Comparing the Effectiveness of Different Techniques for the Management of Dental Implant Peri-Implant Mucositis: A Randomized Controlled Trial.

Background: Dental implant peri-implant mucositis is a prevalent complication that can lead to implant failure if left untreated. Various management techniques have been proposed, but their comparative effectiveness remains unclear of dental implant peri-implant mucositis. Materials and Methods: A total of 120 patients with peri-implant mucositis were randomly assigned to one of four treatment groups: Group A received mechanical debridement alone, Group B received mechanical debridement with adjunctive antiseptic mouthwash, Group C underwent laser therapy, and Group D received a combination of mechanical debridement and systemic antibiotics. Clinical parameters, including bleeding on probing (BOP), probing pocket depth (PPD), and plaque index (PI), were recorded at baseline and after a three-month follow-up period. Results: At the three-month follow-up, significant improvements were observed in all treatment groups. However, Group D, which received a combination of mechanical debridement and systemic antibiotics, showed the most substantial reduction in BOP (mean reduction of 78.2%), PPD (mean reduction of 2.5 mm), and PI (mean reduction of 1.7). Group C, treated with laser therapy, demonstrated the second-best outcomes with a mean reduction of 65.4% in BOP, 2.0 mm in PPD, and 1.3 in PI. Groups A and B showed moderate improvements, with no statistically significant differences between them. Conclusion: This randomized controlled trial (RCT) suggests that a combination of mechanical debridement and systemic antibiotics (Group D) is the most effective treatment for managing dental implant peri-implant mucositis, yielding superior clinical outcomes compared to other techniques.

A Comparative Study of the Flap and Flapless Techniques of Ridge Preservation: A Clinical Double-Blinded Study.

Introduction: Extraction of the tooth often leads to crestal bone loss. It is difficult for clinicians to decide on the technique of extraction. Many studies on flap and flapless have led to confusion. Hence it becomes necessary to conduct this study to show the efficient ridge preservation technique. Materials and Methods: Twenty patients were selected for this study. It was divided into the flap and flapless groups. In group A, the flap was elevated, tooth extraction was undertaken, the socket was cleaned, a graft was placed, a barrier was placed, and a suture was placed. In group B all the procedures were the same but without flap elevation. After surgery, clinical and radiographical parameters were recorded. Result: Flapless technique showed a better result in bone preservation. There was a low vertical bone loss in the flapless technique. Conclusion: Both techniques showed bone loss. But the flapless technique gave better results.

Evaluation of immuno-histochemical markers in oral squamous cell carcinoma.

Evaluation of immuno-histochemical (IHC) markers like p53, p63, PDPN, C-erb-B2, CK19, and VEGF in oral squamous cell carcinoma (OSCCs) is of interest to dentists. Sixty formalin-fixed paraffin embedded tissue blocks from the Department of Oral Pathology, New Horizon Dental College and Research, Institute, Sakri, Bilaspur, Chhattisgarh, India. The conventional IHC method was used to assess the expression of p53, p63, PDPN, C- erb-B2, CK19 and VEGF using the different antibodies. Data shows that P53, p63 had high values of labeling index (LI) of staining while PDPN, C-erb-B2 had low values of LI of staining. The values of LI of staining for CK19, and VEGF were in between the two types of IHCs. Combining the analysis of multiple IHC markers for OSCC can yield precise cancer diagnosis results.

Goldenhar Syndrome with Tessier's 7 Cleft: Report of a Case.

Goldenhar syndrome, a variant of hemifacial microsomia, is a well-known developmental anomaly of maxillofacial skeleton that is apparent at birth. The first and second branchial arch involvement during early embryonic development results in a wide spectrum of anomalies that may include macrostomia and lateral facial clefts. Though clefts of the orofacial region are among the most common congenital facial defects, the occurrence of lateral facial clefts (Tessier 7 cleft) in conditions such as the Goldenhar syndrome, is very rare (<5%). The lateral facial cleft, which results because of improper development of the perioral muscles of the face, gives an appearance of macrostomia giving rise to potential psychological, aesthetic and feeding problems. This clinical report describes the closure of a Tessier 7 cleft and the use of distraction osteogenesis to treat mandibular asymmetry in an 11-year-old female patient with Goldenhar's syndrome.

Bilateral Tessier's 7 Cleft with Maxillary Duplication.

Tessier's 7 cleft or lateral facial cleft are unusual lesions that result from failure of the embryonic mandibular and maxillary process of the first branchial arch to fuse properly and form the corners of the mouth. It may be seen alone or in combination with other anomalies, accompanied by varying degrees of severity. We report an extremely rare case of bilateral Tessier's 7 cleft along with maxillary duplication, macrostomia, bilateral posterior maxillary cleft, and mandibular retrusion in an 18-year-old male patient.

Solitary eosinophilic granuloma of mandibular condyle: literature review and report of a rare case.

Solitary eosinophilic granuloma (EG) is traditionally included as 1 of the 3 clinical manifestations of the histiocytosis-X group of diseases, which also encompasses Hand-Schuller-Christian disease and Letterer-Siwe disease. EG is the most common lesion in the spectrum of disorders under the classification of Langerhans cell histiocytosis. EG represents the monostotic form of the disease with the head and neck region representing the most common site of initial presentation. We report a rare case of solitary EG involving mandibular condyle in a 49-year-old male patient, which is the first reported case in Indian literature.

A cross-sectional clinical study on shape of nose inner-canthal distance and geometric progression as predictors for width of the maxillary incisor teeth.

OBJECTIVES: The objective of this study is to evaluate the relationship of anatomical landmarks of the face and geometric progression as predictors for the width of the maxillary incisor teeth. MATERIALS AND METHODS: The central incisor width (CIW), lateral incisor width (LIW), inner-canthal distance (ICD) and inter-alar distance (IAD) from a total of 150 subjects were measured clinically. The width of the root of the nose (WRN) was measured on standard photographs of the subjects. Student t-test has been used to find the significance of parameters between male and female. Pearson correlation has been used to find any relation of the parameters. RESULTS: The IAD and the WRN measurements suggest that the shape of the nose is wider and more triangular in males. The mean maxillary CIW and ICD was significantly higher in males than females. CONCLUSION: The proportion of IAD to WRN seems to be a reliable guide for deciding the proportion of the maxillary central and LIW. The ICD, when multiplied by a decreasing function value of the geometric progression term 0.618 and divided by 2, was a reliable predictor of the maxillary CIW.

Midline nasal dermoid cyst with Tessier's 0 cleft.

This is a rare anomaly of midline nasal dermoid cyst (NDC) along with Tessier's 0 cleft. Midline NDCs present most commonly result from aberrant embryological development, and most commonly give rise to bifid nasal deformity resulting in midline cleft of the nose. Craniofacial clefts are among the most disfiguring of all facial anomalies. They exist in a multitude of patterns and with varying degrees of severity. The bifid nose deformity is generally an indicator of Tessier number 0 cleft. We present a rare combination of midline NDC with a mild Tessier's 0 cleft in a 4-year-old female child who was surgically treated with wide emphasis given on its diagnosis and other treatment modalities.

Comparative Study of Genotoxicity in Different Tobacco Related Habits using Micronucleus Assay in Exfoliated Buccal Epithelial Cells.

BACKGROUND: Oral cancer is one of the most debilitating diseases afflicting mankind. Consumption of tobacco in various forms constitutes one of the most important etiological factors in initiation of oral cancer. When the focus of today's research is to determine early genotoxic changes in human cells, micronucleus (MN) assay provides a simple, yet reliable indicator of genotoxic damage. AIMS AND OBJECTIVES: To identify and quantify micronuclei in the exfoliated cells of oral mucosa in individuals with different tobacco related habits and control group, to compare the genotoxicity of different tobacco related habits between each group and also with that of control group. PATIENTS AND METHODS: In the present study buccal smears of 135 individuals with different tobacco related habits & buccal smears of 45 age and sex matched controls were obtained, stained using Giemsa stain and then observed under 100X magnification in order to identify and quantify micronuclei in the exfoliated cells of oral mucosa. RESULTS: The mean Micronucleus (MN) count in individuals having smoking habit were 3.11 while the count was 0.50, 2.13, and 1.67 in normal control, smoking with beetle quid and smokeless tobacco habit respectively. MN count in smokers group was 2.6 times more compared to normal controls. MN count was more even in other groups when compared to normal control but to a lesser extent. CONCLUSION: From our study we concluded that tobacco in any form is genotoxic especially smokers are of higher risk and micronucleus assay can be used as a simple yet reliable marker for genotoxic evaluation.

An assessment of etiological spectrum and injury characteristics among maxillofacial trauma patients of Government dental college and Research Institute, Bangalore.

BACKGROUND: Maxillofacial injuries pose a therapeutic challenge to trauma, maxillofacial and plastic surgeons practicing in developing countries. This was a retrospective study carried out to determine the incidence, etiology, injury characteristics of maxillofacial injuries reported at our centre. PATIENTS AND METHODS: The data for this study were obtained from the medical records of 689 cases reported to our centre during the period from 2006-2009. Records of patients who were either treated in the emergency room as outpatients or the Department of Oral and Maxillofacial Surgery as inpatients were analyzed and were subjected to statistical analysis using statistical package for social sciences (SPSS) for Windows version 17.0. Data was summarized in form of proportions and frequency tables for categorical variables and was subjected to Chi-Square test. RESULTS: Out of 689 patients, 75.9% were male and 24.1% were female. 42.5% of the patients were in the age group of 21 to 30 years. Road traffic accidents accounted for the majority (74.3%) of cases of maxillofacial trauma. Mandible was seen as the most commonly fractured bone (50.3%) and 53.8% head and neck injuries were most common among the associated injuries. CONCLUSION: Road traffic accidents were clearly the most prevalent etiological factor for maxillofacial trauma. Measures on prevention of road traffic crashes should be strongly emphasized in order to reduce the occurrence of these injuries.

Palatoscopy: An adjunct to forensic odontology: A comparative study among five different populations of India.

OBJECTIVES: This study was conducted to analyze and identify differences in the palatal rugae patterns and to identify gender wise changes in the palatal rugae shapes in populations of five different states of India. STUDY DESIGN: Study was conducted in five different Indian states. 500 sample subjects from Andhra Pradesh, Tamil Nadu, Karnataka, Madhya Pradesh and Maharashtra were included. Rugae patterns with predominant shapes were analyzed and categorized according to different states and both genders, data was statistically analyzed using SPSS software 15.0 and the results were obtained by Chi-square analysis. RESULTS: "Wavy" type of palatal rugae pattern is the most predominant variant in five different study groups in both the genders. CONCLUSION: This study could identify variations in distribution of various palatal rugae pattern in five different states and confirmed the "wavy" type of palatal rugae patterns to be the most predominant variant in five different study groups.

Incidence of nutrient canals in hypertensive patients: A radiographic study.

OBJECTIVES: To determine if any correlation exists in the presence of nutrient canals in hypertensive patients and nonhypertensive patients, to compare the incidence of nutrient canals in different age groups, and also to compare the incidence of nutrient canals between dentulous and edentulous patients. MATERIALS AND METHODS: This study was carried out on patients, who were divided into a control group comprising of healthy individuals, without history of hypertension and a study group of patients with the history of hypertension. The necessary information like age of the patient, presence or absence of hypertension, its duration, and blood pressure were recorded. An intraoral periapical radiograph of lower anterior region was made using bisecting angle technique and was interpreted. The presence or absence of nutrient canals, bone loss, and the levels of bone loss were recorded. The results so obtained were subjected to statistical analysis. RESULTS: We found that the incidence of nutrient canals was statistically higher in the study group (55.2%) as compared to the control group (36.2%). The incidence of nutrient canals was also found to be increased with, the age till 60 years, amount of alveolar bone loss and in edentulous patients. CONCLUSION: Hypertension being one of the most commonly encountered medical problems in dental practice and many cases being undiagnosed, the presence of nutrient canal though not entirely indicative of hypertension, should increase the suspicion of the condition to be investigated further.

Giant cemento-ossifying fibroma of the mandible.

Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient.

Rare giant granular cell ameloblastoma: a case report and an immunohistochemical study.

Aims. The aim is to present a case of rare giant granular cell ameloblastoma and to review the pertinent literature highlighting the molecular aspects of its pathogenesis by analyzing the expression of CD-68, Bcl-2, and ß -catenin. Methods. H and E stained sections showed large odontogenic islands showing peripheral ameloblast-like cells and central stellate reticulum-like cells with extensive granular cell transformation surrounded by fibrous stroma. Polyclonal rabbit anti-CD 68, anti-Bcl2, and anti- ß -catenin were stained immunohistochemically. Results. CD-68 showed a moderate to strong staining intensity in granular cells. Moderate staining of Bcl-2 was expressed by the peripheral columnar cells of tumor islands and negative in the granular cells. Expression of ß -catenin was generally weak, except for only the focal areas that showed a moderate staining intensity and weak in peripheral cells. Conclusion. The present case of giant granular cell ameloblastoma is a rare entity. Development of monstrous size is indicative of ameloblastomas persistent growth. Granular cell transformation in ameloblastomas probably occurs as a consequence of extensive molecular changes. Immunohistochemical studies help us to know the pathogenesis of this granular cell ameloblastoma. Therefore, an effort has been made here to study the expression of Bcl-2, CD-68, and ß -catenin.

Efficacy of colour Doppler ultrasound in diagnosis of cervical lymphadenopathy.

OBJECTIVES: The purpose of the study was to evaluate the efficacy of colour doppler ultrasound (CDUS) in diagnosis of cervical lymphadenopathy. MATERIALS AND METHODS: The study group consisted of 30 patients with clinical evidence of cervical lymphadenopathy (19 patients with clinically suspected reactive/benign cervical lymphadenopathy and 11 patients with clinically suspected malignant/metastatic cervical lymphadenopathy). CDUS examinations were carried out for one lymph node (LN) in each patient and fine needle aspiration cytology of the same LN was obtained. To evaluate the efficacy of CDUS, comparison between clinical features, CDUS features and cytological features of enlarged cervical LNs were then done. RESULTS: Clinical examination evaluated 54 cervical LNs. CDUS evaluation discovered an additional 55 LNs (54 + 55 = 109). Accuracy of the CDUS examination was higher than clinical evaluation. Patterns of colour doppler flow signals when correlated with cytological diagnosis showed central flow for benign nodes and peripheral flow for malignant nodes. The mean pulsatility index (PI) was 1.977 ± 0.669 in LNs involved with metastases and 0.839 ± 0.135in LNs affected by benign processes. LNs involved with metastases showed a characteristic high resistive index (RI) and a high pulsatility index than the lymph nodes affected by benign processes. The RI and PI were significantly different between LNs affected by benign versus malignant disease. CONCLUSION: Nodal vascularity of the LNs can be used to differentiate benign from malignant lymphadenopathy. CDUS can be trusted upon as a reliable marker for the diagnosis of cervical lymphadenopathy.

Botulinum toxin type a for the treatment of hyperkinetic lines of the face.

BACKGROUND: This study sought to determine the efficacy of Botulinum toxin A (BTA) for the treatment of hyperkinetic lines of the face. Twenty three patients who were concerned for facial wrinkles and desiring correction are presented. METHODS: This clinical study evaluated the postoperative results of 23 patients who underwent treatment for facial wrinkles with BTA. Among the patients included in the study, 20 were males and remaining 3 were females. The age of the patients ranged from 27 to 46 years (mean 34.69 years) and the treatment was done in three different sessions and divided into 3 treatment subgroups of forehead, crow's feet, and glabellar wrinkles. RESULTS: All the patients were followed up for a period of at least 6 months and graded for the response to treatment with BTA by the operator, observer and the patient independently using the facial wrinkle scale. The patient's satisfaction to the treatment was also noted on all the follow-up visits on the satisfaction scale and the results were subjected to statistical analysis using Kappa analysis, Chi-square test and T test. The results showed that the treatment of facial hyperkinetic lines with BTA is associated with few adverse events like pain on injection, transient headache, and mild change in facial appearance in subjects with high hair line which are not serious and thus safe. CONCLUSION: The findings of this study support the use of BTA for the treatment of hyperkinetic lines of the face although further studies with more sample size are required.

Infected dentigerous cyst of maxillary sinus arising from an ectopic third molar.

A dentigerous cyst or follicular cyst is a form of odontogenic cyst. It is believed that it forms during the development of the tooth and is associated with pressure exerted by the crown of an unerupted (or partially erupted) tooth on the fluid within the follicular space. Typically, dentigerous cysts are painless and discovered during routine radiographic examination. However, they may be large and result in a palpable mass. Additionally, as they grow they displace adjacent teeth. They almost exclusively occur in permanent dentition. The cyst is lined by stratified squamous non-keratinizing epithelium. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla. Dentigerous cysts associated with ectopic teeth within the maxillary sinus are very rare. We report radiologic and pathologic features in a rare case of infected dentigerous cyst of maxillary sinus arising from an ectopic third molar in a 21-year-old female patient.

Dermal cylindroma of the scalp.

Dermal cylindroma is a benign neoplasm of the eccrine sweat glands, which presents in the head and neck area in majority of cases. In its most florid presentation, the entire scalp can be involved, leading to the descriptive label turban tumor. They most commonly occur on the head and neck as solitary or multiple tumors. Solitary cylindromas occur sporadically and typically are not inherited. Multiple tumors are observed in an autosomal dominantly inherited manner. When nodules enlarge and coalesce on the scalp, they form the distinctive turban tumor feature. We present a case of multiple form of dermal cylindroma, occupying the anterior scalp in a 38-year-old male patient.

Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis.

Obstructive sleep apnea syndrome (OSAS) is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty.

Auricular reconstruction of congenital microtia using autogenous costal cartilage: report of 27 cases.

BACKGROUND: Total auricular reconstruction in congenital lobule type microtia is one of the most challenging problems faced by a reconstructive surgeon as it demands precise surgical technique combined with artistic creativity. Ear reconstruction requires carefully planned procedures. METHODS: We present a simple method for auricular reconstruction consisting of three stages. The first stage is carving the cartilage framework from the costal cartilages of 6th, 7th and 8th ribs, lobule transposition and insertion in a skin pocket. The second stage is performed 5 months later to elevate the ear framework using a full thickness skin graft and a cartilage spare part. The third stage is done after 3-4 months later to give finer detail to the reconstructed ear. This method was used in 27 patients with lobule type microtia. RESULTS: The results of the reconstructed auricles in 27 patients were satisfactory with good aesthetic balance. The complications ranged from small localized skin infection treated with topical and oral antibiotics to catastrophic loss of the skin pocket and the framework. CONCLUSION: Although various donor sites have been used for harvesting the cartilage, only costal cartilage provides a substantial source for fabricating total ear framework. The cosmetic outcome and least complication results in our series support this conclusion.