Comparative and clinical evaluation between piezoelectric and conventional rotary techniques for mandibular impacted third molar extraction.

Purpose: The aim of this study was to evaluate and compare the operative and postoperative outcomes of the mandibular impacted third molar removal using piezoelectric technique and conventional rotary bur technique. Settings: The study was conducted in the department of oral and maxillofacial surgery between January 1, 2019, and January 1, 2020. Materials and Methods: Thirty patients, with an age of 18-40 years, with asymptomatic bilateral impacted mandibular third molars, were selected for the study and randomly surgical extraction was done either using piezoelectric or the conventional rotary bur technique on each site. The intraoperative time taken, postoperative pain, swelling, and trismus were assessed over a follow-up period of 7 days postoperatively. Results: Study and control groups were compared using paired t-test. There was statistical significance in reduction of pain and swelling in the study group where the duration of surgery was increased in the study group. Conclusion: Even if piezoelectric technique takes more time but can be used safely as another technique to conventional surgical method with surgical bur and handpiece for removal of impacted mandibular third molars.

Evaluation of biphasic hydroxapatite and ß-tricalcium phosphate as a bone graft material in the treatment of periodontal vertical bony defects - A clinical and digital radiological measurement study.

Aims and Objective: The present study aimed to evaluate 2 bone graft materials, that is, biphasic hydroxyapatite and ß-tricalcium phosphate, in the treatment of periodontal vertical bony defects. In term of attachment level, probing depth and radiographic bone level changes. Also, a new digital method of radiographic assessment was used for measurement of vertical bone defect. Material and Methods: Ten subjects with periodontitis and having two or more vertical bony defects were enrolled in the study. Patients were classified randomly into 2 groups. Group I consisted of the experimental site where defect was filled with biphasic hydroxyapatite and ß-tricalcium phosphate graft and Group II consisted of control site where only the open flap debridement (OFD) was carried out. Clinical parameters were evaluated at baseline, 3 and 6 months; Radiographs were taken at baseline and 6 months after surgery. Results: Overall, by the end of 6 months, biphasic hydroxyapatite and ß-tricalcium phosphate and OFD treatment groups exhibited a significant reduction in probing depth almost by 75% and gain in clinical attachment level at follow-up. In the biphasic hydroxyapatite and ß-tricalcium phosphate group, radiographic bone level gain appeared to be greater than in the OFD group. Conclusion: In the present study, biphasic hydroxyapatite and ß-tricalcium phosphate have shown promising results and have showed reduction in probing depth, a resolution of osseous defects and gain in clinical attachment level when compared to open flap debridement.

Saliva as a Potential Diagnostic Tool to Evaluate Relationship between Oral Microbiome and Potentially Malignant Disorders for Prevention of Malignant Transformation.

OBJECTIVE: The current research was conducted with an aim to assess the association of oral microbiome with Potentially malignant disorders (PMDs) because usage of tobacco in any form alters the normal microbiome and shifts it towards dysbiosis. Thus, our definitive knowledge of the oral commensal bacteria and oral cancer link can definitely be used as a potential adjunct to early diagnosis and management of PMDs and prevent it's malignant transformation. STUDY DESIGN: A total of 100 individuals of minimum 18 years of age were included in the study which, were classified into 2 groups of tobacco users (50) and non-tobacco users (50). The tobacco users had a history of tobacco consumption for at least 5 years. RESULTS: The present study, showed highest percentage (72%) of anaerobic bacteria, followed by aerobic (22%) and lowest count of yeast (4%). CONCLUSION: The ecological shift to dysbiosis is a significant finding in oral carcinogenesis. Further investigation on a larger group of altered microbiomes will definitely help in establishing relationship of altered microbiome and PMDs, which can help in appropriate treatment and better prognosis.

Aggressive type of central giant cell granuloma in a woman on hormone replacement therapy: a histopathological insight.

Quite a few lesions of the oral cavity specifically of the gingiva have a greater inclination towards women and mostly occur during the first four decades of life, the cause of which may be credited to the changing levels of sex hormones. Out of all such lesions, one lesion whose aetiology is still unclear and which originats from the periosteum or periodontal ligament is central giant cell granuloma. Repeatedly, it is has been described as a reactive lesion, the cause of which may be secondary to local irritants or trauma, specifically plaque or calculus, which is not considered to be a true neoplasm. Here we present a case of a 51-year-old female patient with aggressive gingival growth within 10-13 months of hormonal replacement therapy. The aetiology, histological features and appropriate treatment are discussed in the light of current literature.

Hybrid ameloblastoma: a mystified histopathological entity.

Ameloblastoma a benign neoplasm of the maxillofacial region has been divided into various histopathological types by WHO. A more complex and confusing type includes hybrid type, which as the name suggest include more than two variants mostly histopathological. Various authors have reported cases of this type but the exact histopathological features are still unclear and each case that is being reported add to the literature, which further strengthens its histopathological feature. Also, this is a lesion whose clinical and radiographical features are similar to all the variants and a definitive diagnosis is achieved by histopathology only. Here, we present a case of hybrid ameloblastoma with striking and unique histopathological features.

Correlation of E-cadherin Immunohistochemical Expression with Histopathological Grading of Oral Squamous Cell Carcinoma.

OBJECTIVES: The current research was undertaken with an aim to correlate the expression of E-cadherin with histopathological grading in oral squamous cell carcinoma (OSCC) patients. Further, the objectives of the study were to evaluate the qualitative and quantitative expressions of E-cadherin in OSCC and to correlate the number of tumor cells of OSCC, immunopositive for E-cadherin with histopathological grading of OSCC. MATERIALS AND METHODS: Immunoexpression of E-cadherin antibody was evaluated in previously diagnosed, paraffin-embedded sections of 20 tissues each of well-differentiated and moderately differentiated OSCC, 17 tissues of poorly differentiated OSCC, and 10 tissues of normal oral mucosa; Chi-square test, analysis of variance, and Tukey's honestly significant difference test were employed for statistical analysis. RESULTS: E-cadherin immunoreactivity was inversely correlated to the loss of cell differentiation. There was a significant decrease in expression of E-cadherin (P < 0.0001) in advanced cases of OSCC. Furthermore, there was a significant reduction in intensity of E-cadherin expression with advancing histological grades of OSCC. CONCLUSION: From the present study, it is concluded that the reduced expression of E-cadherin may be a reliable indicator of increase in the invasiveness of OSCCs.

Prevention of Malignant Transformation of Oral Leukoplakia and Oral Lichen Planus Using Laser: An Observational Study

Objectives: The present observational study was conducted with an aim to evaluate the efficacy of diode laser in management of homogenous oral leukoplakia (OL) and reticular oral lichen planus (OLP), so that these potentially malignant disorders can be limited and further malignant transformation can be prevented. Further the assessment of associated postoperative complications after laser therapy was also carried out. Study Design: Present study was carried out using diode laser 810nm on 60 subjects, of whom 30 subjects were of homogenous OL and 30 subjects were of reticular OLP aged between 20 ­ 60 years, the diagnosis of which was histopathologically confirmed. Results: Of the 60 subjects none complained of pain during and immediately after surgery with no bleeding at any stage of the procedure. By the end of 3rd day post operative most subjects reported no pain and swelling and very few subjects had negligible pain and swelling when evaluated. On subsequent follow-up of 1,2 and 4 week(s) none of the subject reported of pain, swelling or bleeding and it was noted that all the areas treated with laser had healed without scarring with no signs of recurrence. Fibrosis was seen in two male patients and one female patient treated for OL and OLP respectively. Conclusion: Patient compliance and contentment without any postoperative complications were observed to be of high degree in the present study. Thus diode laser can be considered as a best alternative to conventional surgical treatment modality in managing OL and OLP and preventing its further transformation.

Evaluation of Collagen in Leukoplakia, Oral Submucous Fibrosis and Oral Squamous Cell Carcinomas Using Polarizing Microscopy and Immunohistochemistry

Objectives: Picrosirius red and MMP are capable of degrading extracellular matrix proteins, expressed in lesions such as squamous cell carcinomas. The present study was undertaken with an aim to analyze and compare changes in collagen using Picrosirius red staining under polarizing microscopy and immunohistochemical staining using anti MMP-13 in samples of oral leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma. Materials and Methods: A total of 70 slides were prepared and divided into 3 groups. Group I comprised 10 slides of normal gingival tissue, Group II 40 slides of potentially malignant disorders and Group III 20 slides of well differentiated oral squamous cell carcinoma. Half the slides for each group were stained with Picrosirius red stain and the remainder with antibodies to MMP-13. Rerults: In Group II, MMP-13 connective tissue expression was greater in OSMF as compared to leukoplakia. Group III showed elevated expression among 70% of cases. Picrosirius red staining in Group II cases, showed higher staining Yellow-Orange andGreen-Yellow mature fibers in OSMF than leukoplakia cases while in Group III, 50% OSCC cases showed Green-yellow stained immature thin fibers. Conclusion: In future, therapeutic measures targeted against MMP-13 may inhibit collagenolysis to some extent and delay spread of tumors. An easy and reliable method to determine the state of the stroma in such cases may be Picrosirius red staining with polarizing microscopy.

Primary oral tuberculosis on the tongue mimicking squamous cell carcinoma.

Tuberculosis is chronic granulomatous disease with rare oral manifestations. But if so are overlooked by most of the health care professionals. Clinically, most of the times, a tuberculous ulcer may mimic an ulcer of malignant origin and may be misdiagnosed. So, keeping in mind the etiology and the nature of the ulcer, it should be differentially diagnosed and a histopathological examination should only confirm the final diagnosis of the ulcer.

Atypical CT Findings in Plexiform Ameloblastoma.

Ameloblastoma is an uncommon epithelial odontogenic neoplasm that is nonmineralized, locally aggressive, and, in most cases, benign. Most ameloblastomas develop in the molar-ramus region of the mandible with 70% of them arising in the molar-ramus area. Radiologically they are unilocular or multilocular radiolucency with a honeycomb or soap bubble appearance. The radiographic appearance of ameloblastoma can vary according to the type of tumor. CT is usually helpful in determining the contours of the lesion, its contents, and its extension into soft and hard tissues. Through this case we would bring to light some of the unusual CT findings which include the destruction of the surrounding structures by the lesion which appeared to be normal routine lesion when viewed clinically.