Journal of Clinical and Experimental Dentistry. 2013. Vol. 5, no. 1

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    Florid cemento-osseous dysplasia: report of a case documented with clinical,radiographic, biochemical and histological findings
    (2013) Kutluay Köklü, Harika; Çankal, Dilek Aynur; Bozkaya, Süleyman; Ergün, Gülfem; Baris, Emre
    Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment.
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    Odontogenic tumours: a review of 266 cases
    (2013) Lawal, Ahmed O.; Adisa, Akinyele O.; Olusanya, Adeola A.
    Objectives: The aim of this study was to examine the relative frequency of odontogenic tumours at a tertiary hospital in Ibadan, as well as to study the various histologic types based on WHO 2005 classification and to compare results from this study with those of previous studies. Study design: The records of the Oral Pathology Department of University College Hospital were reviewed. Lesions diagnosed as odontogenic tumours were categorized into four groups based on WHO 2005 classification and were analyzed for age, sex and site using SPSS for Window (version 18.0; SPSS Inc. Chicago, IL) and frequency tables were generated. Results: Two hundred and sixty six (41.7%) cases of odontogenic tumours were seen. The mean age of occurrence was 32.6 (±15.815) years (range3-82 years) and peak age was in the third decade of life. Eleven (4.1%) malignant odontogenic tumours were seen. Ameloblastoma with 65.4% of cases was the most common odontogenic tumour followed by fibromyxoma (14.7%), no case of odontoma was seen in this series. Conclusion: The findings were mostly similar to those of African and Asian series and showed variations from reports from the Americas. The reason for the disparity in African and American series needs further investigations.
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    History of materials used for recording static and dynamic occlusal contact marks: a literature review
    (2013) Sharma, Ashu; Rahul, G.R.; Poduval, Soorya T.; Shetty, Karunakar; Gupta, Bhawna; Rajora, Varun
    In the discipline of prosthetic dentistry it is important not only to examine the occlusion, but to be able to record, store, and transfer the information. Over the years many occlusion testing materials have been used. It has been suggested the clinical recording and transfer of information using waxes and other occlusion recording materials have disadvantages relating to inaccuracy and problems of manipulation. Therefore, there has been introduction of many new systems for recording occlusion contacts to overcome such problems. The correct physiological recovery of occlusion posses as much a challenge as ever for every dentist and technician. Even the smallest high spots measuring just a few microns can cause dysfunctions like temporo-mandibular pain. Occlusal proportions are being constantly changed with every procedure. Therefore, an understanding of the synergy of the teeth in static and dynamic occlusion forms the basis of good dentistry. The purpose of this review article is to give and overview of the various materials and methods that have been used to record occlusal contact marks.
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    The influence of different types of fixed orthodontic appliance on the growth and adherence of microorganisms (in vitro study)
    (2013) Saloom, Hayder F.; Mohammed Salih, Harraa S.; Rasheed, Shaymaa F.
    Orthodontic appliances serve as different impact zones and modify microbial adherence and colonization, acting as foreign reserves and possible sources of infection. This study was conducted to investigate the effect of different types of fixed orthodontic appliances on the growth and adherence of microorganisms in oral flora which are Streptococcus mutans (S. mutans) and Candida albicans. Sixty-four of four different fixed orthodontic appliance-samples were used, divided into four groups of sixteen. Type I: Sapphire brackets- Coated wires, type II: Sapphire brackets- Stainless steel wires, type III: Stainless steel brackets- Coated wires and type IV: Stainless steel brackets- Stainless steel wires. Oral strains of S. mutans and Candida albicans were studied in the present study using biochemical test then microbial suspensions were prepared to do the tests of each microorganism including the antimicrobial effects of different appliance-samples on the growth of microorganisms and their adhesion tests. The results showed significant differences between the different appliances in terms of inhibition zone formation (P<0.001). The adhesion test, which is classified into low, medium and high, showed the adhesion of S. mutans, is low with type I and II, medium with type III and high with type IV, whereas the adhesion of Candida albicans is medium with both type I and II and high with both type III and IV with high significant differences (P<0.001). Appliance with high esthetic appearance, sapphire brackets and coated arch wire, showed the least adherence of S. mutans and Candida albicans in comparison to other appliances with less esthetic and more metal components.
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    Appraisal of jaw swellings in a Nigerian tertiary healthcare facility
    (2013) Lasisi, Taye Jemilat; Adisa, Akinyele O.; Olusanya, Adeola A.
    Introduction: The mandible and maxilla can be the site of myriads of lesions that may be categorized as neoplastic, cystic, reactive and infective or inflammatory. Literature reviewing jaw swellings in an amalgamated fashion are uncommon, probably because aetiologies for these swellings are varied. However, to appreciate their relative relationship, it is essential to evaluate the clinico-pathologic profile of jaw swellings. The aim of this appraisal is to describe the array of jaw swellings seen at our hospital from 1990 to 2011, to serve as a reference database. Methodology: Biopsy records of all histologically diagnosed cases of jaw swellings seen at the department of Oral Pathology, University College Hospital between January 1990 and December 2011 were retrieved, coded and inputted into SPSS version 20. Data on prevalence, age, sex, site and histological diagnosis were analysed descriptively for each category of jaw swellings. All patients below 16 years were regarded as children. Results: A total of 638 jaw swellings were recorded in the 22-year study period. The Non Odontogenic Tumours (NOT) were the commonest, accounting for 46.2% of all jaw swellings. Odontogenic Tumours (OT) formed 45% of all adult jaw swelling while it formed 25.2% in children and adolescents. Ameloblastoma was the commonest while the most common NOT was ossifying fibroma (OF). Chronic osteomyelitis of the jaws was about 6 times commoner in adult females than males and mostly involved the mandible. The most common malignant jaw swelling was Burkitts' lymphoma (BL) that was about 7 times more in children than adults. Osteogenic sarcoma was the most common malignancy in adults. Conclusion: Jaw swellings are extensively varied in types and pattern of occurrence. This study has categorized jaw swellings in a simple but comprehensive fashion to allow for easy referencing in local and international data acquisition and epidemiological comparison.
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    A clinical study of the effect of calcium sodium phosphosilicate on dentin hypersensitivity
    (2013) Acharya, Anirudh B.; Surve, Sai M.; Thakur, Srinath L
    Objective: Dentinal hypersensitivity is a commonly encountered problem with varied treatment options for its management. A large number of home use products have been tested and used for the management of dentinal hypersensitivity. This 8 week clinical trial investigates the temporal efficacy of commercially available calcium sodium phosphosilicate containing toothpaste in comparison to a potassium nitrate containing toothpaste. Methods: A total 20 subjects between the ages of 18 to 65 years were screened for a visual analogue score (VAS) for sensitivity of 5 or more by testing with a cold stimulus and randomly divided into test and positive control groups. Baseline sensitivity VAS scores to air evaporative stimulus were recorded for minimum two teeth. The subjects were prescribed respective dentifrices and revaluated for sensitivity scores at 2, 4 and 8 weeks. Results:The study demonstrated reduction in symptoms for all treatment groups from baseline to 2, 4 and 8 weeks. The calcium sodium phosphosilicate group showed a higher degree of effectiveness at reducing hypersensitivity to air evaporative stimulus at 2 weeks, than commercially available potassium nitrate. However, there was no significant difference in scores of subjects using the calcium sodium phosphosilicate toothpaste as compared to potassium nitrate at 4 weeks and 8 weeks. Conclusion: Calcium sodium phosphosilicate showed greater reduction in sensitivity compared to potassium nitrate at an earlier stage which is of high clinical value. However, based on the findings of the present study long term effects of calcium sodium phosphosilicate seem to be less promising than previously claimed.
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    Prevalence of elongation and calcification patterns of elongated styloid process in south india
    (2013) Sudhakara Reddy, R.; Sai Kiran, Ch.; Sai Madhavi, N.; Raghavendra, M.N.; Satish, A.
    Objective: Very few studies have been reported in the literature classifying the elongation and calcification patterns of styloid process. The present study was done to investigate the prevalence of elongation and calcification patterns of styloid process in patients attending a dental institution in south India. Study design: 600 digital panoramic radiographs of patients with dental problems were obtained from the outpatient department of the Dental institution. The apparent length of the styloid process was measured by a single experienced oral radiologist, with the help of the measuring tools on the accompanying software. The type of elongation and calcification patterns of each elongated styloid process was classified as per Langlai's classification with few modifications. Finally the data was subjected to statistical analysis. Results: Out of 520 measurable styloid processes (260 panoramic radiographs), 154 styloid processes had length greater than 3cm. The mean average length of elongated styloid process was 3.67±0.62 cm. No significant association was obtained between age and length of styloid process. In present study, the type of elongation pattern has no effect on the calcification pattern. Our results suggested that Type I elongated styloid processes were most likely to be completely calcified (type D), but statistically not significant. Conclusion: Type I pattern of elongation was found to be more prevalent in elder age group and was completely calcified in most of the cases. Interestingly, only three patients (out of 260) showed symptomatic elongation of styloid process. A relatively high prevalence of type IV elongation pattern (9 /154) was obtained in the present study, when compared to type III styloid process. Further large scale imaging studies are required to evaluate the presence of type IV elongation pattern in various population groups.
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    Histologic and Histomorphometric Assessment of Eggshell-Derived Bone Graft Substitutes on Bone Healing in Rats
    (2013) Uraz, Ahu; Gultekin, Gultekin; Sengüven, Burcu; Karaduman, Burcu; Sofuoglu, Sofuoglu; Pehlivan, Selcen; Capan, Yilmaz; Eren, Kaya
    Objective: The objective of this study was to histologically and histomorphometrically evaluate the efficacy of the new formulations of eggshell-derived calcium carbonate in rats. Study Design: The study was conducted on 30 adult male rats. Four standardized and circular intra-bony defects were created in the both maxilla and mandibula of each animal. Three different graft materials were prepared as follows: 1) Material A: Eggshell-derived calcium carbonate combined with carrageenan gel, 2) Material B: Eggshellderived calcium carbonate combined with xanthan gum gel, and 3) Material C: Eggshell-derived calcium carbonate powder. The right mandibular defect sites were grafted with Material A in all animals, and defects on the left were grafted with Material B. Defects on the right side of maxilla were received Material C in all animals, and all left maxillary defects were remained untreated as controls. The animals were sacrificed either postoperatively on the 15th day, postoperatively on the 30th day or postoperatively on the 45th day. Histomorphometric measurements were made of the areas of newly formed bone, necrotic bone, fibrous tissue and residual graft material. Results: Material A exhibited the highest level of osteoid formation followed by Material B and Material C on the 45th day. In terms of osteoid formation, statistically significant differences were observed between graft materials and controls at 45th day compared to 15th and 30th day (p<0.05). Conclusions: Eggshell-derived graft substitutes in both gel and powder forms are biocompatible materials which may have the potential to enhance the new bone formation.
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    Ancient Schwannoma of the hard palate: an uncommon case report and review
    (2013) Gainza Cirauqui, María Luisa; Eguía Del Valle, Asier; Martínez-Conde Llamosas, Rafael; Coca Meneses, Juan Carlos; Aguirre Urízar, José Manuel
    Schwannoma or neurilemmoma is an infrequent benign tumor in the oral cavity that originates from the Schwann cells on the neural sheath of the peripheral nerves. Schwannomas are frequently located in the soft tissues of head and neck region, but only a 1 to 12% of them are located in the oral cavity. Some histological variants of schwannoma have been described including the cellular, plexiform, epithelioid, ancient, and melanocytic types. The 'ancient schwannoma' is an uncommon variant of this tumor that shows specific histological characteristics, and is rare in the oral cavity with less than 15 cases described on the literature. Most of them were located in the tongue or in the floor of the mouth, being the hard palate an extremely rare localization. We present a new clinical case of an ancient schwannoma with a long time of evolution, arising from the nasopalatine nerve, and located in the hard palate of a 35 year old female. We also review the main clinical and histological characteristics of this pathology.
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    Oral lesions and immune status of HIV infected adults from eastern Nepal
    (2013) Naidu, S. Giridhar; Thakur, Rachana; Singh, Asutosh Kumar; Rajbhandary, Srijana; Mishra, Rajeev Kumar; Sagtani, Alok
    Objective: To document the prevalence, age and gender distribution of oral lesions in HIV infected adults and the influence of highly active antiretroviral therapy and correlate them to the immune status of the patients. Materials and Methods: Oral lesions were diagnosed by a detailed physical examination by trained and calibrated examiners according to the case definitions established by the Oral HIV/AIDS research alliance. Demographic details, risk behavior patterns and oral symptoms and habits were collected by a questionnaire. Results: 81 patients; 54 men and 27 women aged between 20 ' 55 years participated in the study. A total of 49 patients; 60.5% had some oral lesion when examined. Oral candidiasis (21 %) and oral melanosis (21%) were the most common lesions, followed by linear gingival erythema, oral hairy leukoplakia, necrotizing ulcerative periodontitis/ gingivitis, herpes labialis, parotid gland enlargement and reccurent apthous ulcers. Oral hairy leukoplakia was exclusively seen in men (p=0.018). All six cases of herpes simplex lesion were seen in non - anti retro viral group (p=0.073) while oral candidiasis was commonly noted in the anti retro viral group (p=0.073). Lowering CD4 counts had the strongest association with the prevalence of oral candidasis (p=0.012), pseudomembranous candidiasis (p=0.014) and oral hairy leukoplakia (p= 0.065). Conclusion: This study shows a high prevalence of oral candidiasis, melanosis, linear gingival erythema and oral hairy leukoplakia in the patients.
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    Oral Findings in Postmenopausal Women Attending Dental Hospital in Western Part of India
    (2013) Santosh, Patil; Nidhi, Sinha; Sumita, Kaswan; Farzan, Rahman; Bharati, Doni; Ashok, KP
    Objectives: To know the nature, incidence and severity of oral manifestations occurring in postmenopausal women. Study design: Oral changes were observed in 365 postmenopausal women and 365 age matched male individuals attending the department of Oral Medicine and Radiology. The patients were asked about complaints of dry mouth, taste and breath changes, mucosal and facial pain and were examined for oral changes such as ulceration, white and red lesions. The results obtained from the study were then correlated with various other similar studies. Results: The important oral findings in postmenopausal women were mucosal burning/pain (25.8%), dry mouth (27.1%), altered taste (3.6%), altered breath (6.3%) and facial pain (3.6%). Oral submucous fibrosis (OSMF) was significantly more common in males (5.5%) as compared to postmenopausal females (1.9%). Conclusion: Results from the present study reveal that oral symptoms are common problems in postmenopausal women. Postmenopausal patients showed significantly more oral changes than the control. These changes could be related to the hormone alterations. Therefore, dentists need to refer postmenopausal women with oral symptoms to a gynaecologist for more careful examinations and medical interventions if necessary.
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    Unicystic ameloblastoma in 3 year old paediatric patient: a rare entity
    (2013) Arora, Shelly; Kumar, Priya; Urs, Aadithya-Basavaraj; Augustine, Jeyaseelan
    Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed.