The efficacy of Punica granatum extract gel in the treatment of symptomatic oral lichen planus in an Indian population: A clinical study.

INTRODUCTION: The autoimmune disorder, oral lichen planus (OLP), primarily affects oral mucous membranes. Current drug treatments are only palliative and have serious side effects. Pomegranate has been used as a potential herbal remedy for the treatment of OLP. MATERIALS AND METHODS: The study consisted of a sample size of 30 individuals who were diagnosed with symptomatic OLP based on both clinical and histological evidence and were equally assigned to Group A (4% topical Punica granatum seed extract gel, which has been customized for this particular study purpose only) and Group B (0.1% topical steroid). All patients were evaluated for the outcome criteria of pain, burning sensation, and lesion size. RESULTS: In the present study, results were highly statistically significant (P = 0.001) in intragroup observation for both Group A and Group B from baseline to the end of 30 days of follow-up for all three parameters. There was no statistically significant difference between groups for each week of follow-up. CONCLUSION: P. granatum has been used in very few studies, but this is one of the few where a gel made from P. granatum seed extract is used as an oral gel. In conclusion, it can be said that topical P. granatum extract gel is as good as topical corticosteroids at getting rid of the signs and symptoms of OLP, so it can be used as an alternative treatment.

Anatomical Variants of Condylar Process, Coronoid Process, and Sigmoid Notch in a Maharashtrian Population: A Radiographic Study.

Background The cornerstone of an individual's singularity is identification. Digital orthopantomography (OPG) helps to illustrate the varying condylar process, coronoid processes, and sigmoid notch found within a population to facilitate individual recognition. This study aims to assess the various shapes of the condylar process, coronoid process, and sigmoid notch found using OPG in a sample population of an Indian city. Methodology This retrospective, cross-sectional study was conducted using 1,000 good-quality digital OPG scans to evaluate the different shapes. The scans were evaluated by two experienced oral radiologists and tabulated for statistical analysis. Results The current investigation revealed varied morphological forms of the three entities, with the round shape being the most frequently observed condylar process, coronoid process, and sigmoid notch. Comparisons across sides and between sexes revealed differences in all three variables which were found to be statistically significant. We discovered a crooked finger condyle (58.56% on the left side and 41.44% on the right side), a beak-shaped coronoid process (50.0% on the left side and 50.0% on the right side), and a V-shaped sigmoid notch (41.35% on the left side and 58.65% on the right side) in this study. This is a unique finding not reported by other studies. Conclusions Analyzing the shape of the condylar process, coronoid process, and sigmoid notch found on an OPG scan can help with gender identification in forensic odontology and anthropology as these anatomical features show strong sexual dimorphism.

Prevalence of Anterior Loop and other Patterns of Mental Nerve in a Sample Population of an Indian City: A Retrospective Study.

Introduction: The final portion of the inferior alveolar nerve (IAN), the mental nerve (MN), is a general somatic afferent nerve that provides sensation to the lip, chin, and gingival tissue. Three patterns of MN have been observed - straight, perpendicular or vertical, and anterior loop (AL) of MN. The interforaminal region of the mandible possesses a MN with a path that creates an AL before entering the mental foramina. The aim of the study is to evaluate the presence of AL of MN using cone-beam computed tomography (CBCT) and to measure the length of the AL of MN, if present, also to evaluate the prevalence of other anatomical patterns of MN - straight and vertical patterns. Materials and Methods: Mandible CBCT of 400 patients with the age of 20 years onward was included in the study. The images obtained were assessed for the different patterns of MN - straight, vertical, and ALs. The statistical analysis was done using the Chi-square test, paired t-test, and sample t-test. Results: Out of 400 CBCT scans comprising 800 hemimandibles, straight pattern was observed in 67.1%, vertical pattern in 26%, and Anterior Loop in 6.9%. The prevalence of AL pattern was 6.9%. AL length was found to be in a range of 2.4-6.6 mm. Discussion: Surgical trauma or injury to the AL of MN is possible during implant surgery in the interforaminal area of the mandible if AL is not assessed preoperatively.

Ameloblastic Fibroma Mimicking Dentigerous Cyst: A Diagnostic Dilemma.

Ameloblastic fibroma is a rare, slow-growing odontogenic mixed tumor with neoplastic epithelial and ectomesenchymal tissue, which does not show inductive changes to form enamel and dentin. It is frequently found in the first two decades of life. It is often confused with ameloblastoma and dentigerous cyst due to the presence of an impacted tooth and can be distinguished histologically. Ameloblastic fibroma can be differentiated from ameloblastoma by the presence of myxoid appearance of connective tissue. A case of an 11-year-old female with a slow-growing swelling on the left side of mandible in the molar ramus region has been presented which was diagnosed as ameloblastic fibroma postenucleation.

Correlation of ultrasonographic measurements, histopathological grading, and clinical staging in oral submucous fibrosis.

AIMS AND OBJECTIVES: To evaluate the presence and thickness of submucosal fibrosis in oral submucous fibrosis (OSMF) patients ultrasonographically and to correlate these findings with the clinical stage and histological grade of OSMF. MATERIALS AND METHODS: Forty participants (twenty cases and twenty controls) were included in the study. The patients diagnosed clinically as having OSMF and consented for biopsy were included in the cases, and completely healthy individuals with no habit history or oral lesions were included in the control group after matching the body mass index. After clinically staging, the patients' transcutaneous ultrasonography (USG) was performed and after that punch biopsy was taken and the specimen was graded histopathologically. RESULTS: The data were statistically analyzed using Mann-Whitney test and Spearman's rank correlation. The cases showed increased submucosal thickness as compared to the controls. The USG measurements statistically correlated with the clinical stage and histopathological grade of OSMF. CONCLUSION: USG proves to be a valuable adjunctive modality in diagnosing, staging and also evaluating the prognosis of OSMF.

Estimation of Serum Beta 2-Microglobulin Levels in Individuals Exposed to Carcinogens: Clinical Study in Indian Population.

AIM: The aim of the study is to evaluate the prognostic value of ß2-m as a biochemical parameter for the diagnosis and prognosis of oral squamous cell carcinoma (SCC). MATERIALS AND METHODS: The study included 60 patients (15 oral SCC, 15 leukoplakia, 15 individuals exposed to various carcinogens and without oral cancerous or precancerous lesions, 15 healthy individuals). The levels of ß2-m were estimated using chemi-luminescent immunometric assay on Immulite fully automated machine. Statistical analysis of the data was done using Tuckey's test, ANOVA and independent sample t test. RESULTS: Results showed that ß2-m was increased in individuals exposed to carcinogens without precancerous and cancerous lesion. CONCLUSION: Serum ß2-m can be used as a better indicator and can give an early indication of malignant change and therefore malignancy can be detected at an early and treatable stage.

Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a well-established precancerous condition affecting the oral mucosa. It is a disease that causes significant morbidity (in terms of loss of mouth function as tissues become rigid and mouth opening becomes difficult) and mortality (when transformation into squamous cell carcinoma occurs). AIM: The aim of the study is to compare the efficacy of Aloe vera with antioxidant when given along with physiotherapy in the management of OSMF. MATERIALS AND METHODS: Forty patients presenting with clinical signs and symptoms of OSMF were included for the study after informed consent. Group A included 20 patients who received Aloe vera gel (forever living gel) along with physiotherapy. Group B included 20 patients who received antioxidant capsules twice daily for 3 months along with physiotherapy exercises four times in a day. The following parameters, that is, burning sensation, mouth opening, tongue protrusion and cheek flexibility were recorded at each visit. RESULTS: Majority of the participant enrolled were in the age range of 30 to 35 years. Improvement in all the parameters was seen with the individuals receiving Aloe vera gel in comparison to antioxidants. CONCLUSION: So, Aloe vera being a soothing, simple and safe mode of treatment along with proper habit restriction can be considered to be an effectual protocol in the management of OSMF. The analgesic effects of Aloe vera with the physiotherapy exercises provide better results in reducing burning sensation and improving mouth opening, tongue protrusion and cheek flexibility in comparison to antioxidants.

An Atypical Presentation of Multiple Central Osteomas Mimicking Craniofacial Fibrous Dysplasia - A Pictorial Essay.

Osteoma is benign neoplasm with slow growth characterized by deposition of compact lamellar cortical or cancellous bone creating a tumour mass. It is still unclear whether osteomas are benign neoplasms or hamartomas. They have typical clinical presentations and are easily diagnosed with the help of radiographs. We present a rare case of non-syndromic multiple osteomas in the craniofacial region which are typically restricted to the midline and presents radiographically as craniofacial fibrous dysplasia causing a diagnostic dilemma.

Ectopic tooth in maxillary sinus: Case series.

Ectopic eruption of a tooth within the dentate region of the jaws is often noticed in clinical practice and is well documented in the literature. But the ectopic eruption into the non dentate region is rare and scantly documented. The maxillary sinus is one such a non dentate region, apart from nasal septum, mandibular condyle, coronoid process and the palate, to accommodate such ectopic eruptions of teeth. Due to its rarity and lack of consensus over its management, the incidence deserves to be added to the literature and discussed. Early surgical intervention for removal of ectopic tooth along with enucleation of the associated cyst, if any, is the treatment of choice.

Retrospective analysis of sutureless skin closure in cleft lip repair.

The technique of approximating tissues resulting in minimal amount of scar usually requires skillful suturing techniques by the surgeons, especially in cleft lip repair. Increased awareness and demand for aesthetic surgical correction with quality in tissue closure has led to the invention of new materials and techniques. Amcrylate (iso amyl 2-cyanoacrylate) is retrospectively evaluated as tissue glue in cleft lip repair, and the results are compared with skin closure by 6-0 Prolene. A retrospective analysis of 60 patients with unilateral or bilateral cleft lip repair was carried out to compare the results of skin closure with Amcrylate and 6-0 Prolene. Patients were randomly divided into 2 groups, each group containing 30, and the study was designed to evaluate the quality of scars after the use of Amcrylate tissue adhesive to close the skin during cleft lip repair and its advantages over sutures (6-0 Prolene). Both groups were analyzed for the time taken for skin closure, resultant scar, parental satisfaction, and complications, and the results were found to be statistically significant for the Amcrylate group. Amcrylate, when used as tissue glue for skin closure in cleft lip repair, definitely has an edge over conventional suturing techniques.

Adenoid cystic carcinoma associated with mucous retention cyst of the parotid gland.

Mucous retention cysts of the parotid gland are rare, and a coexistent adenoid cystic carcinoma is even an unusual occurrence. Such coexistent adenoid cystic carcinomas with mucous retention cyst of the parotid gland are difficult to diagnose clinically and, at times, stage difficulty in their management. We report a rare case of adenoid cystic carcinoma associated with mucous retention cyst of the parotid gland with its diagnostic and management dilemma in a 14-year-old adolescent girl.

Modified lateral orbitotomy approach: a novel technique in the management of lacrimal gland tumors.

Lateral orbitotomy is a well-known approach in the surgical management of lesions in the lateral orbital regions. It is still appropriate for laterally situated tumors, although contemporary cranial base approaches were defined and developed within the last decades. The extent of lateral orbitotomy should depend on the size, consistency, and nature of the lesion for easy surgical removal and reconstruction thereafter. In this regard, contrast-enhanced computed tomographic scans provide useful information for operative strategy. Although there is a wide range of histopathologic diagnosis for orbital tumors, lateral orbitotomy is a safe approach, particularly if the lesions are extraconal. We present a case of pleomorphic adenoma of lacrimal gland managed by a modified lateral orbitotomy approach with pleasing results.

Giant aneurysmal bone cyst of the mandible.

The aneurysmal bone cyst is a type of pseudocysts of the jaw. It is a nonneoplastic lesion of the bone, characterized by replacement with fibro-osseous tissue containing blood-filled sinusoidal or cavernous spaces. The lesion remains a relatively uncommon finding in the facial bones, and the cause and pathogenesis are yet to be elucidated. Aneurysmal bone cyst was first described as a distinct clinical and pathologic entity by Jaffe and Lichtenstein in 1942. Aneurysmal bone cyst comprises 1.5% of all nonodontogenic cysts of the jaws and 1.9% of all aneurysmal bone cysts of skeleton. A rare case of giant aneurysmal bone cyst of mandible in a 10-year-old child is presented, which was managed by surgical curettage with a long-term follow-up.

Treatment of midline cleft of the mandible-A 2-stage approach.

Midline clefts of the lower lip and mandible are rare congenital anomalies. They may present as complete or incomplete in nature along with associated bifid tongue and ankyloglossia. Some may present with cleft of lower lip, cleft of mandible, fissured tongue, absent hyoid bone, cleft of manubrium sterni, or an extremely rare anomaly known as Tessier cleft no. 30. We present this unique case of midline cleft of the lower lip (incomplete) and mandible (complete) with initial soft-tissue surgery for the lower lip. The hard-tissue surgery for this case is deferred at a later date, and the reasons are discussed.