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Language Journal of Clinical and Experimental Dentistry. 2010. Vol. 2, no. 4
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- Oral submucous fibrosis a disease with malignant potential: report of two Cases(2010) Pundir, Siddharth; Saxena, Susmita; Aggarwal, PoojaOral submucous fibrosis (OSF) is a high risk precancerous condition characterized by changes in the connective tissue fibers of the lamina propria and deeper parts leading to stiffness of the mucosa and restricted mouth opening. Patients with severe cases have distinct difficulties in chewing, swallowing and speaking. It predominantly occurs in Indians and other population of the Indian subcontinent with certain oral habits. In patients with submucous fibrosis, the oral epithelium becomes atrophic and thereby becomes more vulnerable to carcinogens. It is now accepted that chewing areca is the most important aetiological factor for developing OSF. The atrophic epithelium shows first an intercellular edema and later epithelial atypia associated with moderate epithelial hyperplasia. From then on, carcinoma may develop any time. It is suggested that submucous fibrosis should be regarded as a condition that causes predisposition to the development of oral cancer. Here we are presenting two cases of oral submucous fibrosis showing malignant potential and development of oral squamous cell carcinoma.
- Active Giant Peripheral Osteoma of the mandible: presentation of one case with follow-up to 6 years(2010) Donohue-Cornejo, Alejandro; Franco Garrocho, Laura Elena; Albarran-Vergara, Surisadey; Gaitán Cepeda, Luis AlbertoOsteoma, a benign neoplasia of bone tissue, is considered a quiescent neoplasm. An active osteoma is an uncom- mon lesion. We presented a case of a mandibular osteoma with an unusual active behavior. In January of 2001 was admitted in the Oral Medicine Service a 11-years old female because an asymptomatic growth in the left side of their face with two years of evolution. Radiographical examination revealed a well circumscribed spherical radio- paque lesion of approximately 2 x 2 cm in diameter on lateral side of the left angle of the mandible. Microscopically the surgical sample coming from incisional biopsy showed normal bone tissue. A diagnosis of osteoid osteoma was emitted. Surgical treatment was indicated and refused by the parents of the patient. In August 2007 the same was readmitted because an increase in their facial asymmetry. Radiographical examination revealed an increase in the size of the radiopaque area to 3x3 cm. A 99m Tc MDP bone scintigraphy was indicated and performed. Because the scintigraphy showed bone activity the surgical elimination of the whole lesion was indicated and done. Mi- croscopically the lesion was composed by vital mature lamellar and trabecular bone. A diagnosis of giant active osteoma of the mandible was emitted. The maxillofacial surgeon should awake by the possibility of an osteoma shows neoplastic activity.
- Hypoplastic amelogenesis imperfecta with multiple impacted teeth: report of two cases(2010) Reddy, Sujatha S.; Aarthi Nisha, Aarthi; Harish, B.N.Amelogenesis Imperfecta (AI) represents a group of developmental conditions, genomic in origin, which affect the structure and clinical appearance of enamel of all or nearly all the teeth in a more or less equal manner. It is usually inherited either as an X-linked, autosomal dominant or autosomal recessive trait. The enamel may be hypoplastic, hypomineralised or both and affected teeth may be discolored, sensitive or prone to disintegration. Diagnosis is based on the family history, pedigree plotting and meticulous clinical observation. The treatment of patients with AI should start with early diagnosis and intervention to prevent latter restorative problems. Herein, we present two case reports of hypoplastic amelogenesis imperfecta with oligodontia, multiple unerupted teeth, pulpal calcification, taurodontism and anterior deep bite who were provided with functional and esthetic rehabilitation.
- Dental management of patients with endocrine disorders(2010) Carlos Fabuel, Laura; Jiménez Soriano, Yolanda; Sarrión Pérez, María GraciaIntroduction: The endocrine system is responsible for hormonal secretion and is closely related to the central nervous system, as it diversifies its functions through the hypothalamus and pituitary glands. It controls physiological processes and maintains homeostasis. The neuroendocrine system is responsible for adaptation to environmental changes. Therefore, in dentistry, it is important to be aware of the risks and difficulties that may arise during the dental management of patients with endocrine disorders, and that visits to the dental clinics often represent a stressful situation. Objectives: To review the literature on oral manifestations and dental management in patients with endocrine disorders (disorders of the thyroid, parathyroid and adrenal glands). Material and Methods: For the literature review, we carried out a search in Pubmed / Medline database using limits and keywords according to the controlled vocabulary “Medical Subject Headings” (MeSH). We obtained a total of 19 articles (ten literature reviews, one case-control study, and eight clinical case series). Results and discussion: We describe the most common oral manifestations in patients with endocrine disorders and the special dental management that should be carried out on these patients
- Desmoplastic ameloblastoma of maxilla: a case report(2010) Gade, Lalitkumar; Patankar, Sangeeta; Khot, Komal; Korde, Sheetal; Alex, SheebaAmeloblastoma is the most common neoplasm affecting the jaws, arising from the odontogenic epithelium. Despite its locally aggressive nature, it is considered to be benign. The chief histopathological variants of ameloblastoma are the follicular and plexiform types, followed by the acanthomatous and granular cell types. Uncommon variants include desmoplastic, basal cell, clear cell ameloblastoma, keratoameloblastoma and papilliferous keratoameloblastoma. When the desmoplastic type co-exists with other types, it is called as “hybrid” ameloblastoma. There are significant anatomic, histopathological and radiological differences between desmoplastic ameloblastoma and the classical type. The purpose of this article is to report a case and to review the relevant literature, emphasizing peculiar aspects of this unusual lesion.
- Dental management of patients with inflammatory bowel disease(2010) Mancheño Franch, Aisha; Jiménez Soriano, Yolanda; Sarrión Pérez, María GraciaUlcerative colitis and Crohn’s disease are the most common forms of inflammatory bowel disease (IBD), both of unknown aetiology. These conditions are characterised by the chronic and recurrent inflammation of different parts of the gastrointestinal tract, but while in CD, chronic inflammation may affect any part of the gastrointestinal tract, in UC, mucosal inflammatory changes are confined to the colon. IBD is currently on the increase, and it is important for the dental professional to be familiar with the condition as patients with IBD may present oral manifestations of the underlying disease. Such manifestations of IBD may precede the onset of intestinal radiographic lesions by as much as a year, or even more. Treatments used to manage IBD can affect the delivery of routine dental care.
- Taurodontism: a review on its etiology, prevalence and clinical considerations(2010) Manjunatha, B.S.; Kovvuru, Suresh KumarTaurodontism can be defined as a change in tooth shape caused by the failure of Hertwig’s epithelial sheath diaphragm to invaginate at the proper horizontal level. An enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cemento-enamel junction are the characteristic features. Although permanent molar teeth are most commonly affected, this change can also be seen in both the permanent and deciduous dentition, unilaterally or bilaterally, and in any combination of teeth or quadrants. Whilst it appears most frequently as an isolated anomaly, its association with several syndromes and abnormalities has also been reported. Despite the clinical challenges, taurodontism has received little attention from clinicians. Because of the prevalence of tauro- dontism in modern dentitions and the critical need for its true diagnosis and management, this review addresses the etiology, clinical and radiographic features of taurodontism, its association with various syndromes and anomalies, as well as important considerations in various areas of expertise dental treatments of such teeth.
- Oral granular cell tumor: a study of twelve cases in a Brazilian population(2010) Sousa, Fabrício Bitu; Osterne, Rafael Lima Verde; Matos Brito, Renata Galvão de; Negreiros Nunes Alves, Ana Paula; Studart Soares, Eduardo Costa; Gurgel Costa, Fábio WildsonObjectives: Analyze clinic and epidemiological aspects of all Oral Granular cell tumor (GCT) during a 5-year period in a Brazilian population. Study design: clinical and treatment outcome data of patients with oral GCT seen at the Division of Stomatology, School of Dentistry, Federal University of Ceara, Brazil, between January 2001 and December 2005 were reviewed. Results: during the analyzed period, 6231 oral lesions were collected from files of different anatomo-pathology laboratories situated in the state of Ceara, Brazil. Of all cases, only 12 of GCT were diagnosed. The lesion was more common in female patients, with a mean age of 40.8 years, occurring mainly in tongue. Conclusion: Oral GCT is a rare and infrequent lesion in this population, and affects more female in the third, fourth a fifth decade of life. Clinical significance: Although it is a rare occurrence in the oral cavity, the clinician must know about its occurrence and should include GCT in the differential diagnose of certain lesions especially when situated in tongue
- Analysis of cell proliferation rate in Oral Leukoplakia and Oral Squamous Cell Carcinoma(2010) Mehkri, Sushma; Iyengar, Asha R.; Nagesh, K. S.; Bharati, M. B.Objectives: Assessment of the cell proliferation rate in tissues can be one of the markers for impending malignancy in precancers. The state of activation and the proliferation activity of the cells can be assessed by the frequency of silver stained Nucleolar Organiser regions (AgNOR) within the nuclei which is significantly higher in malignant cells. The present study was carried out to analyze the distribution of the AgNOR in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC), and in their various histological grades, and to assess if the AgNOR distribution could give information on the malignant potentiality in premalignant lesions and aggressiveness of the malignant lesions. Study design: The study specimens comprised of 35 archival cases, of which 15 cases were of OL and 20 cases of OSCC. The specimens were stained by hematoxylin and eosin and modified silver staining method of Ploton et al. for the Nucleolar Organiser Regions. The specimens were analyzed independently by the two observers and was further statistically analysed. Results: The mean AgNOR count in OL was 2.80 ±0.50 and in cases of OSCC was 5.71± 1.08. The mean AgNOR count in OL cases of mild dysplasia was 2.59 ±0.66, in moderate dysplasia was 2.92± 0.43 and in severe dysplasia was 2.79. The mean AgNOR count in cases of well differentiated OSCC was 5.73± 1.62 and in cases of moderately differentiated OSCC was 5.67±1.19. Conclusion: The mean AgNOR count was higher in cases of OSCC as compared to cases of OL, and the AgNOR counts increased with the increase in the grades of dysplasia indicating a higher proliferative rate with increase in dysplasia
- Odontogenic tumors: a review of 60 cases(2010) Varkhede, Ajinkya; Tupkari, J. V.; Mandale, M. S.; Sardar, ManishaObjective: Studies on odontogenic tumors published from many parts of the world show a distinct geographic va- riation; however, there is little information available in the English-language literature on the relative frequency of odontogenic tumors in India. This retrospective study was designed to determine the relative frequency of odonto- genic tumors in an Indian population and compare them with various reports from other parts of the world. Study design: The histopathology records of the Department of Oral pathology and Microbiology of Government Dental College and Hospital, Mumbai were retrieved retrospectively within the period of January 2001 to March 2010. A total of 60 lesions classified as odontogenic tumors were reviewed. These were analyzed for age, gender, site of tumor and histopathologic typing. Criteria used were World Health Organization (WHO) classification 2005. The controversy still exists regarding the nature of odontogenic keratocyst or tumor, so it has not been included in this study. Results: A total of 60 cases of odontogenic tumors were reported in this period. The most frequent histological type was ameloblastoma (66.67%), followed by odontome (20%), adenomatoid odontogenic tumor (10%). In general, the odontogenic tumors showed a predilection for the mandible and the posterior regions of the jaws. Ameloblastomas occurred with a marked predilection for the mandible, while adenomatoid odontogenic tumor showed predi- lection for the maxilla, anterior regions of the jaws, and young females. Conclusion: Odontogenic tumors show a definite geographic variation. In our study, ameloblastomas were the most frequent odontogenic tumors, with distinct anatomic predilections
- In vitro effectiveness of different endodontic irrigants on the reduction of Enterococcus faecalis in root canals(2010) Vijaykumar, Singamaneni; GunaShekhar, M.; Himagiri, SuraObjective: To compare the reduction of E. faecalis counts in root canals produced by irrigation with distilled water, hydrogen peroxide, sodium hypochlorite, chlorhexidine, and combinations of solutions, in vitro. Study Design: Study sample included sixty mandibular premolar teeth mounted in dental stone. Root canals were prepared using crown down technique under distilled water irrigation. Specimens were sterilized overnight by ethylene oxide gas. Each canal was completely filled up with the E. faecalis suspension and incubated at 37ºC for 24 hours. Root canals were irrigated with the test solutions. A volume of 5 ml of the tested irrigant was used for each sample with an exposure period of 5 minutes. 10 ml of distilled water was used as final irrigant in all the samples. Canals were sampled before and after irrigation. After serial dilutions, samples were plated onto Mitis salivarius agar, and the colony forming units were counted. Results were analyzed by Chi-square test, Fisher’s exact test, and one-way ANOVA followed by multiple range Tukey HSD test with the level of significance set at P < 0.05. Results and Conclusions: Reduction of colony counts in distilled water group was significantly lower than the mean reduction in all the other groups. However, no other contrasts are statistically significant. Combination of sodium hypochlorite and chlorhexidine showed the most effective antimicrobial activity followed by sodium hypochlorite and hydrogen peroxide together. Hydrogen peroxide was the least effective irrigant when used alone
- The prevalence of tongue lesions in Libyan adult patients(2010) Byahatti, Sujata M.; Ingafou, Mohammed S. H.This is the first ever-detailed study of tongue diseases in Libyan population, where the tongue conditions found in 320 patients (9.2%) of 3,460 consecutive patients screened in the department of Oral Medicine and Oral Diagnosis at faculty of dentistry, Benghazi Libya. Both sexes were affected almost equally and only 25 patients were aware of their tongue disease. Forty patients had one or more systemic illness, 34 of them was on regular medications. Fissured tongue was the most prevalent condition, as it has been found in 155(48.4%) patients, depapillated tongue in 82(25.6%) patients and geographic tongue in 55(17.2%) patients, other disease conditions were found in a lesser number of patients. Fifty-four patients had painful tongue conditions; other complaints included malodor, speech interferences or swallowing difficulties. Most conditions were confined to the tongue and in more than 90%, there had been involvement of the dorsum of the tongue. Fortunately, most tongue conditions can easily be diagnosed on clinical grounds by any experienced clinician, hence, the histopathological examination and other investigations are needed in only few cases. There is a wide variation in the prevalence of most of tongue diseases worldwide due to the lack of uniformity in criteria of the studies. Thus, more studies are needed in this regard.
