Comparative Analysis of Tissue Copper Levels in Oral Submucous Fibrosis (OSMF) Patients.

Background: Oral submucous fibrosis (OSMF) is a recognized potentially malignant oral condition linked to the consumption of areca nut. Chewing areca nut has been shown to elevate soluble copper levels in mouth fluids. Materials and Methods: Participants: The study included a panel of 30 patients with OSMF from Rama Dental College, Kanpur, India, and 30 nonareca chewing individuals serving as controls. Tissue Sample Collection and Analysis: Buccal mucosal biopsies were obtained from both OSMF patients and controls. The tissue copper concentrations were quantified using mass absorption spectrometry (MAS). Additionally, energy-dispersive X-ray microanalysis (EDX) was employed to identify the presence and distribution of copper in the tissue. Statistical Analysis: Statistical comparisons were performed using appropriate methods, with a P-value of less than 0.05 considered statistically significant. Results: MAS analysis revealed that the mean tissue copper level was 6.2 ± 3.1 micrograms per gram (µg/g) in OSMF specimens (n = 30), slightly higher than the 4.5 ± 2.0 µg/g in the nonareca chewing controls (n = 30) (P = 0.1). EDX analysis showed distinct copper peaks in both the epithelium (22/23) and connective tissue (18/23) of OSMF specimens compared to control biopsies. These findings were corroborated by secondary ion mass spectrometry (SIMS) in a subset of samples. Conclusion: The study revealed higher copper concentrations in buccal mucosal tissue of OSMF patients from Rama Dental College, Kanpur, suggesting a potential connection between copper and the initiation of OSMF.

Intraosseous Hemangioma with unusual presentation.

Intrabony vascular lesions are extremely rare conditions. The lesions include 0.5% to 1% of all intraosseous tumors. Females are more predilected than males with a female: male ratio of 2:1, usually affecting the second decade of life. Most common sites of occurrence of these lesions are in the vertebral column and skull, jaws are the rare location with the mandible being the quite rare location. The origin of hemangiomas is still doubtful. Many of the authors believe it as hamartoma but as per World Health Organization, it as a true benign neoplasm of vascular origin. The clinical presentation of hemangiomas is variable with atypical radiographic presentations. Due to the varied presentations of this lesion, the diagnosis becomes very difficult. But diagnosing central hemangiomas early is essential for preventing uncontrollable hemorrhage and even death during any surgical intervention. We present a case of intraosseous cavernous hemangioma which presented as periapical radiolucency with specks of calcification, quiet a rare presentation. The case was managed by embolization followed by surgical resection of the body of the mandible.

A Case Report of Carcinosarcoma of the Tongue Mimicking a Fibroma: An Enigmatic Lesion With a Diagnostic Dilemma.

Carcinosarcoma of the tongue is a rare biphasic tumor composed of squamous cell carcinoma (SCC), either in situ and/or in invasive form, and a mesenchymal component but of epithelial origin. It is important to diagnose this variant because of its aggressive nature and tendency to metastasize early. The present report describes the case of a carcinosarcoma of the tongue in a 48-year-old male with a short history of 30 days, the clinical feature of which resembles that of an irritational fibroma. The diagnosis often represents a clinicopathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. We here present a case report of this rare tumor, with an unusual presentation, to contribute in part to better understanding and awareness of this rare malignancy.

Sexual dimorphism of inferior alveolar canal location: A record- based CBCT Study in Eastern India.

Background: Sex determination from unidentified skeletal remains a daunting task in forensic odontology. The mandible is the strongest and most durable of bones available for post-mortem profiling and its morphometric characteristics have been investigated. Less explored is the location of the mandibular canal which in a few populations has shown gender dimorphism. Aim: The present cross-sectional study explores sexual dimorphism in an eastern Indian population of Odisha from an analysis of cone-beam CT system (CBCT) images for the relative position of the mandibular canal and its foramina. Method and Materials: A total of 120 CBCT images from either gender (1:1 ratio) of adult dentate individuals aged 18-60 years were analysed for the relative position of the mandibular canal. Ten measurements (8- coronal and 2- from axial slices) concerning the mandibular canal; at the level of the mandibular foramen, mandibular first molar and mental foramen were performed. Unpaired Student's t-test was employed to compare variables between the sexes at P < 0.05 level of significance. Results: The results revealed statistically significant differences (P < 0.05) between the genders in most of the variables (8/10), with higher mean values in males compared to females except in the distance between mandibular foramen and anterior border of the ramus (2.648 ± 0.67 mm in females, 2.527 ± 0.75 mm in males) and in the distance between the canal and lingual cortical plate in the region of the first molar (14.515 ± 1.33 mm in females, 14.288 ± 2.01 mm in males). Conclusion: The relative position of the mandibular canal and its associated foramina show sexual dimorphism in an adult eastern Indian population.

Tramadol versus ketorolac for pain management after third molar surgery.

OBJECTIVES: To compare the analgesic efficacy of preoperative intravenous (IV) ketorolac versus tramadol in preventing postoperative pain after mandibular third molar surgery. METHODOLOGY: Two hundred patients in the age group of 18-40 years with asymptomatic impacted mandibular molars were randomly allocated into one of the two groups (100 in each group) and underwent third molar surgery under local anesthesia. Group I received IV ketorolac 30 mg and Group II received IV tramadol 50 mg preoperatively. The difference in postoperative pain was assessed by five primary end points: pain intensity being measured hourly by Wong-Baker pain assessment scale for 6 h, onset of analgesia, duration of action, total number of analgesics consumed, and patient's global assessment. RESULTS: Throughout the 6 h investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser postoperative analgesic consumption, and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia. All the drug-related complications were mild and did not require any investigation. CONCLUSION: The result of the present study shows that preoperative IV ketorolac 30 mg is more effective than tramadol 50 mg for postoperative pain following third molar surgery.

Inferior alveolar nerve canal position in relation to mandibular molars: A cone-beam computed tomography study.

OBJECTIVE: This study was carried out to prevent the risk of iatrogenic injuries to the inferior alveolar nerve (IAN) canal associated with various surgical interventions in the area of mandibular molars, by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The present retrospective study was carried out by using CBCT of 100 patients between 18 and 40 years of age group. The linear measurements were made in relation to the 1st and 2nd mandibular molars on both the sides. Linear distances between buccal and lingual aspects to the mandibular, buccal, and lingual cortical bone thickness; IAN canal diameter; and the superior corticated border of the IAN canal from the periapex of the 1st and 2nd mandibular molars. The statistical evaluation was done using SPSS V.20 (SPSS: an IBM company), and P < 0.05 was considered statistically significant. RESULTS: Both genders of all age groups showed statistically significant result (P < 0.00). All the linear measurements were statistically significant in relation to both the 1st and 2nd mandibular molars (P < 0.005), and also the bilateral comparison of the linear measurements showed statistically significant difference in relation to the mandibular 2nd molar (P < 0.03) and 1st molar (P < 0.04) among both the sexes. CONCLUSION: Clinicians should be aware of the proximity of root apices and cortical plates to the mandibular canal when performing surgical and root canal procedures in the posterior mandible to avoid serious nerve injuries.

Assessment of the Anterior Loop of the Mandibular Canal Using Cone-Beam Computed Tomography in Eastern India: A Record-Based Study.

OBJECTIVE: The aim of this study was to assess the presence and course of the anterior loop (AL) in an Odisha sample population using cone-beam computed tomography (CBCT) and to accurately identify and analyze the length, height, and diameter of AL in male and females. MATERIALS AND METHODS: CBCT images from 1000 patients obtained for various clinical indications were randomly selected and evaluated to determine the presence, length, height, and diameter of the AL. The various parameters were then compared based on gender, age, and the side of the mandible. The data were analyzed using the Chi-square test, independent t-test, multiple post hoc procedure, and one-way ANOVA test. RESULTS: An AL was identified in 9.7% of the cases, and its mean length ranged from 1.8 to 4.8 mm. The loop had a greater mean length and was significantly more prevalent in males. The diameter ranged from 1 to 4 mm and height ranged from 7.8 to 15.1 mm. The AL was most commonly found in the middle-aged patients (39-48 years) which attributed to around 27.83%. CONCLUSION: In this study, a lower prevalence of the AL of the mandibular canal was found. Being an anatomical variation, an exact evaluation of the AL must be established using the imaging techniques prior to any surgical procedure.

Estimation of Salivary and Serum Lactate Dehydrogenase in Oral Submucous Fibrosis.

AIM AND OBJECTIVES: The objective of the present study was to estimate the serum and salivary lactate dehydrogenase (LDH) levels in patients with oral submucous fibrosis (OSMF) and to study the association between serum and salivary LDH levels and mouth opening, frequency of habit, and duration of habit in patients with OSMF. MATERIALS AND METHODS: Participants were divided into two groups: Group I - case group diagnosed with OSMF and Group II - the control group. Unstimulated whole saliva was collected from all the participants. The International Federation of Clinical Chemistry method was carried out with the help of LDH (P-L) kit (Crest Biosystems, Goa). Collection of blood sample was done under aseptic precautions and processed for LDH. The data were analyzed using SPSS software 2010 (version 19, IBM, Armonk, NY, USA). Descriptive statistics including mean, range, standard deviation, and percentage were used along with unpaired t-test and Pearson's correlation test. RESULTS: All the participants were male and were in the age range of 18-60 years, with a mean age of 28.63 ± 10.39 years. The mean salivary LDH levels in patients with OSMF were 1057.30 ± 640.12 µg/dl and in the control group were 668.25 ± 498.45 µg/dl. The mean serum LDH level in patients with OSMF was 408.35 ± 158.35 µg/dl as compared to the control group was 313.05 ± 82.69 µg/dl. The Pearson's correlation coefficient between serum LDH and frequency of habit, duration of habit, and mouth opening was found to be 0.55, 0.53, and 0.69, respectively. The Pearson's correlation coefficient between salivary LDH and frequency of habit, duration of habit, and mouth opening was found to be 0.33, 0.04, and 0.13, respectively. The Pearson's correlation coefficient between salivary LDH and serum LDH was found to be -0.18. CONCLUSIONS: There was a significant increase in the serum and salivary LDH in OSMF patients as compared to controls; the salivary LDH did not seem to correlate with frequency of the habit, duration of the habit, or mouth opening of OSMF patients. However, serum LDH was found to correlate directly with frequency of the habit and mouth opening in OSMF patients. Hence, based on the results of the present study, it can be hypothesized that serum LDH is a better biological marker than salivary LDH in the evaluation of OSMF.

Awareness, Attitude, and Knowledge of Basic Life Support among Medical, Dental, and Nursing Faculties and Students in the University Hospital.

OBJECTIVE: To assess the awareness, attitude, and knowledge about basic life support (BLS) among medical, dental, and nursing students and faculties and the proposal of BLS skills in the academic curriculum of undergraduate (UG) course. Recognition, prevention, and effective management of life-threatening emergencies are the responsibility of health-care professionals. These situations can be successfully managed by proper knowledge and training of the BLS skills. These life-saving maneuvers can be given through the structured resuscitation programs, which are lacking in the academic curriculum. MATERIALS AND METHODS: A questionnaire study consisting of 20 questions was conducted among 659 participants in the Kalinga Institute of Dental Sciences, Kalinga Institute of Medical Sciences, KIIT University. Medical junior residents, BDS faculties, interns, nursing faculties, and 3rd-year and final-year UG students from both medical and dental colleges were chosen. The statistical analysis was carried out using SPSS software version 20.0 (Armonk, NY:IBM Corp). RESULTS: After collecting the data, the values were statistically analyzed and tabulated. Statistical analysis was performed using Mann-Whitney U-test. The results with P < 0.05 were considered statistically significant. Our participants were aware of BLS, showed positive attitude toward it, whereas the knowledge about BLS was lacking, with the statistically significant P value. CONCLUSION: By introducing BLS regularly in the academic curriculum and by routine hands on workshops, all the health-care providers should be well versed with the BLS skills for effectively managing the life-threatening emergencies.

Evaluation of masseter muscle hypertrophy in oral submucous fibrosis patients -an ultrasonographic study.

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic insidious disease of the oral mucosa, commonly seen in South East Asia. It occurs mainly due to the habit of quid or gutkha chewing. There is a clear dose dependent relationship between gutkha chewing and development of OSMF, also due to continuous chewing for larger intervals of time unnecessary forces are exerted on the muscles mainly the masseter muscle. So, the present study was done to evaluate the thickness of masseter muscle in OSMF patients and to compare it with normal patients. MATERIALS AND METHODS: The present study involved 50 subjects, 25 OSMF patients and 25 normal individuals. The thickness of masseter muscle was evaluated by ultrasonography (5-11mHz). RESULTS: There is a positive association between masseter muscle hypertrophy and OSMF (p-value 0.001). Thickness of masseter muscle was found to be more in OSMF patients as compared to control group and also thickness is more during contraction as compared to relaxation in both OSMF patients and normal individuals.

Sialocele: an unusual case report and its management.

A post traumatic parotid sialocele is an acquired lesion that arises from extravasation of saliva into glandular or periglandular tissues secondary to disruption of the parotid duct or parenchyma. Facial trauma and surgery in the parotid region are the most common causes of this rare condition. This paper presents an unusual incidence of post traumatic parotid sialocele after Le-Fort II fracture reduction and its management by relatively simple and cost-effective technique which can be carried out in routine dental surgery suite. The results achieved justify our recommendation of scalp vein cannula for the treatment of sialocele in clinical practice.