Two-Piece Hollow Bulb Obturator for Postsurgical Partial Maxillectomy Defect in a Young Patient Revamping Lost Malar Prominence: A Clinical Report.

The most frequent type of treatment for patients diagnosed with a malignant neoplasia of the oral cavity is surgical resection of the tumor. Ablative surgery may be followed by a reconstructive phase, in which the surgeon may choose between local flaps, nonvascularized bone grafts or free vascularized flaps to close the surgical site, depending on the general conditions of the patient. Esthetic and functional results are challenging to achieve for the prosthodontist, as variable amount of hard and soft tissues are removed. This report describes the fabrication of a two-piece hollow obturator for a 19-year-old patient who underwent wide surgical excision of the osteosarcoma of the maxilla and was rehabilitated to function. In this case, the surgical site was covered with submental flap, and the second piece of the obturator provided fullness to the lost malar prominence.

Achieving an esthetic smile with fixed and removal prosthesis using extracoronal castable precision attachments.

Satisfactory restoration in a patient with a partially edentulous situation can be challenging especially when unilateral or bilateral posterior segment of teeth is missing. Successful restoration can be done with various conventional and contemporary treatment options. One such treatment modality is attachment-retained cast partial dentures. A key to success for an attachment retained cast partial denture is the strategic selection of teeth for retention. This clinical report discusses rehabilitation of a patient with the help of a combined prosthesis in the upper arch and stud retained overdenture in the lower arch.

Seesaw of matrix metalloproteinases (MMPs).

The family of human matrix metalloproteinases (MMPs) comprises several tightly regulated classes of proteases. These enzymes and their specific inhibitors play important roles in tumor progression and the metastatic process by facilitating extracellular matrix (ECM) degradation. As scientific understanding of the MMPs has advanced, therapeutic strategies focusing on blocking these enzymes by MMP inhibitors (MMPIs) have rapidly developed. This paper reviews MMPs in detail. Their perspectives in therapeutic intervention in cancer are also mentioned.

Objective measurement of shade color in age estimation.

INTRODUCTION: Age estimation is an important subspecialty of forensic medicine. Dental hard tissues are highly resistant to degradation and putrefaction. Enamel is translucent and varies in color from light yellow to grey white. The color of the teeth has been reported to be affected by chronological age. Enamel color may also depend on environmental factors viz. diet, occupational habits, vitamin deficiencies, fluoride level in drinking water etc., It has been found that color changes in dentin vary from white to yellow. Studies have been done to measure the dentin color for age estimation. AIM: To find a correlation between the enamel color and chronological age and secondly to estimate the age of an individual from enamel color. MATERIAL AND METHODS: A total of 300 patients visiting the outpatient department of oral medicine and radiology were selected. Out of those, 150 were men and 150 women. The patients were divided into V groups based on the age. A thorough case history was taken for all the patients. Maxillary Central and Lateral incisor was used for the estimation of shade. The enamel color was evaluated using a VITA classical shade guide. STATISTICAL ANALYSIS: Data were exported to an Excel spread sheet and statistical analysis was performed using the SPSS. Linear regression analysis was used to find correlations between age and enamel shade. RESULTS: In the group 1 and 2 i.e. from 15 to 36 years, the shades A 2 and B 2 (reddish hue) was found to be most common. While in the group 3 and 4, shades ranged from A 3 to B 3 (brownish to yellowish hue). In the patients above 59 years i.e. group 5 the enamel shade with greyish hue was found to be most common. CONCLUSION: Age determination using enamel color can be tried in forensic cases in the identification of individuals with no birth records.

An update on intraoral application of colposcopy.

Colposcopy is an established technique for diagnosis in gynecology. Many premalignant and malignant lesions in these areas have discernible characteristics which can be detected using a colposcope, providing an enlarged view of the areas, allowing the colposcopist to visually distinguish normal from abnormal appearing tissue and take directed biopsies for further pathological examination. The diagnosis of a dysplastic lesion of the oral mucosa cannot be based solely on clinical findings. Therefore, histological evaluation of a representative biopsy specimen is necessary. The site for the biopsy is a subjective choice that sometimes raises doubts about its representativeness. So far, no simple and reliable method is available for selecting the most appropriate area for biopsy. Intraoral microscopy (oral application of the colposcopy technique) of mucosal lesions seems to offer advantages in selecting more representative sites for biopsy than routine clinical examination alone. The biopsy sites identified by direct oral microscopy show more advanced histologic signs than those selected by routine clinical examination. This article enlightens the application of colposcopy in diagnosis of oral premalignant lesions and malignant lesions.

Triology of nitric oxide, mast cell and stress in pathogenesis of oral lichen planus.

INTRODUCTION: Oral Lichen planus (OLP) is chronic, autoimmune, mucocutaneous disease. Numerous etiological factors have been proposed, but an authoritative and exact source of the disease has not been brought forward. Reactive nitrogen species (RNS), mast cell (MC) and stress are considered to play a key role in inflammation-mediated carcinogenesis generating nitric oxide (NO). AIM: To evaluate the salivary NO levels, mast cells and stress levels and to correlate them in pathogenesis of OLP. MATERIALS AND METHODS: The study was conducted using saliva samples of patients. The study consisted of two groups: Group-I constituted the subjects with OLP group (n=25) and group II comprised the control group (n=25). The saliva of the patients was evaluated using Griess Reagent and Spectrophotometer, MC count done by using special stains, and stress levels measured using DASS Scale. RESULTS: The difference between the means was found to be highly significant (P < 0.05). The intergroup comparison of optical density (OD) values, a mast cell count and stress level was found to be highly significant. CONCLUSION: Salivary NO, increase in mast cell count and stress has a definitive role in OLP pathogenesis.

Verruco-papillary lesions in relation to human papilloma virus.

Plethora of pathologic conditions may affect the normal morphologic characteristics and intactness of the oral mucosa, presenting as surface alterations.The prevalence of the different types of HPV worldwide has implications for the effectiveness of HPV vaccinations against HPV-induced carcinogenesis. This article discusses HPV related lesions with emphasis on verrucopapillary lesions.

Current concepts in diagnosis of unusual salivary gland tumors.

Salivary gland tumors are relatively uncommon and account for approximately 3-6% of all neoplasms of the head and neck. Tumors mostly involve the major salivary glands, 42.9-90% of which occur in the parotid glands and 8-19.5% in the sub-mandibular glands; tumors in the sub-lingual glands being uncommon. Despite the plethora of different malignant salivary gland tumor presented to pathologists for diagnosis, there is consensus on a limited number of pathologic observations that determine treatment and outcome. There are few absolutes in salivary gland tumor diagnosis given the marked spectrum and overlap of differentiated cell types that participate in the numerous benign and malignant tumors. Thus, there are enumerating antibodies that may be helpful in resolving difficult differential diagnoses when applied with astute morphologic correlation. In general, immunohistochemistry as an ancillary diagnostic tool should be used sparingly and wisely as a morphologic adjunct because of the lack of specificity of many markers for specific histologic tumor types. The aim of this review is to discuss the molecular profiling of salivary gland neoplasms and correlate this with histogenesis of salivary gland neoplasms. We have elected to discuss and illustrate some of the unusual salivary gland tumors that the practicing pathologist find difficult to diagnose. These have been selected because they readily simulate each other but have very different clinical therapies and, therefore, should be included routinely in differential diagnosis.