Benign osteoblastoma of the palate: a rare clinical presentation.

Osteoblastoma is a rare, benign type of osteoblastic tumor. It constitutes approximately 1% of all primary bone tumors. Osteoblastoma most commonly affects the long bones; it very rarely affects the jaw bones. Because of its clinical and histological similarity with other bony tumors, such as osteoid osteoma and fibro-osseous lesions, osteoblastoma is a diagnostic challenge. Very few cases of osteoblastoma involving the maxillofacial region have been reported to date. We herein describe a 15-year-old female patient with osteoblastoma that presented as a palatal swelling of 6 months' duration.

Multiple talon cusps on maxillary central incisor: A case report.

Dental anomalies affecting the teeth are relatively common. Simultaneous occurrence of multiple dental abnormalities in a single tooth is uncommon and relatively rare. One such abnormality routinely encountered in dental clinics is the talon cusp. It is also referred to as dens evaginatus, characterized by the presence of an accessory cusp-like structure projecting from the cingulum of anterior teeth. It has an increased predilection for maxillary teeth and permanent dentition. Although numerous cases of talon cusp have been reported in the literature, occurrence of multiple talon cusps in maxillary central incisors has not been found in the literature. This case report highlights the presence of talon cusps in maxillary anterior teeth with multiple impacted supernumerary teeth.

Evaluation of Efficacy of 1% Curcuminoids as Local Application in Management of Oral Lichen Planus - Interventional Study.

INTRODUCTION: Oral Lichen Planus (OLP) is a chronic inflammatory mucocutaneous disease affecting the oral cavity which has been associated with severe burning sensation which in turn affects the quality of life of the patients. Currently, the effective treatment of choice remains the use of corticosteroids. The chronicity and recalcitrant nature of the disease demand the long term use of these drugs with ensuing adverse effects. Turmeric and its active ingredient, "curcumin", have been found to have anti-inflammatory, antioxidant and anticancer properties. Hence, this intervention study was done to evaluate the efficacy of curcumin oral gel in the management of oral lichen planus. AIM: The study was conducted to compare the efficacy of 1% curcumin gel with the conventional mid-potent topical corticosteroid, triamcinolone acetonide 0.1% in managing the signs and symptoms of OLP. MATERIALS AND METHODS: An intervention study was conducted on 75 patients diagnosed with OLP divided into three groups, Group 1 (0.1% triamcinolone acetonide oral paste thrice daily in tapering doses), Group 2 (curcumin oral gel thrice daily) and Group 3 (curcumin oral gel six times daily). The patients were analysed for the symptom (burning) and sign (erythema and ulceration) using the numerical rating score and Modified Oral Mucositis Index (MOMI) for a period of three months on a bimonthly basis. The results were analysed using Students t-test and unpaired t-test. RESULTS: Intragroup comparison using paired t-test showed statistically significant reduction in burning sensation (p<0.001) as well as erythema and ulceration (p<0.001) in all the three groups. However, when the three groups were compared Group 1 showed the maximum reduction in burning sensation (77%) and erythema and ulceration (67%). Among the curcuminoid group, increased frequency was found to be more beneficial. CONCLUSION: Curcumin oral gel can bring about clinical improvements in OLP patients; however it cannot be used as a mainstay drug. Instead, it can be used as a maintenance drug after the patient is treated with an initial course of corticosteroids. Further studies with larger sample size and increased drug concentrations may be required.

Systemic absorption of 0.1% triamcinolone acetonide as topical application in management of oral lichen planus.

CONTEXT: Topical corticosteroids are the treatment of choice for oral lichen planus (OLP) due to its potential anti-inflammatory effect. However, chronic nature of OLP often requires long-term and frequent applications, exposing patients to local and systemic side effects. AIM: To detect the systemic absorption of 0.1% triamcinolone acetonide (TAC) through the oral mucosa of patients with OLP. SUBJECTS AND METHODS: This was a pilot pharmacokinetic study carried out in the Department of Oral Medicine and Radiology in collaboration with the Department of Toxicology, over 10 months. A total of twenty patients with OLP were included and advised to apply 0.1% TAC 3 times/day for 2 weeks and 2 times/day for next 2 weeks. Blood samples were obtained on the first and second visits and analyzed for triamcinolone using High pressure liquid chromatography (HPLC). STATISTICAL ANALYSIS USED: Paired t-test was done to compare visual analog scale (VAS) score for burning sensation at the first and second visits, statistically significant if P < 0.05. The baseline demographic data were analyzed using descriptive statistics. RESULTS: Paired t-test was done to compare VAS score for burning sensation at the first and second visits, which turned to being statistically significant (P = 0.001). Although HPLC is an established method for the detection of TAC, none of the study populations showed evidence of steroid (TAC) in the blood sample during 4 weeks of treatment duration. CONCLUSIONS: 0.1% triamcinolone is a relatively safe drug to be used with no systemic absorption in the standard dose regimen for oral lichen palnus.

Oral mucosal diseases in anxiety and depression patients: Hospital based observational study from south India.

OBJECTIVES: The objective of this study was to evaluate the prevalence of different Oral Mucosal diseases in Anxiety and Depression patients. MATERIAL AND METHODS: A hospital based observational Study was conducted in the department of Psychiatry and department of Oral Medicine and Radiology. Patients who were diagnosed with Anxiety or Depression by the psychiatrists using Hamilton Anxiety and Depression scale were subjected to complete oral examination to check for oral diseases like Oral Lichen Planus (OLP), Recurrent Aphthous Stomatitis (RAS), and Burning Mouth Syndrome (BMS). Equal number of control group subjects were also included. RESULTS: In this study statistically significant increase in the oral diseases in patients with anxiety and depression than the control group was recorded. Oral diseases were significantly higher in anxiety patients (20.86%) than in depression (9.04%) and control group patients (5.17%). In anxiety patients, the prevalence of RAS was 12%, OLP was 5.7%, and BMS was 2.87%. In depression patients, the prevalence of RAS was 4.02%, OLP was 2.01% and BMS was 3.01%. In control group the prevalence was 2.2%, 1.33% and 1.62% in RAS, OLP and BMS respectively. RAS and OLP were significantly higher in the younger age group (18-49) and BMS was seen between the age group of 50-77 years in both study and control groups. CONCLUSIONS: The results of the present study showed a positive association between psychological alterations and changes in the oral mucosa, particularly conditions like OLP, RAS and BMS. Thus psychogenic factors like anxiety and depression may act as a risk factor that could influence the initiation and development of oral mucosal diseases. Hence psychological management should be taken into consideration when treating patients with these oral diseases. Key words:Lichen planus, anxiety, depression, burning mouth syndrome, recurrent aphthous stomatitis.

Adenoid cystic carcinoma presenting as an ulcer on the floor of the mouth: a rare case report.

Adenoid cystic carcinoma is a rare epithelial tumour, and comprises about 1% of all malignant tumours of the oral and maxillofacial region. It is a malignant tumour which may develop in the trachea, bronchus, lungs or mammary glands, in addition to the head and neck region. Occurrences in the head and neck are mostly detected in the major salivary gland, oral cavity, pharynx and paranasal sinus where it presents as a slow growing firm nodular swelling. The aim of the article is to highlight the unique presentation of adenoid cystic carcinoma as a solitary ulcer on the floor of the mouth.