Are Adults Over 18 Years of Age with Anaemia More Likely to Develop Chronic Periodontitis Than Adults Without Anaemia? - A Systematic Review and Meta-Analysis.

Aims and Objectives: Periodontitis is a chronic disease affecting the supporting tissues of the teeth and exhibits bidirectional relation with systemic diseases. This study aims to determine the association between chronic periodontitis and erythrocyte functional measures: total red blood cells (RBCs), hemoglobin (Hb) concentration, mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC) by systematic review and meta-analysis. Materials and Methods: A systematic search of the electronic databases PUBMED, OVID, Embase, Web on Science, and Google Scholar was undertaken from inception to July 2022. English language studies that evaluated the erythrocyte functional measures in periodontitis and health were selected. Other review reports, letters/opinion articles, studies without a definition of periodontitis, and the concomitant presence of systemic conditions (diabetes, kidney disease, cancer) were excluded. Two reviewers determined full-text eligibility in a blinded process. Meta-Essentials software was used to generate forest plots and to determine heterogeneity and publication bias. Results: Twenty-six studies involving 1082 patients with chronic periodontitis and 980 healthy controls were analyzed. Pooled results showed lower Hb concentration (Hedges' g = -1.16; 95% confidence intervals [CI], -1.7 to -0.62), RBC counts (Hedges' g = -0.85; 95% CI, -1.31 to -0.38) and packed cell volume (-0.56; 95% CI, -1.02 to -0.11) in patients with chronic periodontitis. Conclusion: This meta-analysis showed a decreasing trend in the hematological parameters, including hemoglobin concentration, number of erythrocytes, and hematocrit in patients with chronic periodontitis compared to healthy controls.

Keratinizing pleomorphic adenoma: A rare variant in an unusual location.

Pleomorphic adenoma is the most common benign salivary gland tumour characterized by great histologic diversity. The presence of extensive squamous metaplasia and numerous keratin pearls is mostly uncommon in the microscopic study and can signify a potential pitfall in the histopathological diagnosis Pleomorphic adenoma can show the presence of squamous metaplasia with keratin pearls as a rare finding and is encountered most often in the parotid gland (84%) and 6% in the minor salivary gland. Here we present a case report of a rare histopathological variant of pleomorphic adenoma with exuberant squamous metaplasia and keratin pearl formation of the minor salivary gland in an unusual location.

Epithelial expression of keratinocytes growth factor in oral precancer lesions.

BACKGROUND: Keratinocyte growth factor (KGF) is a potent epithelial mitogen that acts by binding the KGF receptors (KGFRs) expressed on epithelial cells and regulates proliferation and differentiation. The objective of this study was to investigate the expression of KGF in the epithelium in oral precancer. MATERIALS AND METHODS: Archival tissues of oral submucous fibrosis (SMF) and leukoplakia were assessed for epithelial KGF expression by immunohistochemistry and real-time quantitative polymerase chain reaction. RESULTS: KGF was predominantly expressed in the basal and parabasal cells in the epithelium of SMF tissues. KGF transcript in the epithelial cells increased with increasing severity of epithelial dysplasia in oral leukoplakia. CONCLUSION: Although widely reported as a product secreted by the mesenchymal cells, our data suggest that the KGF is also expressed in oral epithelial cells much like the expression in ovarian epithelial cells. Based on the localization of KGF in cells at the epithelial mesenchymal junction and that of the reported presence of KGFR in oral keratinocytes, a potential mechanism involving paracrine and autocrine interactions of KGF and KGFR in early stages of oral precancer is postulated.

Comparative Effects of Clonidine and Adrenaline with Lignocaine during Maxillary Infiltration Anaesthesia for Dental Extraction.

INTRODUCTION: Lignocaine is a commonly used local anaesthetic in dental practice. Many practitioners use adrenaline (epinephrine) as additive with lignocaine, and some have used clonidine, instead of adrenaline. Both having benefits and limitations. AIMS: Hence a study was undertaken in our department to evaluate the advantages and disadvantages of using (plain lidocaine local anaesthetic) versus (lidocaine with adrenaline as additive) versus (lidocaine with clonidine as additive). STUDY DESIGN: Randomised, prospective, double blind study. MATERIALS AND METHODS: Seventy five patients requiring extraction of maxillary molar teeth who fall under ASA I category were included and randomly divided into group - I (n=25) (Lignocaine), group - II (n=25) (Lignocaine ± Adrenaline) and group - III (n=25) (Lignocaine ± Clonidine). The observations recorded were, time of onset of anaesthesia, hemodynamic parameters, blood loss during procedure and duration of post operative analgesia. STATISTICAL ANALYSIS: The statistical analysis was carried out using SPSS 16 software. RESULTS: A statistically significant difference was seen in blood loss, being higher in group I and duration of anaesthesia, being shortest in group I. There was no statistical difference between the three groups amongst other parameters. CONCLUSION: Adrenaline at 10 µg/ml and clonidine at 15 µg/ml can be safely used as additives with lignocaine, in maxillary infiltration anaesthesia for dental extraction; with addition of either of these two drugs, having an equal advantage over use of plain lignocaine; in terms of lower blood loss and longer duration of anaesthesia; but, with no difference in the onset of anaesthesia and with no significant hemodynamic changes.

Assessment of bleeding during minor oral surgical procedures and extraction in patients on anticoagulant therapy.

INTRODUCTION: The risk of postoperative hemorrhage from oral surgical procedures has been a concern in the treatment of patients who are receiving long-term anticoagulation therapy. A study undertaken in our institution to address questions about the amount and severity of bleeding associated with minor outpatient oral surgery procedures by assessing bleeding in patients who did not alter their anticoagulant regimen. SUBJECTS AND METHODS: Eighty-three patients receiving long-term anticoagulant therapy visited Department of Oral and Maxillofacial Surgery from May 2010 to October 2011 for extractions and minor oral surgical procedures. Each patient was required to undergo preoperative assessment of prothrombin time (PT) and measurement of the international normalized ratio. Fifty-six patients with preoperative PT values within the therapeutic range 3-4 were included in the study. The patients' age ranged between 30 and 75 years. Application of surgispon was done following the procedure. Extraction of teeth performed with minimal trauma to the surrounding tissues, the socket margins sutured, and sutures removed after 5 days. RESULTS: There was no significant incidence of prolonged or excessive hemorrhage and wound infection and the healing process was normal.

Role of DNA profiling in forensic odontology.

The recent advances in DNA profiling have made DNA evidence to be more widely accepted in courts. This has revolutionized the aspect of forensic odontology. DNA profiling/DNA fingerprinting has come a long way from the conventional fingerprints. DNA that is responsible for all the cell's activities, yields valuable information both in the healthy and diseased individuals. When other means of traditional identification become impossible following mass calamities or fire explosions, teeth provide a rich source of DNA as they have a high chemical as well as physical resistance. The recent evolution in the isolation of DNA and the ways of running a DNA fingerprint are highlighted in this literature review.

Ghost cell lesions.

Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms.

Circulating tumor cells in oral squamous cell carcinoma-an enigma or reality?

Oral squamous cell carcinoma (OSCC) is ranking 1(st) among males and 4(th) among females in India. In spite of major advances in diagnosis and treatment of OSCC, survival rates, have remained poor. Circulating tumor cells (CTCs) in the blood stream, play an important role in establishing metastases. It is important to identify patients suffering from nonlocalized tumor with "circulating" tumor cells to determine the tailor made, systemic therapy in addition to local resection and irradiation. Thus, detecting metastases at an early stage are needed for better prognosis and survival. CTCs as new prognostic marker to detect the metastatic potential will provide a novel insight into tumor burden and efficacy of therapy. The recent advances and its application in OSCC will be reviewed.

Evolution of forensic odontology: An overview.

Forensic dentistry or forensic odontology admits dentists' participation or identification of the victim and assisting legal and criminal issues. It refers to the proper handling, examination, identification and evaluation of dental evidence. This article summarizes the evolution of forensic odontology that started right from Garden of Eden to the modern scenario in identification of the gang rape case which happened in the state capital. Forensic dentistry plays a significant role in identifying the victims of crime, deceased individuals through the examination of anatomical structures, dental appliances and dental restorations.

Burning mouth syndrome.

Burning mouth syndrome (BMS) is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a result, a multidisciplinary approach is required for better control of the symptoms. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms.

Immunologically mediated oral diseases.

Immune mediated diseases of oral cavity are uncommon. The lesions may be self-limiting and undergo remission spontaneously. Among the immune mediated oral lesions the most important are lichen planus, pemphigus, erythema multiformi, epidermolysis bullosa, systemic lupus erythematosis. Cellular and humoral mediated immunity play a major role directed against epithelial and connective tissue in chronic and recurrent patterns. Confirmatory diagnosis can be made by biopsy, direct and indirect immunoflouresence, immune precipitation and immunoblotting. Therapeutic agents should be selected after thorough evaluation of immune status through a variety of tests and after determining any aggravating or provoking factors. Early and appropriate diagnosis is important for proper treatment planning contributing to better prognosis and better quality of life of patient.

Dental caries vaccine - a possible option?

Dental caries is an irreversible microbial disease of the calcified tissues of the teeth and it has a multifactorial origin. In India, the dental caries prevalence in 35-44 year olds was reported to be 80-95% in a DCI survey. Among the elderly in the 65-74 years age group, the DCI survey reported the caries prevalence to be about 70%, while the present survey reported it to be 51- 95% in various states. Surveys which were done on school children in India showed a carie prevalence of approximately 58%.Among the U.S. population, a survey showed an incidence of 93.8% in adults with either past or present coronal caries and an incidence of 45.3% in children 23. In countries like Brazil and China, it is reaching epidemic proportions. Thus, more effective public-health measures are needed to combat dental caries. Mutans streptococci is one of the main microorganisms which are associated with the aetiology of dental caries. Preclinical studies of immunological interventions have shown that the disease can be interrupted. Clinical trials have indicated that a mucosal immune response to Streptococcus mutans crucial antigens can influence the pathogenesis of dental caries. The dental caries vaccine, when it is used in appropriate individuals at the appropriate time, can reduce the reemergence of the disease.

Giant cell fibroma: a case report with immunohistochemical markers.

Giant cell fibroma may mimic fibroma of the gingiva, but have distinctive histopathological difference. Immunohistochemical markers are required to diagnose GCF. It may occur at any age but most often in the third decade of life. It may be often asymptomatic but may not be esthetic if present in the anterior region of the jaw. Surgical excision should be performed, and the prognosis is good. However long term follow-up is required to check for any recurrence. The most common gingival enlargements like fibroma and granuloma may be mistaken for GCF. We present a case report with histopathological markers used to diagnose GCF.