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.

Electrocautery assisted harvesting of free gingival graft to increase the width of attached gingiva - an uncommon case report.

Procuring a free gingival autograft for the purpose of gingival augmentation has been advocated in areas of inadequate width of attached gingiva that result in gingival recession and/or accumulation of local factors. As obtaining the graft from the palatal donor site with conventional scalpel techniques can result in problems such as prolonged bleeding, increased surgical time and patient discomfort, alternative methods have been advocated to procure such grafts using lasers and electrocautery. This case report elaborates, a free gingival graft harvested for the purpose of increasing the width of attached gingiva using electrocautery principles. The parameters assessed included the extent of patient reported discomfort at the donor site and clinical gain of keratinized and attached gingival width.

Conservative surgical approach and aesthetic management of a focal gingival hyperplastic lesion.

Focal reactive hyperplastic lesions of the gingiva are quite common soft tissue enlargements of the oral cavity. Presence of local factors, tissue irritation and endocrinal discrepancies contribute to its etiology. The fact that these lesions are caused by diverse pathological conditions and its histo-pathological resemblances poses a great diagnostic challenge. Due to the site predilection of the these lesions to the maxillary anterior region, this article presents a case report of focal gingival hyperplastic lesion in the anterior maxillary region and its conservative management leading to pleasing results and soft tissue esthetics.