Efficacy of Transcutaneous Electric Nerve Stimulation (TENS) on Whole Salivary Flow Rate: A Descriptive Observational Study.

Statement of the Problem: Saliva is a precious oral fluid that contributes to oral health and when its quantity is diminished, it hampers the quality of life. Individuals suffering from diabetes have a complaint of reduced salivation due to the consumption of xerogenic drugs and autonomic neuropathy. Purpose: Our study aims to evaluate the effectiveness of the transcutaneous electric nerve stimulation (TENS) device on the salivary flow rate with respect to age and gender in Jaipur population. Materials and Method: A descriptive observational study was carried out on individuals in Jaipur at the Department of Oral Medicine and Radiology at Rajasthan Dental College and Hospital during a period of 7 months. The study consisted of 200 individuals who were divided into two groups. Unstimulated and stimulated saliva were collected for 5 minutes in a graduated beaker. Stimulated saliva was collected after keeping the TENS unit activated at 50Hz. Kolmogorov-Smirnov, Shapiro-Wilks normality tests and Mann Whitney U test were done. The p value <0.05 was considered to be significant. Results: The TENS unit was effective in increasing the quantity of stimulated saliva and a highly statistical significance was seen in age groups. TENS was also found to be more effective in increasing saliva in diabetic individuals. The mean unstimulated salivary rate was 1.64ml/5min and the mean stimulated salivary rate was 1.914ml/5min for Group I. The mean unstimulated salivary rate was 1.231ml/5 min and the mean stimulated salivary rate was 1.547ml/5 min for Group II. The p value for Group I and II for unstimulated saliva was 0.01 and for stimulated saliva was 0.03. Conclusion: It seems that TENS has shown positive results in increasing salivary secretions and salivary values may diminish with age; therefore, TENS might be used in aged individuals as well as in diabetic patients to increase the quantity of saliva.

A Comparative Evaluation of Digital Radiography and Ultrasound Imaging to Detect Periapical Lesions in the Oral Cavity.

Purpose This study evaluates the efficacy of digital radiography and ultrasound (USG) for the distinction between periapical cysts and granulomas, determines the nature and extent of the periapical lesion, visualizes the lumen of the lesion, assesses its size, content, and vascularity. Material and Methods Thirty patients, ages 18 to 40, with well-defined periapical radiolucencies on maxillary or mandibular teeth, indicated for the extraction or periapical surgery, underwent digital radiography examination using the paralleling technique, followed by USG examination. A sonologist evaluated the lesions' size, echogenicity, and vascular content. The diagnosis was compared to histopathological examinations of tissues obtained through extraction or periapical surgery. Results The diagnostic value of USG compared to the histopathological diagnosis of the periapical cyst was greater than that of the radiographic diagnosis, with an ultrasonographic diagnostic sensitivity (SN) value of 60% and a radiographic diagnostic SN value of 40%, respectively. The diagnostic value of USG imaging against the histopathological diagnosis of periapical granuloma was slightly lower than that of digital radiography, with an SN value of 72.2% for USG and 83.33% for digital radiography. However, the specificity (SP) value and precision of USG imaging were superior to those of digital radiographic diagnosis. USG imaging and radiographic diagnosis had 58.33% and 50% SP values, respectively. In cases of periapical abscess, the diagnostic values of USG against histopathological diagnosis were lower than those of radiographic diagnosis, which had an SN value of 100%. Conclusion USG with color doppler is a more effective tool than digital radiography for diagnosing periapical lesions. The echo structure of the lesions and the presence of vascularity on USG with color doppler correlated with histopathology better than the radiological diagnosis.

Betel quid oral lichenoid lesions: a hospital based cross-sectional study.

OBJECTIVE: The aim of this study was to assess the prevalence and risk indicators of betel quid oral lichenoid lesions in chewers. METHODS: A total of 1209 chewers were identified and categorized into three main groups based on the type of lesion: betel quid oral lichenoid lesions only, betel quid oral lichenoid lesions in association with quid-induced other oral mucosal lesions, and no lesions. Multinomial regression analyses were used to determine associations between dependent and independent variables. RESULTS: Betel quid oral lichenoid lesions were more common in individuals who chewed quid comprising both tobacco and areca nut, and in those who chewed it two to three, or greater than three, times a day. Betel quid oral lichenoid lesions + quid-induced other oral mucosal lesions were more likely to occur in females, and in individuals who chewed quid containing both tobacco and areca nut, in their processed and unprocessed forms, and greater than three times a day. CONCLUSION: The prevalence of betel quid oral lichenoid lesions was higher than that reported in previous studies conducted in India. Increase in the frequency and duration of quid chewing was associated with increased likelihood of developing these oral lichenoid lesions.

Oral Implant Imaging: A Review.

Selecting an appropriate implant imaging technique has become a challenging task since the advent of advanced imaging modalities, and many of these are used for implant imaging. On imaging, the modality should not only consider the anatomy but should also provide dimensional accuracy. Many dentists use the conventional method, mostly orthopantograph (OPG), in their routine practice of implant placement. However, because of the drawbacks associated with OPG, higher technologies, such as computed tomography (CT) and cone beam computed tomography (CBCT), are better accepted. These help improve image sharpness and reduce distortion. These techniques are not used widely due to the cost effect. Therefore, to decide on the type of imaging technique, all associated advantages and disadvantages should be considered, which will be broadly discussed in this review.

The effect of highly active antiretroviral therapy on the prevalence of oral manifestation in human immunodeficiency virus-infected patients in Karnataka, India.

OBJECTIVES: Acquired Immunodeficiency Syndrome (AIDS) is a highly lethal, progressively epidemic viral infection characterized by profound impairment of the immune system. Oral manifestations are common in Human Immunodeficiency Virus (HIV) infected AIDS patients, and are usually the first indicator of symptom and disease progression. The main objective of the current study was to compare the prevalence of oral manifestations in HIV patients on Highly Active Antiretroviral Therapy (HAART) with those, not on HAART therapies. MATERIALS AND METHODS: A cross sectional study was conducted among 100 patients diagnosed as human immune virus sero-positive. These patients were divided equally into two groups (50 each); Group I patients on HAART and Group II patients who were not on HAART. Information regarding age, sex and cluster of differentiation 4 cell count was obtained from the medical records. Oral examination was done, and findings were recorded by using internationally accepted presumptive clinical criteria. Statistical analysis was performed using Chi-square statistical test. RESULTS: The presence of oral manifestations was significantly decreased in subjects on HAART (32%) compared to those who are not on HAART (56%). The most common oral lesions detected in patients on HAART were increased oral hyper-pigmentation (14%), recurrent aphthous stomatitis (8%), non-specific ulcerations (4%), pseudo-membranous candidiasis (2%), periodontitis (2%) and xerostomia (2%), whereas in non HAART oral hyperpigmentation (10%), pseudo-membranous candidiasis (8%), angular cheilitis (4%), and erythematous candidiasis (4%) and Periodontitis (14%) were more prevalent. CONCLUSION: The number and severity of oral manifestation decreased, and even there was a change in the type of oral manifestations on HAART, which may be because of the improvement in immunity gained by the therapy.

Prevelance of Haller's Cells: A Panoramic Radiographic Study.

BACKGROUND: Infraorbital ethmoid cells, also known as Haller's cells can be seen on panoramic radiographs. These help in identification of various pathologies and patient symptoms. OBJECTIVE: To determine the prevelance and characteristic of Haller's cells on panoramic radiographs. Infraorbital ethmoid cells are extensions of ethmoid air cells into areas of orbit and maxillary sinus. MATERIALS AND METHODS: This study comprised of 1000 panoramic radiographs of healthy adults of the age 18-80 years. Each radiograph was interpreted for the presence of haller's cells. The data collected were then tabulated and subjected to descriptive statistics and chi-square test. RESULTS: Haller's cells were observed in 19.2% patients. Majority of cells were present unilaterally (176 cells) while only 15 were seen bilaterally. Maximum cells were oval in shape, unilocular and single in number. CONCLUSION: Presence of haller's cells helps in enumerating the differential diagnosis for orofacial pain and in avoiding surgical complications in endonasal procedures.

Scurvy extinct? Think again!

Scurvy is still seen sporadically in the developed world. Scurvy, a dietary disease due to the deficient intake of vitamin C, is uncommon in the pediatric population. Scurvy occurs as a result of decreased vitamin C consumption or absorption. We present the case of a 6-year-old boy visiting our department with bleeding gums, musculoskeletal pain, and weakness. Four days after starting oral vitamin C supplementation, there was significant improvement in the patient's gingival appearance and general health. The clinical presentation and laboratory investigation (Hemoglobin %, total blood picture) , together with the dramatic therapeutic response to ascorbic acid administration, confirmed the diagnosis of scurvy. Scurvy can be missed unless oral and general physicians maintain a high index of suspicion. Therefore it is time to wonder if scurvy is extinct yet.