Mucormycosis- A Case Report

Mucormycosis, an aggressive and opportunistic fungal infection caused by Rhizopus sp., Mucor, and Lichtheimia, poses a significant challenge in the post-COVID era. Previously considered a rare occurrence, mucormycosis has witnessed a surge in cases, particularly affecting the nose, paranasal sinuses, and cerebral tissue. These fungal pathogens exhibit a destructive behaviour, eroding small blood vessels and leading to thrombosis, ischemia, and tissue necrosis. Patients with compromised systemic health, such as diabetes mellitus, leukemia, and immunosuppressive therapy, are particularly susceptible to this infection due to impaired immunity. The various clinical manifestations of mucormycosis are categorized into rhinocerebral, pulmonary, cutaneous, gastrointestinal, and disseminated forms. Within the rhinocerebral form, subdivisions based on the affected tissues further refine the classification like rhino-orbital, rhino-sino-orbital, rhino- orbito-cerebral. Fungal culture remains a cornerstone for identifying the causative organism, while magnetic resonance imaging is the gold standard for radiological evaluation, offering detailed imaging of the affected regions. Computed tomography scans also play a crucial role in the diagnostic pathway. With dental practitioners encountering an increasing number of mucormycosis cases, Cone Beam Computed Tomography has emerged as a valuable diagnostic tool. Recent advancements have led to the development of diagnostic criteria based on CBCT findings, aiding in the accurate and timely diagnosis of mucormycosis. We report a case of mucormycosis affecting maxilla highlighting the importance of CBCT in addition to conventional diagnostic methods thereby improving its management and clinical outcome.

Evaluation of incidence of mental nerve loop in Central India population using cone beam computed tomography

Anatomical literature has described the anterior loop being an extension of the mental nerve which is present anterior to the mental foramen while the caudal loop has been described as the distance between the lower border of the mental foramen and the lowest point of the mandibular canal. The knowledge and identification of the anterior and caudal loop of the mental nerve are important in surgical procedures performed around the mental foramen to avoid inadvertent damage to these vital structures resulting in postoperative complications. Aim: The present study was conducted to determine the incidence and measurement of mental nerve loop in the mandibular arches using cone beam computed tomography (CBCT). Settings and Design: A total of 200 CBCT images were retrieved and inspected for the presence of the mental nerve loop. The length of the anterior loop was measured by counting the number of consecutive contiguous vertical cross sections displaying two round hypodense images. This number was multiplied by the thickness of the slices. The caudal loop was measured as the distance between the lower border of the mental foramen and the lowest point of mandibular canal. Statistical Analysis Used: Shapiro–Wilk test and Mann–Whitney U-test were used. P < 0.05 was considered statistically significant. Results: 57.5% (n = 200 scans) presented with the anterior loop of the mental nerve with a mean length of 0.50 mm and 0.37 mm on the right side and left side, respectively. All the samples of CBCT scans taken were having caudal loop extension with a mean length of 3.53 mm. Conclusion: A considerable number of individuals (57.5%) in the present study presented with the anterior loop of the mental nerve. CBCT was found to be an effective imaging modality for the detection of anterior loop of the mental nerve.

Foramen magnum as a tool for sexual dimorphism: A cone beam computed tomography study.

Background and Objectives: (1) To evaluate dimensions of the foramen magnum (FM) among males and females and to establish its role in sexual dimorphism using cone beam computed tomography (CBCT). (2) To evaluate sagittal diameter, transverse diameter, area, and circumference of FM among males and females. Materials and Methods: Two hundred and eighty CBCT scans (140 males and 140 females; age range, 20-80 years) were selected for this study. The sagittal diameter, transverse diameter, area, and circumference of FM were measured, and data were subjected to discriminant analysis for the evaluation of sexual dimorphism. Results: The area of FM was the best discriminant parameter which is used to study the sexual dimorphism with an overall accuracy of 72%. Interpretation and Conclusions: It can be concluded that the reconstructed CBCT image provides valuable measurements for the FM and could be used for sexing even when other methods are inconclusive.

Evaluation of proximity of mandibular molars and second premolar to inferior alveolar nerve canal among central Indians: A cone‑beam computed tomographic retrospective study.

Context: A study was done to assess the average distances of root apices of mandibular first molar, second molar, and second premolar to inferior alveolar nerve canal (IANC), among males and females in central India. Materials and Methods: High‑resolution full‑volume cone‑beam computed tomography (CBCT) scans were obtained from the radiology database at the Sri Aurobindo College of Dentistry, Indore. After scrutinizing the database, CBCT of 40 males and 40 females that conformed to the inclusion and exclusion criteria were selected for the study. Results: All the data were analyzed using SPSS, Version 16. Descriptive statistics of the variables and measurements are presented using Students t‑test (paired and unpaired), and correlation between age was tabled by Karl Pearson’s correlation coefficient method. Conclusion: For the second premolar, the average distance to the IANC was 0.88–13.03 mm for males and 0.00–5.49 mm for females. The average distance of IANC to the mesial root apex of first molar was 1.46–13.23 mm for males and 0.93–8.03 mm for females. For the second molar, the average distance was 1.31–14.71 mm for males and 0.00–6.91 mm for females (values on left side were shorter as compared to right side). In the overall population, only second molar exhibited significant difference in the distance from root apex to IANC when compared bilaterally. In addition to gender differences, age‑related differences were found to be significant for the first molar on left side and second molar on the right side of the population (P < 0.05).

Cervical Vertebral Metastasis from Tongue Carcinoma: A Rare Case Report and Review.

Head and neck cancers are emerging as major health problems in India. In 2010, head and neck cancer was ranked as the sixth leading cause of cancer death worldwide. Approximately 481,100 new cases developed, and 320,000 persons died of this disease, resulting in an average mortality rate of 7.3 and 3.2 per 100,000 males and females, respectively. Oral squamous cell carcinoma is the most common head and neck malignancy having a propensity for the locoregional spread. Vascular invasion is very rare when compared to lymphatic spread. Most frequent sites of distant metastasis are lung, bone, liver, adrenals, heart, and kidney. We report a rare case of 39-year-old male with cervical vertebral metastasis from tongue carcinoma which is 9th case reported according to literature.