Ethnic-Guided Soft Tissue Cephalometric Analysis on Lambani Indian Inhabitants for Forensic Facial Reconstruction.

BACKGROUND: Forensic craniofacial reconstruction is a combination of both scientific technique and artistic skill that assist facial soft tissue approximation on the skull to obtain an image of an individual that varies in the different ethnic groups depending on genetic and environmental factors such as soft tissue norms. OBJECTIVES: The present study was aimed to evaluate the soft tissue norms for Lambani Indian tribes spread across the state of Karnataka in India and compare them with the local inherent ethnolinguistic Kannadiga population. MATERIAL AND METHODS: Forty healthy individuals encompassing 20 Lambanis and 20 Kannadigas were selected using demographic information. Lateral cephalograms obtained were analyzed for various soft tissue landmarks that include facial angle, upper lip curvature, skeletal convexity, H angle, nose tip to H-line, upper sulcus depth, lower sulcus depth, upper lip thickness, upper lip strain, lower lip to H line, soft tissue chin thickness, and glabella. RESULTS: It was observed that glabella thickness, upper sulcus depth, and lower lip to H line showed a significant difference between Lambani and Kannadiga populations. Lambani's have a higher facial angle than the Kannadiga group though not statistically significant. Gender-wise comparison had shown a significant difference in variables on upper sulcus depth, glabella among females, and lower lip to H line, glabella among males. CONCLUSION: The differences obtained between the two ethnic groups in this study clearly suggest the need for separate soft tissue thickness norms for distinctive populations that could be vital in the facial reconstruction of an individual in the field of forensic investigation to narrow down the identification process.

A Comparison of Pre- and Postbreakfast Tooth Brushing in Caries Prevention through the Estimation of Streptococcus mutans Counts: A Prospective Clinical and Microbiological Study.

Objectives: The purpose of this study was to compare the efficacy of prebreakfast tooth brushing (PrBTB) and postbreakfast tooth brushing (PoBTB) with or without a prebrushing rinse in caries prevention through the estimation of Streptococcus mutans count. Materials and Methods: Sixty consenting dental students were divided into three age-matched groups of 20 each and instructed to follow prebreakfast, postbreakfast tooth brushing, and prebreakfast rinsing plus PoBTB using the Bass technique. Plaque samples were collected at the start and at the end of every quarter for a total of 6 quarters (18 months) for the evaluation of S. mutans colony-forming unit (CFU) counts. The decayed missing filled surface (DMFS) index of participants was also recorded and compared at the beginning and end of the study period. Results: The post-breakfast tooth brushing group with pre-breakfast rinse (RPoBTB) and without pre-breakfast rinse (PoBTB) showed a highly significant reduction in total S. mutans CFU counts per ml (38% and 29% respectively) at the end of the study. The changes in DMFS value were not significant and did not show any correlation with the S. mutans counts. Conclusion: Our study revealed that PoBTB with or without a prebreakfast rinse reduces the total counts of the cariogenic bacteria S. mutans more efficiently than PrBTB. Although further proof in the form of clinical trials is essential, this study provides the proof of concept for a minor change in the tooth brushing habit, which can significantly enhance caries prevention.

Bcl-2 expression in reactive oral lesions with atypical epithelium and in oral epithelial dysplasia associated with carcinogen exposure.

BACKGROUND: Reactive lesions of the oral cavity are nonneoplastic proliferations with very similar appearance to benign neoplastic lesions and are associated with chronic local irritation or trauma. Although these lesions are uncommonly associated with carcinogen exposure, at times, they present histopathologically with dysplastic epithelium, thus making it difficult to differentiate it from true potentially malignant disorders. Hence, the present study was conducted to evaluate the expression of Bcl-2 protein, an antiapoptotic marker, in reactive lesions with and without atypical epithelium and in true epithelial dysplasia, which clinically presents as premalignant disorders. MATERIALS AND METHODS: The samples included 15 cases each of normal oral mucosa (NOM), reactive lesions with and without dysplasia and oral epithelial dysplasia (OED) associated with carcinogen exposure. All the samples were subjected to immunohistochemical staining using Bcl-2 antibody. The total number of cells in the basal and parabasal layers in each field and total number of cells expressing Bcl-2 among them and the staining intensity were assessed. STATISTICAL ANALYSIS: Kruskal-Wallis ANOVA test was used to compare the number of positive cells among the four groups. The comparison of average percentage of positive cells between the study groups was done using Mann-Whitney U-test. RESULTS: The immunohistochemical staining for Bcl-2 protein was identified in few cells in the basal layers of NOM, reactive lesions without atypical epithelium and in the basal and parabasal layers in reactive lesions with atypical epithelium and OED, as a granular cytoplasmic staining and as an accentuation around the nuclear membrane. There was a gradual increase in the expression and intensity of staining from Group I to IV. INTERPRETATION AND CONCLUSION: The altered or increased expression of Bcl-2 oncoprotein in reactive lesions with atypical epithelium and in OED with carcinogen exposure may lead to prolonged cell survival and can be considered as an early molecular event in carcinogenesis, helping us in understanding the nature of dysplasia in reactive lesions, which was not considered during the histopathology reporting.

Prevalence of oral squamous cell carcinoma of tongue in and around Davangere, Karnataka, India: A retrospective study over 13 years.

AIM: The aim was to determine the frequency and distribution of oral squamous cell carcinoma (OSCC) involving tongue among patients by studying biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 13 years. METHODOLOGY: Data for the study were retrieved from the case records of patients. Analyzed clinical variables included age, sex, anatomical site, and histological diagnosis. RESULTS: Of the 369 squamous cell carcinoma involving head and neck region, we found 52 biopsies reported exclusively involving tongue. Lateral border of the tongue was most commonly involved (43 cases, 82.7%), followed by base of tongue and posterior part of tongue. The patient were affected over a wide range of 27-80 years with mean age of 55.75 years and peak incidence was seen in the fourth and fifth decades of life, with the male: female ratio of 1.7:1. CONCLUSION: The prevalence rate of OSCC involving tongue showed a definite geographic variation when compared with a study done in other parts of the world.

Habit-associated salivary pH changes in oral submucous fibrosis-A controlled cross-sectional study.

CONTEXT: Oral submucous fibrosis (OSF) is a multi-causal inflammatory reaction to the chemical or mechanical trauma caused due to exposure to arecanut containing products with or without tobacco (ANCP/T). Arecanut and additional components such as lime and chewing tobacco render ANCP/T highly alkaline. Fibrosing repair is a common reaction to an alkaline exposure in the skin. OSF may be related to the alkaline exposure by ANCP/T in a similar manner. AIMS: The study was aimed at establishing the relationship of habit-associated salivary pH changes and OSF. SETTINGS AND DESIGN: The study design was controlled cross-sectional. MATERIALS AND METHODS: Base line salivary pH (BLS pH), salivary pH after chewing the habitual ANCP/T substance, post chew salivary pH (PCSpH) for 2 min and salivary pH recovery time (SpHRT) were compared in 30 OSF patients and 30 sex-matched individuals with ANCP/T habits and apparently healthy oral mucosa. RESULTS: The group's mean BLSpH values were similar and within normal range and representative of the population level values. The average PCSpH was significantly higher (P ˂ 0.0001) than the average BLSpH in both groups. There was no significant difference (P = 0.09) between PCSpH of OSF patients and controls. OSF patients had a significantly longer (P = 0.0076) SpHRT than controls. Factors such as age, daily exposure, cumulative habit years, BLSpH and PCSpH, had varying effects on the groups. CONCLUSIONS: Chewing ANCP/T causes a significant rise in salivary pH of all individuals. SpHRT has a significant association with OSF. The effect of salivary changes in OSF patients differs with those in healthy controls.

Halitosis - An overview: Part-I - Classification, etiology, and pathophysiology of halitosis.

Halitosis is a condition where the breath is altered in an unpleasant manner for the affected individuals and impairs them socially as well as psychologically. Halitosis can be clinically classified as real halitosis, pseudohalitosis, and halitophobia. Real halitosis has oral and extra-oral etiologies and the pathophysiology involves interaction of anaerobic microbes (mainly) with the proteins present in the oral cavity fluids and contents, resulting in production of volatile sulfur compounds (VSCs). These VSCs, beyond responsible for halitosis, can also initiate and accelerate periodontal disease progression. Thus, this review is about the pathophysiology and various etiologies of halitosis, the knowledge of which can help in the betterment of treatment options.

Predentin thickness analysis in developing and developed permanent teeth.

BACKGROUND: Predentin, the unmineralized organic matrix is important in maintaining the integrity of dentin. It is usually thick where active dentinogenesis occurs. A wide variation in its thickness is reported. Hence, we determined the variation in predentin thickness at various sites of different age groups. MATERIALS AND METHODS: 60 freshly extracted teeth (maxillary and mandibular first premolars) were divided into three groups with 20 teeth in each as, Group 1 - teeth with incomplete root formation (age <16 years), Group 2 - teeth with complete root formation (aged between 16 and 30 years), Group 3 - teeth of patients aged above 30 years. The teeth were fixed, decalcified and sections of 6 µ thickness were obtained, and stained with hematoxylin and eosin. The distance between the odontoblastic cell layers of the pulp to the border line of the dentin was considered for the measurement of the predentin thickness. A total of nine sites were considered for each specimen. RESULTS: The present study revealed varied mean predentin thickness at all nine sites in all three age groups. Maximum and minimum thickness was observed at the apex and pulp floor respectively in all three groups. There was a statistical significant difference in predentin thickness between groups 1 and 3 and 2 and 3. CONCLUSION: The predentin thickness in the first group gradually increased toward the growing end near the apex, while it was relatively constant in the second group and increased overall thickness at all the sites in the third group. A notable finding was a linear increase with age in width of the predentin and the thickness vary as a function of odontoblastic activity during different stages of tooth development.

Prevalence and clinicopathological comparison of kerotocystic odontogenic tumor and orthokeratinized odontogenic cyst in South Indian sample population: A retrospective study over 13 years.

AIM AND METHODOLOGY: The purpose of this study is to determine the prevalence of keratocystic odontogenic tumor (KCOT) and orthokeratinized odontogenic cyst (OOC), to identify their clinicopathological features among the patients by studying the biopsy specimens obtained from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India during the period of 2001-2013. Data for this study is retrieved from the case records of the patients fitting the histological classification of the World Health Organization (2005). The following clinical variables, namely age, gender, anatomical location, and histological features are analyzed. RESULTS: Of the 3026 biopsy reports (100%) present in the archives, we had 31 cases (1.02%) of KCOT, 11 cases (0.36%) of OOC and a combination of para and orthokeratinized lining epithelium made 1 case (0.033%). The most frequent clinical manifestation was asymptomatic followed by the combination of pain and swelling. The male: female ratio was 1.4:1 with a mean age of 30 years in KCOT, while 2.7:1 with a mean age of 29.1 years in OOC. Posterior molar-ramus region was most commonly involved in both KCOT and OOC. CONCLUSION: Due to aggressiveness and high recurrence rate of KCOT, differentiation between KCOT and OOC is important, with respect to their treatment modalities. Such epidemiological pools are also essential for the analysis of geographical distribution of odontogenic tumours.

Analysis of prevalence and clinical features of multicystic ameloblastoma and its histological subtypes in South Indian sample population: A retrospective study over 13 years.

OBJECTIVE: The study was designed to analyze the frequency and clinical features of multicystic ameloblastoma and its histological variants in South Indian sample population, as there is minute information available in the English literature. METHODOLOGY: The study source was the biopsy specimens retrieved from the archives of the Department of Oral and Maxillofacial Pathology, College of Dental Sciences, Davangere, Karnataka, India, during the past 13 years, from 2001 to 2013. Clinical data for the study were obtained from the case records of patients and the analyzed clinical variables were age, gender and anatomical location. Histologically, hematoxylin and eosin stained sections fitting the World Health Organization (2005) criteria for diagnosis of multicystic ameloblastoma were selectively included. RESULTS: Of the 3026 biopsy reports analyzed, 103 cases were odontogenic tumors (3.4%) and 58 cases were ameloblastoma. 31 cases of multicystic ameloblastoma, including follicular ameloblastoma (54.8%), acanthomatous ameloblastoma (29%), plexiform ameloblastoma (6.5%), granular cell ameloblastoma (6.5%) and desmoplastic ameloblastoma (3.2%) were recorded. The age of the patients during the presentation of the lesion was ranging from 21 to 73 years, with a mean of 39.5 years. The most frequent clinical manifestation was swelling, followed by a combination of pain and swelling. In our study, ameloblastoma showed distinct anatomic predilections for occurrence in mandible (96.8%) rather than maxilla (3.2%). This study result also indicated that there is geographical variation in the frequency and distribution of ameloblastoma.

Granularity in granular cell ameloblastoma.

Granular cell ameloblastoma (GCA) is one of the rare histological variants of ameloblastoma (1.5-3.5%), identified by Krompechner in 1918 and is diagnosed by the characteristic presence of granular cells. These granular cells are seen in several physiological and pathological conditions and the granularity in GCA is due to lysosomal aggregates. This review is about the clinical features, histopathological features and differential diagnosis of GCA and also adds the theories for occurrence of granularity, electron microscopic findings, cell signaling pathways and immunohistochemistry findings related to these granular cells in GCA.

Morphological alterations in the dentition of type I diabetes mellitus patients.

INTRODUCTION: Type 1 diabetes mellitus (DM) is an endocrine disorder that occurs commonly in an age group, where the development of primary and permanent dentition takes place. As altered endocrine functions may affect the shape and size of teeth leading to dental anomalies, this study was conducted to look for the occurrence of any dental anomalies in type I DM patients. MATERIALS AND METHODS: A diabetic camp was conducted at Alur Chandrashekharappa Memorial Hospital, Davangere, where 30 diabetic patients were examined and the impressions of their maxillary and mandibular arches were recorded. Age and sex matched controls were selected randomly, and similar recordings were done. RESULTS: Type I diabetic patients showed statistically significant (P < 0.001) morphological alterations of total number of cusps, including presence of 6(th) cusp in mandibular molars and extra cusps in mandibular premolars. Other alterations such as microdontia, flower shaped mandibular molars, prominent cusp of carabelli, and oblique ridge in maxillary molars were also noted. Severe attrition was found in 11 (36.6%) of the diabetic patients, whereas the control group showed attrition only in 2 (6.8%) patients. CONCLUSION: Remarkable morphological alterations do occur in the dentition of type I DM patients.