Oral manifestations of systemic leukemia-first sign of presentation.

Acute myeloid leukemia (AML) is an aggressive hematopoietic malignancy that left untreated or undiagnosed can lead to death within few days. Hence, early diagnosis and appropriate treatment become necessary. Oral manifestations in AML could be the presenting feature or could a part of systemic manifestations. Gingival lesions appear as generalized enlargement with hemorrhagic discoloration with or without spontaneous bleeding. Sometimes, gingival lesions itself could a presenting sign without any other systemic manifesto. We report a similar case which was undiagnosed earlier and the patient came with a complaint of only the gingival swelling.

ANALGESIC EFFECT OF INTRAVENOUS ASCORBIC ACID VERSUS ACELCOFENAC POST-TRANSALVEOLAR EXTRACTION: A CASE-CONTROL STUDY.

One of the most important aspects of postsurgical care is finding an efficient way for the management of pain. Third molar extractions/surgical impaction is one of the most frequent surgical procedures in dental hospitals, and it is most often associated with postoperative complications like severe pain, oedema and reduced mouth opening. This study was aimed to evaluate the efficacy of 2 g intravenous (IV) vitamin C compared to 100 mg aceclofenac on postsurgical pain, swelling and trismus after the surgical removal of third molars. A total of 101 patients were recruited for the study, and theywere divided into two treatment groups; group A (n = 51) received 2 g IV vitamin C and group B (n = 50) received 100 mg aceclofenac. Pain intensity, facial swelling and mouth opening were assessed till day 3 post-surgically. Statistical analysis of pain intensity revealed that IV vitamin C performed slightly better but not significantly different (p>0.05) from aceclofenac group at the end of day 3. No significant difference for facial swelling and mouth opening between the two treatment protocols was seen (p>0.05). Our results concluded that both treatment groups were overall similar in analgesic efficacy, postoperative oedema and reduction in mouth opening. It was also determined that the method devised administering 2 g IV vitamin C intravenously was well suited to the treatment of postoperative pain, swelling and trismus following the surgical extraction of impacted third molars.

Assessing Difficulties Encountered by Dental Students Studying Oral Pathology and Addressing Their Concerns.

INTRODUCTION: The present scenario of Oral Pathology and Oral Histology as a subject is alarming. In spite of so many advancements in terms of books, internet and conferences there are still lacunae between the understanding and interest for the subjects in the students. It can be partly due to the fact that the students perceive it as a non-clinical subject having a lesser scope for practice. AIM: The present study was aimed at evaluating the students approach towards oral pathology department and the subject. The purpose of the study was to analyze practical hurdles encountered by students and to find out solutions to overcome them. MATERIALS AND METHODS: The cross-sectional questionnaire based study was done with BDS students of People's Dental Academy, Bhopal, India, to gauge the understanding of their knowledge in the subject of Oral Pathology and Oral Histology. Questionnaire comprised of 28 multiple choice questions under five parameters. The data recorded was subjected to statistical analysis using chi-square test. RESULTS: We found that study samples were efficient enough in terms of following instructions related to their day to day training. Although they were content with light microscope, they thought that some more interactive sessions could be beneficial for them in Oral Pathology. CONCLUSION: Through our study we found out that the students are well oriented on the whole about Oral Pathology. They certainly encounter difficulties which are easy to handle if proper measures are taken. We through our study would like the readers to be aware of the changing trends in teaching and to incorporate them routinely.

Eustachian tube dysfunction in OSMF- often present seldom discovered.

OBJECTIVES: To evaluate the effect of OSMF on the eustachian tube function and to correlate it with various grades of the disease. STUDY DESIGN: Twenty OSMF patients (40 ears) and 20 healthy controls (40 ears) were evaluated for eustachian tube function by eustachian tube function test, tympanometry and audiometry. RESULTS: The audiometric and tympanometric analysis showed no significant differences in hearing abilities of OSMF patients and controls and between various grades of OSMF, indicating no hearing impairment. However, eustachian tube function test revealed a statistically significant difference in eustachian tube function in OSMF patients and controls. Further, there was a significant increase in severity of dysfunction with increase in severity of disease. CONCLUSIONS: From the present study it is evident that the subjective function of Eustachian tube may be affected by disease process. But, probably the amount of deviation found in function of the eustachian tube is non contributing to cause a conductive hearing loss. Key words:Oral submucous fibrosis, eustachian tube function, tympanometry.

Total sialic acid, total protein and total sugar levels in serum and saliva of oral squamous cell carcinoma patients: A case control study.

BACKGROUND: Detection of cancer at an early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, non-invasive methods like analysis of serum and saliva may provide cost-effective approach for screening a large population. Tumor markers are a major part of secondary prevention and thus, the detection of malignancies. The aim of this study was to evaluate total sialic acid (TSA), total protein and total sugar (TS) in serum and saliva of oral squamous cell carcinoma (OSCC) and controls to assess their role as a diagnostic marker. MATERIALS AND METHODS: Unstimulated whole saliva and sera were collected from 40 squamous cell carcinoma patients and 20 controls. Serum and salivary TSA, total protein and TS estimation was carried out. This was correlated with clinical stages and histopathological grades of OSCC. The data obtained was analyzed statistically using Chi-square test, ANOVA and Student's t-test with SPSS statistical software. RESULTS: A highly significant rise in the salivary sialic acid, serum sialic acid and serum protein was noted in OSCC subjects compared to controls. Salivary protein, serum and salivary sugar did not show any significance. Furthermore, serum and salivary sialic acid levels were found to be significantly increased with increasing level of histopathological grading. CONCLUSION: The present study showed a significant increase in serum sialic acid, salivary sialic acid and serum protein from control to OSCC and suggests that these markers may be reliable in diagnosis and predicting prognosis.

Cyclin d1 expression and its correlation with histopathological differentiation in oral squamous cell carcinoma.

BACKGROUND: Cyclin D1 regulates the G1 to S transition of cell cycle. Its deregulation or overexpression may lead to disturbance in the normal cell cycle control and tumour formation. Overexpression of cyclin D1 has been reported in various tumors of diverse histogenesis. This case control retrospective study was carried out to study the immunohistochemical reactivity and expression of cyclin D1 and its association with site, clinical staging, and histopathological differentiation of oral squamous cell carcinoma (OSCC). METHODS: Forty formalin-fixed paraffin-embedded tissue blocks of biopsy specimens of oral squamous cell carcinoma were immunohistochemically evaluated for expression of cyclin D1. RESULTS: Cyclin D1 expression was seen in 45% cases of OSCC. It did not correlate with site and clinical staging. Highest expression was seen in well-differentiated, followed by moderately differentiated, and poorly differentiated squamous cell carcinomas, with a statistically significant correlation. CONCLUSION: Cyclin D1 expression significantly increases with increase in differentiation.

Lycopene in the management of oral lichen planus: a placebo-controlled study.

CONTEXT: Oxidative stress has been implicated in the pathogenesis of lichen planus, and a lower level of lycopene has been reported in erosive and atrophic oral lichen planus (OLP) patients. However, its efficacy in the management of OLP has not been reported. AIM: This study was designed to assess the efficacy of systemic lycopene in the management of OLP. SETTINGS AND DESIGN: This prospective, randomized, double-blind, placebo-controlled study was done in the Oral Medicine Department of a postgraduate teaching dental hospital in India. MATERIALS AND METHODS: Thirty symptomatic OLP patients, randomly divided into two groups of 15 each, were administered lycopene 8 mg/day and an identical placebo, respectively, for 8 consecutive weeks. Burning sensation using visual analogue scale and overall treatment response using Tel Aviv-San Francisco scale were recorded at every visit. The data obtained were analyzed statistically using Wilcoxon Rank test, Mann-Whitney and Fischer's Exact test. RESULTS: A higher (84%) reduction in burning sensation was seen in lycopene than in the placebo group (67%). All 15 (100%) patients in the lycopene group showed 50% or more benefit and 11 (73.3%) patients showed 70-100% benefit, while this number was only 10 and 4 (26.7%), respectively, in the placebo group. CONCLUSION: Lycopene was very effective in the management of OLP, and oxidative stress may have a role in disease pathogenesis.

Maintaining dental records: Are we ready for forensic needs?

CONTEXT: Dental remains are usually the last to get destroyed among body parts after death. They may be useful for personal identification in cases of mass disasters and decomposed unidentified bodies. Dental records may help in the identification of suspects in criminal investigations and in medicolegal cases. Maintenance of dental records is legally mandatory in most of the European and American countries. Unfortunately, the law is not very clear in India, and the awareness is very poor. AIMS: To assess the awareness regarding the dental record maintenance among dentists in Rajasthan, to deduce the quality of average dental records kept by them and to evaluate the potential use of their maintained records, in any of forensic or medicolegal cases. SETTINGS AND DESIGN: A cross-sectional survey was conducted among 100 dental practitioners of different cities in Rajasthan, India. MATERIALS AND METHODS: Data were collected through a structured questionnaire, which was responded by the study population in the course of a telephonic interview. The questionnaire addressed on the mode of maintaining dental records in their regular practice. STATISTICAL ANALYSIS USED: The data so gathered were subjected for descriptive analysis. RESULTS: As for knowledge or awareness about maintaining dental records, surprisingly a very low percentile (about 38%) of surveyed dentists maintained records. Sixty-two percent of the dentists were maintaining no records at all. CONCLUSION: Nonmaintenance or poor quality of records maintained indicates that the dentists in Rajasthan are not prepared for any kind of forensic and medicolegal need if it arises.