White spongy nevus: a nonhereditary presentation.

White spongy nevus (WSN) is a rare hereditary dyskeratotic hyperplasia of the mucous membranes. It is an autosomal dominant disorder with variable penetrance. A few cases of WSN occur due to de novo mutations. We report a case of WSN in a 12-year-old female child, with none of her family members having similar lesions.

Stature estimation using odontometry and skull anthropometry.

OBJECTIVE: To investigate the possibility of estimating height from odontometry and anthropometric data of the skull for the positive identification of height in forensic investigations concerned with fragmentary human remains. MATERIALS AND METHODS: The study was carried out on 100 Mysorean patients, 50 males, and 50 females. Measurements of mesiodistal widths of the six maxillary anterior teeth, circumference of the skull, and height were made directly on each patient. Anteroposterior diameter of the skull was obtained on the lateral cephalograph. The data collected were subjected to statistical methods. The known heights of the combined data, data for males, and females were regressed against the odontometric and anthropometric variables using linear regression analysis. RESULTS: Significant sexual dimorphism was observed for the parameters studied ( P 0.05). Highly significant correlation was found between height and other parameters when combined data and data for males were regressed. The equation relating height to the combined mesiodistal width of maxillary anterior teeth was derived as height = 982.421 + 13.65 x combined mesiodistal width of maxillary anterior teeth ( P 0.0001). Similarly equations were obtained by regressing height to head circumference and skull diameter ( P 0.0001 for both). The above findings may hence provide reliable method of estimation of height from skeletal remains in the forensic setup.

Facial plexiform neurofibroma in a child with neurofibromatosis type I: a case report.

Plexiform neurofibroma is a non-circumscribed, thick and irregular benign tumor of the peripheral nerve sheath. It is a virtually pathognomonic and often disabling feature of neurofibromatosis type I. The diffuse and soft nature of plexiform neurofibroma is often compared to 'a bag of worms' and is difficult to distinguish from a vascular malformation or a lymphangioma, thus necessitating thorough clinical and histopathological examination and imaging of the lesion. We present a case of plexiform neurofibroma in a 12-year-old male child.

Burkitt's lymphoma in an Indian girl: a case report.

Burkitt's lymphoma (BL) is a rare monoclonal proliferation of B-lymphocytes and is classified as a poorly differentiated lymphocytic lymphoma. This tumor was first noted in Africans. The cause of this tumor is debatable, but strong evidence implicates Epstein-Barr virus in its development. This tumor predominantly affects children and is probably the fastest growing tumor in humans, with exuberant proliferation. It is a very rare malignancy accounting for only 0.76% of solid malignant tumors among Indian children. A case of BL of the mandible in a 9-year-old girl of Indian origin is reported.

Klestadt's cyst: a rarity.

Klestadt's cyst, more commonly known as the nasolabial cyst is an uncommon, non-odontogenic, soft tissue cyst characterized by its extra osseous location in the nasal alar region. Following its description first by Zukuerkandl in 1882, only 267 cases have been found in English literature. A case of nasolabial cyst in a 30-year-old female patient is presented.

Malignant peripheral nerve sheath tumour: an elusive diagnosis.

Malignant peripheral nerve sheath tumour (MPNST) also termed as spindle cell malignancy of the peripheral nerve Schwann cells or neurogenic sarcoma, represents approximately 10% of all soft tissue sarcomas. This tumour is usually found in the lower extremities and only 10-12% of all lesions occur in the head and neck region, which makes it a rare entity. The diagnosis of MPNST has been described as one of the most difficult and elusive diagnosis in the soft tissue diseases because of its non-specific presentation both clinically and histopathologically. This was overcome by the use of immunohistochemistry. A case of MPNST of the left maxillary antrum in a 45 -year -old male patient is reported.

Extragingival pyogenic granuloma.

Pyogenic granuloma is a well-known localized granulation tissue overgrowth in reaction to mild irritation. Although it is known to show a striking predilection for the gingiva, it can be found extragingivally with varying clinical features that sometimes may mimic more serious lesions such as malignancies. The clinical diagnosis of such an uncommon extragingival pyogenic granulomra can be quite challenging. The purpose of this article is to report an unusual case of extragingival pyogenic granuloma occurring on the lower lip, which presented as a cutaneous horn.

Sinonasal verrucous carcinoma with oral invasion.

Verrucous carcinoma is a rare warty variant of squamous cell carcinoma, most often seen in the oral cavity and larynx. Its occurrence in the sinonasal tract is rare. This tumor constitutes approximately 1% of all sinonasal neoplasms. The clinical presentation and the histopathological features of verrucous carcinoma are a subject of continuous discussion amongst diagnosticians and pathologists. A case with oral and nasal presentation of this tumor is reported here.

Papillary cystadenoma lymphomatosum: case report and review of literature.

Papillary Cystadenoma Lymphomatosum or Warthin's tumour is a unique neoplasm arising almost exclusively in the parotid salivary gland and is composed of oncocytic epithelium with a prominent lymphoid infiltrate. The tumor is usually asymptomatic and may be associated with varying degrees of pain not necessarily an indication of malignant transformation in the tumour. The tumour is managed easily by surgical excision. This article presents a typical case arising in the right parotid gland of a 73-year-old male with review of literature of this rare tumour.

Juvenile nasopharyngeal angiofibroma.

Juvenile nasopharyngeal angiofibroma is a rare, histologically benign yet locally aggressive, vascular tumor that typically affects adolescent males. It accounts for 0.5 percent of all neoplasms of the head and neck. A case of juvenile nasopharyngeal angiofibroma manifesting in the oral cavity in a 20-year-old male patient is presented and discussed.

Palatal rugae pattern in Mysorean and Tibetan populations.

OBJECTIVES: To compare the palatine rugae pattern of Mysorean and Tibetan subjects, to assess the predominant palatine rugae pattern in Mysorean and Tibetan population, and to determine the uniqueness of palatine rugae pattern in an individual. MATERIALS: Maxillary study models of 60 subjects each (30 males and 30 females) of age group 17-23 years, of Mysorean population and Tibetan population were assessed for the length, shape, and unification of rugae based on the classification by Lysell et al. The palatine rugae were compared for the above mentioned parameters. 2 way ANOVA and Chi square tests were used for statistical analysis. RESULTS: Statistical analysis showed that males had significantly more number of total rugae on the right compared to the left side in both populations. Indian males had more primary rugae on the left side as compared to females and vice versa for the Tibetan population. Also, Indian males had more number of curved rugae on both right and left sides than Tibetan males and Tibetan females had more wavy rugae on right and left sides than Indian females. In other aspects, no significant difference or association was found. CONCLUSIONS: A statistically significant association between the total number of rugae and the gender in both the study populations exists. Parameters like the length and shape of the rugae show racial differences.

Enriched vascularity in ameloblastomas, an indeterminate entity: Report of two cases.

Vascularity is a highly essential element that is required for the growth, development, and functioning of the body and variations in it can cause pathologies. It is one of the prime features of a proliferating lesion, where it aids in the growth of the lesion through its nutrition supply. Highly increased vascularity in a disease can itself affect the prognosis of the lesion, and in malignancies, it can induce tumor seeding and secondaries. Most of the pathologies including tumors, related to blood vessels, and vascularity are well established. There are some conditions, wherein altered vascularity is one of the prime components along with other diagnostic components of an established disease. In such cases, these lesions are diagnosed with special names, with varying biological behavior and prognosis in comparison to that of established entity. However, there still are few similar conditions whose nature is uncertain due to the rarity of the lesion and the insufficient scientific evidence which eludes the diagnostician. Here is the report of two cases of ameloblastoma, an established entity, with significant vascularity whose nature is indeterminate.

Juvenile aggressive cemento-ossifying fibroma. A case report.

Juvenile Aggressive Cemento-Ossifying Fibroma is a benign, fibro osseous neoplasm commonly affected maxilla but also other bones including mandible, arising in children. It is considered to be a locally aggressive and quickly expansile lesion. Because of its aggressive nature and high recurrence rate, an early detection and a complete surgical excision is essential. A case of Juvenile Aggressive Cemento-Ossifying Fibroma in a 9 year old male child who visited the Department of Oral Medicine and Radiology, J.S.S. Dental college and Hospital, Mysore is being reported and discussed.

Radiomorphometric analysis of frontal sinus for sex determination.

CONTEXT: Sex determination of unknown individuals carries crucial significance in forensic research, in cases where fragments of skull persist with no likelihood of identification based on dental arch. In these instances sex determination becomes important to rule out certain number of possibilities instantly and helps in establishing a biological profile of human remains. AIMS: The aim of the study is to evaluate a mathematical method based on logistic regression analysis capable of ascertaining the sex of individuals in the South Indian population. SETTINGS AND DESIGN: The study was conducted in the department of Oral Medicine and Radiology. METHODS AND MATERIAL: The right and left areas, maximum height, width of frontal sinus were determined in 100 Caldwell views of 50 women and 50 men aged 20 years and above, with the help of Vernier callipers and a square grid with 1 square measuring 1mm(2) in area. STATISTICAL ANALYSIS USED: Student's t-test, logistic regression analysis. RESULTS: The mean values of variables were greater in men, based on Student's t-test at 5% level of significance. The mathematical model based on logistic regression analysis gave percentage agreement of total area to correctly predict the female gender as 55.2%, of right area as 60.9% and of left area as 55.2%. CONCLUSION: The areas of the frontal sinus and the logistic regression proved to be unreliable in sex determination. (Logit = 0.924 - 0.00217 × right area).

Age estimation of an Indian population by using the Kim's scoring system of occlusal tooth wear.

CONTEXT: Age is one of the prime factors employed to establish the identity of an individual and the use of teeth for this purpose has been considered reliable. Tooth wear is widely accepted as a physiological consequence of aging and evaluation of tooth wear can be a simple and convenient tool to estimate age in adults. AIMS: The present study was conducted to record the degree of tooth wear among Indian adults and to estimate their ages from the degree of tooth wear based on Kim's scoring system. MATERIALS AND METHODS: Dental stone casts of 120 participants were used to assess the degree of occlusal tooth wear based on the criteria given by Kim et al. STATISTICAL ANALYSIS USED: The age of all subjects was estimated based on these scores using multiple regression analysis function. RESULTS: The degree of tooth wear showed a significant positive correlation with age in each and every examined tooth of both males and females. The predicted age was within ± 5 years of actual age in 70% of males and 68.3% females, and within ± 3 years of actual age in 50% of males and 50.1% of females. CONCLUSIONS: Kim's scoring system has proven to be a useful tool in estimation of age using occlusal wear in an Indian population with a high level of accuracy in adults.

Prevalence of zygomatic air cell defect in adults--a retrospective panoramic radiographic analysis.

OBJECTIVES: This research involved retrospectively evaluating panoramic radiographs of patients from India with the intention of assessing the prevalence of Zygomatic Air Cell Defect (ZACD) and establishing its dominant location and type. METHODS: Seven thousand seven hundred and fifty-five panoramic radiographs of routine outpatients aged between 19 and 91 years were concomitantly evaluated by four investigators for estimating the prevalence and characteristics of the Zygomatic Air Cell Defect. RESULTS: The prevalence of ZACD was noted to be 1.82%, with male preponderance. Unilateralality and multilocular appearance of ZACD were the dominant patterns observed. CONCLUSION: The frequency of ZACD amongst Indian population is in harmony with most of the similar studies conducted on various geographic populations.

A comparative evaluation of film and digital panoramic radiographs in the assessment of position and morphology of impacted mandibular third molars.

BACKGROUND AND OBJECTIVE: Digital photo stimulable phosphor (PSP)-based radiography has many known theoretical advantages over conventional film radiography but its diagnostic efficacy has to be assessed clinically. This study compared the efficiency of conventional film-based panoramic radiographs with that of digital PSP-based panoramic radiographs in the assessment of position and morphology of impacted mandibular third molars. MATERIALS AND METHODS: We selected a total of 80 impacted mandibular third molars that fulfilled the inclusion and exclusion criteria of this study. Both conventional film-based panoramic radiographs and digital PSP-based panoramic radiographs were taken of all the study samples and the teeth were later surgically removed. Conventional film-based and digital PSP-based panoramic radiographs were compared for their relative efficiencies in the assessment of impaction status, position of tooth, number of roots, root morphology, and proximity to mandibular canal of impacted mandibular third molars. An oral surgeon graded these same factors during/after surgical exploration and this assessment was considered the gold standard. The data obtained were statistically analyzed using descriptive statistics, chi-square test, and McNemar's test. RESULTS: There was no statistically significant difference between conventional film-based radiographic assessment and digital PSP-based panoramic radiographic assessment of impaction status, position of tooth, number of roots, and proximity to mandibular canal of impacted mandibular third molars (P>0.05). However, there was significant difference between the two methods with regard to assessment of root morphology of impacted mandibular third molars (P=0.00). INTERPRETATION AND CONCLUSION: Conventional film-based panoramic radiographs and digital PSP-based panoramic radiographs were comparable in their accuracy in the preoperative study of impacted mandibular third molar with regard to impaction status, tooth position, number of roots, and proximity to the mandibular canal. Digital PSP-based panoramic radiographs were more accurate than conventional film-based panoramic radiographs in the assessment of root morphology of impacted mandibular third molars. Hence, we conclude that digital PSP-based panoramic radiographs can be used as an effective alternative to conventional film-based panoramic radiographs for assessment of position and morphology of impacted mandibular third molars.

Recurrent oral angioleiomyoma.

Angioleiomyomas are vascular variant of leiomyomas which are benign tumors of smooth muscle. They are exceedingly rare in the oral cavity. Malignant transformation of these tumors has also been reported occasionally which warrants knowledge of this soft tissue tumor. A 57 year old male patient reported with a 15 day history of an asymptomatic growth that had started insidiously in his lower left back tooth region. Clinical examination revealed a solitary, oval, sessile growth in the mandibular left retro molar region. Excisional biopsy was suggestive of Angioleiomyoma. A recurrence of the same was noted two months later which was also histopathologically reported as Angioleiomyoma. The same was confirmed using special stains. This case reports an unusual presentation of Angioleiomyoma with regards to both recurrence as well as rapid growth. It is important to be well aware of this uncommon entity as these tumors often can mimic or transform into malignancy. Precise clinicopathological examinations are therefore invaluable in establishing an accurate diagnosis and delivering suitable treatment.

Extranodal non-Hodgkin's lymphoma of the gingiva in an HIV seropositive patient.

Among the myriad manifestations of HIV, non-Hodgkin's lymphomas (NHL) are considered as the second most common malignancies after Kaposi's sarcoma. HIV-associated NHLs are extranodal and have a predilection for sites in the head and neck region in 50-60% of cases. Of all the extranodal NHLs, oral cavity constitutes only 25%. It is now considered that oral NHL serves as the first indicator of HIV infection.