Surgical management of intramuscular hemangioma of left masseter muscle: A case report.

Hemangiomas are benign soft tissue tumors which are congenital and occur due to abnormal proliferations of blood vessels. Most common location of hemangiomas is subcutaneous adipose tissue, but skeletal muscle hemangiomas are very rare which make up to 0.8% of all hemangiomas. Usually, the intramuscular lesions are common in thigh region and calf muscles and are relatively rare in the facial muscles. Long-standing lesions results in phleboliths, and this may cause some symptoms. Conventional treatment of these isolated lesions may not yield satisfactory results. Hence, surgical excision of the lesion in toto results in aesthetically pleasing results with low chances of recurrence. In this article, we report a case of a left masseter intramuscular hemangioma in 19-year-old patient which was successfully managed by complete surgical excision.

Age estimation in Western Indian population by Cameriere's and Drusini's methods.

Objectives: The aim of the present study is to determine applicability of Cameriere's and Drusini's methods in Western Indian population. Methodology: Panoramic radiographs of total 300 Gujarati individuals, equally divided into four study groups were studied by two investigators. The pulp/tooth area ratio (AR) were calculated for maxillary and mandibular canines and tooth coronal indexes (TCI) i.e., the ratio between coronal pulp cavity height and crown height were calculated for mandibular premolars and first and second molars. The acquired data were subjected to correlation and regression analysis and also inter and intraobserver reliability was obtained for both the investigators. Results: The ARs and TCIs for all the respective teeth were significantly correlated with the age of the individuals. The individual regression formulae were derived for all the teeth and were then used separately to calculate the age. There was no statistically significant difference between the mean chronological age and mean calculated age for all the teeth.(P > 0.05). The mean absolute errors for all the teeth were <10 years. Conclusion: The findings of this study prove the applicability of Cameriere's and Drusini's age estimation methods for Western Indian population. However, the weak correlation coefficients suggest the need for further studies to get more accurate results.

Insight in to the Awareness of CBCT as an Imaging Modality in the Diagnosis and Management of ENT Disorders: A Cross Sectional Study.

The advent of Cone-beam computed tomography (CBCT), has revolutionized 3D imaging in dentistry. CBCT has enormous potential to be used as an alternative imaging modality by Otolaryngologists. But their knowledge regarding CBCT is limited. The study aims to evaluate the awareness of CBCT as an imaging modality among Ear, nose and Throat (ENT) practitioners. The validated questionnaire was sent by email and the participants were asked to fill the google form through the link provided to record the responses. The participants were asked to answer 25 multiple choice questions regarding the general information and practice related to CBCT imaging. Data was evaluated according to the descriptive statistics and the Chi-square test was used to determine the test of significance. The response rate for this study was 84.4%. The mean age of the participants was 44.9 ± 11.3. 69% of the respondents were academicians,14.2% had exclusive clinical practice, and 16.8% had both clinical and academic exposure. Among the study population, 76.8% had never advised CBCT in their practice. Only 10.3% of the study participants were aware of the potential of CBCT in ENT disorders. The mean knowledge, attitude and practice scores were very low regarding the applications of CBCT. Most of the study participants advised CBCT for maxillofacial fractures (78.1%) and was statistically significant p < 0.05. The knowledge about various advantages and clinical applications of CBCT among Otolaryngologists is limited. However, continuing medical education and inclusion in the medical curriculum will increase the scope and awareness about CBCT among ENT fraternity.

Age- and sex-related mandibular dimensional changes: A radiomorphometric analysis on panoramic radiographs.

INTRODUCTION: Mandible undergoes age- and sex-related structural changes similar to other bones of the body. Thus, morphometric analysis of the mandible helps in age and sex determination. AIM: To investigate the influence of age and sex on the mandible by measuring three parameters, i.e. gonial angle, ramus height and bigonial width. MATERIALS AND METHODS: A retrospective radiomorphometric analysis was conducted in the department of Oral Medicine and Radiology. A total of 300 panoramic radiographs (150 males and 150 females) equally distributed in six study groups according to the age were analysed. The measurements were performed using DIGORA 2.8 software for Windows. The acquired data was statistically analysed by one way ANOVA test and Student's t-test using SPSS (v. 19.0). RESULTS: Statistically significant differences according to age were found in gonial angle dimensions. Ramus height and bigonial width did not demonstrate statistically significant co-relation with age. According to sex, all the three study parameters showed statistically highly significant differences. CONCLUSION: The morphometric analysis of the mandible is a useful tool for age estimation and sex determination.

Prevalence of Bifid Mandibular Canal Amongst Indian Population: A Radiographic Study.

BACKGROUND: Bifid mandibular canal (BMC) is a normal anatomical variation and has been less studied in the Indian population. This study was aimed at estimating the prevalence of BMC amongst Indian population. MATERIALS AND METHODS: The study sample comprised of 5800 digital orthopantomograms (OPGs) which were from four zones of India, i.e. North India, South India, East India, and West India (1700 OPGs from each zone). Any pathological or normal digital OPGs having age between 15 and 80 years in the format of jepg or jpg image were included, while OPGs of operated case of hemimandibulectomy and blurred in which mandibular canal was not traceable were excluded from this study. Each radiograph was assessed for BMC based on the classification given by RP Langlais. Four examiners (two Oral and Maxillofacial surgeons and two Oral and Maxillofacial Radiologists) individually assessed every OPG for the presence of BMC. BMC was considered present, if all the examiners detected it independently. RESULTS: There were 5800 OPGs examined, out of which 2576 were of women and 3224 were of men. Bifid mandibular canals were observed in 135 (2.3%) out of 5800 digital panoramic images. There was no statistically significant correlation found with regard to age. Bifid mandibular canals were found with a female-to-male ratio of 1:1.2. The most frequently encountered type of BMC was type II (1.34%) followed by type I (0.72%), type IV (0.15%), and type III (0.1%).

Estimation of Serum Protein in Oral Potentially Malignant Disorders and Oral Malignancy - A Cross-Sectional Study.

INTRODUCTION: In carcinogenesis, increased oxidative stress and weakened antioxidant defense produces damage to the macromolecules like proteins. Thus, protein can act as potential biomarker in oral premalignant and malignant lesions. AIM: To determine and compare the levels of serum proteins in Oral Submucuous Fibrosis (OSMF), Oral Leukoplakia (OL), Nicotina Stomatitis (NS), Oral Malignancy (OM) and Healthy Controls (HC). MATERIALS AND METHODS: A total of 250 participants, were equally divided in five groups i.e., OSMF, OL, NS, OM and HC. Five ml of blood was collected from antecubital vein from each participant. The serum was analyzed for total protein, albumin and globulin levels using EBRA EM 200 semi-quantitive analyzer with the help of diagnostic kits. RESULTS: There were total 193 males and 57 females, who were between 18 to 82 years of age, with a mean of 46.32±13.89 years. The serum protein and globulin levels were significantly decreased in OSMF, OL and NS and increased in OM as compared to HC (p<0.001). No statistically significant difference was found in serum albumin levels between the study groups (p>0.05). CONCLUSION: Serum proteins can be used as diagnostic and prognostic marker for oral premalignant and malignant lesions.

Comparison of Therapeutic Efficacy of Placental Extract with Dexamethasone and Hyaluronic Acid with Dexamethasone for Oral Submucous Fibrosis - A Retrospective Analysis.

INTRODUCTION: Oral Submucous Fibrosis (OSMF) is a potentially malignant disease of the oral cavity associated with betel nut chewing. The management of OSMF has been a subject of controversy and no definitive and widely accepted treatment is currently available for this condition. AIM: To retrospectively evaluate the therapeutic efficacy of two treatment regimens (placental extract with dexamethasone and hyaluronic acid with dexamethasone) for the treatment of OSMF. MATERIALS AND METHODS: The records of the patients diagnosed with OSMF were obtained from the departmental archives. A total of 25 records were selected and divided into two study groups based on the treatment regimens, as Group A (placental extract + dexamethasone) and Group B (hyaluronidase + dexamethasone). The records were studied for improvement in mouth opening and reduction in burning sensation. Descriptive statistics, paired t test and student's t test were used for statistical analysis. RESULTS: In Group A and Group B, the average increase in mouth opening from baseline record to 8th week of treatment was 3.53±1.26mm and 3.65±1.42mm respectively and average decrease in burning sensation, noted by VAS scale, was 5.13±1.13 and 4.90 ±1.29 respectively. The pre- and post-treatment differences were found to be statistically significant for both the groups (p<0.001) and for both the treatment outcomes. When the average difference of the treatment outcomes was compared between the two study groups, no statistically significant difference was noted (p>0.05). CONCLUSION: The results of the present study indicate that both the treatment regimens studied are equally effective in the treatment of oral submucous fibrosis.

Pulp/tooth ratio of mandibular first and second molars on panoramic radiographs: An aid for forensic age estimation.

OBJECTIVE: To determine and compare the accuracy of pulp/tooth ratio method in mandibular first and second molar teeth in forensic age estimation. MATERIALS AND METHODS: A total 300 panoramic radiographs of the Gujarati population (187 males and 113 females) were studied. The measurements of Pulp Chamber Height (PCH) and Crown Root Trunk Height (CRTH) were performed on the mandibular first and second molar teeth. The acquired data was subjected to correlation and regression. RESULTS: The pulp chamber crown root trunk height ratios (PCTHR) of both the first (r = -0.609) and second molars (r = -0.422) were significantly correlated with the age of the individual. Individual regression formulae were derived for both the teeth which were then used separately to calculate the age. The standard errors estimate (SEE) for the first and second molars were 8.84 years and 10.11 years, respectively. There was no statistically significant difference between chronological and calculated age by both the teeth (P = 1.000). CONCLUSION: The mandibular first and second molar is a potential tool for age estimation in forensic dentistry. The pulp/tooth ratio of both the teeth is a useful method for forensic age prediction with reasonable accuracy in the Gujarati population.

Dental students' knowledge and attitude towards cone-beam computed tomography: An Indian scenario.

BACKGROUND: Cone-beam computed tomography (CBCT) is an upcoming imaging modality in field of dentistry with promising outcomes. AIM OF THE STUDY: To assess the dental student's knowledge and attitude regarding CBCT in K. M. Shah Dental College and Hospital as they are future practitioners. METHODOLOGY: An anonymous questionnaire consisting of 11 questions was distributed among 320 dental students which included final BDS students, interns, and postgraduate students. Descriptive statistics was used to analyze the responses of the participants, and Chi-square test was applied to statistically evaluate the differences in the responses according to the education level. RESULTS: Totally, 96.9% response rate was achieved. All the students had heard of CBCT used for dental practice. The majority of them gained knowledge about CBCT through faculty lessons. Lower radiation dose was given as the most important advantage of CBCT over medical computed tomography. Many of the students thought that CBCT should be taught during clinical phase of their education, and there is necessary for CBCT unit at dental faculties. More than half of the students believed that the use of CBCT would become more widespread in the near future, and they aspire to use CBCT technology in their future careers. CONCLUSION: Seeing the positive attitude, it was concluded that the students' should be provided with thorough practical knowledge and efforts should be made to improve their concepts regarding CBCT.

Extramedullary plasmacytoma of gingiva and soft tissue in neck.

Plasmacytoma is a malignant disease that present either in bone marrow (medullary plasmacytoma), within the bone (solitary plasmacytoma of bone), or outside of bone, as the extramedullary plasmacytoma. Extramedullary plasmacytoma accounts for 3% of all plasma cell tumours and approximately 90% of extramedullary plasmacytomas affect the head and neck region commonly affecting the nasal cavity, paranasal sinuses, tonsillar fossa and oral cavity. Multiple extramedullary plasmacytoma is defined when there is more than one extramedullary tumour of clonal plasma cells and such presentations are extremely rare. We report such a rare case of multiple extramedullary plasmacytoma involving gingiva and neck. Here is a case report of a 65-year-old female patient presenting with extramedullary plasmacytoma of the gingiva and soft tissue in neck.

Chronic sazetidine-A at behaviorally active doses does not increase nicotinic cholinergic receptors in rodent brain.

Chronic nicotine administration increases α4ß2 neuronal nicotinic acetylcholine receptor (nAChR) density in brain. This up-regulation probably contributes to the development and/or maintenance of nicotine dependence. nAChR up-regulation is believed to be triggered at the ligand binding site, so it is not surprising that other nicotinic ligands also up-regulate nAChRs in the brain. These other ligands include varenicline, which is currently used for smoking cessation therapy. Sazetidine-A (saz-A) is a newer nicotinic ligand that binds with high affinity and selectivity at α4ß2* nAChRs. In behavioral studies, saz-A decreases nicotine self-administration and increases performance on tasks of attention. We report here that, unlike nicotine and varenicline, chronic administration of saz-A at behaviorally active and even higher doses does not up-regulate nAChRs in rodent brains. We used a newly developed method involving radioligand binding to measure the concentrations and nAChR occupancy of saz-A, nicotine, and varenicline in brains from chronically treated rats. Our results indicate that saz-A reached concentrations in the brain that were ∼150 times its affinity for α4ß2* nAChRs and occupied at least 75% of nAChRs. Thus, chronic administration of saz-A did not up-regulate nAChRs despite it reaching brain concentrations that are known to bind and desensitize virtually all α4ß2* nAChRs in brain. These findings reinforce a model of nicotine addiction based on desensitization of up-regulated nAChRs and introduce a potential new strategy for smoking cessation therapy in which drugs such as saz-A can promote smoking cessation without maintaining nAChR up-regulation, thereby potentially increasing the rate of long-term abstinence from nicotine.

Proposed clinical classification for oral submucous fibrosis.

Oral Submucous Fibrosis (OSMF) is a chronic, progressive, scarring disease, that predominantly affects people of South Asia and South-East Asia, where chewing of arecanut and its commercial preparation is high. Presence of fibrous bands is the main characteristic feature of OSMF. Based on clinical and/or histopathological features of OSMF, various classifications have been put forth till date. But the advantages and drawbacks of these classification supersedes each other, leading to perplexity. Our various studies and clinical experience in the field of OSMF have initiated us to propose/introduce the new clinical classification which could assist the clinician in the categorization of this potentially malignant disorder according to its biological behaviour and hence its subsequent medical and surgical management.

Cheiloscopy: An aid for personal identification.

AIM: Cheiloscopy is a forensic investigation technique that deals with identification of humans based on lips traces. The aim of this study is to establish the uniqueness of lip prints which aids in personal identification. MATERIALS AND METHODS: The study group comprised of 200 subjects. The materials used were dark-colored lipstick, paper, cellophane tape, a brush, and a magnifying lens. RESULTS: This study shows that lip prints are unique and permanent for each individual, and the lip prints among family members and between twins revealed different patterns on the whole with few similar grooves suggesting the existence of heredity in the lip prints. CONCLUSION: Our study showed that lip prints are unique to each individual and can be used for personal identification.