Surgical Correction and Oral Health-Related Quality of Life (OHRQoL) Evaluation of Non-syndromic Congenital Double Lip: A Case Report and Literature Review.

Congenital double lip is a rare clinical finding that is more common in the upper lip, but the lower lip can also be involved in a few cases. It has no gender predilection, and its incidence rate is yet unknown. It can be classified into two types: congenital or acquired. Congenital type results from the persistence of the sulcus between the pars glabrosa and the pars villosa, while the acquired type occurs secondary to trauma and oral habits such as lip sucking and lip biting. It can be syndromic or non-syndromic based on the other systemic involvement. In the present case, a 24-year-old male patient presented to the outpatient department (OPD) with the chief complaint of an excessive tissue fold visible in relation to his upper lip while smiling and talking, which posed an aesthetic concern to the patient and decreased his self-esteem. The oral health-related quality of life (OHRQoL) was taken before and after the treatment to assess patient satisfaction and improvement in quality of life after surgery. The patient was diagnosed with a non-syndromic congenital double lip based on clinical history and oral examination. The surgical removal of excessive lip tissue was done, and the lesion healed completely with no recurrence up to a six-month follow-up. This case report illustrates the uncomplicated surgical treatment for congenital double lips and improves the patient's aesthetic.

A Unique Presentation of Gingival Melanoacanthoma: Case Report and Review of Literature.

Melanoacanthoma is a benign, deeply pigmented condition of the oral mucosa characterized by the proliferation of melanocytes and keratinocytes. A 60-year-old male, with no history of systemic diseases or medical treatment, presented with an asymptomatic diffuse pigmentation involving the maxillary and mandibular gingiva. The histopathology of the anomalous pigmented area was analyzed and the dendritic melanocytes expressed positively for Masson-Fontana, S-100, and HMB-45. The clinical and microscopic findings were indicative of melanoacanthoma. Depigmentation with a diode laser was performed in the areas of esthetic concern. A regular periodic screening was done to rule out any alteration in color, size, and shape. A one-year follow-up disclosed no new lesions. The observations noted in this case are rare, and our literature review identified only a single previously documented case of gingival melanoacanthoma in the Indian subpopulation.

Role of cytokines in development of pre-eclampsia associated with periodontal disease - Cohort Study.

AIM: The present study was designed to find any association of cytokines in women with periodontal disease and development of pre-eclampsia in North Indian population. MATERIALS AND METHODS: A total of 504 consecutively registered primigravida with a single live pregnancy were recruited at 14-18 weeks of gestation from antenatal clinic of Maulana Azad Medical College & associated Lok Nayak Hospital and Maulana Azad Institute of Dental Sciences, New Delhi. One periodontist performed oral health examination of all patients at inclusion into study. Blood samples were collected to measure the level of cytokines IL-4, IL-10, TNF-α and IFN-γ. RESULTS: The profile of blood levels of cytokines from women with periodontal disease was observed. The log serum levels of TNF-α & IL-4 at 16-18 weeks of gestation were significantly higher in women with periodontal disease (4.13 ± 2.06; 0.47 ± 1.56 pg/ml respectively) than in women with healthy gums (2.16 ± 1.51; 0.02 ± 1.84 pg/ml respectively, p < 0.001). Periodontal disease is associated with log serum TNF-α levels at cut-off ≥14.43 pg/ml at sensitivity 71.2% and specificity 62% (OR = 4.04; 95%CI = 2.77-5.87). Woman with periodontal disease who later developed pre-eclampsia had lower levels of TNF-α (3.72 ± 1.33 pg/ml) than those with periodontal disease who did not develop pre-eclampsia (4.20 ± 2.15 pg/ml, p ≥ 0.05). CONCLUSION: Reduced TNF-α level secretion in the early second trimester in women with periodontal disease appears to be associated with the development of pre-eclampsia.

Haim-Munk syndrome.

Haim-Munk syndrome is an extremely rare autosomal recessive disorder of keratinization characterized clinically by palmoplantar hyperkeratosis, severe early onset periodontitis, onychogryphosis, pes planus, arachnodactyly, and acro-osteolysis. Recently, germline mutations in the lysosomal protease cathepsin C gene have been identified as the underlying genetic defect in Haim-Munk syndrome and in the clinically related disorders, such as Papillon-Lefèvre syndrome and prepubertal periodontitis. The periodontal disease associated with these syndromes is particularly aggressive and unresponsive to traditional periodontal therapies. As a result, most patients become edentulous by 15 years of age. This case report describes a patient with the cardinal features of Haim-Munk syndrome.