Evaluation of relationship between odontogenic infections and maxillary sinus changes: A Cone Beam Computed Tomography-based study.

Introduction: Odontogenic infections affects the maxillary sinus mucosa. Cone Beam Computed Tomography (CBCT) is helpful in diagnosis of maxillary sinusitis of odontogenic origin. This cross-sectional study was planned with the aim to assess maxillary sinus changes associated with odontogenic infection by evaluating CBCT images. Material and methods: In cross-sectional analytical study, total 213 patients (404 sinuses) were evaluated on CBCT after thorough clinical examination of the individuals and taking into consideration the history of rhino or allergic rhinitis. Based upon CBCT images and clinical examination, patients were divided into, study group (odontogenic infection) and control group (no associated odontogenic infection). Effect of the size of periapical lesion, spatial relationship of lesion to the sinus floor and periodontal bone loss on maxillary sinus changes were evaluated. Results: Mucosal changes found in 200 sinuses (49.5%), mucosal thickening being the most prevalent and more commonly associated with odontogenic infections (p = 0.004). A significantly increased risk of mucosal thickening was observed with severe periodontal bone loss (p = 0.008). Size and spatial relationship of lesion to the maxillary sinus had no impact on the prevalence of mucosal thickening (p = 0.6, p = 0.4 respectively). Periodontal bone loss was 2.2 more likely to be associated with mucosal thickening than periapical or combined lesion. Conclusions: Most prevalent sinus change was mucosal thickening. Periodontal bone loss was significantly associated with mucosal thickening. CBCT is an appropriate method for sinus evaluation.

Evaluation of neurovascular anatomical variation in the anterior mandible in North Indian population: A CBCT assessment.

Introduction: The purpose of this retrospective study was to determine the visibility, location and other morphometric features of lingual foramina on CBCT along with its age wise and gender wise correlation. Material and methods: A total of 250 patients were included in the study. Cross-sectional CBCT images of the mandible in the midline were used to locate and define each detected lingual foramen and canal. Descriptive statistics including tables and graphs were used. Genderwise and Age wise correlations were analyzed using Chi-square tests. Results: The number, direction, length, diameter, distance from alveolar crest and inferior borders of mandible were evaluated. Genderwise Lingual foramen was most frequently located in the mandibular midline, above genial tubercle (81.7%). Agewise it was found to be significant (p = 0.019). Genderwise length of canal was found to be significant (p = 0.022). Genderwise diameter of canal at midpoint was found to be very highly significant (p < 0.001) and at innermost point was found to significant. (p = 0.037) Genderwise and Agewise distance between orifice of canal and alveolar crest was found to be very highly significant. (p < 0.001) Genderwise and Agewise distance between innermost point of canal and alveolar crest was found to be highly significant (p = 0.001) and very highly significant (p < 0.001) respectively. Conclusion: Clinicians may consider CBCT for procedures with a risk of hemorrhagic and neurosensory complications such as dental implant placement in the anterior mandible.

Evaluation of transcutaneous electrical nerve stimulation as an adjunct therapy in trigeminal neuralgia - a randomized double-blind placebo-controlled clinical study.

BACKGROUND: Trigeminal neuralgia (TN) is a severe form of pain that affects the daily activities of a patient. Transcutaneous electrical nerve stimulation (TENS) therapy is an emerging option for the treatment of acute and chronic pain. The aim of this study was to evaluate the effect of TENS therapy as an adjunct to drug therapy for the treatment of TN. METHODS: A total of 52 patients diagnosed with TN according to the International Classification of Headache Disorders (version 3) were included. Each patient was randomized to either the TENS or placebo TENS groups. Intervention was given in continuous mode and 100-Hz frequency for 20 mins biweekly for 6 weeks. Parameters were measured at baseline, TENS completion and 3 months, 6 months, and 1 year of follow up. The parameters observed were mean carbamazepine dose, mean visual analog scale (VAS) score, mean present pain intensity (PPI) score, and functional outcome. Non-parametric analyses, one-way ANOVA and the Kruskal-Wallis test were applied for intragroup comparisons, while the Mann-Whitney U test and independent t-test were used for intergroup comparisons of variables. The chi-square test was applied to analyze categorical data. RESULTS: Compared to the placebo TENS group, the mean dose of carbamazepine in the TENS group was significantly reduced at TENS completion, as well as at 6 months and 1 year follow up. Changes in mean VAS score, mean PPI score, and functional outcome did not show significant differences between the groups (P>0.05). CONCLUSION: TENS therapy does not lead to any changes in pain levels but it may reduce the mean dose of carbamazepine when used as an adjunct treatment in patients with TN.

Significance of Morphometric and Anatomic Variations of Nasopalatine Canal on Cone-Beam Computed Tomography in Anterior Functional Zone - A Retrospective Study.

INTRODUCTION: Oral rehabilitation in maxillary anterior region has increased concerns in the dental fraternity to have detailed morphological examination in treatment planning. The nasopalatine canal (NPC) along with its contents plays an important role in determining the prognosis of implants and their associated surgeries. The present study was performed to evaluate morphometric anatomic variations of the NPC using focused small field of view on cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The study included 250 participants. CBCT examination was conducted using standard exposure and patient positioning protocols. Sagittal, coronal, and axial sections were reviewed to determine NPC morphology and dimensions. RESULTS: Single, round, incisive foramen with mean mesiodistal diameter of 3.23 (±1.00) mm, and mean anteroposterior dimension of 3.03 (±0.96) mm was found. Single Stenson's foramen along with funnel shaped, slanted NPC with mean angulation of 81.97 (±42.19), and mean length of 12.67 (±2.69) mm was found. Mean mesiodistal diameter at nasal fossa of NPC was 3.27 (±1.75) mm, at mid-level was 2.23 (±1.02) mm, at palate was 3.46 (±1.12) mm. At least one additional foramen was found. DISCUSSION: Anatomy of the NPC is highly variable. Age-wise and gender-wise correlations revealed statistically significant results for different parameters. The present study highlighted significance of NPC along with its variations. Therefore, a methodical three-dimensional presurgical assessment is mandatory before any surgical intervention in this region.

Odontogenic myxoma: ambiguous pathology of anterior maxilla.

Swellings in the anterior maxilla are uncommon and if present can be deemed as paradoxical conundrums presenting diagnostic and therapeutic dilemmas. Odontogenic myxoma is a rare, locally aggressive lesion that is primarily seen affecting the mandibular posterior region in association with an impacted tooth. It is found to be associated with odontogenesis. Treatment is usually surgical, with extent varying from curettage to resection. This report describes a rare case of odontogenic myxoma of the anterior maxilla in a 14-year-old boy, with an emphasis on its epidemiology, clinical presentation, histopathology, diagnosis and treatment planning.