Acetic acid versus toluidine blue as screening tools for oral potentially malignant disorders.

Background: Diagnostic adjuncts such as toluidine blue have been investigated as screening tools that improve visual examination of potentially malignant disorders (PMD) and oral cancer. Acetic acid has been reported to be of value in the early detection of cervical cancers. This study assessed the utility of 5% acetic acid as a diagnostic adjunct in oral PMD and compared the accuracy of acetic acid with toluidine blue in the detection of dysplastic PMD and high-risk lesions. Materials and Methods: This cross-sectional study was conducted at a dental hospital in a rural setting. Thirty-one patients with oral PMD formed the study group. Five percent acetic acid was applied to the lesions, followed by toluidine blue application and biopsy. Sensitivity, specificity, and positive and negative predictive values were computed considering true positives as stain uptake in dysplastic and high-risk PMD. Results: The sensitivity, specificity, and positive and negative predictive values of acetic acid for identifying dysplastic or malignant lesions were 100%, 13.3%, 51.2%, and 100%, respectively, and that for toluidine blue were 75%, 100%, 100%, and 78.9%, respectively. The corresponding values for identifying high-risk PMD (lesions with moderate and severe dysplasia) using acetic acid were 100%, 9.1%, 25.9%, and 100%, respectively, and for toluidine blue were 85.7%, 81.8%, 60%, and 94.7%, respectively. Conclusion: The utility of acetic acid in detecting dysplasia and high-risk PMD is severely limited due to its poor specificity. Compared with acetic acid, toluidine blue is a superior screening tool.

Variable antifungal activity of curcumin against planktonic and biofilm phase of different candida species.

OBJECTIVE: To evaluate the in vitro antifungal activity of curcumin against 2 strains of Candida albicans (ATCC 90028 and a clinical isolate - JY strain) and 1 isolate each of 3 nonalbicans - Candida species [Candida parapsilosis (ATCC 22019), C. glabrata (ATCC 90030), and C. dublieniensis (MYA 646)]. MATERIALS AND METHODS: Planktonic MIC of the 4 Candida species was determined using micro broth dilution assay according to CLSI M27-A3 criteria. The biofilm development and sensitivity assay were performed with the 2 C. albicans strains. RESULTS: Curcumin at high concentrations (0.1-2 mg/mL) was effective in inhibiting planktonic organisms of all the 5 tested Candida strains. The planktonic phase and the biofilm phase of C. albicans ATCC 90028 exhibited similar MIC values for curcumin (0.5 mg/mL). Both curcumin and fluconazole were ineffective against the mature biofilms of JY strain. CONCLUSION: Our results reported here for the first time, in particular for the biofilm state of C. albicans, imply that curcumin a natural product could be used as a therapeutic alternative to conventional antifungals although further investigations are required to evaluate its potential.

Prevalence and risk indicators of oral mucosal lesions in adult population visiting primary health centers and community health centers in Kodagu district.

BACKGROUND AND OBJECTIVE: Utilization of primary health center (PHC) and community health center (CHC) could be one of the few practical approaches in early detection of oral cancers and potentially malignant disorder (PMD). This study was designed to estimate the prevalence and distribution of oral mucosal lesion (OML) and its associated risk factors among the adult population of Kodagu district. METHODOLOGY: 1048 patients, 18 years of age and above, attending the outpatient department of PHC and CHC in Kodagu district comprised the study population. The World Health Organization Oral Health Assessment Form, cinical examination, and demographic factors were recorded using a proforma. Chi-square test and contingency coefficient and logistic regression were applied to check statistical differences. RESULTS: The overall prevalence of OML was found to be 18.89%. Prevalence of PMD was 5.63%. Prevalence of PMD was highest among the elementary occupation (15.63%). Two cases of oral cancer were identified. There was a significant association of PMD with the age group of 41-60 years. Leukoplakia was strongly associated with male gender [odds ratio (OR) 2.83, P < 0.001]. Smoking and chewing were significant risk factors associated with leukoplakia (OR 11.05, P < 0.001) and oral submucous fibrosis (OR 4.63, P < 0.001), respectively. CONCLUSION: The overall prevalence of OML in the study population was 18.89%. A high prevalence of PMD in the population could be attributed to the associated risk factors such as smoking, chewing habits, and alcohol use. Utilization of PHC and CHC could be a useful strategy to detect previously undiagnosed OML including PMD and cancerous lesions among the population.

Low-level laser therapy: A novel therapeutic approach to temporomandibular disorder - A randomized, double-blinded, placebo-controlled trial.

AIMS AND OBJECTIVE: The objective of this study was to assess the effectiveness of low-level laser therapy (LLLT)/low intensity laser therapy (LILT) in the management of temporomandibular joint (TMJ) pain in a random and double-blind research design. MATERIALS AND METHODS: TMJ pain patients, randomly assigned into two groups: Group 1 (n = 20) and Group 2 (n = 20), received 2-3 treatments per week for 8 sessions of active LILT with diode laser (gallium aluminum arsenide, 810 nm, 0.1 W). Measures of TMJ pain during function were evaluated at baseline, after completion of 8 sessions of laser treatment, and 30 days after the final laser therapy. RESULTS: At the final treatment point, within-group, pain reduction was observed in both active LLLT and placebo groups at day 0 (P = 0.000), 8th session (P = 0.000), and 1 month (P = 0.001). Between the groups, there is no significant difference at day 0 (P = 0.214), 8th session (P = 0.806), and 1 month (P = 0.230). Significant increased mouth opening was observed in both Group 1 and Group 2 (P = 0.006 and P = 0.021, respectively) after treatment. However, no significant difference was found between the two groups (P = 0.330). Furthermore, significant improvement in clicking was recorded before and after treatment both in Group 1 (P = 0.000) and Group 2 (P = 0.001). CONCLUSION: The study suggests that LLLT is not better than placebo at reducing TMJ pain during function. It may be assumed that a more tailored application of LLLT should be developed to take into account the multifactorial aspect of the disorder.

Utility of two methodologies in the clinical assessment of oral dryness in postmenopausal women.

OBJECTIVE: The aim of this study was to assess the oral dryness in postmenopausal women and to correlate the salivary flow rate determined by sialometry with the clinical oral dryness score (CODS) obtained from Challacombe Scale. To correlate between subjective and objective oral dryness and relationship of salivary flow rate with that of the duration of menopause. MATERIALS AND METHODS: Sixty postmenopausal women were questioned regarding their oral dryness status and the duration of menopause. Patients complaining of xerostomia formed the case group and rest formed the control group. CODS was assessed based on the 10 features of oral dryness. Unstimulated whole salivary (UWS) flow rate was assessed by sialometry for 5 min. RESULTS: Highly significant negative correlation was observed between UWS and CODS (r = -0.651), low negative correlation was noted between the duration of menopause and UWS flow rates (r = -0.159), and no significant correlation was found between subjective oral dryness with that of UWS flow rates (P = 0.0964). There was no statistically significant difference between case and control group with regard to CODS (P = 0.525). CONCLUSION: A good correlation of CODS with sialometry scores indicates that CODS can be utilized for semiquantitative assessment of oral dryness. It appears that UWS has poor correlation with duration of menopause. Xerostomia and UWS were not significantly related.

Steven Johnson syndrome due to I.V Ceftriaxone--a case report.

Steven-Johnson syndrome (SJS) is a rare vesiculobullous disease characterized by an acute cutaneous eruption that ivolves the skin and mucous membranes including those of the oral cavity. A rare case of Steven-Johnson syndrome, an unexpected treatment response, in a 25-year-old female patient due to administration of intravenous Cefriaxone (1 gm), a third generation cephalosporin has been reported and literature reviewed.

Adenomatoid odontogenic tumor of the mandible with unusual radiographic features: A case report.

Adenomatoid odontogenic tumor (AOT) usually presents as a unilocular, pericoronal radiolucency in the maxillary anterior region in adolescent females. Very few conditions occur in such a narrow age range and at such a restrictive site. Rarely, these tumors present with varied clinical features. A case of AOT of the mandible is reported with unusual features such as large size, multilocular appearance, and aggressive behavior. The role of radiology in diagnosis of atypical AOT is extremely important. The unique radiological manifestations of the lesion helped in the diagnosis, and it was managed conservatively with no evidence of recurrence.