Vikash Ranjan

Management of myofascial pain by therapeutic ultrasound and transcutaneous electrical nerve stimulation: A comparative study.

Objective: The present comparative study was aimed to determine the effectiveness of Th US and TENS in the management of myofascial pain in TMD patients. Materials and Methods: The present randomized comparative study was on 90 patients who were further assigned in three different groups each having 30 patients; Group I was healthy control patients, Group II was receiving Th US therapy, and Group III was receiving TENS therapy. All the 90 patients were further evaluated for maximum inter incisor subjective evaluation regarding muscle pain, impediment to daily life, massage impression on visual analog scale (VAS) scale, and intensity and duration used in Th US massage. Results: The masseter muscle thickness in control group was 12.00 (standard deviation [SD] ±1.1) mm when compared with TMD patient of 13.00 (SD ± 1.1) mm before treatment. Statistical significant findings on VAS score of muscle pain, impediment to daily life, and massage impression were observed in Th US. After treatment, the anechoic areas disappeared or were reduced in Th US group by 95.6% and in TENS by 74.4%. Conclusion: Th US appeared to be subjectively better which was related to VAS score of massage impression, muscle pain, and impediment to daily life after treatment as well as sonographically related to existence of anechoic areas.

Eagle's syndrome veiling as pain of odontogenic origin: Report of two cases with cone beam computed tomography illustration

Eagles syndrome, also known as an elongated styloid process, is a condition that may be the source of craniofacial and cervical pain. It is infrequently reported but is probably more common than generally considered. The symptoms related to Eagles syndrome can be confused with those attributed to a wide variety of facial neuralgia and or oral, dental, and temporomandibular joint diseases. In this paper, there are two cases, which reported to the Department of Oral Medicine, Diagnosis, and Maxillofacial Radiology, with a chief complaint of radiating pain in the preauricular region of the face. After radiographic investigation, these cases are considered as a case of Eagles syndrome because of increase in the size of the styloid process.

Efficacy and evaluation of cone beam computed tomography in determining the prevalence and length of anterior loop of inferior alveolar nerve in North Indian population

Introduction: The section of the inferior alveolar nerve (IAN) in front of the mental foramen and just before its ramification to the incisive nerve is known as anterior loop (AL) of IAN. Surgeries in the area of the anterior mandible may violate the AL resulting in neurosensory disturbances. Cone beam computed tomography (CBCT) is a new imaging modality that provides a multidimensional view of the facial skeleton. Aim: To evaluate the efficacy of CBCT in measuring the anterior looping of IAN. Objectives: To determine the prevalence of AL of IAN using CBCT, and to determine AL length using CBCT. Materials and Methods: Out of the total 1075 reported patients, 193 study participants fulfilling the inclusion criteria constituted the sample size were assessed for estimating the prevalence and determining the length of AL of IAN. They were scanned with a suitable digital imaging system for a variety of clinical indications using appropriate Dental Imaging Software. Results: The prevalence of anterior looping was found to be 37.3% and was highest (43.5%) in the age group of 36–56 years and was found to be statistically significant. The mean length of anterior looping was found to be 3.661 mm (SD ± 1.9933) with a maximum loop length of 8.8 mm. Conclusion: CBCT provides an accurate means to determine the anterior looping of IAN, measures its length, and thereby, helps in preoperative surgical planning.

Computed Tomography in Diagnosis of Admantinoma.

Context: Admantinoma is second most common benign odontogenic tumor which clinically appears as an aggressive odontogenic tumor, often asymptomatic and slow growing, associated with symptoms such as swelling, dental malocclusion, pain, and paresthesia of the affected area. The radiographic appearance may vary from unilocular to multilocular radiolucencies, imparting a characteristic honey comb, soap bubble appearance or may resemble a caricature of spider. Case Report: This report highlights the importance of conventional and advanced imaging in the diagnosis of large and invasive lesions. Patient reported with complaint of swelling in jaw, which progressively increased; and was found to be bony hard, both intra- and extraorally. Radiographs revealed large multilocular radiolucency on left body and ramus of mandible with soap bubble pattern and knife edged root resorption. Computed tomographic examination evaluated the extent of the lesion, internal structure, and relation to adjacent structures; further a reconstructed image was obtained to evaluate extent of destruction in three dimensions. Conclusion: Computed tomography has an important role in the diagnosis and treatment planning is imperative as it is superior in revealing the cortical destruction and extension into the neighboring soft tissues than conventional radiography.

Estimation of serum antioxidant enzymes in histopathological grades of oral leukoplakia, oral submucous fibrosis, and oral cancer: A clinicopathologic study

Introduction: This study was undertaken to assess the levels of malondialdehyde (MDA), superoxide distmutase (SOD), beta carotene, and vitamin E in oral submucous fibrosis (OSMF), oral leukoplakia (OL), and oral cancer patients. Though several studies have been done on the levels of antioxidants in these disorders, there are very few available reports in patients with various histological staging of these disorders. Materials and Methods: Blood samples were collected from 40 patients who were divided into three groups: Group I as control with 20 normal individuals, group II with histopathologically confirmed different stages of OSMF and OL, and group III with histopathologically confirmed different stages of oral squamous cell carcinoma (OSCC). Standard methods for estimation of serum values were used and statistical comparisons were performed using SPSS software 16.0 version and the level of significance was calculated. Results: The mean levels of vitamin E, beta carotene, MDA, and SOD among Group I subjects were 9.89 ± 0.75, 112.10 ± 11.97, 2.92 ± 0.36, and 189.45 ± 14.17, respectively. In group II patients with OL having mild dysplasia, serum vitamin E, beta carotene, MDA, and SOD levels were found to be 7.89 ± 0.87, 70.75 ± 2.82, 9.89 ± 0.92, and 119.63 ± 24.97, respectively. In moderate dysplasia, these values were 7.16 ± 0.55, 69.80 ± 5.54, 10.56 ± 0.46, and 115.20 ± 23.03, respectively. Serum vitamin E, beta carotene, MDA, and SOD levels were 7.70 ± 0.57, 70.50 ± 3.54, 9.81 ± 0.11, and 115.00 ± 8.49, respectively, in grade I OSMF and 7.32 ± 0.29, 69.67 ± 3.43, 9.76 ± 0.38, and 113.67 ± 8.32, respectively, in grade II OSMF. In group III patients with well-differentiated squamous cell carcinoma (WDSCC), serum vitamin E, beta carotene, MDA, and SOD levels were 7.01 ± 0.36, 64.32 ± 3.42, 12.98 ± 0.67, and 59.22 ± 4.01, respectively, and in patients with moderately differentiated squamous cell carcinoma (MDSCC), the values were 6.54 ± 0.41, 61.87 ± 2.03, 13.34 ± 0.42, and 58.43 ± 2.26, respectively. The P-value was calculated and the results were highly significant. Conclusion: A decrease in the levels of antioxidants like beta carotene, vitamin E, and SOD and an increase in MDA level in these disorders have been previously reported in the literature.

Diagnostic reliability of panoramic radiography and spiral computed tomography in evaluating topographic relationship of impacted mandibular third molar with inferior alveolar canal

Introduction: The inferior alveolar canal is described as a dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone. Conventionally, preoperative assessment is performed by orthopantomogram (OPG). Spiral computed tomography (CT), allows the clinician to localize and determine the relation of the impacted tooth and the inferior alveolar neurovascular canal (IANC) in three dimensions. Objectives: To describe the anatomical and morphologic variation of IANC as it appears in digital OPG and to correlate its relation with IANC on the CT. Materials and Methods: 100 patients were subjected to OPG and were studied for anatomic and morphologic variation. Eleven patients with mandibular impacted third molar in close proximity to the IANC were further subjected to CT examination. Results: Linear type was the commonest on the left side (39.5% in females and 41.9% in males) and elliptical type on the right side (52.6% in females and 45.2% in males). Morphologic variation showed bifid canal present in only 1 (1.6%) male on the left side. On the left side, narrowing of canal was seen in 4 (100%) teeth on OPG, in which 3 (75%) teeth showed 0 mm with cortical break in the CT. Three (100%) teeth showing interruption of white line (superior radiopaque border of IANC) on the OPG also showed 0 mm with cortical break in the CT. On the right side, 2 (100%) teeth showing narrowing of canal on the OPG correlated with 0 mm with cortical break in the CT and 1 (100%) tooth showed interruption of white line which correlated with 0 mm with cortical break in the CT. Conclusion: The comparison between the OPG patients and the CT patients (selected using the Roods criteria from the OPG patients) showed statistically significant value for narrowing of canal and interruption of white line with 0 mm loss of cortication in CT.

Nanodentistry - A Review

Nanotechnology is a phenomenon present since the late 1950′s and is currently finding a strong ground in the field of dentistry. Nanotechnology when integrated into dentistry gives rise to a new stream nanodentistry. Nanodentistry is an emerging field with significant potential to yield new generation of technologically advanced clinical tools and devices for oral healthcare. Nanoscale topology and quantitative biomechanical or biophysical analysis of dental surfaces are of significant interest. In particular, using Atomic force microscopy techniques -diseases such as dental caries, tooth hypersensitivity, and oral cancer can be quantified based on morphological, biophysical and biochemical nanoscale properties of tooth surface itself and dental materials or oral fluids such as saliva.

Oral health services utilization among the rural population of western Rajasthan, India

Introduction: The greatest burden of oral diseases is on the disadvantaged and socially marginalized populations. In developing countries like India, the availability and accessibility of oral health services in rural areas are limited, and the provision of oral health care is also very limited. Aims and Objectives: To assess the factors affecting the utilization of oral health services among the rural population of western Rajasthan, India. Materials and Methods: A structured self-administered questionnaire was employed as the instrument for data collection. Study was carried out for a period of 1 year in the rural areas of western Rajasthan, India. A total of 5476 people were selected. The questionnaire was explained to all the participants before the distribution, and the participants returned questionnaires after it was completed. Results: Among the total study group of 5476 subjects, 3934 were males and 1542 females. The study group was divided into five equal age groups from 20 to 60 years and above. It was found that 31.57% were illiterate and only 1.53% were graduates. One thousand, four hundred and thirty-six participants (26.22%) stated that cost of dental treatment was the major factor, followed by 1386 (25.31%) who believed in myths associated with dental treatment. Conclusion: Utilization of oral health services among the rural population has been found to be influenced by socio-demographic factors. Improving access to oral health care is a critical and very important first step to improving oral health outcomes and reducing disparities.

Study of lip prints: A forensic study

Background: Although several studies have been done on lip prints for human identification in forensic science, there is a doubt about their use in gender determination. Aims: The present study was designed to study the lip groove patterns in all the quadrants of both male and female subjects to identify the sex, based on the patterns of the grooves of the lip prints. Study Design: 300 lip prints were collected from volunteers of D. J. College of Dental Sciences and Research, Modinagar (UP). Materials and Methods: Lip prints were recorded with lip stick and transferred on to a glass slide. Statistical Analysis: Pearson chi-square test was adopted for statistical analysis and probability value (P value) was calculated. Conclusion: In our study, none of the lip prints were identical, thus confirming the role of lip prints in individual identification. According to Suzukis classification, Type I, II, III and IV patterns were significant in gender determination.

Diagnosis of a case of relapse of acute lymphoblastic leukemia based on oral manifestation of leukemic gingival enlargement and acute necrotizing gingivitis: A case report

Acute leukemias are the most common malignancy in childhood. They represent approximately 30% of malignant diseases in patients under the age of 15 years. Acute lymphoblastic leukemia (ALL) is the most frequent type of leukemia in children. Despite high cure rates, approximately 20% of patients with ALL have disease relapse. Oral manifestations are common in leukemia, particularly in acute leukemias. One of the oral manifestations of leukemia is diffuse gingival enlargement thought to be, at least partly, the result of gross infiltration of the gingiva by blast cells. The occurrence of acute necrotizing gingivitis, although a rare occurrence, is seen in such immunocompromised individuals. This is a case report of a 19-year-old patient who was under remission after treatment for ALL in whom a recurrence of leukemia was detected based on the oral findings and highlights the importance of its early detection by the dentist in preventing further complications and for instituting therapy swiftly.