Perception, Awareness, and Practice about Missing Teeth, Prosthetic Options, and Knowledge about Dental Implants as a Treatment Modality in the Adult Population of Jharkhand State: A Hospital-Based Study.

Context: Several options to restore the missing teeth are currently available; however, minimal information is there regarding the tooth loss consequences and knowledge of the various prosthetic options in the Indian population. Aim: The aim of this study was to investigate the perception, awareness, and practice about missing teeth, prosthetic options, and knowledge about dental implants among the adult population of Jharkhand state. Materials and Methods: A questionnaire-based cross-sectional study was carried out on 400 participants. The questionnaire was divided into two sections, i.e., perception awareness and practice about missing teeth, its consequences, and prosthetic options and the second part was about the knowledge of dental implants. Statistical Analysis: Chi-square test was applied for comparison, and P < 0.05 was considered statistically significant. Results: Maximum numbers of people 178 (44.5%) were interested to get their teeth replaced as a definite requirement. Loss of esthetics as a consequence after tooth loss was known to 72.5% followed by tilting of adjacent teeth (47%). Awareness for prosthetic options available after tooth loss was highest (71.5%) for fixed partial denture's (Bridge). Sixty-three percentage of the studied population had not replaced their missing teeth with any dental prosthesis. Knowledge about dental implants was restricted to a meager of 84 (21%) of the participants. Dentist was the main source of information for dental implants, followed by media. Conclusion: Awareness of patients toward missing teeth and its consequences requires more emphasis. Special effort is needed to improve the knowledge of dental implants among the less educated population of this region.

Comparative Evaluation of Mitochondrial Antioxidants in Oral Potentially Malignant Disorders.

Various endogenous mitochondria-associated antioxidants protect mitochondria from oxidative stresses such as Superoxide Dismutase 2 (SOD2), Catalase, Glutaredoxin 2 (GLRX2), educed Glutathione (GSH), Glutathione Peroxidase (GPx), and Thioredoxin 2 (TXN2). They protect mitochondria from Reactive Oxygen Species (ROS). Excess ROS causes mitochondrial DNA damage and respiratory chain dysfunction leading to carcinogenesis. In an earlier study we found complex alterations of mitochondrial antioxidants in different stages of oral squamous cell carcinoma. Here, we profiled mitochondrial antioxidants in different oral potentially malignant disorders such as oral leukoplakia (OL), oral lichen planus (OLP), and oral submucous fibrosis (OSMF). Mitochondria was prepared from oral tissues from OL, OLP, and OSMF patients. Biochemical assays and immunoblotting were performed to investigate expression of various mitochondrial antioxidants. Catalase was expressed as Control> OL > OSMF > OLP. GLRX 2 was expressed as OLP> OL >Control >OSMF. GPX1 and GPX4 were expressed as Control >OSMF> OLP > OL. GSH increased in OL and OSMP, but decreased in OLP. SOD2 was expressed as Control >OSMF> OLP > OL. PRX3 was expressed as OL > OLP > OSMF > Control. TXN2 expression was nearly the same in all groups except OL, which showed elevated expression. We conclude that endogenous mitochondria-associated antioxidants show different levels of expressions in various oral potentially malignant disorders.

Validating the Usage of Cariogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study.

AIM: To validate the caries risk profiles in 5- and 12-year-old school-going children and to single out main contributing factor, if any, using cariogram over a period of 1 year. MATERIALS AND METHODS: A cariogram model was used to create caries risk profiles on 499 children aged 5 and 12 years ±6 months. They were divided into 2 groups. The group I and group II consisted of 250 and 249 children respectively. Re-examination was done after 1 year and caries increment was recorded. The caries risk profiles generated by the cariogram software were compared with caries increment. RESULTS: Percentage of subject having caries increment in groups I and II in high-, medium-, and low-risk group after 1 year was 66.2, 39.5, and 13%, and 48.5, 27.3, and 13.9% respectively. The mean caries increment after 1 year in groups I and II in high-, medium-, and low-risk patients was 0.96, 0.49, and 0.13, and 0.7, 0.36, and 0.11 respectively. Linear regression analysis showed dental caries, diet content, diet frequency, plaque index, Streptococcus mutans count, fluoride, salivary flow rate, and buffer capacity are significantly associated with actual chance to avoid caries. CONCLUSION: The risk of developing new carious lesions consistently reduced from high-risk category to low-risk category, reflecting the cariogram ability in accurately estimating future caries. Hence, cariogram can be said to be a useful tool for caries prediction. Initial dental caries came out to be the strongest predictor of future caries.How to cite this article: Garg A, Madan M, Dua P, Saini S, Mangla R, Singhal P, Dupper A. Validating the Usage of Car-iogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study. Int J Clin Pediatr Dent 2018;11(2):110-115.

Oral lymphangiomas - clinical and histopathological relations: An immunohistochemically analyzed case series of varied clinical presentations.

Lymphangiomas are benign malformations that represent hamartoma of malformed lymphatics and are composed of cystically dilated lymphatic channels which do not communicate or drain into other lymphatic channels or veins leading to accumulation of lymph. They are congenital malformations with rare occurrence in oral cavity within which tongue dorsum is the most affected site. Venous malformations are often difficult to differentiate from lymphatic malformations leading to the development of several lymphatic markers like D2-40 which seems to be useful for distinguishing vascular from lymphatic vessels. The most effective treatment is surgery having good prognosis for most of the patients but depending on their location (neck/tongue) and size (large size) they may cause airway obstruction causing death. Herewith, we present the rare cases of oral lymphangiomas of tongue, palate and buccal mucosa with varied and characteristic clinical presentations.

Altered expression of mitochondrial antioxidants in oral squamous cell carcinoma.

Reactive oxygen species, if produced in excess by oxidative phosphorylation, contributes to mitochondrial DNA damage and progressive respiratory chain dysfunction, leading to various diseases including carcinogenesis. Mitochondria are susceptible to oxidative stress (OS) owing to lack of introns, protective histones, and DNA repair enzymes. However, mitochondria are protected from OS by numerous antioxidants such as superoxide dismutase 2 (SOD2), catalase, glutaredoxin 2 (GLRX2), reduced glutathione (GSH), glutathione peroxidase (GPX), and thioredoxin 2 (TXN2). To obtain insights regarding expression of these mitochondrial antioxidants in oral squamous cell carcinoma (OSCC), we performed qualitative and quantitative estimations of key molecular players of mitochondrial antioxidants during various stages of OSCC by immunoblotting with specific antibodies against antioxidant enzymes and/or biochemical assays. Different mitochondrial antioxidants varied in their expression levels as OSCC progressed. The levels of GPX1, GPX4, and catalase reduced with progression of OSCC. However, GLRX2, PXR3, TXN2, and reduced GSH gradually increased. Expression of SOD2 decreased initially in Stages II and III of OSCC but increased in Stage IV. In conclusion, our findings indicate a complex interplay of various mitochondrial antioxidants in different stages of OSCC, and further insights regarding these molecular players can help us better understand the pathogenesis of OSCC in context of mitochondrial redox status.

Unilateral fourth, fifth, sixth, and seventh molar in a nonsyndromic patient: A rare and unusual case report.

Multiple supernumerary teeth are rare developmental anomalies which are often associated with syndromes. Only few examples of nonsyndromic supernumerary teeth have been reported with fourth, fifth, sixth, and seventh molar rarest of all. The cause, frequency, complications, and surgical operation of supernumerary teeth are always interesting subjects for study and research. Literature reports increased occurrence of the supernumeraries in the maxilla, but here, a unique and unusual case report of 12-year-old female patient with unilateral multiple impacted supernumerary teeth in the mandible in otherwise healthy individual has been presented.

Evaluation of histomorphometric changes in tissue architecture due to fixation delay.

INTRODUCTION: All good tissue specimen preparations require complete fixation. The process of tissue handling and processing from patient to paraffin block is too frequently invisible to the pathologists. Many times due to certain emergencies or unavailability of a proper fixative, tissues are kept in different carrying media such as normal saline (NS) or local anesthetic till the availability of a proper fixative solution. This fixation delay can lead to various tissue architectural changes which can affect its diagnostic value. AIMS: The aim of this study was to assess sectioning ability, staining intensity and microscopic details of tissues kept in different carrying media at different time intervals followed by standard fixation. MATERIALS AND METHODS: Fresh tissue specimen, i.e., goat tongue was collected and its middle portion was retained and was used for study purpose. The tissue was grossed and kept in various carrying media for five different time intervals. Standard formaldehyde fixation was then carried out followed by sectioning and staining. The sections were evaluated histologically under light microscope. STATISTICAL ANALYSIS: For sectioning parameter, Fisher's exact test and for staining and microscopic details, Mann-Whitney U-test was used. RESULTS: According to the study, NS is considered as a best carrying media followed by 10% honey and local anesthetic. Two percent hydrogen peroxide cannot be used as a carrying media. CONCLUSION: It was concluded that NS should be given first preference as a carrying media till the availability of a suitable fixative. Clinicians and Pathologists should have to familiarize themselves with the advantages and disadvantages of using various carrying media and the histomorphometric changes associated with delayed fixation which may lead to incorrect diagnosis.

Evaluation of Histomorphometric Changes in Tissue Architecture in Relation to Alteration in Fixation Protocol - An Invitro Study.

INTRODUCTION: Preparation of good tissue specimens for microscopy requires complete fixation. No ideal fixative has been found till date, with every fixative showing advantages and disadvantages. Appropriate fixation is required to maintain clear and consistent morphologic features for histologic examination. Pathologists mostly examine formalin fixed tissue sections and are less used to the morphologic changes induced by other fixatives. Underfixed and overfixed tissue in various fixatives can lead to tissue architectural changes which can affect its diagnostic value. AIM: To assess sectioning ability, staining intensity and microscopic details of tissues kept in different fixatives at different time intervals. MATERIALS AND METHODS: Fresh tissue specimen i.e., goat tongue was collected and its middle-third portion was used for the study purpose. The tissue was grossed into 10 equal pieces and kept in various fixatives (10% Buffered formalin, Carnoy's solution, Absolute ethyl alcohol, Bouin's fluid) for five different time intervals (6, 12, 18, 24 and 30 hours) and normal tissue processing steps were carried out followed by sectioning and staining. During sectioning, sectioning parameter was assessed. Following sectioning, sections were observed under light microscope and were histologically evaluated for staining and microscopic details. To calculate the sectioning parameter Fisher's exact test was used and to assess parameters for staining and microscopic details Mann-Whitney U test was used. RESULTS: According to the study, 10% buffered formaldehyde is considered as a superior fixative under all parameters followed by Bouin's fluid, Carnoy's solution and Absolute alcohol. CONCLUSION: In our study, it was concluded that 10% buffered formaldehyde should be continued as a routine fixative however, other fixatives can be used depending upon the non-availability of required fixative or in case of emergencies. Pathologist should be accustomed to histologic and morphologic changes of underfixed and overfixed tissue which can affect its diagnostic value.