Levamisole Monotherapy in Treatment of Oral Lichen Planus-A Clinical Study

Background Oral lichen planus is a chronic inflammatory disease of oral mucosa which rarely undergoes spontaneous remission and has potential for malignant transformation. There are several different kinds of treatment that have been used to treat chronic oral lichen planus. Most commonly advised treatment is steroid therapy to treat oral lichen planus either in topical form or systemically. As steroid therapy has various underlying adverse effects other alternative drug has to be used in the treatment of oral lichen planus. Objective The aim of the study is to evaluate the efficacy of levamisole monotherapy in oral lichen planus. Methods Seven patients who had oral lichen planus were treated with levamisole 50 mg thrice daily for 3 consecutive days and not administered for the following 4 days. Result After 2 weeks of treatment, four patients reported with partial response, three patients had no response and no patients showed clearance of the lesion. Furthermore, after 2 months of treatment, five patients showed clearance of lesion, one patient showed partial response and one patient had no response to therapy. There were no significant side effects noted. Conclusion Levamisole therapy can be a substitute to steroid therapy in treating oral lichen planus in patients who can't take steroids.

Reduction and Fixation of Zygomatic Complex Fractures with Miniplates at the Fronto-zygomatic Suture and Zygomatic Buttress Area-A Clinical Study

Background Zygomatico-maxillary complex fractures are one of the most frequently occurring injuries of the facial skeleton due to its position and also the facial contour. The principal aetiologic factors that may result in zygomatic bone fracture include assaults, road traffic accidents and also falls. There are many methods of fixation that have been applied for treatment of zygomatic arch fractures. Aim To reduce and fix the zygomatic complex fracture using miniplates at the fronto-zygomatic suture and zygomatic buttress area. Material and method The present study includes five cases of zygomatic complex fractures who visited the Department of Oral and Maxillofacial Surgery in Government Dental College and Hospital, Hyderabad. The operative procedure adopted was the lateral bow incision for exposure of fronto-zygomatic suture, the Gillie temporal approach for reducing the zygoma and intra-oral incision for exposure of zygomatic buttress fracture. Fixation was done with miniplates at the fronto-zygomatic suture and the zygomatic maxillary buttress suture. Result All the cases were successfully treated without any post-operative complications and with uneventful restoration of aesthetics and function.

A Case Report on Marfan Syndrome

Marfan syndrome (MS) is a disorder of the connective tissues characterised by various phenotypical and genetic manifestations. About 75% of the time, the condition is inherited from a parent, whereas 25% of the time, it is a new mutation. It involves a mutation to the gene that makes fibrillin. People with Marfan tend to be tall and thin, with long arms, legs, fingers and toes. They also typically have long face, prognathic maxilla, high arched palate, irregularly aligned teeth, flexible joints and scoliosis. The most serious complications involve the heart and aorta with an increased risk of mitral valve prolapse and aortic aneurysm. Other commonly affected areas include the lungs, eyes, bones and the covering of the spinal cord. Here, we report a case of Marfans syndrome with focus on oral manifestations to increase the awareness among dental practitioners to avoid complications due to infective carditis and cardiac defects.

Papillon-Lefevre Syndrome-A Report of Two Cases

Papillon-Lefevre syndrome is a rare autosomal recessive trait characterised by palmoplantar hyperkeratosis and precocious loss of both deciduous and permanent teeth. The aetiology is multifactorial with genetic, immunological, microbiological factors being considered a main etiopathogenic factors. We present here two cases of two siblings affected with Papillon-Lefevre syndrome.

Evaluation of Plasma Fibrinogen Degradation Products and Total Serum Protein Concentration in Oral Submucous Fibrosis

Background Oral submucous fibrosis (OSF), a potentially malignant disorder, is a chronic, inflammatory, progressive debilitating disease of the oral cavity with a multifactorial etiology. As an inflammatory response, more fibrinogen and its degradation products are produced by the body in OSF patients. Detection of these plasma fibrinogen degradation products (FDP) in OSF patients has contributed a new direction to enlighten the etiopathogenesis of OSF. Objectives To ascertain the role of FDP of OSF patients in betel nut chewers and in control subjects and also to estimate serum levels of proteins in the patients. Materials & Methods The study included 25 clinically diagnosed oral submucous fibrosis patients with betel nut chewing habit & 25 healthy controls without any deleterious habits. All the patients were evaluated for fibrinogen degradation productions and total serum protein concentration (TSP) by agglutination and Biuret method respectively. The results were analysed using unpared ttest and Pearson chi square test. Results The study revealed an increased FDP level in all the betel nut chewers with OSF when compared with the healthy individuals. There was a marginal increase in Total serum Protein concentration levels in OSF patients, thus inferring to a positive correlation between FDP and TSP in all OSF cases. Conclusion This study validates the relationship of plasma FDPs in the etiology of OSF and can be used to measure the prognosis of the disease. Plasma FDP may also be useful as a nonsurgical diagnostic tool in suspected OSF cases without necessitating a histopathological confirmation. However, further studies with a larger sample size may be required to elucidate the precise role of plasma FDP levels and detailed fractional analysis of protein in OSF, thus facilitating to obtain more conclusive results. It can be suggested that biochemical assessment of patients with areca nut chewing habit may help in the earlier diagnosis of OSMF and thus may lead to a better prognosis of these lesions.

A Comparative Study of Micronuclei in Oral Exfoliated Epithelial Cells in Potentially Malignant and Oral Squamous Cell Carcinoma

Background Micronuclei are small, additional nuclei formed as a result of exclusion of chromosome fragments or the whole-chromosome lagging at mitosis. Micronuclei indirectly reflect the chromosomal breakage or impairment of mitotic apparatus. Micronuclei in exfoliated oral epithelial cells are widely used as biomarkers of chromosomal damage, genome instability and cancer risk in humans. Micronuclei scoring can be used as a biomarker to identify different preneoplastic conditions much earlier than manifestations of clinical features and might specifically be exploited in screening of high-risk population for a specific cancer. Aim To correlate frequency of micronuclei in oral exfoliated cells in clinically diagnosed cases of potentially malignant disorders (PMDs) and oral squamous cell carcinoma. Material and Methods The study subjects consisted of clinically and histopathologically diagnosed cases of oral squamous cell carcinoma, oral sub mucous fibrosis and leucoplakia. Healthy subjects without any tobacco consumption habits formed the control group. The cytosmear from all the four groups were stained with Papanicolaou stain. Micronuclei were identified according to the criteria given by Tolbert et al. (1992). Result The frequency of micronuclei was higher in patients with oral squamous cell carcinoma as compared to the other subject groups and the difference was found to be highly significant. Conclusion This study concluded that there is gradual increase in micronuclei counts from normal oral mucosa to PMDs to oral carcinoma.