Efficacy of Transcutaneous Electric Nerve Stimulation on Parotid Saliva Flow Rate in Relation to Age and Gender.

STATEMENT OF THE PROBLEM: Treatment with salivary substitutes and stimulation of salivary flow by either mechanical or pharmacologic methods has side effects and only provides symptomatic relief but no long-lasting results. PURPOSE: To assess the effectiveness of extraoral transcutaneous electric nerve stimulation (TENS) as a mean of stimulating salivary function in healthy adult subjects; as well as to determine the gender and age-dependent changes in salivary flow rates of unstimulated and stimulated parotid saliva. MATERIALS AND METHOD: Hundred patients were divided into two groups; Group I aged 20-40 and Group II aged ≥ 60 years. The TENS electrode pads were externally placed on the skin overlying the parotid glands. Unstimulated and stimulated parotid saliva was collected for 5 minutes each by using standardized collection techniques. RESULTS: Eighty seven of 100 subjects demonstrated increased salivary flow when stimulated via the TENS unit. Ten experienced no increase and 3 experienced a decrease. The mean unstimulated salivary flow rate was 0.01872 ml/min in Group I and 0.0088 ml/min in Group II. The mean stimulated salivary flow rate was 0.03084 ml/min (SD= 0.01248) in Group I, and 0.01556 ml/min (SD 0.0101) in Group II. After stimulation, the amount of salivary flow increased significantly in both groups (p< 0.001). Statistical comparison of the two groups revealed them to be significantly different (p< 0.001), with Group I producing more saliva. Gender-wise, no statistically significant difference was seen among the subjects in Group I (p = 0.148), and those in Group II (p= 0.448). Out of 12 subjects with 0 baseline flows, 7 continued to have no flow. Five subjects observed side effects, although minimal and transient. CONCLUSION: The TENS unit was effective in increasing parotid gland salivary flow in healthy subjects. There was age-related but no gender-related variability in parotid salivary flow rate.

Glandular odontogenic cyst of the anterior mandible.

CONTEXT: Glandular odontogenic cyst (GOC) is a rare cyst occurring in the middle-age people with mandibular anterior as the common site of occurrence. CASE REPORT: We report a case of massive GOC in a 65-year-old female with an emphasis on its clinical course, histological features, and treatment modalities. CONCLUSION: The aggressiveness and recurrences of GOC warrants clinicians for the careful examination, treatment, and long-term follow-up.

Traumatic ulcerative granuloma with stromal eosinophilia.

Chronic ulcers of the oral mucosa are the lesions which a physician comes across frequently. "Eosinophilic Ulcer" is a rare variety of that. Eosinophilic ulcer or traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a chronic benign lesion of the oral mucosa and is a relatively recent delineated entity. Its etiopathogenesis is still uncertain but trauma seems to play a fundamental role. Clinically the lesion manifests as an isolated ulcer, showing a raised and indurated border in addition to a white or yellowish bed. Microscopically, it is characterized by diffuse polymorphic inflammatory infiltrate, rich in eosinophils, involving the superficial mucosa and the deeper muscle layer with epitheliod cells. Hereby, reporting a case of a 60-year-old female patient who presented with a chief complaint of non-healing painful ulcer on the tongue.

Ackerman's tumour of buccal mucosa in a leprosy patient.

Leprosy (Hansen's disease) is a chronic granulomatous disease caused by Mycobacterium leprae (Hansen's bacillus). Oral manifestations occur in 20-60% of cases, usually in lepromatous leprosy, and are well documented. They may involve both the oral hard and soft tissues. Incidence of verrucous carcinoma/Ackerman's tumour developing in anogenital region and plantar surfaces of feet in lepromatous leprosy has been sufficiently documented in the literature. However, association of oral verrucous carcinoma with lepromatous leprosy has not been established. We report for the first time a case of verrucous carcinoma of the buccal mucosa occurring in a leprotic patient, with brief review of literature on orofacial manifestations of leprosy.

Review and update: advanced investigation methods for diagnosis of tongue lesions.

Various specialized imaging modalities and guided microscopic methods developed in recent years, having proven value for the evaluation of tongue disorders. The list of which includes cineradiography, pulsed ultrasound, computer-assisted tomography, isotopic scanning, electromyography, magnetic resonance, video microscopy and stereo microscopy. The basic aim of the article is to review and throw light on the importance of complete examination of the tongue and application of advanced investigations for the proper diagnosis of the tongue lesions and its usefulness to the clinician.

Positioning errors and quality assessment in panoramic radiography.

PURPOSE: This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college. MATERIALS AND METHODS: This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'. RESULTS: Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable. CONCLUSION: The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.

Hemifacial microsomia: a clinicoradiological report of three cases.

Hemifacial microsomia is a congenital malformation in which there is deficiency in the amount of hard and soft tissues on one side of the face. It is primarily a syndrome of first and second branchial arches involving underdevelopment of the temporomandibular joint, mandibular ramus, masticatory muscles, ears and occasionally defects in facial nerve and muscles. Here, we report three cases of hemifacial microsomia diagnosed based on clinical and radiographic findings. All three cases had variable presentations ranging from the mildest form that included facial asymmetry and ear deformity to the most severe and unusual form with facial nerve paralysis and spine deformity.