Ectopic Mandibular Canine with Partial Anodontia - A Rare Case Report.

Ectopic eruption of the tooth is a developmental disturbance where the tooth does not erupt in a normal position. This may be due to arch length deficiency or due to, delayed or premature exfoliation of deciduous teeth, or a combination of the above. A total or complete absence of teeth is called true anodontia; if one or more teeth are missing, it is called partial anodontia. It can be syndromic or non-syndromic in occurrence. Here, we present a rare case of non-syndromic partial anodontia and ectopic eruption of permanent mandibular canine in a female patient.

Carabelli Trait in Primary Tooth - A Case Report.

The Carabelli cusp (Cusp of Carabelli) is a tubercle or the extra fifth cusp found on the mesiopalatal cusp of the maxillary permanent and deciduous molars. It is nonfunctional but it can be used to distinguish populations and is also used in forensic and anthropological studies. This condition is uncommon on deciduous teeth. In this case report, we present a rare case of unilateral presence of cusp of Carabelli in deciduous dentition.

Survival Function of Clinical and Radiographic Success of Three Obturating Materials in Primary Teeth at 3, 6 and 9 Months Periodic Intervals - A Randomized Controlled Clinical Trial.

The study aims to assess clinically and radiographically the success of zinc oxide eugenol, metapex, and endoflas as root canal obturating materials in primary teeth over 3, 6, and 9 months of time intervals. The randomized controlled trial was performed in 60 primary molars of 36 children aged between 4 and 9 years. Permanent restorations were given and stainless steel crowns were placed for the treated tooth. Comparing the survival proportion between the three groups was done using the Wilcoxon (Gehans) statistical test. The clinical survival variable showed 100% survival proportion for zinc oxide eugenol and endoflas, while for metapex it was 69% at the end of 9 months. The radiographical survival proportion was 100% for zinc oxide eugenol, followed by endoflas at 92% and 58% for metapex group.

Nicotina Stomatitis - A Report of Two Cases.

Nicotina stomatitis is the inflammation of the minor salivary glands present in the hard palate due to chronic smoking habit. The patients are mostly symptomless and present with multiple red discrete papules in the hard palate surrounded by grayish white areas. The histopathology of the lesion is discussed and cessation of the smoking habit treats the condition within 2-4 weeks.

Lip Biting Scar and its Treatment - A Rare Case Report.

Oral habits are an acquired mode of behavior that has become nearly or completely involuntary. Oral habits such as thumb sucking, lip sucking, tongue thrusting, lip biting, nail biting, object biting, and bruxism have serious health consequences. Several etiological factors have been linked to the development of oral habits. In this article, a rare case of a scar on the lower lip, which occurred due to lip biting habit, has been reported.

First Molars in Permanent Dentition and their Malformations in Various Pathologies: A Review.

Permanent maxillary and mandibular first molars are the first permanent teeth to erupt into the oral cavity along with the mandibular incisors. It serves as an excellent record of maternal and fetal health, reflecting the prenatal, perinatal, and postnatal health and diseases. This review focuses on the molar morphogenesis, molar malformations, their etiopathogenesis, and pathologies causing specific pattern of molar malformations.

Basics of Epigenetics and Role of Epigenetics in Diabetic Complications.

The term "Epigenetics" includes mechanisms by which genetic expression is altered without a change in the underlying DNA sequence. The changes caused by epigenetic mechanisms are inheritable and are one way in direction (irreversible) and also explains why there is differences in genetic expressions of monozygotic twins. The epigenetic mechanisms alter the genetic expressions through DNA methylation, posttranslational modifications (PTMs) of histone, and noncoding RNAs. DNA methylation and histone PTMs cause relaxation or condensation of chromatin units. The epigenetic actions of noncoding RNAs such as microRNAs, small nucleolar RNAs, small interfering RNAs, and long noncoding RNAs act by modifying transcription factors or by degrading target messenger RNAs and their translation factors. Various pathologies and environmental factors cause changes in the cellular epigenetic mechanisms and the epigenetic alterations occurring in diabetes mellitus (DM) are reviewed. DM causes hemodynamic changes and metabolic changes like hyperglycemia and dyslipidemia. These changes induce oxidative stress and activate intracellular signaling and kinases in the target cells. Epigenetic alterations cause chromatin remodeling and altered gene expression leading to inflammation, proliferation, atrophy, hypertrophy, etc.; thereby, diabetic complications such as neuropathy, nephropathy, vasculitis result in the corresponding target organ. When these epigenetic alterations persist for a longer period without intervention, the target cells attain "metabolic memory" meaning that these epigenetic mutations cannot be reversed even after attaining normal blood glucose levels. Thus, epigenetics, an insightful and efficient tool in genomic research, has started crawling into the research arena and needs to reach leaps and bounds for the better understanding of health and diseases.

Molecular Insight into Odontogenesis in Hyperglycemic Environment: A Systematic Review.

Diabetes mellitus is an endocrinal disorder affecting worldwide and the disease incidence is rising alarmingly high. The effects of diabetes on tooth development are explored by limited studies and their molecular insights are very rarely studied. This systematic review is aimed to provide the best scientific literature source on the molecular insights into odontogenesis in hyperglycemic environment caused by diabetes mellitus or by maternal diabetes on the offspring. The literature search was conducted on the databases, namely PubMed, PubMed Central, Cochrane, and Scopus. The original studies exploring the alterations in the molecular pathways of odontogenesis in diabetes mellitus were selected. Data were extracted, chosen, and evaluated by two independent researchers. At the end of thorough data search, four articles were eligible for the review. Three articles brought out the molecular pathways involved in the offspring of gestational diabetes through animal models. Fourth article was an in vitro study, which treated the stem cells in hyperglycemic environment and drafted the molecular pathway. The altered molecular pathways in dental epithelial stem cells (DESCs), dental papilla cells (DPCs), and stem cells from apical papilla were studied and empowered with statistical analysis. Thus with this systematic review, we conclude that apurinic/apyrimidinic endonuclease1 downregulation causing deoxyribonucleic acid hypermethylation and Oct4, Nanog gene silencing, activation of toll-like receptor-4/nuclear factor kappa B (TLR4/NF-κB) pathway are involved in suppressing cell proliferation and accelerated apoptosis in DESCs in high glucose environment. DPCs are suppressed from odonto differentiation by activation of TLR4 signaling and resulting inhibition of SMAD1/5/9 phosphorylation in diabetic condition. NF-κB pathway activation causes decreased cell proliferation and enhanced differentiation in apical papilla stem cells in hyperglycemia. Further studies targeting various stages of odontogenesis can reveal more molecular insight.

Immunohistochemical Detection of Nerve Growth Factor (NGF) in Follicular and Plexiform Ameloblastoma - A Novel Study.

BACKGROUND: Ameloblastoma is the second most common odontogenic tumor that holds a unique position among benign tumors due to its locally destructive and invasive nature. The differed tumor biology behind follicular and plexiform ameloblastoma is always an enigma. Nerve growth factor (NGF), a neurotrophin that plays a major role during odontogenesis, could also possibly play a role in the pathogenesis of odontogenic tumors such as ameloblastoma. With this background, the study was aimed to investigate the expression of NGF in follicular and plexiform ameloblastoma. OBJECTIVES: The objectives of this study were to analyze the immunohistochemical expression pattern of NGF in ameloblastoma and to compare the immunohistochemical expression pattern of NGF among the follicular and plexiform histological types of ameloblastoma. MATERIALS AND METHODS: Forty histological sections of ameloblastomas (20 follicular and 20 plexiform) were stained immunohistochemically with anti-human NGF mouse IgG monoclonal antibody and the staining was analyzed statistically. RESULTS: Almost all the 40 ameloblastoma samples (20 follicular and 20 plexiform) showed positive immunoreactivity to NGF. Both peripheral pre-ameloblast-like tall columnar cells and central stellate-reticulum-like cells showed positive reactivity. The pattern of staining was membranous in the immunoreactive cells. The χ2 value for the immunoexpression between follicular and plexiform ameloblastoma was statistically significant with a P value <0.002. A possible mechanism has been proposed after studying the results with the downstream pathways obtained from literature. CONCLUSION: The pattern of expression of NGF is seen in both follicular and plexiform ameloblastoma. But the intensity is more in plexiform than that of follicular ameloblastoma.

Role of proteomics in physiologic and pathologic conditions of dentistry: Overview.

Proteomics is the study of structure and function of proteins in a large scale. For any living organism, preteins are considered to be the vital part because of its role in metabolic pathways of cells. These proteins not only play a role in physiological condition of the cell but also in altered manner during pathologic conditions. These altered proteins in diseased conditions are called as biomarkers. Several such biomarkers were identified in oral diseaes. This review is a brief note on proteins involved in odontogenesis and list of altered proteins proteins identified in various dental and oral diseases. The knowledge about the role of proteomics in dentistry and the importance of proteomic studies in early diagnosis and prognostic part of oral diseases helps in appliction of precised and sucessful treatment.

Halitosis - An overview: Part-I - Classification, etiology, and pathophysiology of halitosis.

Halitosis is a condition where the breath is altered in an unpleasant manner for the affected individuals and impairs them socially as well as psychologically. Halitosis can be clinically classified as real halitosis, pseudohalitosis, and halitophobia. Real halitosis has oral and extra-oral etiologies and the pathophysiology involves interaction of anaerobic microbes (mainly) with the proteins present in the oral cavity fluids and contents, resulting in production of volatile sulfur compounds (VSCs). These VSCs, beyond responsible for halitosis, can also initiate and accelerate periodontal disease progression. Thus, this review is about the pathophysiology and various etiologies of halitosis, the knowledge of which can help in the betterment of treatment options.

Prevalence of oral squamous cell carcinoma of tongue in and around Davangere, Karnataka, India: A retrospective study over 13 years.

AIM: The aim was to determine the frequency and distribution of oral squamous cell carcinoma (OSCC) involving tongue among patients by studying biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 13 years. METHODOLOGY: Data for the study were retrieved from the case records of patients. Analyzed clinical variables included age, sex, anatomical site, and histological diagnosis. RESULTS: Of the 369 squamous cell carcinoma involving head and neck region, we found 52 biopsies reported exclusively involving tongue. Lateral border of the tongue was most commonly involved (43 cases, 82.7%), followed by base of tongue and posterior part of tongue. The patient were affected over a wide range of 27-80 years with mean age of 55.75 years and peak incidence was seen in the fourth and fifth decades of life, with the male: female ratio of 1.7:1. CONCLUSION: The prevalence rate of OSCC involving tongue showed a definite geographic variation when compared with a study done in other parts of the world.

Clinical evaluation of nonsyndromic dental anomalies in Dravidian population: A cluster sample analysis.

AIM: To record the prevalence rate of dental anomalies in Dravidian population and analyze the percentage of individual anomalies in the population. METHODOLOGY: A cluster sample analysis was done, where 244 subjects studying in a dental institution were all included and analyzed for occurrence of dental anomalies by clinical examination, excluding third molars from analysis. RESULTS: 31.55% of the study subjects had dental anomalies and shape anomalies were more prevalent (22.1%), followed by size (8.6%), number (3.2%) and position anomalies (0.4%). Retained deciduous was seen in 1.63%. Among the individual anomalies, Talon's cusp (TC) was seen predominantly (14.34%), followed by microdontia (6.6%) and supernumerary cusps (5.73%). CONCLUSION: Prevalence rate of dental anomalies in the Dravidian population is 31.55% in the present study, exclusive of third molars. Shape anomalies are more common, and TC is the most commonly noted anomaly. Varying prevalence rate is reported in different geographical regions of the world.

Dermatoglyphic patterns and salivary pH in subjects with and without dental caries: A cross-sectional study.

BACKGROUND: Dermatoglyphic patterns, which are regularly used in judicial and legal investigations, can be valuable in the diagnosis of many diseases associated with genetic disorders. Dental caries although of infectious origin, may have a genetic predisposition. Hence, we evaluated the correlation between dental caries and dermatoglyphic patterns among subjects with and without dental caries and evaluated its association with environmental factors such as salivary pH. MATERIALS AND METHODS: Totally, 76 female students within the age group of 18-23 years were clinically examined, and their decayed, missing, filled teeth (DMFT) score and oral hygiene index-simplified were recorded. Based on their DMFT score, they were divided into following three groups; group I (n = 16, DMFT score = 0), group II (n = 30, DMFT score <5), and group III (n = 30, DMFT score ≥5). Their fingerprint patterns and salivary pH were recorded and analyzed using descriptive statistics. RESULTS: Dermatoglyphic pattern distribution in caries-free group showed more ulnar loops than high caries group (group III) while high caries group showed more whorl patterns. Presence of whorl with double loop, whorl within a loop was associated with high DMFT score. The total finger ridge count was lower in caries group. The mean salivary pH was higher in caries-free group than high caries group. Thus, we conclude that dermatoglyphic patterns may be potential diagnostic tool for detecting patients prone to develop dental caries.

Dimensional and morphological analysis of various rugae patterns in Kerala (South India) sample population: A cross-sectional study.

BACKGROUND: Analysis of palatal rugae patterns, which are similar to fingerprints, is one of the techniques used in forensic sciences for human identification. As palatal rugae patterns are genetically determined, they can also be used in population differentiation and gender determination. Hence, we aimed to record the distribution of the predominant rugae pattern in Kerala population. MATERIALS AND METHODS: A total of 100 maxillary study models (40 males and 60 females) recorded from Kerala population within the age group of 17-25 years were analyzed. The dental casts were examined for the interpretation of the total number, length, shape, location and unification of rugae. Chi-square test and unpaired t-test were employed for statistical analysis. RESULT: The total number of rugae was significantly (P < 0.001) greater in females than males. Regarding the shape, wavy pattern predominated in both males and females, followed by curve, straight, divergent, convergent and circular pattern. Circular pattern was more in males than females. The rugae patterns were located more in between mesial aspect of first premolar to mesial aspect of second premolar. CONCLUSION: The palatal rugae and their features of an individual may be considered as a reliable guide for identification purpose, provided antemortem casts are available. Nevertheless, gender differentiation is evident in terms of number and shape of rugae.

Morphological alterations in the dentition of type I diabetes mellitus patients.

INTRODUCTION: Type 1 diabetes mellitus (DM) is an endocrine disorder that occurs commonly in an age group, where the development of primary and permanent dentition takes place. As altered endocrine functions may affect the shape and size of teeth leading to dental anomalies, this study was conducted to look for the occurrence of any dental anomalies in type I DM patients. MATERIALS AND METHODS: A diabetic camp was conducted at Alur Chandrashekharappa Memorial Hospital, Davangere, where 30 diabetic patients were examined and the impressions of their maxillary and mandibular arches were recorded. Age and sex matched controls were selected randomly, and similar recordings were done. RESULTS: Type I diabetic patients showed statistically significant (P < 0.001) morphological alterations of total number of cusps, including presence of 6(th) cusp in mandibular molars and extra cusps in mandibular premolars. Other alterations such as microdontia, flower shaped mandibular molars, prominent cusp of carabelli, and oblique ridge in maxillary molars were also noted. Severe attrition was found in 11 (36.6%) of the diabetic patients, whereas the control group showed attrition only in 2 (6.8%) patients. CONCLUSION: Remarkable morphological alterations do occur in the dentition of type I DM patients.

Analysis of prevalence and clinical features of multicystic ameloblastoma and its histological subtypes in South Indian sample population: A retrospective study over 13 years.

OBJECTIVE: The study was designed to analyze the frequency and clinical features of multicystic ameloblastoma and its histological variants in South Indian sample population, as there is minute information available in the English literature. METHODOLOGY: The study source was the biopsy specimens retrieved from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 13 years, from 2001 to 2013. Clinical data for the study were obtained from the case records of patients and the analyzed clinical variables were age, gender and anatomical location. Histologically, hematoxylin and eosin stained sections fitting the World Health Organization (2005) criteria for diagnosis of multicystic ameloblastoma were selectively included. RESULTS: Of the 3026 biopsy reports analyzed, 103 cases were odontogenic tumors (3.4%) and 58 cases were ameloblastoma. 31 cases of multicystic ameloblastoma, including follicular ameloblastoma (54.8%), acanthomatous ameloblastoma (29%), plexiform ameloblastoma (6.5%), granular cell ameloblastoma (6.5%) and desmoplastic ameloblastoma (3.2%) were recorded. The age of the patients during the presentation of the lesion was ranging from 21 to 73 years, with a mean of 39.5 years. The most frequent clinical manifestation was swelling, followed by a combination of pain and swelling. In our study, ameloblastoma showed distinct anatomic predilections for occurrence in mandible (96.8%) rather than maxilla (3.2%). This study result also indicated that there is geographical variation in the frequency and distribution of ameloblastoma.

Granularity in granular cell ameloblastoma.

Granular cell ameloblastoma (GCA) is one of the rare histological variants of ameloblastoma (1.5-3.5%), identified by Krompechner in 1918 and is diagnosed by the characteristic presence of granular cells. These granular cells are seen in several physiological and pathological conditions and the granularity in GCA is due to lysosomal aggregates. This review is about the clinical features, histopathological features and differential diagnosis of GCA and also adds the theories for occurrence of granularity, electron microscopic findings, cell signaling pathways and immunohistochemistry findings related to these granular cells in GCA.