Treatment of hemifacial spasm in patient with hemifacial atrophy using combination therapy (ultrasound therapy and TENS): a case report.

A 19-year-old male patient presented with facial hemi-atrophy with unilateral spasms of the masseter and temporalis muscles. Ultrasound therapy and Transcutaneous Electric Nerve Stimulation therapy, known as combination therapy, were given on alternate days for 2 weeks. At the end of 2 weeks of combination therapy the patient reported a drastic reduction in the number of episodes of muscle spasm. The visual analog scale score for tenderness of the masseter and temporalis was also markedly reduced. No one has previously used combination therapy for the treatment of facial hemi-atrophy with hemi-facial spasms. The encouraging results of the combination therapy has prompted us to document this study.

Diagnostic CBCT in Dentigerous Cyst with Ectopic Third Molar in the Maxillary Sinus-A Case Report.

Dentigerous cyst is the second most common odontogenic cyst after radicular cyst. This report describes a case of a dentigerous cyst associated with an impacted maxillary third molar. Patient presented with foul smelling discharge through nose and oral cavity. Cone beam computed tomography revealed maxillary third molar displaced to lateral wall of the nose and a unilocular radiolucency obliterating the entire maxillary sinus. A provisional diagnosis of infected dentigerous cyst was made. The cyst was enucleated along with removal of third molar. Histopathological examination confirmed the diagnosis of dentigerous cyst. The patient recovery was uneventful.

Lipid profile and metabolic syndrome status in patients with oral lichen planus, oral lichenoid reaction and healthy individuals attending a dental college in northern India - a descriptive study.

BACKGROUND: Chronic inflammation causes disturbances in the lipid metabolism. When this dyslipidemia becomes prolonged it increases the risk of cardiovascular disease. Recent literature reveals similar dyslipidemia in patients with lichen planus. However, the results were not compared with lichenoid reactions. OBJECTIVE: The aim of this study was to profile the lipid levels and metabolic syndrome status in patients with oral lichen planus (OLP), oral lichenoid reactions (OLR) and healthy individuals in order to evaluate their respective cardiovascular risk. MATERIALS AND METHODS: This case-control descriptive study included 32 adults from the OPD visiting the Department of Oral Medicine, 18 with either oral lichen planus or oral lichenoid reactions and 14 age and sex matched healthy controls. Ethical clearance and informed consent were obtained. Their lipid levels, body mass index and metabolic syndrome status were evaluated. Statistical analyses were performed with the SPSS version 16.0 software.P≥0.05 was considered significant. RESULTS: The key findings of this study were a) increased levels of S.cholesterol and LDL-C in OLP and OLR patients when compared to normal healthy individuals b) significantly higher S.triglyceride and VLDL in OLP when compared to OLR and c) lower HDL-C levels in OLP when compared to OLR. 2(18%) patients with OLP and 3(50%) with OLR were found to have high BMI suggestive of obesity whereas none of the normal individuals were obese. CONCLUSION: There may be an association between chronic inflammation and dyslipidemia that increases the risk for cardiovascular disease. OLP and OLR patients have increased serum cholesterol and LDL-C when compared to normal adults. Further research on lipid levels in OLR are required to establish the findings of this study.

Notching in the posterior border of the ramus of mandible in a patient with neurofibromatosis type I - a case report.

Neurofibromatosis Type I (NFI) is a relatively common hereditary, autosomal dominant neurocutaneous condition. It is a benign peripheral nerve sheath tumour arising from Schwann cells and peripheral fibroblasts. Even though it is a neurocutaneous disorder, NF I has significant skeletal manifestations. Oral and maxillofacial skeletal structures are also often involved in the form of deepening of sigmoid notch, enlarged mandibular canal and notching of inferior border of mandible. In this paper, we are reporting a female patient of NF I who presented with a notching in the posterior border of ascending ramus of mandible.

Ackerman's tumour of buccal mucosa in a leprosy patient.

Leprosy (Hansen's disease) is a chronic granulomatous disease caused by Mycobacterium leprae (Hansen's bacillus). Oral manifestations occur in 20-60% of cases, usually in lepromatous leprosy, and are well documented. They may involve both the oral hard and soft tissues. Incidence of verrucous carcinoma/Ackerman's tumour developing in anogenital region and plantar surfaces of feet in lepromatous leprosy has been sufficiently documented in the literature. However, association of oral verrucous carcinoma with lepromatous leprosy has not been established. We report for the first time a case of verrucous carcinoma of the buccal mucosa occurring in a leprotic patient, with brief review of literature on orofacial manifestations of leprosy.

Management of oral submucous fibrosis by two different drug regimens: A comparative study.

BACKGROUND: Oral Submucous Fibrosis (OSF) is a precancerous condition of the oral mucosa. Existing treatments give only temporary symptomatic relief. Colchicine is an ancient drug with anti-fibrotic and anti-inflammatory properties. We planned to study the effects of colchicine in the management of oral submucous fibrosis. MATERIALS AND METHODS: Fifty OSF patients were divided randomly into two groups and treated for 12 weeks. Group 1-Patients were administered tablet colchicine orally, 0.5 mg twice daily and 0.5 ml intralesional injection Hyaluronidase 1,500 IU into each buccal mucosa once a week. Group 2-Patients were administered 0.5 ml intralesional injection Hyaluronidase 1,500 IU and 0.5 ml intralesional injection Hydrocortisone acetate 25 mg/ml in each buccal mucosa once a week alternatively. Student's t test and analysis of variance (ANOVA) were used to compare pre and post treatment results. P<0.05 was considered as significant. RESULTS: Thirty-three percent in group 1 got relief from burning sensation in the second week. Inter group comparisons of increase in mouth opening and reduction in histological parameters indicated that group 1 patients responded better than group 2. CONCLUSION: These encouraging results should prompt further clinical trials with colchicine alone on a larger sample size to broaden the therapeutic usefulness of the drug in the management of OSF.

TMJ imaging by CBCT: Current scenario.

Radiographic examination forms an integral component of the clinical assessment routine in patients with temporomandibular joint disorders (TMJ). There are several imaging modalities to visualize the TMJ. Cone beam computed tomography (CBCT) is a developing technique that is being increasingly used in dentomaxillofacial imaging due to its relatively low-dose high-spatial-resolution characteristics. Research in TMJ imaging has been greatly inspired by the advent of CBCT. In this paper we aim to discuss the present scenario of the role of CBCT in TMJ imaging.

Encysted Tenia solium larva of oral cavity: Case report with review of literature.

Cysticercosis is caused by the larvae of the pig tapeworm, Tenia solium. Oral cysticercosis is a rare event and is often a diagnostic challenge to the clinician. We report a 12-year-old girl who presented with a single, painless, nodule on the lower lip that was diagnosed as cysticercosis. Current literature on the clinical presentations, investigations, and treatment of the condition has been reviewed in this article. We have also proposed a set of criteria for the diagnosis of oral cysticercosis.

Positioning errors and quality assessment in panoramic radiography.

PURPOSE: This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college. MATERIALS AND METHODS: This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'. RESULTS: Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable. CONCLUSION: The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.

Scrotal distension after endoscopic harvesting of the saphenous vein in patients with inguinal hernia.

The great saphenous vein remains the most commonly used conduit for coronary artery bypass grafting. The endoscopic vein harvesting technique is widely used due to reduced postoperative complications. We present the case of 5 patients with a history of inguinal hernia undergoing coronary artery bypass grafting, which resulted in CO2 infiltration through the deep inguinal ring and into the scrotum leading to acute scrotal enlargement. Due to the risk of impediment of vascular blood supply and necrosis, endoscopic vein harvesting was withdrawn, and the vein was harvested by using the bridging technique. Postoperatively, severe contusion, inflammation, and erythematous vesicular eruption resulted in a lengthened hospital stay.