Knowledge, attitudes, and practices of dentists after the COVID-19 pandemic: A cross-sectional study.

Background: Dentists are at an increased risk of encountering cross-infections because of working in close proximity with oral mucosa and saliva making use of high-speed rotary instruments during treatment generating large amount of aerosols and splatter which in turn increases the probability of nosocomial spread of infections. The present study aimed to evaluate the knowledge, attitudes, and practices of dentists after the COVID-19 pandemic. Materials and Methods: The present cross-sectional study was conducted using Google Forms wherein a well-structured questionnaire composed of a total of 25 closed-ended questions was distributed among practicing dentists through online mode. Step-wise linear regression analysis was done to determine the influence of independent variables on the knowledge, attitude, and practice scores of the participants. P < 0.05 was considered statistically significant. Results: On analyzing the results, multiple linear regression analysis revealed no significant difference in the knowledge scores among the participants, while good attitude and practice scores were significantly associated with higher qualification of the participants. Another noteworthy finding in the study was the significant correlation observed between the various components of the knowledge, attitude, and practice scores among the participants (P < 0.05). Conclusion: It could be concluded from the findings of the present survey that dentists were found to have good knowledge scores about the COVID-19 pandemic. They should, however, pay more emphasis on practicing tele-triaging and proper screening and should follow various guidelines and advisories issued from time to time by the competent authorities.

Comparative evaluation of impact strength of mechanically modified heat polymerized polymethyl methacrylate (PMMA) resin with addition of 0.5, 1, 2 wt% of silver nanoparticles (AgNPs): An in-vitro study.

OBJECTIVE: Polymethyl methacrylate (PMMA) is one of the most widely used denture base material because of favorable esthetics and desirable characteristics such as easy handling. Acrylic resins, although, have some inherent disadvantages such as relatively poor physical and mechanical properties. The objective of the present study was to evaluate and compare the impact strength of unmodified and modified heat cure PMMA-based denture base material with addition of different concentrations of silver nanoparticles (AgNPs) (0.5, 1, 2 wt%). METHODS: The present in-vitro study comprised of a total of 60 samples allocated to four groups with Group A samples consisting of heat cure acrylic resin without any modification (used as control); Group B samples consisting of heat cure acrylic resin modified with 0.5 wt% of AgNPs; and subsequently, Group C and Group D samples consisting of heat cure acrylic resin modified with 1 wt% and 2 wt% of AgNPs, respectively. The impact strength of the prepared acrylic samples was evaluated using Izod/Charpy Impact Tester, while the values obtained were tabulated and subjected to statistical analysis. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), while one-way analysis of variance and Tukey's multiple post-hoc procedures were used for statistical analysis. P < .05 was considered statistically significant. RESULTS: The highest impact strength was found in Group C samples consisting of heat cure acrylic resin modified with 1 wt% of AgNPs to be closely followed by Group B samples consisting of heat cure acrylic resin modified with 0.5 wt% of AgNPs. Group D samples consisting of heat cure acrylic resin modified with 2 wt% of AgNPs, although, revealed relatively lower impact strength compared to Group B and Group C samples. CONCLUSIONS: Within the limitations of the present study, it was concluded that the impact strength of mechanically modified heat polymerized PMMA resin was significantly enhanced with addition of varying concentrations of AgNPs, although, it was observed that with an increase in the concentration of AgNPs, a subsequent decrease in the tensile strength of the final polymer material was observed.

Canine retraction and anchorage loss using self-ligating and conventional brackets with sliding mechanics: A split-mouth clinical study.

OBJECTIVE: Appliance biocompatibility, orthodontic treatment efficiency and patient convenience are the major issues confronting contemporary orthodontic practice. Very few studies have been published till date regarding the efficiency of self-ligating brackets as against conventional brackets. Hence, the present study was planned to compare the rate of canine retraction between self-ligating and conventional brackets and to determine the amount of anchorage loss during canine retraction. METHODS: The present clinical study was designed as a prospective, observational study comprising of 25 patients requiring first premolar extraction as a part of orthodontic treatment. Self-ligating and conventional brackets were bonded using a split-mouth study design randomly. Retraction of canines was done with 150 grams of force using Dontrix gauge with E-chains. The study was conducted in relation to upper arch only, while the rate of retraction was evaluated every 4 weeks for 3 months. Average rates of retraction in 3 months were calculated. For anchorage loss, an acrylic guide plug was used in mid-treatment cast (T0) and after 3 months of retraction (T3). The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA). Independent t-test was used to compare the means of the two variables studied, while Pearson's correlation coefficient was used to evaluate the correlation between the variables studied in the groups included. P < .05 was considered statistically significant. RESULTS: The correlation coefficient between the average rate of canine retraction with self-ligating brackets vs. conventional brackets over a period of 3 months came out to be 0.6434, while on comparing the data in terms of anchorage loss over a period of 3 months, the respective correlation coefficient value was found to be 0.6659 with the results being statistically highly significant in either case (P < .001). CONCLUSIONS: Self-ligating brackets showed double the amount of displacement compared to conventional brackets in some of the cases. Also, chair side time was significantly reduced with self-ligating brackets as against conventional brackets.

Osseodensification implant site preparation technique and subsequent implant stability: A pilot study.

OBJECTIVE: The objective of the present study was to evaluate and compare primary and secondary implant stability of conical endosteal implants placed using osseodensification osteotomy and conventional osteotomy techniques. MATERIALS AND METHODS: The present invivo study was designed as a prospective, observational study in which a total of 26 endosteal implants were placed in the posterior edentulous regions of upper and lower jaws in 13 patients divided into two groups, Group A and Group B. In Group A, implants were placed using osseodensification osteotomy technique while in Group B, conventional osteotomy technique was used. Primary implant stability was measured in both groups immediately after implant placement while secondary implant stability was measured in both groups at an interval of 4 months. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.00 (SPSS Inc., Chicago, IL, USA) while an independent t-test, also, called Student's t-test was used to conduct the analysis. RESULTS: The mean value of primary implant stability in Group A was found to be 74.5 as against that in Group B which was 62.08 (P-value 0.001). Likewise, the mean value of secondary implant stability in Group A after 4 months' interval was 70.92 while in Group B, it was found to be 63.69 (P-value 0.001). CONCLUSIONS: The dental implants placed with the osseodensification technique showed higher mean primary and secondary implant stability values when compared to implants placed by the conventional technique.

Linear Cephalometric Analysis of Pharynx at the Level of Epiglottis among Snorers and Nonsnorers: A Cross-Sectional Study.

Aim Snoring, which falls within the spectrum of sleep-related breathing disorders, is considered to be one of the common symptoms of airway obstruction. Lateral cephalometric analysis is an effective way of diagnosing airway obstruction by evaluating skeletal and soft tissue abnormalities in patients with sleep-disordered breathing (SDB). The present study was planned to analyze the pharyngeal space among snorers and nonsnorers in the retroglossal region and in the region of hypopharynx at the level of epiglottis. Materials and Methods The present cross-sectional study included a total of 60 individuals who were grouped into snorers and nonsnorers based on their answers for the study questionnaire related to snoring. Digital lateral cephalograms were taken for all maintaining the exposure parameters while Digora software was used for measurements related to the soft tissue parameters. The two significant soft tissue parameters analyzed were the distance of epiglottis from the tip of the soft palate, the retroglossal length, and the distance of posterior pharynx from the tip of the epiglottis, the pharyngeal space. Statistical Analysis The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, Illinois, United States) while paired t -test was used for intergroup analysis. A p -value of < 0.05 was considered statistically significant. Results The mean retroglossal length was found to be 25.52 mm among the snorers and 23.70 mm among the nonsnorers. In case of pharyngeal space, a mean of 8.54 mm was recorded among the snorers whereas among the nonsnorers, the respective mean value of 10.16 mm was observed. Conclusion In the present study, pharyngeal space was found to be less at the level of the tip of epiglottis among the snorers compared with nonsnorers which can be attributed to be one of the significant reasons behind snoring and obstructive sleep apnea syndrome.

Accidental Pathological Findings in Asymptomatic Maxillary Sinuses in Patients Referred for Head and Neck Cone-Beam Computed Tomography: A Cross-sectional Study Analysis.

Background: The aim of the present study was to detect the prevalence of accidental pathological findings in asymptomatic maxillary sinuses in patients referred for head and neck cone-beam computed tomography (CBCT) examination for varied reasons. Methods: The present cross-sectional study included a detailed analysis of CBCT scans of 150 patients aged between 18 and 70 years reporting for varied dental complaints for detecting accidental pathological findings in maxillary sinuses while the patients did not have any complaint pertaining to sinuses. Results: The findings of the present study revealed 58% patients to have pathological findings in maxillary sinuses while they were asymptomatic for sinuses. Furthermore, the prevalence of mucosal thickening was found in 29.3% of the patients while 36.7% patients presented with polypoidal mucosal thickening. Conclusion: Higher prevalence of pathologies in asymptomatic maxillary sinuses found in the present study emphasized significance of a thorough examination of routine dental patients by dento-maxillofacial radiologists with necessary investigations to be advised in the form of higher imaging modalities like CBCT, if necessary.

Serum ceruloplasmin as cancer marker in oral pre-cancers and cancers.

BACKGROUND AND AIM: Oxidative stress leads to a compensatory increase in levels of serum ceruloplasmin in patients with such imbalances. Greater than normal serum ceruloplasmin levels are noticed in numerous cancers including the leukemias and Hodgkin's lymphoma. The purpose of the present study was to estimate and evaluate the efficacy of serum ceruloplasmin levels as a potential biomarker in the early detection of oral potentially malignant epithelial lesions (PMELs) including leukoplakia, oral submucous fibrosis (OSMF), and oral squamous cell carcinoma (OSCC) patients. MATERIALS AND METHODS: The present observational study was conducted over a period of 2 years wherein 100 subjects aged between 18 to 60 years were divided into four groups with Group A consisting of 25 healthy controls, Group B and C with 25 patients each, clinically diagnosed with oral leukoplakia and OSMF and Group D with 25 patients clinically diagnosed and histopathologically proven OSCC. The patients were subjected to incisional biopsy after routine hematological investigation while the same sera samples were used for analysis of serum ceruloplasmin levels. STATISTICAL ANALYSIS USED: Comparison of serum ceruloplasmin levels between the groups was performed using one way analysis of variance (one way ANOVA) test while P < 0.05 was considered statistically significant. RESULTS: The mean serum ceruloplasmin levels were found to be 43.19 ± 1.90mg/dl in subjects of group A, 47.68 ± 1.51mg/dl in group B, 47.74 ± 1.45mg/dl in group C and 47.73 ± 0.74mg/dl in group D. Using one-way ANOVA, statistically significant variations were found in the values of mean serum ceruloplasmin levels in subjects of the four groups (F-value = 59.58, P = 0.0001). CONCLUSIONS: The observations of the present study revealed that serum ceruloplasmin levels were found to be raised in all 3 study groups including oral leukoplakia, OSMF and OSCC as compared to the controls while the results were found to be statistically significant.

Pulp Stones: Diagnostic Significance in Early Diagnosis and Radiographic Correlation with Ischemic Heart Diseases.

Context and Aim Sufficient evidence exists in the literature which indicates that patients with ischemic heart diseases (IHDs) show higher degree of pulp calcifications. The present study was, therefore, planned to estimate the prevalence of pulp stones in patients diagnosed with/or undergoing treatment for IHDs. Materials and Methods The present study, which consisted of 300 subjects within the age range of 25 to 65 years, was divided into two groups: study group comprising 150 patients (113 males and 37 females) and 150 age- and sex-matched healthy controls. Pulp stones were imaged using bitewing radiographs and paralleling technique under standard conditions. Statistical Analysis Used Statistical analysis was done using IBM SPSS Statistics for Windows version 21 (IBM Corp, Armonk, USA), while independent t -test and Chi-square test were done to check the prevalence of pulp stones in the study and control groups, based on gender-, arch-, region- and side-wise distribution. p < 0.05 was considered statistically significant. Results The patients with IHDs exhibited 100% prevalence of pulp stones and the difference was found to be statistically significant, although there was a significant difference in the mean number of pulp stones observed in the study and control groups, with the study group revealing 2217 pulp stones as against 639 pulp stones observed in the control group ( p < 0.001). Furthermore, maxillary arch and posterior teeth were predominantly affected in both the groups, although the difference was not found to be statistically significant. Conclusions The findings of the present study suggested a positive correlation between pulp stones and IHDs, highlighting the significance of dental radiographic examination, which may have a possibility for an early detection of IHDs.

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.

Clinical diagnostic criteria versus advanced imaging in prediction of cervical lymph node metastasis in oral squamous cell carcinomas: A magnetic resonance imaging based study.

CONTEXT AND AIM: The inaccuracies in clinical examination have been well documented, while advanced imaging modalities, including computed tomography 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. MATERIALS AND METHODS: 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 the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), while paired t-test was performed for evaluating the size of tumor and lymph node recorded on clinical and imaging findings. A P < 0.05 was considered statistically significant. RESULTS: Detection of tumor size and lymph node metastasis was 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 such as MRI for an efficient preoperative diagnostic workup, as well a tool for planning treatment in patients with OSCCs.

Comparative Evaluation of Mineral Trioxide Aggregate Pulpotomy and Laser-Assisted Mineral Trioxide Aggregate Pulpotomy: An Original Research Article.

CONTEXT AND AIM: Formocresol has been used as the material of choice (gold standard) for pulpotomy procedures because of the ease of use but was discouraged due to its potential immune sensitization and mutagenic effects. Laser irradiation was first applied for pulpotomy procedure in the year 1985. Recently, diode lasers have been used for pulpotomy in primary teeth and have shown clinical success rates comparable to formocresol. The present in vivo study was carried out to compare the clinical and radiographic success rates of mineral trioxide aggregate (MTA) pulpotomy and diode laser-assisted pulpotomy in human primary molars. MATERIALS AND METHODS: The present study was a randomized clinical trial in design wherein 40 primary teeth requiring pulpotomy treatment which met the selection criteria (clinical and radiographic) were divided into two groups, Group 1 (n = 20) wherein the pulpotomy was performed with MTA alone and Group 2 (n = 20) wherein laser-assisted pulpotomy was performed with MTA (L-MTA). The patients were recalled after 3, 6, and 9 months, respectively and evaluated clinically and radiographically. STATISTICAL ANALYSIS USED: The data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 22 (IBM corporation, Washington DC, United States). Descriptive statistics were used to analyze the data while the Pearson's correlation coefficient test was used to analyze the statistical correlation between the overall success rates observed in the clinical and radiographic findings of both the groups. P < 0.05 was considered statistically significant. RESULTS: The clinical success rate in the MTA group was 90%, 84.21%, and 88.23% at 3, 6, and 9 months, respectively, with no clinical signs or, symptoms reported at the said follow-up visits while the radiographic success rate was found to be 85%, 84.21%, and 82.3%, respectively. On the contrary, the clinical success rate in the L-MTA group was found to be 95%, 94.74%, and 94.44% at 3, 6, and 9, months, respectively with the radiographic success rate reported being 90%, 89.47%, and 88.89%, respectively. CONCLUSION: The combination of diode laser and MTA yielded better clinical and radiographic success rates over the pulpotomy procedures done with the help of MTA alone, thereby, concluding that lasers may be considered as adjuvant alternatives for vital pulp therapy on human primary teeth.

A report of a novel approach for the management of paediatric mandibular fracture using a prefabricated adaptable surgical splint.

Paediatric facial fractures are relatively rare. The inherent elasticity of the bones with more of the cartilage than that of the mineralised bone accounts for this. The principles involved in the management of facial fractures are the same irrespective of the age of the patient; however, in children, the techniques used are necessarily modified by certain anatomical, physiological, psychological and feeding factors related to childhood and the parents. In an attempt to keep the treatment and fixation technique simple, the case, presented here, describes the management of a mandibular parasymphyseal fracture in a 16-month-old child with the use of a prefabricated adaptable surgical splint.

Variations in Canal Morphology, Shapes, and Positions of Major Foramen in Maxillary and Mandibular Teeth.

CONTEXT AND AIM: A plethora of studies have revealed that there is a lack of general consensus in the precise anatomic detailing of the canals and the major foramen in both the maxillary and mandibular teeth while emphasizing the significance of the same for a successful endodontic treatment. The aim of the present study was to determine the variations in canal morphology, shapes, and positions of major foramen in maxillary and mandibular teeth. MATERIALS AND METHODS: In the present study, 420 extracted human maxillary and mandibular teeth with completely formed apices were included. The specimens were cleaned for surface debris including remnants of periodontal tissue and were stored in saline. Examination of the apices was performed with the help of stereomicroscope for their exact shapes and configurations and precise anatomic location. Comparison of different parameters within the group was done using Chi-square test while P < 0.05 was considered statistically significant. RESULTS: The results of the present study indicated that apical foramen in mandibular teeth showed higher degree of deviation with a prevalence of 70.2% while flat shape of apical foramen was observed only in maxillary teeth. Furthermore, maximum deviation in maxillary teeth was recorded in the canines with a prevalence of 90% while, in mandibular teeth, maximum deviation was recorded with mandibular second premolars with a prevalence of 79.12%. CONCLUSIONS: The results of the present study revealed that deviation of apical foramen from the root apex was seen in 68.2% of the specimens. Furthermore, deviation was greater in the mandibular than the maxillary teeth.

Efficacy of Transcutaneous Electrical Nerve Stimulation on Salivary Flow Rates in Normal Healthy Adults According to Gender and Age Groups.

INTRODUCTION: Salivary gland hypofunction might be associated with various local and systemic conditions and is managed with a plethora of therapeutic options with associated side effects. Transcutaneous electrical nerve stimulation (TENS) is one such option with no known systemic side effects for dealing with this crippling condition. The present study was planned with a similar intent of assessing impact of TENS on salivary flow rates in normal healthy adults according to gender and age groups. MATERIALS AND METHODS: The present study was designed as a cross-sectional study on 130 healthy adults wherein unstimulated and stimulated saliva was collected for 5 min in graduated test tubes fitted with a funnel while mean salivary flow rates were calculated. The data were analyzed using SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). RESULTS: In the present study, differences between mean unstimulated and stimulated salivary flow rates with TENS were found to be statistically significant for both genders (P < 0.001). Furthermore, in relation to age groups included, maximum increase in salivary flow rate was seen in 20-29 years of age group, though significant results were seen in all three age groups included namely 20-29 years, 30-39 years, and 40-49 years (P < 0.001). CONCLUSIONS: Based on results from the present study, it could be concluded that TENS comes out to be a safer, nonpharmacological therapeutic option for treating patients with xerostomia.

Linear Cephalometric Analysis of Pharynx at the Level of Epiglottis among Snorers and Nonsnorers: A Cross-Sectional Study.

BACKGROUND AND AIM: Snoring, which falls within the spectrum of sleep-related breathing disorders, is considered to be one of the common symptoms of airway obstruction. Lateral cephalometric analysis is an effective way of diagnosing airway obstruction by evaluating skeletal and soft-tissue abnormalities in patients with sleep-disordered breathing. The present study was planned to analyze the pharyngeal space among snorers and nonsnorers in retroglossal region and in the region of the hypopharynx at the level of epiglottis. MATERIALS AND METHODS: The present cross-sectional study included a total of 60 individuals who were grouped into snorers and nonsnorers based on their answers for the study questionnaire related to snoring. Digital lateral cephalograms were taken for all maintaining the exposure parameters, whereas Digora software was used for measurements related to the soft-tissue parameters. The two significant soft-tissue parameters analyzed were the distance of epiglottis from the tip of the soft palate, the retroglossal length and the distance of posterior pharynx from the tip of the epiglottis, the pharyngeal space. STATISTICAL ANALYSIS USED: The statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), whereas paired t-test was used for inter-group analysis. P <0.05 was considered statistically significant. RESULTS: The mean retroglossal length was found to be 25.52 mm among the snorers and 23.70 mm among the nonsnorers. In the case of pharyngeal space, a mean of 8.54 mm was recorded among the snorers, whereas among the nonsnorers, the respective mean value of 10.16 mm was observed. CONCLUSION: In the present study, pharyngeal space was found to be less at the level of the tip of epiglottis among the snorers compared to nonsnorers which can be attributed to be one of the significant reasons behind snoring and obstructive sleep apnea syndrome.

Prevalence of Color Vision Anomalies among Dental Professionals.

PURPOSE: Color blindness is one of the potential disabilities affecting the ability of color perception by the eye. The aim of the present study was to evaluate the prevalence of color blindness among dental professionals. METHODS: For the present study, a total of 198 dental professionals were randomly selected as subjects who were asked to fill the required questionnaire followed by which their color vision status was evaluated using the Ishihara test. The results obtained were subjected to statistical analysis. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA). The prevalence of color blindness, age specificity, and the ratio of the occurrence of color blindness in relation to gender were assessed using Chi-square test for independence and Chi-square test with Yates's correction for independence when the expected frequency was <5. P < 0.05 was considered statistically significant. RESULTS: The present study reported 3.54% prevalence of color blindness among the study population. A higher number of cases were reported from males (9.26%) than females (1.39%). (P < 0.05) Furthermore, the prevalence of color blindness was found to be more in faculty members (5.88%) than in students with a reported prevalence of 3.31%. CONCLUSION: The present study reported high prevalence of color blindness in dental professionals while they were totally unaware of it.

Calcifying Epithelial Odontogenic Cyst of Maxilla: A Clinical and Histological Rarity with Literature Review.

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 the 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 dentogenic 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 the 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 workup.

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.

Prevalence of congenitally missing upper lateral incisors in an orthodontic adolescent population.

OBJECTIVE: To determine the frequency of congenitally missing maxillary lateral incisors (LIs) and to find out its variability in relation to gender. MATERIALS AND METHODS: A retrospective study was carried out between January 2017 and December 2017. Orthopantomographs (OPGs) and lateral cephalographs record search of all orthodontic adolescent patients aged 12 to 18 years were taken from the archival records of the department. Orthopantomographs helped to diagnose the presence of unilateral/bilateral maxillary lateral incisors while the ANB angle was calculated from the lateral cephalographs to divide the subjects into various skeletal malocclusions. STATISTICAL ANALYSIS USED: The statistical analysis was done using the Statistical Package for Social Sciences (SPSS version 17.0). The frequencies were compared with the help of the Chi-square test. P <0.05 was considered statistically significant. RESULTS: The frequency of missing upper laterals among the male patients was 0.9%, however, 2.8% of the female patients were having missing maxillary lateral incisors. Based on gender, 62.16% had a bilateral expression of missing upper laterals, 16.21% had left unilateral expression, and 21.62% had right unilateral expression. Furthermore, skeletal class I malocclusion had a prevalence of 54.16% of bilateral missing lateral incisors in upper arch as compared to 40% of left unilateral expression and 37.5% of right unilateral expression whereas in skeletal class II malocclusion, the prevalence of right unilateral expression was 37.5% as compared to bilateral expression which was 33.33%. The left unilateral expression in skeletal class II malocclusion was found to be only 20%. The highest prevalence of missing laterals in skeletal class III malocclusion was left unilateral expression which was around 40%. The prevalence of right unilateral expression was 25% whereas the bilateral absence of upper laterals in skeletal class III malocclusion was 12.5%. CONCLUSION: The prevalence rate for congenitally missing upper lateral incisors in the orthodontic adolescent population aged 12 to 18 years was found to be 3.77% in the present study while females were found to have a greater percentage of agenesis of the upper lateral incisors (2.8%) as compared to the males (0.9%).

Craniofacial morphology of HIV-infected adolescents undergoing highly active antiretroviral therapy (HAART): An original research.

OBJECTIVES: To analyze the craniofacial morphology in child patients and adolescents by evaluating the skeletal cephalometric profile of the HIV infected patients in this age group and comparing them with the HIV-negative controls. MATERIALS AND METHODS: The present study was a planned case-control study which included 25 HIV-positive adolescent patients aged between 10 and 18 years (the study group) who were compared with 25 age- and sex-matched HIV-negative adolescent controls (the control group). All the patients had been HIV infected via a vertical transmission with positive serology confirmed in two different tests and had been kept on HAART since they were born. The diagnostic aids used for orthodontic documentation included facial photographs, digital orthopantomographs, lateral teleradiographs, and study models. RESULTS: With reference to the methodologies used for taking the cephalometric values, all the methods used were in strong agreement with each other for almost all the variables studied and had high intra-class correlation coefficient values except Co-A, SN.ANSPNS, and SNB which, too, had a good agreement of 60%. Nevertheless, the agreement was positive for these variables, too, since the P values obtained were found to be statistically significant (P < 0.05). CONCLUSION: Most of the measurements in the HIV-infected adolescents were found to be similar to the ones obtained for the HIV-negative controls, although, the study results highlighted the significance of further studies to be conducted in this regard, especially, the longitudinal study designs wherein the said variables can be studied on a follow-up basis in longitudinal studies to have an idea of the exact changes observed and their pattern in the included groups.