Outlandish manifestation of swelling in early childhood seen in the patient's floor of the mouth.

Ranula is a cyst-like growth that occurs in the oral cavity beneath the tongue. It consists of saliva from a ruptured salivary gland or duct. Rather than just flowing directly from the glands into the oral cavity, saliva permeates the nearby connective tissues and creates a bubble. A ranula could indeed appear at any time span in a person's life for inexplicable reasons. A trauma such as an oral operation, a facial blow or nibbling the lower lip may possibly start one. The following is a case study of an early childhood boy who reported with a swelling in the floor of the mouth with unknown aetiology from the last 6 months.

Comparison of salivary flow rate and pH between healthy subjects and tobacco and areca nut chewers.

Introduction: Tobacco and areca nuts release carcinogens, which cause alterations in saliva. Evaluation of these changes through estimation of salivary flow rate and pH was performed in tobacco and areca nut chewers and apparently healthy subjects. Material and Methods: The study group for this comparative study comprised 60 subjects with 20 areca nut chewers (group 1), 20 tobacco chewers (group 2), and 20 non-tobacco and areca nut chewers (group 3) in the ages between 18 and 75 years. After collection of saliva from each subject, the salivary flow rate (SFR) was measured by using graduated tubes, whereas salivary pH was measured using a digital salivary pH meter. Tukey HSD post hoc test was performed for comparison of mean SFR and mean pH between study group subjects. Analysis of variance (ANOVA) test was used to find the mean difference in SFR and pH in duration, intensity, and frequency among various types of areca nut and tobacco users. A "P" value of less than 0.05 was considered as statistically significant. Results: The mean age among groups 1, 2, and 3 was 37.70 ± 10.44, 39.75 ± 10.16, and 37.90 ± 10.52 years, respectively, with a statistically insignificant difference. The mean salivary flow rate (ml/20 min) was maximum in group 3 (13.23), followed by group 2 (11.75) and group 1 (10.48), with the statistically significant difference as P < 0.05. The mean salivary pH was maximum in group 3 (7.07), followed by group 2 (6.86) and group 1 (6.49), with the statistically significant difference as P < 0.05. Conclusion: Long-term use of tobacco and areca nuts in a chewable form can significantly reduce the salivary flow rate and salivary pH. Hence, these measurements can be used as chair side, non-invasive measures for assessing pathological changes in oral mucosa linked to vulnerable effects among people addicted to these adverse habits; thereby, early re-organization can prevent mobility and mortality.

Relationship between bad oral habits, signs, and symptoms of temporomandibular joint disorders among Saudi population: A cross-sectional study.

Background: According to the American Dental Association, temporomandibular disorders (TMD) refer to a group of disorders characterised by pain in the temporomandibular joint (TMJ), the periauricular area, or the muscles of mastication. TMJ noise/sounds, and any deviations or restriction during jaw movements. Many oral habits are common and usually do not harm the TMJ and associated structures. However, these habits may result in TMJ disorders, if the activity goes beyond someone's physiological tolerance. The causes of degenerative changes of TMJ are believed to be multifactorial and controversial too. Objectives: This study aims to evaluate the prevalence of oral habits and its relationship with temporomandibular disorders in the Saudi population of Taif city. Materials and Methods: This questionnaire-based cross-sectional study was conducted from March 2021 to July 2021 at Taif city, Kingdom of Saudi Arabia (KSA). The Arabic version of a standardized questionnaire (recommended by the American Academy of Orofacial Pain) was used and distributed randomly among 441 citizens of Taif city. Results: Our study showed that many respondents had different TMJ disorders, such as pain during eating, sound in jaw joint, pain around ear, temples, and cheek, headache and neck pain, change in bite, and pain during opening and closing of the mouth. On the other hand, many respondents answered that they had TMD, pain associated with nail biting/object biting, lip biting, clenching teeth, and chewing gum. Conclusion: In the present study, a relationship between harmful oral habits and the development of signs and symptoms of TMDs among adolescents who lived in Taif city, KSA was noted. In the present study, no clinical examinations were conducted and only consisted of closed-ended questions, all of which may have a lower the validity rate. An effort was made to overcome these limitations by using a well-designed standardized questionnaire by the American Academy of the Orofacial Pain. We conclude that further studies are required and using of clinical examination to measure the severity of the signs and symptoms for better understanding the association of oral habits with TMJ disorders.

Unusual association of torticollis with Russell-Silver syndrome.

Russell-Silver syndrome is a unique disorder characterised by intrauterine growth retardation before and after birth, large-sized head, a triangular facial appearance, a protuberant forehead, asymmetry and feeding difficulties. This extensive spectrum of features varies in both occurrence and gravity from one individual to another. Congenital muscular torticollis or commonly known as wry neck is one of the common presenting complaints in the outpatient department. It is characterised by rotational deformity of the cervical spine and consequently secondary tilting of the head.

Oral soft-tissue myxoma.

Oral soft-tissue myxomas of the oral cavity have been sparsely cited in the medical literature worldwide. This could be due to other clinically and/or histologically similar lesions requiring accurate differential diagnosis by experienced physicians and pathologists. Although myxomas are benign and do not metastasise, they have higher rates of recurrence and deserve proper attention and to be reported as well. Soft-tissue myxomas of the oral cavity are extremely rare and very few cases have been reported in the literature. The article describes a soft-tissue myxoma in a male patient in his 40s and review of published cases.

Prevalence and distribution of selected developmental dental anomalies in Taif, Saudi population.

BACKGROUND: Developmental dental anomalies are seen as abnormalities in tooth size, shape, position, and structure due to multiple reasons during various stages of tooth development. These anomalies can create disturbances in dental arch lengths and occlusions. Hence, it is very important to treat, recognise and perform proper treatment. The purpose of this study was to find out the prevalence and distribution of selected developmental anomalies in shape, size and position of teeth in the Saudi population of Taif Region. DESIGN AND METHODS: The study was based on the clinical examination of 2481 adults who are Saudi nationals came for dental treatment from September 2019 to February 2020, at Taif University Dental Hospital, Saudi Arabia. These patients were examined clinically for developmental dental anomalies affecting shape, size and position. RESULTS: We found that a total of 512 individuals (20.63%) had developmental anomalies and out of which 386 persons (15.56%) had at least one developmental dental anomaly. The frequency and distribution of anomalies of shape and size, number and position were 46.8%, 26.9% and 42.9% respectively. In the present study, 15.56% individuals exhibited at least one anomaly, 8.54% subjects had more than one anomalies and 79.36% did not any developmental anomaly. On comparison, statistical significant results were seen between different groups of anomalies. CONCLUSIONS: The present study had varying results for the prevalence rate of selected dental anomalies. This variation in results might be due racial differences or discrepancy in sample size or/and diagnostic or inclusion criteria. Treatment of developmental anomalies necessitates a multidisciplinary approach and mostly may comprise of orthodontic correction or prosthetic replacement.

Oral malignant melanoma of alveolar ridge.

Malignancy of melanocytes, a pigment-producing cell, is referred as malignant melanoma (MM) which occur basically on skin and oral mucous membrane, but as well found in ears, eyes, gastrointestinal tract and genital mucosa. Oral melanomas has propensity to metastasise and invade more voluntarily than other malignant counterparts. Here we present a case of 52-year-old male patient with a chief symptom of blackening of gums in the upper front tooth region. In dental history, the patient revealed history of faulty artificial prosthesis fixed in the same region since 6 months. On the basis of a through clinical assessment, a provisional opinion of oral malignant melanoma, was prepared. On histopathological and immunohistochemical analysis with S-100 and homatropine methylbromide 45 the diagnosis of MM was confirmed.

Ewing's sarcoma in maxilla.

Ewing sarcoma is a lesion of bone, described in small round cell neoplasm. This tumour resembles primitive neuroectodermal tumour both clinically and histologically. Major difference between these two is that the former arises in the bone and the later in soft tissue. It appears most frequently in males at the age range of of 5-25 years, 80% of which occurs within first two decades of life. Males are more commonly affected than females. Present paper reported with a case report of male patient with 24-year-old showing Ewing's sarcoma of right maxilla.

A complex case of brown tumors as initial manifestation of primary hyperparathyroidism in a young female.

Brown tumor is one of the lesions that develop in patients with hyperparathyroidism (HPT) and represents the terminal stages of bone remodeling process. Any of the skeletal bones can be affected including the craniomaxillofacial ones. Many a times, brown tumor was detected after a final diagnosis of HPT is made. However, on occasions, brown tumor can be the first clinical sign of the disease. Primary HPT is an uncommon systemic disease usually caused by hyperplasia or adenoma of the parathyroid glands. It causes overproduction of parathormone, which may affect the entire skeleton, causing bone resorption appear as cyst-like lesions called osteitis fibrosa cystica or brown tumors. Here, we report such a rare case in which multiple radiolucent lesions were noticed in the ramus part of the mandible and premolar region bilaterally, as the initial signs of primary HPT are presented in this report.

Palatal rhinosporidiosis: an unusual case report and review of the literature.

Rhinosporidiosis is a chronic, granulomatous, mucocutaneous infection caused by Rhinosporidium seeberi . The infection is non-contagious and sporadic in humans. The site most commonly affected is the mucous membrane of the nose and nasopharynx, followed by the oropharynx, trachea, bronchi, ear, eye, and genitourinary tract. It can also spread to other areas through blood and lymph. Here, we report a case of rhinosporidiosis affecting the palate in a 60-year-old female patient.

Diffuse large B cell lymphoma of hard palate: a case report with literature review.

OBJECTIVE: Lymphomas are diverse group of neoplasm affecting the lymphoreticular system. Diffuse large B cell lymphoma is the most frequently diagnosed type of non-Hodgkin lymphoma and is the fifth most frequent malignancy, accounting for about 40% of cases reported. In the present case report a 40 year old female patient complains of swelling on right side of face since 45 days and gradually increased to present size. Intra-orally an ulcero-proliferative growth was present on the right side of hard palate. Incisional biopsy was suggestive of Lymphoproliferative disorder. Panel of immunohistochemical antibodies were used; which showed positivity for CD45, PAX5, Bcl2, Ki67, CD138 and negativity for CD3, CD10, CD20 and CD30. Therefore through routine standard hematoxylin and eosin staining a clear cut diagnosis of specific lymphoma was difficult to obtain and thus immunohistochemistry plays an important role in confirming the pinpoint diagnosis.

Immunohistochemical study of p21 and Bcl-2 in leukoplakia, oral submucous fibrosis and oral squamous cell carcinoma.

BACKGROUND: Oral Squamous cell carcinoma (OSCC) results from genetic damage, leading to uncontrolled cell proliferation of damaged cells and the cell death. In the course of its progression, visible changes are taking place at the cellular level (atypical) and the resultant at the tissue level (epithelial dysplasia). OBJECTIVES: The Aim of the present study was to evaluate and compare the expressions of intensity of p21 and Bcl-2 in Leukoplakia, oralsubmucous fibrosis (OSMF) and oral squamous cell carcinoma. METHODS: Total 60 cases, 30 cases of oral squamous cell carcinoma, 15 cases of oral submucous fibrosis and 15 cases of Leukoplakia were evaluated immunohistochemically for p21 and Bcl-2 expression. RESULTS: p21 showed positive expression in 13 (86.67%) cases out of 15 cases of OSMF, 12 (80%) cases of leukoplakia out of 15 cases and 24 (80%) cases out of 30 cases of OSCC. The Bcl-2 expression was positive in 13 (86.67%) cases of OSMF, all cases of Leukoplakia and 25 (83.33%) cases of OSCC. No statistical significance was noted in the expression of p21 and Bcl-2 positive expression between OSMF, Leukoplakia and OSCC. Statistical analysis for comparison of intensity of p21 expression in different grades of OSCC showed no significance. Statistical significance difference was found between the expressions of Bcl-2 in moderately and poorly differentiated SCC. CONCLUSION: The intensity of p21 and Bcl-2 expressions in different grades of OSCC indicates a key role in progression of oral neoplasia.

Dentigerous cyst associated with ectopically impacted maxillary second premolar.

Dentigerous cysts are benign odontogenic cysts that are accompanying with the crown of permanent teeth. They are typically single in incidence and are situated in the mandible. They are usually associated with impacted mandibular third molar and maxillary canines. Here we report a very rare presentation of dentigerous cyst in anterior maxilla accompanying with ectopically impacted maxillary second premolar. The cyst was enucleated along with extraction of premolar.

Bilateral necrotising sialometaplasia.

Necrotising sialometaplasia is a benign, necrotising, self-healing inflammatory condition categorised as idiopathic disease of salivary glands. This condition holds diagnostic importance because of its clinical and histopathological presentation, which is ambiguous, and can be misdiagnosed as carcinoma particularly squamous cell carcinoma or mucoepidermoid carcinoma. This report describes a case of bilateral necrotising sialometaplasia occurring in a 38-year-old male patient.

Lipoma of mandibular buccal vestibule: a case with histopathological literature review.

Lipoma is a tumour of soft tissue with rare occurrence in oral cavity accounting for only 1-4% of benign oral tumours. Most common sites of involvement are the buccal mucosa, tongue and floor of the mouth with typical presentation of an asymptomatic, soft, smooth-surfaced, nodular and yellowish mass. Histopathologically, a classical lipoma resembles normal adipose tissue and it has multiple variants which are less commonly seen except fibrolipoma. The article presents a case report of a relatively large oral classical lipoma in a 60-year-old man on a rare site, mandibular buccal vestibule, along with a review of the literature and special emphasis on its various histopathological variants.

Gingival leiomyomatous hamartoma of the maxilla: a rare entity.

Hamartoma is a tumour-like malformation appearing as a focal overgrowth of normal cells. Leiomyomatous hamartomas (LHs) are rare in the oral cavity and commonly seen in the Japanese and less than 40 cases have been reported in the Japanese and English literature. The clinical differential diagnoses are irritational (traumatic) fibroma and congenital epulis. It has to be differentiated histopathologically from its neoplastic counterparts and mesenchymomas. Hence, we report such a case of LHs, which presented as a sessile gingival growth occurring in the midline in a 15-year-old girl. The final diagnosis was based on the histopathological appearance which was confirmed by immunohistochemical staining of various markers. A review of the literature of previous cases was also carried out.

Histopathological evaluation of collagen fibers using picrosirius red stain and polarizing microscopy in oral squamous cell carcinoma.

BACKGROUND: Collagen is a part of structural connective tissue in every organ of the body. Study of collagen brings into focus the current knowledge of biosynthesis and degradation as a complex mechanism. One of the major aspects of tumor cell invasion and metastasis is the interaction between cancer cells and extracellular matrix component. Property of picrosirius red to enhance the birefringence is the result of basic protein nature of collagen molecules. There exists a direct relationship between the presence of type IV collagen and degree of differentiation in squamous cell carcinoma (SCC) cells as they lose their capability to form the basement membrane. MATERIALS AND METHODS: Thirty cases of oral SCC (OSCC) were evaluated for standard staining protocol of picrosirius red to analyze collagen fibers in different grades of OSCC under polarizing microscopy. RESULTS: In this study, moderately to poorly differentiated OSCC cases showed a gradual change in polarizing colors from yellowish orange to greenish yellow particularly in the vicinity of invading tumor islands. Thick collagen fibers forming bundles in parallel disposition were found around the neoplastic areas in discontinuous fashion. Type I collagen fibers of different lengths were strongly birefringent and swirl pattern, parallel orientation was evident. CONCLUSION: An observable stromal change with the progression of neoplasm was evinced with picrosirius red stain in different thickness of collagens with a significant change in the arrangement from the early stage to the advanced stage according to tumorogenesis.

Osteolipoma of floor of the mouth.

Lipomas are benign soft tissue tumours composed mainly of mature adipose tissue. Histological variants of lipomas have been named according to the type of tissue present and they include fibrolipoma, angiolipoma, osteolipoma, chondrolipoma and others. Osteolipoma, a classic lipoma with osseous metaplasia, is a very rare histological variant. Owing to the rarity of oral osteolipomas, we report an uncommon case of osteolipoma located on the floor of the mouth of a 20-year-old female patient and include a review of the literature.

Occlusal morphology of permanent mandibular first and second molars in Gujarati population.

BACKGROUND: Dental identification has been used since long time for disaster victim identification protocol. There is a difference of opinion regarding whether ethnicity influences dental morphology or not. Few studies have shown the associations between these dental features and crown traits in humans using quantitative methods. The present study is an attempt to find correlation of occlusal morphology of Gujarati population with forensic Odontology. AIM: To study different occlusal morphology of permanent mandibular first and second molars in Gujarati Population. MATERIALS AND METHODS: This study comprised of a total of 100 participants of Gujarati origin, selected by random sampling method. Total number of cusps and groove patterns of mandibular first and second molar were examined clinically and photographs of the same were taken. A descriptive statistics, Chi-square test and Student t-test were used for analysis of data. RESULTS: Mandibular first molar with 5 cusps in 71%, 4 cusps in 18% and 6 cusps in 11% were noted in the study. Mandibular first molars with "+" groove pattern in 39.5% and "Y" groove pattern in 60.5% were recorded. Mandibular second molar with 5 cusps in 6.5% and 4 cusps in 93.5% were recorded in the study. Mandibular second molars with "+" groove pattern in 93.5% and "Y" groove pattern in 6.5% were recorded. CONCLUSION: The most common occlusal morphology in permanent mandibular first molar is "5 cusp" and "Y" groove pattern in about 47% and for second molar is "4 cusp" and "+" groove pattern in 88.5% of Gujarati population. It may be concluded that variation in degree of expression and frequency of teeth in dentitions of different populations is different, which may help in forensic identification.