Oral Lichen Planus and Its Therapeutic Approaches: A Case Report.

Lichen planus, a chronic inflammatory skin disorder, presents with pruritic, polygonal, and flat-topped papules and plaques. It encompasses not only the skin but also mucous membranes, nails, and hair follicles. Diagnosis relies on all the clinical and biopsy reports. The etiology of oral lichen planus (OLP) is multifactorial, with genetic, immunological, and environmental factors playing significant roles. Frequently utilized therapies encompass topical corticosteroids, calcineurin inhibitors, and systemic immunomodulatory medications. Management should be tailored to disease severity and the specific site of involvement. Lichen planus can present in papular, hypertrophic, atrophic, erosive, or erythematous forms. In this report, we present a case of a 28-year-old male patient who presented with bilateral white striations on the buccal mucosa and an erythematous lesion on the right buccal mucosa causing significant discomfort. The patient was treated with corticosteroids, resulting in marked symptomatic relief and partial lesion regression over a follow-up period of six months. This case underscores the importance of early diagnosis and tailored therapeutic strategies in managing OLP to improve patient outcomes.

Herpes Zoster Infection of Orofacial Region in a Geriatric Patient: A Case Report.

The varicella-zoster virus reactivates to cause the "herpes zoster" (HZ). ''Varicella-zoster virus'' (VZV) termed as ''HHV-3'' or ''human herpesvirus-3'' infection causes herpes zoster. Varicella, the primary form of the virus, is chickenpox, and the secondary form of the virus is herpes zoster also called shingles. During prior chicken pox episodes, this virus enters the body through cutaneous nerve endings and becomes dormant in the dorsal root ganglia. It sometimes affects the orofacial region and appears as unilaterally distributed burning pain, multiple, painful vesicular lesions, and ulcerations. Immunocompromised people are more likely to have disseminated zoster, which is defined as the involvement of three or more dermatomes. These are most likely to occur in elderly, immunocompromised patients, patients undergoing cancer chemotherapy, patients on immunosuppressants, and patients suffering from AIDS. This is a study of a male geriatric patient, aged 74 years, who reported unilateral pain, swelling, as well as multiple ulcerations on the left side of his face, extraorally as well as intraorally. The case was diagnosed as a herpes zoster infection involving V1 and V2 dermatome of the trigeminal nerve.

Management of a Submandibular Sialolith: A Case Report.

Sialolithiasis is a condition that is characterized by the obstruction of the salivary gland duct opening by calcified mineral deposits due to various factors discussed in this case report. The most common symptom associated with the pathology is difficulty in deglutition, which can often lead to dehydration due to poor water intake. This, in turn further increases the viscosity of saliva which further promotes the formation of sialoliths. The management is dictated by the location and size of the sialolith, and in this case report, the significance of conservative treatment is emphasized while acknowledging the importance of invasive treatment when necessary.

Acute Necrotizing Ulcerative Gingivitis: A Case Report.

Compared to other conditions found in the necrotizing periodontal diseases group, acute necrotizing ulcerative gingivitis (ANUG) is a definite and specific disease. This illness has a long history that originates from the time of Hippocrates and is also referred to by several synonyms. ANUG occurs less commonly than other oral disorders, even though it is typically not rare. It starts suddenly, advances quickly, and finally results in significant loss of alveolar bone and soft tissue. Viral microorganisms and weakened host defenses have been linked to the etiology and pathophysiology of ANUG. In situations where there is psychological and physiological stress, the incidence of ANUG rises. In developed nations, the incidence of ANUG has declined and, in some cases, gone extinct due to the development of antibiotics and improved nutritional status. However, due to the persistently low nutritional status, the illness continues to be a frequently diagnosed clinical lesion in developing nations. This case report presents the case of a 24-year-old ANUG patient and the sequential treatment of this patient.

Exploring Non-invasive Therapies for Bell's Palsy: A Case Report.

Unknown in origin, Bell's palsy is a common acute facial nerve paralysis that is usually characterized by unilateral facial weakening or paralysis. People of all ages are affected by this illness, which peaks in the fourth decade of life. Although the precise etiology is yet unknown, viral infections - particularly type 1 herpes simplex virus - are frequently linked to the problem. Based on the evidence of abrupt onset facial weakness and the elimination of other neurological diseases, the diagnosis is essentially clinical. The goals of management techniques are to lessen related symptoms, encourage nerve regeneration, and lessen inflammation. Corticosteroids, antiviral drugs, physical therapy, and supportive measures are available as treatment alternatives. The majority of patients experience spontaneous recovery within weeks to months, and the prognosis is generally excellent. Nonetheless, a portion may experience long-term consequences, highlighting the significance of individualized follow-up care. Bell's palsy is succinctly summarized in this abstract to aid in better comprehension and well-informed clinical practice decision-making.

Herpes Simplex Virus (HSV)-Induced Erythema Multiforme: A Rare Case Report.

A polymorphous recurrent eruption mostly composed of macules, bullae, papules, and target lesions, which are often distributed symmetrically and can spread to distant extremities, and oral mucosae are the features associated with erythema multiforme (EM). Herpes simplex virus (HSV) is a common condition that is associated with EM and manifests in late adulthood. It shows recurrence and is usually diagnosed clinically. Following is a case of HSV-associated EM. A 45-year-old patient visited the outpatient department with complaints of oral ulceration and associated pain and burning sensation. The patient also reported that similar ulcers were seen two months prior to her visit, which resolved on their own and the recurrence was seen two days prior to the visit. The recurrence occurred with more severity of pain and inflammation as compared to previous ulcers. The patient was kept on a combination therapy of antivirals, steroids, silymarin, and multivitamins for four visits with a tapering dose of steroids. Post-treatment, there was no recurrence till date and the patient is able to perform mastication as well as deglutition without any pain or burning sensation.

Cherubism: Cone-Beam Computed Tomography Findings in Two Siblings.

Cherubism is an uncommon, multilocular cystic condition of the jaws. This autosomal dominant, nonneoplastic, fibro-osseous condition of the jaws affects children and is self-limiting. Clinically, it shows up as an expansion or distortion of the jaw together with an unnatural teeth alignment. In their most severe forms, these deformations might cause phonation difficulties, decreased pharynx lumen, visual issues, and psychological effects. This case report describes a case report of two siblings involving the maxilla and the mandible presenting with a painless bilateral symmetrical enlargement. Cherubism is a hereditary condition characterized by nonneoplastic bone lesions that damage the jaws. Surgery should be used to resolve any functional or aesthetically problematic issues. Typically, the surgical procedure is postponed until after puberty.

Chronic Inflammatory Gingival Enlargement: A Case Report.

Gingival enlargement can be referred to as an increased size of the gingival tissues. It might have originated because of inflammation, induced by certain drugs, linked to generalized illness, malignant, or pseudo enlargement, based on its etiology and pathogenesis. Enlargements may be widespread, papillary, or marginal, depending on the location. It affects the patient's masticatory, functional, aesthetic, and psychological health. Diagnosing the condition and its underlying cause through a detailed history is the mainstay for management. Diagnosis is based on a careful clinical examination in relation to the consistency, texture, and color of enlarged gingival tissues. Once diagnosed, the intervention relies on treating the causative factor involved in the condition. Early diagnosis and treatment with the elimination of the etiologic factor along with strict oral hygiene instructions and regular follow-up results in the restoration of aesthetics and function. This article presents a case report of a female patient aged 31 years who presented to the Oral Medicine and Radiology Department with chief complaints of swollen gums, bleeding gums while brushing for one month, and pain and loosening of teeth in the upper left back region of the jaw since 15 days. On thorough clinical examination, oral hygiene instructions were given along with antimicrobials and analgesic medications, and extensive scaling and sub-gingival curettage were done. On the follow-up visit after seven days, there was reduced inflammation due to the removal of local irritants like plaque and calculus and reduced gingival enlargement. The takeaway message from this case is that clinicians should be thoroughly acquainted with the normal and pathologic alterations of the gingival tissues and possible etiologic factors for it. Careful examination, prompt diagnosis, and treatment form the mainstay of management.

Trigeminal Neuralgia Due to Neurovascular Conflict: A Case Report.

A 47-year-old female patient visited the outpatient department with the complaint of "sharp shooting, radiating type of pain" on the maxillary left posterior gingiva for the last three months. The patient was advised a magnetic resonance imaging (MRI) scan which gave the radiological diagnosis of trigeminal neuralgia (TN). It also stated that the root entry zone of cranial nerve-V (CN-V) was in contact with the superior cerebellar artery and anterior inferior cerebellar artery. The patient was kept on a carbamazepine and gabapentin combination and a supportive therapy of multivitamins which brought complete remission within 1.5 months. This case report supports the combination therapy of carbamazepine and gabapentin with supportive therapy of multivitamins.

Laser-Assisted Surgical Management of Oral Mucocele: A Case Report.

This case represents mucocele of extravasation phenomenon associated with a lower lip on the right side in the last 15 days. A 19-year-old male patient visited the outpatient department with a history of constant trauma due to lip biting and due to soft and flocculent consistency on palpation, mucocele was considered under the provisional diagnosis. The borders of the lesion were marked following all the protocols of asepsis and sterilization and laser-assisted surgical excision was undertaken resulting in total removal of the lesion with a diode laser by resecting it from the base to reduce chances of re-occurrence. The specimen that was resected was sent for histopathological examination, which confirmed the final diagnosis of mucous extravasation cyst or mucocele. The following report underlines that laser-assisted resection offers a minimally invasive and precision approach for the treatment of mucocele.

Role of Betel Nut in Liver Toxicity in Oral Submucous Fibrosis and Oral Cancer Patients: A Case-Control Study.

BACKGROUND: In 2004, the International Agency for Research on Cancer (IARC) revised its conclusion that betel quid, both with and without tobacco, as well as areca nut alone, was carcinogenic to humans. Areca nut may enhance chemical hepatocarcinogenesis. Researchers have studied the role of areca nut components in the etiology of oral submucous fibrosis (OSF) for the past two decades. OBJECTIVES: In this, we will study the role of betel nut chewing on the liver and its correlation with the occurrence of OSF and oral cancer. METHODOLOGY: It is a type of case-control study for a duration of three months. A total of 60 subjects were selected based on the selected groups and exclusion criteria. A detailed case history was taken, and after that blood samples were collected for conducting liver function tests. After the collection of reports from the labs, the results were assessed, analyzed, and correlated with the case history of each subject. RESULTS: This research aids in the identification of a link between the occurrence of OSF, oral squamous cell carcinoma (OSCC) liver damage, and the practice of eating betel nuts. Chewing betel quid on a regular basis appears to be a separate risk factor for liver damage, OSCC, and OSF. CONCLUSION: This assessment of liver function with case history in each subject aids in providing an improvised and prioritized method for the early diagnosis of liver misfunctioning in the patient with OSF or Oral Cancer due to a common etiological factor, that is betel nut.

The Management of Oral Pemphigus Vulgaris in a Hypertensive Patient: A Case Report.

Pemphigus vulgaris (PV) is a chronic autoimmune disorder that causes painful blisters on the skin and mucosa along with erosions due to intra-epithelial acantholysis. This acantholysis is mainly due to an immune reaction against desmoglein (an adhesion glycoprotein molecule) by IgG autoantibodies, which causes loss of cell-to-cell adhesion. The treatment consists of systemic corticosteroids such as tablet prednisolone along with topical steroids such as 0.1% triamcinolone paste. But steroids are known for their side effects, one of which is hypertension. It is vital for a dentist to curate the management of this lesion particularly when the drug of choice can potentially lead to adverse effects including systemic complications. This is a case report of a 60-year-old female with PV with systemic hypertension, emphasizing the management of this condition so as to prevent any complications that may arise due to the drug that is administered.

Evaluation of serum vitamin B12 levels and its correlation with clinical presentation in patients with trigeminal neuralgia.

Background: The objective of this study was to estimate serum vitamin B12 levels and its correlation with severity of clinical presentation in patients with trigeminal neuralgia (TN). Methods: A total of 80 participants were included and rendered into study group: 40 TN patients and control group: 40 healthy individuals. The serum vitamin B12 estimation of each participant was carried out by using serum vitamin B12 ELISA kit and pain characteristics of TN patients were recorded in details. Results: The mean serum vitamin B12 level was noticed to be significantly lower (p = 0.042) in study group (296.87 ± 248.75 pg/mol) as compared to control group (423.5 ± 296.41 pg/mol). There was a statistically significant difference in serum vitamin B12 level between vegetarian TN patients and those who were on mixed diet (p = 0.001). The pain associated with TN predominantly reported unilaterally involving the right side (55%), female gender (55%) and mandibular division (50%). Although pain intensity showed no significant relation (p = 0.024), duration of pain reported a strong negative association with mean serum vitamin B12 levels in TN patients (p = 0.001). Conclusions: Vitamin B12 supplements can be added to the established treatment protocol for the holistic management of TN patients particularly those who are on vegetarian diet.

Evaluation of the Role of Propolis and a New Herbal Ointment in Promoting Healing of Traumatic Oral Ulcers: An Animal Experimental Study.

Most of the currently used medications for the treatment of oral ulcers focus primarily on providing symptomatic relief and preventing secondary infections. Not much attention has been paid in the past on agents that can promote healing of these lesions. In the current study, we have tested and compared the efficacy of such wound healing promoting agents i.e. Propolis (product obtained from Bees) and a newly developed herbal ointment (containing extracts of Azadirachta indica (Neem), Linum usitatissimum L.(Linseed) oil, and resin of Shorea robusta) in experimental rabbits. METHODOLOGY: Traumatic oral ulcers were inflicted in experimental rabbits (New Zealand white) with the help of a punch biopsy instrument. The animals were then divided into three groups each group consisted of 12 animals (n = 12), Group I was the untreated control group and Group II was topically treated with nonalcohol extract of propolis and Group III was treated with newly developed herbal ointment. Histological healing scores of the ulcers were evaluated on day 7 and day 14. Data were statistically analyzed using descriptive and inferential statistic methods. RESULTS: In Group III treated with newly developed herbal ointment, significantly higher healing scores, in comparison to the untreated control group (Group I) and propolis (Group II) was observed on day 7 and 14. Improved healing scores in prapolis-treated group were observed than the untreated control group. However, the difference was not statistically significant on both day 7 and day 14. CONCLUSION: With the newly developed herbal ointment, superior healing of traumatic oral ulcers was observed.

Quarantine an effective mode for control of the spread of COVID19? A review.

The outbreak of COVID- 19 disease has taken the world by surprise. The disease mainly affects the respiratory system and is caused by a strain of coronavirus named SARS-CoV-2. Due to its high recombination rates the virus has an immense potential to spread rapidly. Within months of the first case being reported in Wuhan China, the disease has turned rapidly into a pandemic. The world health experts are already actively looking for a definite cure or vaccine for the disease, but till that many of the countries across the globe are looking up onto mass quarantine measures as a method to control its spread. This article is an attempt to review the effectiveness of these measures and the possible adverse effects of the same. Other possible modes of prevention and controlling the spread of the disease have also been reviewed in the article.