineralizing effectiveness of early enamel lesions.

Incidence of Opportunistic Infections among HIV-Positive Adults on Highly Active Antiretroviral Therapy in a Teaching Hospital, India: Prospective Study:

Oral manifestations in HIV infections are numerous and some of these are acknowledged as being of great importance in the early diagnosis of the disease. Many HIV-associated oral infections occur early in HIV disease, not infrequently as the presenting sign or symptom. Thus, early detection of the associated oral opportunistic infections should, in many cases, result in earlier diagnosis of HIV infection. Cytology, a simple, painless, and inexpensive method, has become a preferred method and was used in our study for early diagnosis of certain lesions. To determine the effect of highly active antiretroviral therapy on incidence rate of opportunistic infections among HIV-positive adults in a teaching hospital in India, a prospective study was conducted and the required sample size was 40. Study participants were selected randomly from the outpatient department of an HIV clinic who were currently on for antiretroviral therapy (ART). Data on age, gender, form of contagion, antiretroviral therapy at the time of review, number of CD4 lymphocytes per milliliter, and viral load were collected. Oral cytologic investigation was carried out and then stained for histopathological examination. A total of 40 individuals were examined and the incidence of opportunistic infections was 66.7% in individuals with CD4 counts less than 200, 55.6% in individuals with CD4 counts of 200 to 499, and 40.0% in individuals with CD4 counts more than 500. The incidence of opportunistic infection was higher in individuals with low CD4 counts in spite of being on ART.

A Comparison of Clinicopathological Differences in Oral Squamous Cell Carcinoma in Patients Below and Above 40 Years of Age

Introduction Recent times have revealed an increase in incidence of Oral Squamous Cell Carcinoma (OSCC) in young adults including those who lack association with typical risk factors such as tobacco. There are reported variations in clinical behaviour of tumours in young and older individuals. Aim Present study evaluated differences in clinicopathological characteristics between two groups of OSCC, below and above 40 years of age. Materials and Methods An analytical study was performed on two groups of OSCC patients, below and above 40 years of age. Clinicopathological parameters of site distribution, type of habit, histological grade, nodal metastasis, margin status, mitotic index and Argyrophilic Nucleolar Organizing Regions (AgNOR) count were compared. Chi-square test and Students t- test were applied for statistical analysis. Results Present study revealed that mean AgNOR count was significantly higher in older group (6.38) than younger group (4.27). However, no significant differences were noted in site distribution, tobacco habit, histological grade, mitotic index, nodal metastasis and status of resected surgical margins between the two age groups. A trend for increased metastasis and poor histological differentiation was also observed in the older and younger age group respectively. Most common site was buccal mucosa followed by tongue in both groups. Conclusion Reasons for documented variability in tumour characteristics between young and older patients are currently unclear. Difference in AgNOR count found in present study is suggestive of variability in proliferative and ploidy characteristics between different age groups and supports the hypothesis of genetic and epigenetic influences in development of oral cancer.

Evaluation of Plaque pH Changes Following Consumption of Health Drinks by Children: A Pilot Study

INTRODUCTION With increased trend among people to choose a healthy diet, there is an increased consumption of health drinks by children. Thus, it is important to know their cariogenicity. AIM To evaluate the effect of consumption of health drinks viz., Horlicks, Boost and Complan on plaque pH in children. MATERIALS AND METHODS The study consisted of four groups: Group I (control)- 10% sucrose solution, Group II- Horlicks, Group III- Boost, Group IV- Complan. Samples of plaque from representative teeth were collected and pH was measured using an electrode outside the mouth. After baseline pH was recorded, children were given their respective drinks and were asked to consume slowly over a period of three to five minutes following swish with 20 ml of the test drink for one minute. The pH was then recorded after 10, 20, 30, 40 and 60 minutes of the post consumption period. Obtained values were subjected to one-way ANOVA test for multiple group comparison followed by Post-Hoc Tukeys test for group wise comparison. RESULTS Twenty minutes after consumption of Complan and Boost, pH was decreased, but not to the critical pH value as in case of sucrose. The pH was found to be slightly increased, 20 minutes post Horlicks consumption. Post 60 minutes consumption of all the drinks including sucrose solution, the pH was increased in comparison to post 20 minutes. However, 60 minutes post consumption of Boost and Horlicks, pH increased above the baseline. CONCLUSION Consumption of health drinks viz., Complan and Boost did not lower the plaque pH to the level of critical pH. Consumption of Horlicks increased the plaque pH.

Quit Tobacco: Are We Prepared?

Background: The pattern of tobacco consumption survey among the students in a private dental college in Mangalore helps us to assess the awareness and pattern of tobacco consumption among the dental students and also to assess the preparedness for tobacco control among the future health care professionals in India. Aim: To study the awareness and pattern of tobacco use among undergraduate dental students of a private dental College, at Dakshina Kannada, Karnataka. Materials and Methods: A Cross-sectional study was conducted among 100 dental students using a predesigned and pretested, semi-structured self-administered anonymous questionnaire. Data was analyzed by Microsoft excel and SPSS v 16.Statistical analysis comprised calculating proportion and the chi-square (χ2) test with Yates correction. Results: Among 100 participants, of which 52 students were males and 48 females, out of which 49% believed that the minimum number of cigarettes a person can smoke without causing harm to one’s health. About 89% of the students believe that it is the doctor’s duty to advice patients not to smoke or chew tobacco. 81% believe that health professional intervention would help the patient quit the habit. Conclusion: Awareness about harmful effects of tobacco abuse was good and the students feel that tobacco cessation modules should be incorporated in the dental curriculum. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among dental students are clearly needed worldwide.