Ponticulus Posticus: An Important Diagnostic Finding Often Missed in Lateral Cephalograms.

AIM: The purpose of the current study was to investigate the presence of the ponticulus posticus (PP) frequently encountered in lateral cephalograms. MATERIALS AND METHODS: About 500 patients of age 12-40 years were selected whose digital lateral cephalogram was recorded and traced to confirm the presence of the PP and categorize as: (A) Absent, as evidenced by lateral cephalograms. (B) Complete PP evidenced by the presence of circumferential bone bridge that connected the upper articular process to the atlas's posterior arch. (C) Partial PP: presented as a bone spike that protruded from the top articular process or the posterior arch of the atlas and extended above the vertebral artery sulcus. Symptoms of migraine, shoulder discomfort, orofacial pain, and headache were also evaluated on interaction with the patients. Using the Chi-square test, the relationship between the patient's gender and the presence of the PP was assessed. A p-value of 0.05 or less was regarded as statistically significant. RESULTS: About 10% of the patients reported with the presence of complete variant, 70% with partial variant and rest 20% of patients with neither a partial nor a complete form of PP. There was no statistically significant association between the PP and gender, as indicated by the Chi-square values (3.146; p = 0.526). CONCLUSION: On conclusion, according to the findings of the current study, patients with a complete form of PP experience more symptoms than those with a partial form of PP. In both groups, the PP frequency was higher in females. CLINICAL SIGNIFICANCE: In lateral cephalograms, the cervical spine region is typically ignored and given little weight. A common variation of atlas vertebrae is the PP, which is located in the posterior arch of the atlas. The PP exacerbates symptoms, such as migraine, tension headaches, shoulder pain, double vision, vertigo, stroke, and pain in the neck and orofacial region. Therefore, orthodontic specialists serve as initial diagnosticians and direct the patients to qualified physicians so that they can experience symptom relief.

Expression of heat shock protein 70 in oral epithelial dysplasia and squamous cell carcinoma.

BACKGROUND: Heat shock proteins (HSPs) are overexpressed in a variety of human malignancies. They are involved in tumor cell proliferation, differentiation, invasion, metastasis, death, and immune system detection. HSP 70 has been shown to resist cytotoxicity in cancer cells and even enhance tumor development through an immune escape mechanism, suggesting that HSP70 may play a role in carcinogenesis. The aim of our study was to evaluate the role of HSP70 as a predictive marker for malignant transformation in oral epithelial dysplasia. MATERIALS AND METHODS: Thirty samples of epithelial dysplasia (10 mild dysplasia, 10 moderate dysplasia, and 10 severe dysplasia/carcinoma-in-situ cases), 10 samples of well-differentiated oral squamous cell carcinoma (OSCC), and 10 samples of normal oral mucosa were routinely processed, formalin-fixed, paraffin-embedded, and immunohistochemically examined for HSP70 expressions. To determine the statistical difference between two groups, a one-way analysis of variance (ANOVA) and the Mann-Whitney test were used. RESULTS: HSP70 expression was high but not homogenous in normal mucosa. Dysplasia showed an initial drop, and the expression increased with increasing degrees of dysplasia. There was no statistically significant difference across various types of epithelial dysplasia. From dysplasias to well-differentiated carcinoma, HSP70 exhibited a considerable rise. CONCLUSION: Overexpression of HSP70 in clinically suspicious and histologically established epithelial dysplasia may suggest a likelihood of transformation to well-differentiated OSCC and may have a prognostic value. However, more studies with a bigger sample size are needed to prove HSP70's role as a predictor.

Oral capillary hemangioma in a ten year old female child with hepatitis B treated with monopolar electrocautery.

Capillary hemangioma is a benign, vascular tumor characterized by proliferation of blood vessels that are primarily reported to be a developmental hamartomatous lesion of infancy and childhood. Till date, many cases of capillary hemangiomas have been reported in the literature, but juvenile hemangiomas with other systemic manifestations such as hepatitis B have not been studied well so far. The present paper reports a rare case of capillary hemangioma in a ten-year-old female with hepatitis B, which was treated under general anesthesia using electrocautery and followed up for one year and no recurrence was found.

A Rare Case of Twinning Involving Primary Maxillary Lateral Incisor with Review of Literature.

Twinning is referred to the development of two separate teeth that arose from the complete separation of one tooth bud. To the best of our knowledge very few cases of twinning in primary or permanent dentition have been previously reported. Here, we report an additional case of twinning involving primary maxillary left lateral incisor and a literature review of clinical and radiographic findings of previous reported cases of gemination and twinning is also discussed. A six-year-old male patient reported to the dental clinic with the complaint of decay in the left front teeth region of the upper jaw. On clinical examination, dentinal caries was observed on the labial surface of primary maxillary left lateral incisor. The tooth showed a deep groove present in relation to the labial surface and incisal edge and continued cervically as a shallow groove. The patient had normal compliment of teeth for his age. The intra-oral periapical radiograph of the maxillary anterior region revealed large crown and a radiolucent notch was observed in relation to the incisal edge of the maxillary left primary lateral incisor. Relatively one pulp chamber and two root canals were observed in relation to the primary maxillary left lateral incisor, which was suggestive of a case of twinning involving primary maxillary left lateral incisor. This present case is the first case report of twining seen in primary dentition.