Tanya Khaitan

Nonsurgical Management of Oral Mucocele by Intralesional Corticosteroid Therapy

Background. Oral mucocele is a common lesion resulting from an alteration of minor salivary glands due to mucus accumulation. Rapid appearance, specific location, history of trauma, bluish colour, and consistency help in the diagnosis. Conventional surgical removal is the treatment of choice but has several disadvantages like damage to adjacent ducts with further development of satellite lesions. Therefore, the present study was undertaken to evaluate the efficacy of intralesional corticosteroid injection (betamethasone) as a nonsurgical treatment procedure in oral mucoceles. Material and Method. A total of 20 cases (males and females, 10–30 years of age) with clinically diagnosed oral mucoceles were given 1 mL of betamethasone intralesionally. All the patients were examined after a period of 7, 14, and 21 days to evaluate the response of the lesion towards treatment and consequently given the 2nd, 3rd, 4th injections. If the lesion resolved after one or two injections, the treatment was discontinued. Results. Out of the 20 cases, 18 of them showed complete regression of the lesion whereas the remaining 2 cases showed decrease in size. All the patients received maximum of 4 consecutive shots in weekly interval. Conclusion. Intralesional corticosteroid therapy can be considered as the first choice in the treatment of oral mucoceles.

Oral submucous fibrosis secondary to iron deficiency anemia: A case report, etiopathogenesis and management

Oral submucous fibrosis (OSMF) is a premalignant condition that has received considerable attention in the recent past because of its chronic debilitating and resistant nature. Over the past decades, dental researchers have reported overwhelming evidence about various etiological factors of OSMF. It has been the subject of controversy ever since Schwartz first described the condition in 1952. Areca nut is considered the primary etiology along with other local irritants like capsaicin, pungent and spicy food, nutritional deficiency, defective iron metabolism, collagen metabolic disorder and genetic predisposition. Association of iron deficiency anemia and OSMF is very sparse in literature. Here, we present a case report of a 58 year old male patient where the patient presented with OSMF where iron deficiency anemia was found to be the main etiological factor.

Duchenne muscular dystrophy: Case report and review

Muscular dystrophies are a clinically and heterogeneous group of disorders that all share clinical characteristics of progressive muscular weakness. Duchenne muscular dystrophy (DMD) is the most common X-linked disorder muscular dystrophy in children, presenting in early childhood and characterized by proximal muscle weakness and calf hypertrophy in affected boys. There is usually delay in motor development and eventually wheelchair confinement followed by premature death from cardiac or respiratory complications. Treatment modalities such as corticosteroid therapy and use of intermittent positive pressure ventilation have provided improvements in function, ambulation, quality of life, and life expectancy, although novel therapies still aim to provide a cure for this devastating disorder. Here, we present a case of DMD in a 12-year-old male with remarkable clinical and oral manifestations.

Cephalometric Analysis for Gender Determination Using Maxillary Sinus Index: A Novel Dimension in Personal Identification

Purpose. Radiography is important in forensic odontology for the identification of humans. The maxillary sinus is the largest of the paranasal sinuses and first to develop. Sinus radiography has been used for identification of skeletal remains and determination of gender. Hence, the aim and objectives of the present study were to establish a new method for gender determination using maxillary sinus index from lateral cephalometric radiographs and to establish the reliability of maxillary sinus for gender determination. Methods. A total of 50 adult digital lateral cephalometric radiographs (25 males and 25 females) were included in the study. The maxillary sinus analysis was performed on these radiographs using the height and width measurement tools of Sidexis XG software. Maxillary sinus index was calculated, discriminant function analysis performed, and discriminant equation derived for determination of gender. Results. The mean maxillary sinus height and width were found to be higher in males, whereas the maxillary sinus index was greater in females. The discriminant function analysis derived in the study was able to differentiate the sex groups with sensitivity of 68% and specificity of 76%. Conclusions. From the results of the present study, it may be concluded that morphometric analysis of maxillary sinus can be used as a reliable tool in gender determination.

Screening of Oral Potentially Malignant Disorders Using Exfoliative Cytology: A Diagnostic Modality

Objective. Oral exfoliative cytology (OEC) has been implemented in the diagnosis of pathologic lesions for ages. The present study was undertaken to evaluate the cytomorphological features of some of the commonest potentially malignant disorders (leukoplakia, lichen planus, and oral submucous fibrosis) through a simple procedure and illustrate its importance in mass screening. Materials and Method. A total of 160 subjects with 25–50 years of age were included in the study. Among them, 40 were clinically diagnosed with oral leukoplakia, 40 were diagnosed with oral lichen planus, 40 were diagnosed with oral submucous fibrosis, and 40 were in the control group. The prepared smears were subjected to Papanicolaou stain and analyzed microscopically for the evaluation of the cytomorphological features. Results and Discussion. When analyzed microscopically, 36 (90%) out of the 40 oral leukoplakic lesions showed Class II cytological features whereas 4 (10%) revealed Class I features. Among 40 patients with oral lichen planus, 26 (65%) showed Class II features while the remaining 14 (35%) revealed Class I features. In 40 subjects with oral submucous fibrosis, 32 (80%) showed Class II features while the other 8 (20%) showed Class I features. All the 40 control subjects showed Class I features. Thus, OEC can be widely advocated as an addition to clinical conclusion and an adjunct to biopsy.

A Novel Computer-Assisted Method of Bite Mark Analysis for Gender Determination

Background Bite mark analysis is an imperative area of forensic odontology and considered the commonest form of dental evidence presented in the criminal court. The process of comparing bite marks with a suspects dentition includes analysis and measurement of shape, size, and position of an individuals teeth. The present study was aimed to evaluate the bite marks of males and females using a novel indirect computer-assisted method and explicate its application in forensic odontology. Materials and methods 60 subjects (30 males and 30 females) with normal occlusion were included in the present study. Bite registrations were obtained with help of modelling waxes, and positive replicas were prepared with dental stone and barium powder. Intraoral periapical radiographs were taken for the same. The radiographs obtained were scanned and analyzed by measuring tools using Sidexis Next Generation software. Intercanine distance (ICD), line AB, angle ABX, and angle ABY were measured. The Kruskal–Wallis test was performed to compare the bite marks of males and females. Results The mean ICD of males and females was found to be 32.95 mm and 29.84 mm, respectively, and was statistically highly significant with a p value <0.001. The mean ICD, line AB, and angle ABX were found to be higher in males when compared to females. Conclusion Analysis of bite marks using this novel computer-assisted method is a simple, reliable, easily reproducible, and economical technique with confidentiality of the identity of the participants involved.

Clinicopathological Presentation of Peripheral Ossifying Fibroma with Surgical Management

Peripheral ossifying fibroma (POF) is a slow growing asymptomatic benign tumor which may induce facial asymmetry. It is an occasional growth of the anterior region of mandible and accounts for 3.1% of all oral tumors and 9.6% of the gingival lesions. About 60% of these tumors occur in maxilla and more than 50% of all cases of maxillary POFs are found in the incisors and canine areas. They are thought to arise from the gingival corium, periosteum or periodontal ligament. Dental calculus, plaque, microorganisms, dental appliances, and restorations are considered to be the irritants triggering the lesion. They can cause separation of the adjacent teeth, resorption of the alveolar crest, esthetic deformity. The treatment of choice is complete surgical excision with the removal of the irritating factors. Care must be taken to preserve or reestablish acceptable gingival architecture and periodontal integrity. Here, we present two cases of peripheral ossifying fibroma in left anterior mandible with complete surgical management.

Dentinogenesis imperfecta: case report and review of literature

Dentinogenesis imperfecta (DI) is one of the most common hereditary disorders of dentin formation. It follows an autosomal dominant pattern of transmission, affecting both the formation and mineralization of dentin. Either or both primary and permanent dentition is affected by it. It is characterized by the presence of opalescent dentin, resulting in a dusky blue to brownish discoloration of the teeth. Here we present a case of DI in a 20 year old female with remarkable clinical, radiological and histological presentation.

Solar elastosis: Case report and review

Solar elastosis is degenerative dermal disease of the photodamaged skin, associated with aging and influenced by hereditary factors such as pigmentation, exposure to sunlight and wind. The disease is characterized by the accumulation of abnormal elastic tissue in the dermis. Solar elastotic syndromes include solar elastosis, Favre-Racouchot syndrome, elastotic nodules of the ears, collagenous and elastotic plaques of the hands, and colloid milia. The most common solar elastotic syndrome is solar elastosis. The chief etiological factors contributing to the lesion include chronic exposure to sunlight (ultraviolet, visible, and infrared radiation). Ultraviolet-A radiation causes erythema and its deep penetration into the dermis causes inexplicably chronic photodamage. Here, we present a case report of 32-year-old female with a distinctive clinical presentation.

Intraosseous neurilemmoma of the mandible

Neurilemmomas are relatively uncommon lesions most commonly encountered in the nerve sheath originating from Schwann cells. They are rarely found in the oral cavity and are characterized by solitary occurrence, slow, persistent growth and smooth surface, along with inconsistent clinical aspects depending on the nerve origin. Microscopically, the lesion typically comprises of alternating regions of hypercellularity and hypocellularity such as Antoni A and Antoni B arrangements, respectively. Here, we present a case of a benign spindle cell tumor of the mandible reflecting a case of intraosseous neurilemmoma in a 33-year-old female patient. Immunopositivity with S-100 and vimentin clearly indicates the lesion to be a spindle cell tumor with neural involvement. The prognosis was favorable; complete surgical removal was the treatment of choice with no recurrence noted. The present case further magnifies the importance of neurilemmoma and further aids in the differential diagnosis of several other benign soft tissue tumors in the oral cavity.