Osteomyelitis of Maxilla: A Rare Finding from a Radiologist Point of View.

Osteomyelitis is an inflammatory process of both cortical and medullary bone. In the maxillofacial skeleton, it can be seen more commonly in mandible as compared to the maxilla. Here, we present a rare case of osteomyelitis involving the entire maxillae in a 55-year-old male patient highlighting the clinical findings and radiographic features with treatment modalities.

Significance of Serum Nitric Oxide and Superoxide Dismutase in Oral Submucous Fibrosis and Squamous Cell Carcinoma: A Comparative Study.

INTRODUCTION: This study aimed at comparative analysis of serum nitric oxide (NO) and superoxide dismutase (SOD) levels as therapeutic and prognostic biomarkers in patients with oral submucous fibrosis (OSMF) and squamous cell carcinoma (SCC). MATERIALS AND METHODS: Eighty-seven patients were grouped into Group I (n = 29, OSMF), Group II (n = 29, oral SCC), and Group III (n = 29, controls). Two ml of venous blood was collected from patients after overnight fast to avoid any dietary influence on the serum beta-carotene. Standard protocols were followed in transfer, storage, and processing of blood. Modified copper-cadmium reduction method for rapid assay to estimate the serum NO and Enzychrom™ SOD assay kit to determine SOD levels were used. RESULTS: The mean level of NO level in Group I, Group II, and Group III was 42.49, 50.08, and 32.81, respectively, and mean level of SOD in Group I, Group II, and Group III were 207.65, 196.93, and 226.57, respectively. The P values were calculated and were statistically significant (<0.001). CONCLUSION: An increase in level of oxidant NO in OSMF followed by SCC and decrease in level of antioxidant SOD in OSMF followed by SCC were noted. These levels of NO and antioxidant SOD can be used as prognostic and therapeutic biomarkers.

Evaluation of Oral Pentoxifylline in the Management of Oral Submucous Fibrosis - An Ultrasonographic Study.

AIM AND OBJECTIVE: To evaluate the therapeutic efficacy of oral pentoxifylline in the treatment of oral submucous fibrosis (OSMF) patients by assessing the clinical symptoms such as burning sensation, mouth opening, and submucosal layer thickness and echogenicity using ultrasonography, both pre- and post-operatively. MATERIALS AND METHODS: Thirty study subjects were included in the study and divided into two groups in single-blind randomized manner, oral pentoxifylline and dexamethasone group. Burning sensation, mouth opening, ultrasonographic submucosal thickness, and echogenicity were recorded both pre- and post-operatively. Any adverse effects reported by the patients were also noted. The data collected were statistically analyzed, and response to pentoxifylline and intralesional dexamethasone with hyaluronidase was observed using ultrasonography. RESULTS: A highly significant reduction (P < 0.001) in burning sensation, improvement in mouth opening, and changes in submucosal thickness were noticed in both groups, and significant improvement (P < 0.05) in echogenicity in both the groups was noticed. However, pentoxifylline group showed marginally better improvement than dexamethasone group. CONCLUSION: Pentoxifylline can bring about significant improvement in OSMF, which can be used as better alternative where intralesional steroid was contraindicated or not well tolerated.

Treatment of oral leukoplakia with photodynamic therapy: A pilot study.

AIM OF THE STUDY: Oral leukoplakia (OL) is the most common potentially malignant disorder that may transform into oral carcinoma. By treating leukoplakia in its incipient stage, the risk of occurrence of oral carcinoma can be prevented. In this aspect, photodynamic therapy (PDT) can serve as a useful treatment modality. The aim of the study is to treat patients with OL using PDT in which 5-aminolevulinic acid (ALA) is used as a photosensitizer. MATERIALS AND METHODS: Five patients with OL were included in the study. They were treated with 10% ALA mediated PDT (light source: Xenon lamp, power: 0.1 W, wavelength: 630 ± 5 nm, total dose: 100 J/cm(2) per session) for 6-8 sessions. Follow-up was done for a period of 1 year. RESULTS: One month (4 weeks) after ALA-PDT, the response was evaluated based on clinical examination. It was as follows: Complete response: Two patients; partial response: Two patients; and no response: One patient. There was no recurrence in any of the cases. CONCLUSION: There was satisfactory reduction in the size of the OL lesion without any side-effects. Thus, ALA mediated PDT seems to be a promising alternative for the treatment of OL.

Salivary interleukin-6 in the detection of oral cancer and precancer.

AIM: Oral cancer is a major health concern in many parts of the world. Despite its low survival rates, when detected early or in the precancer stage, it can drastically increase the survival rates. This strongly supports the need for sensitive biomarkers to perk up early detection of oral cancers. The aim of the study is to estimate whether salivary interleukin-6 (IL-6) can be used as a molecular marker to diagnose leukoplakia and oral squamous cell carcinoma (OSCC). METHODS: The sample of 75 cases was divided into three groups of 25 patients each: group I: oral leukoplakia; group II: OSCC; group III: control group. Saliva samples were collected by simple drooling method and the concentration of IL-6 was determined by using ELISA (enzyme-linked immunosorbent assay) technique. RESULTS: When the concentration of salivary IL-6 among the three groups was compared, the results were statistically significant ("P" value <0.001). CONCLUSION: The increase in salivary IL-6 in leukoplakia and OSCC might point out its local production by the tumor cells. The difference in its levels between these two lesions might indicate the progression of precancer to cancer. Further longitudinal studies with increased sample size are needed to substantiate the utility of salivary IL-6 as diagnostic or prognostic marker for oral cancer and precancer.

Treatment of oral lichen planus with methylene blue mediated photodynamic therapy--a clinical study.

BACKGROUND/PURPOSE: Oral lichen planus is an autoimmune disorder that has posed a challenge in spite of the several treatment modalities available. Here, we have proposed yet another treatment modality, photodynamic therapy, for this condition. The aim of the study was to treat patients having symptomatic oral lichen planus with photodynamic therapy with methylene blue as photosensitizer. METHODS: Twenty patients with symptomatic oral lichen planus were included in the study. They were treated with 5% methylene blue mediated photodynamic therapy (light source: Xenon arc lamp, wavelength: 630 ± 5 nm, total dose: 120 J/cm(2) per sitting) in four sessions (1st, 4th, 7th and 15th day). Follow-up was done on second and fourth week after the therapy. RESULTS: There was significant improvement in signs and symptoms of the lesion at first and second follow-up visits (P-value<0.001). CONCLUSION: There was satisfactory reduction in signs and symptoms of oral lichen planus without any side effects. Thus, methylene blue mediated photodynamic therapy seems to be a promising alternative for the control of oral lichen planus.

Stylocarotid syndrome: An unusual case report.

Patients presenting with vague head and neck pain can lead to wide-ranging differential diagnosis. Elongation of styloid process (SP) should also be considered as one of the etiological factors for cervical pain radiating to jaws, pharyngodynia, and difficulty in swallowing. Symptomatic elongation of SP or mineralization of stylohyoid ligament is referred as Eagle's syndrome. It is a rare entity presenting with an array of symptoms like recurrent throat pain, dysphagia, otalgia, and neck pain. History and physical examination play a vital role in diagnosing this condition and further radiological investigation confirms the diagnosis. The preferred radiologic modality is 3D-computed tomography, which gives accurate information about length, angulation, type of elongation, and relation to vital structures and hence helps in execution of treatment planning. This paper describes clinical approach, imaging investigations, and management of a case of Eagle's syndrome.