Comparative evaluation of alteration in taste perception among Gutkha chewers with and without OSMF and healthy subjects: A prospective case-control study.

Context and Aim: The major afflictions such as odynophagia (painful swallowing) and trismus that occur in patients with oral submucous fibrosis (OSMF) are well documented, but the impairment of gustatory functions has not received much consideration in the past. The present study was planned with a similar intent to assess and compare the alteration in taste perception among gutkha chewers with and without OSMF and healthy subjects. Materials and Methods: The present study was designed as a prospective case-control study comprising 90 individuals within an age range of 15-50 years who were divided into three groups with Group A consisting of 30 patients who were gutkha chewers with OSMF, Group B consisting of 30 individuals who were gutkha chewers but without OSMF and Group C consisting of 30 healthy subjects who were included as normal controls. The taste intensity response scores for the four basic tastes were recorded and the results obtained were, then, subjected to statistical analysis. Statistical Analysis Used: The data were analyzed using SPSS version 16.0 (SPSS Inc., Chicago, IL, USA). Comparison of the said parameters was done using Chi-square test, analysis of variance and Tukey's post-hoc test. P < 0.05 was considered statistically significant. Results: The findings of the present study suggested that all taste sensations were affected more in Group A patients than the Group B and Group C individuals. Conclusion: The results obtained in the present study were found to be encouraging as it was demonstrated that taste perception varied significantly among the patients with OSMF as against those having habit of betel nut/gutkha chewing but those who did not develop OSMF and the normal healthy controls and this data, though, initial, might be used on a scientific basis to improve the quality of life in the affected patients as well as to prevent the further progression of the disease process.

Calcifying Epithelial Odontogenic Cyst of Maxilla: Report of A Case and Review and Discussion on the Terminology and Classification.

A cyst is defined as a pathological cavity which may or may not have an epithelial lining and which has a fluid, semi-fluid, or gaseous contents and is not formed by accumulation of pus. The calcifying epithelial odontogenic cyst (CEOC) was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus. It was later renamed as calcifying cystic odontogenic tumor (CCOT) in the World Health Organization classification devised in 2005 due to its histological complexity, morphological diversity, and aggressive proliferation. CCOT was later recognized by numerous names including Gorlin cyst, calcifying ghost cell odontogenic cyst, and/or dentinogenic ghost cell tumor. It has a peak incidence during the second and third decades of life and does not demonstrate any gender predilection. Radiographically, CEOC may appear as a unilocular or multilocular radiolucent lesion with either well-circumscribed or poorly-defined margins and may also be observed in association with unerupted teeth. Calcification is an important radiographic feature for the interpretation of CEOC/CCOT. The typical histopathological features of CEOC include a fibrous wall and lining of odontogenic epithelium with either columnar or cuboidal basal cells resembling ameloblasts. The treatment of choice for CEOC is conservative surgical enucleation, however, recurrence is also not found to be uncommon. Herein, we are reporting a case of the same in a 21-year-old female which was a great dilemma during the diagnostic work-up.

Effect of platelet-rich fibrin versus chitosan-based Axiostat hemostatic agent following dental extraction in cardiac patients on antiplatelet therapy: A comparative study.

BACKGROUND: Platelet-rich fibrin (PRF) is a biomaterial that promotes wound healing. It has a fibrinous matrix wherein platelets, pro-inflammatory cytokines, and various growth factors along with few cells are entrapped while Chitosan is a naturally occurring cationic biopolymeric material that is derived from an animal product, chitin. It has demonstrated biological properties which include acceleration in wound healing, hemostasis, enhancement of immunological response, mucosal adhesion by eliciting biological responses, and anti-microbial action. AIM: The aim of this study was to evaluate the effect of PRF and Axiostat (A chitosan-based product) on hemostasis after tooth extraction among cardiac patients on antiplatelet medication. MATERIALS AND METHODS: This prospective study was carried out on 300 patients undergoing tooth extraction. Participants were divided into two categories (n = 150, respectively) as Group I (PRF dressing) and Group II (Axiostat dressing). Time to achieve hemostasis was observed using a stopwatch. Average pain score calculation was performed using visual analog on the 7-day postoperative period. Descriptive statistics were done, and data analysis was performed using the Mann-Whitney U-test. P < 0.5 and < 0.001 were considered statistically significant and extremely significant, respectively. RESULTS: Average pain score was 1.86 ± 0.06 in Group I and 1.05 ± 0.87 in Group II. Thus, lower postoperative pain was seen with Axiostat dressing. Hemostasis was achieved in Group II participants in 1.25 ± 0.06 min and in 1.89 ± 0.54 min in Group I. P < 0.01 was obtained, although no statistically significant difference in postoperative pain scores (P = 0.8) was seen. CONCLUSION: Chitosan is a superior wound dressing material in achieving hemostasis in cardiac patients on antiplatelet medication after tooth extraction.

Sensitivity and Specificity of Magnetic Resonance Imaging in Prediction of Cervical Lymph Node Metastasis in Oral Squamous Cell Carcinomas.

Background: The inaccuracies in clinical examination have been well-documented while advanced imaging modalities including computed tomography (CT) and magnetic resonance imaging (MRI) have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and of clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI. Methodology: A total of 24 patients attending as outpatients were included in the study while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then, subjected to advanced imaging with the help of MRI. Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA) while paired t-test was performed for evaluating size of tumor and lymph node recorded on clinical and imaging findings. p<0.05 was considered statistically significant. Results: Detection of tumor size and lymph node metastasis were found to be higher in case of MRI than when accomplished by clinical staging alone while paired t-test values for difference in results were found to be statistically significant (p<0.05). Conclusions: The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy highlighting the significance of advanced imaging modalities like MRI for an efficient pre-operative diagnostic work-up as well as, as a tool for planning treatment in patients with OSCCs.

Bilateral Dislocation of Mandibular Condyles following General Anesthesia-An Overlooked Problem: A Case Report.

Dislocation of mandibular condyles can occur following excessive mouth opening or traumatic injury to the temporomandibular joint. It can also occur during general anesthesia that at times may go un-noticed in the modern-day theater setup. Here, we describe a case of bilateral dislocation of mandibular condyle following orotracheal intubation for general anesthesia. Right condyle was dislocated into temporal fossa.

Macrostomia: a review of evolution of surgical techniques.

Macrostomia is a congenital deformity resulting from failure of fusion of maxillary and mandibular process. It is a rare congenital deformity with an incidence of 1 in 60,000 to 1 in 300,000 live births. Transverse facial clefts are more common on right side of face in unilateral cases. Males are more affected than females. Various surgical techniques have been described in the literature for the correction of these defects. We report a case of macrostomia corrected with Z-plasty closure for skin, overlapping muscle closure, and triangular mucosal flap for commissure, with a review on existing techniques.

Supraorbital blowin fracture presenting as an ocular dystopia in a nine-year-old girl.

A 9-year-old girl was referred to a trauma centre with severe head injury. 3D CT scan revealed depressed fracture involving the frontal bone on the right side, right parietal bone, and right superior orbital margin, right lamina papyracea. The frontal table was managed conservatively and open reduction and internal fixation was done for the supraorbital blow in to correct the ocular dystopia. The clinical course, possible mechanism, and management of the patient are discussed.