Indian Journal of Dental Education

Behçet’s syndrome is a rare immune-mediated disease often presents with mucous membrane ulceration and ocular problems. Nearly all patients with Behçet’s syndrome present with some form of painful oral mucocutaneous ulcerations in the form of aphthous ulcers. The cause is not well-defined; the primary mechanism of the damage is autoimmune. Treatment is aimed at easing the symptoms, reducing inflammation, and controlling the immune system. Here we present a case of Behçet’s syndrome with 2 week follow up.

Keywords: Behçet’s Syndrome; Autoimmune Disorder; Oral Ulcers; Patehrgy Reaction.

Peripheral ossifying fibroma (POF) is a reactive lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars. It is considered to origin from the cells of the periodontal ligament in response to local irritating factors.The definitive diagnosis is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. Complete surgical excision is the treatment of choice. Here we report a case of a large peripheral ossifying fibroma in a 52 year old female.

Keywords: Gingival Growth; Epulis; Fibrosed Pyogenic Granuloma; Peripheral Ossifying Fibroma.

The odontogenic keratocyst (OKC) is a commonly encountered developmental cyst of considerable importance because of its potential for aggressive clinical behavior and recurrence. Also, it may be a component of the nevoid–basal cell carcinoma (Gorlin) syndrome. Histologic features of OKC are pathognomonic. The common site of involvement is the mandibular ramus region but this case represents odontogenic keratocyst involving the mandibular anterior region. Most odontogenic keratocyst (60%) arise from dental lamina rests or from the basal cells of oral epithelium and are thus primordial-origin odontogenic keratocysts. The remaining 40% arise from the reduced enamel epithelium of the dental follicle and are thus dentigerous-origin odontogenic keratocysts.

Keywords: Corrugated parakeratinized epithelium; Mandibular anterior region; Odontogenic Keratocyst.

Chronic alveolar abscess, as a sequelae of pulpal necrosis, can drain through a sinus tract, which may be intra-oral or extra-oral, though the intra-oral drainage is much more common. The extra oral sinus tract can be often misdiagnosed as an exclusive cutaneous lesion and get maltreated by systemic antibiotics. This case report demonstrates that if the general health of the patient allows, such ill-treated conditions can be managed by performing single visit endodontic therapy of the involved tooth followed by surgical excision of sinus tract so as to minimize the residual scar formation and therefore, aesthetically more acceptable for the patient.

Keywords: Chronic Alveolar Abscess; Pulpal Necrosis; Cutaneous Sinus Tract.

Maxillary cemento-ossifying fibroma is a rare, benign fibro-osseous lesion; belong to the odontogenic lesions, characterized by replacement of the bone by fibrous tissue and cementum like material. It occur most commonly in the 3rd and 4th decade with a female predilection. The current case report represent a 26- year- old female patient, who had cement-ossifying fibroma in the maxilla that extend to the left orbital rim and treatment is successfully perform by enucleating. 

Keywords: Fibro-Osseous Lesions; Cement-Ossifying Fibroma; Benign Odontogenic Tumor; Maxilla.

The criteria for considering a root canal treatment as success or failure many. Just because the clinical symptoms have subsided that doesn’t mean that the treatment is success, its just the severity of the disease has come down. The clinical, radiographic as well as the time factor after the treatment should be considered in the progress of the treatment. This article highlights the cause of success and failure of endodontics.

Keywords: Endodontics; Failure; LASERS; Success; Surgery.

Dentistry without metals is impossible. It is used for various reasons like posts, crowns, orthodontic braces and brackets. Tooth coloured materials like ceramics also have different metallic oxides as part of their composition. Even the so called resin composites used in dentistry as tooth coloured restorative materials have traces of metals in them which serve various purposes. It is impossible to imagine metal free dentistry. This article provides an in detail review of the various metals and alloys used in dentistry.

Keywords: Alumina; Alloys; Metals; Zinc Oxide.

 Micro-leakage testing has been used to determine the possible clinicalperformance of a restorative material. A large number of different techniques have been developed for the investigation of micro-leakage. Many micro-leakage testing materials have been developed andperformed through the years. There has been no agreement as to which testing methodology would give the most accurate results. Attempts have been made to simulate the oral conditions and to give a more quantitative representation of micro leakage. The different micro leakage testing methodologies are presented in this paper. 

Keywords: Micro-Leakage Testing; Clinical Relevance.

Foreign body reaction is a response of biological tissues to any foreign material when it comes in contact. These reactions can be due to either trauma or any foreign material used for treatment purposes. The various foreign body reactions due to iatrogenic causes includes due to suture material, prosthetic implants, glove powder, gauze piece etc. The events for foreign body reaction include protein adsorption, monocyte adhesion, macrophage adhesion and activation, macrophage fusion and foreign body giant cell formation.

Keywords: Foreign Body; Foreign Body Giant Cell; Gauze; Glove Powder; Prosthetic Implants; Suture Material.

Objective: This study aims at age and sex related changes in mediolateral diameter,antero-posterior Diameter and length of nasolacrimal duct. The mathmetical equations derived from linear regression analysis on the basis of mediolateral diameter,antero-posterior diameter and length of nasolacrimal duct is used in determination of age of study subjects however sex of study subjects can be predicted on the basis of length of nasolacrimal duct by discriminant function analysis using Fischer’s exact test. Material and Methods: The CBCT images of 216 study subjects were analysed prospectively. All the CBCT images are obtained at 90 Kvp, 4 mA for 11.3 seconds at FOV (17"x13.5") voxel size of 300. The mediolateral diameter, anteroposterior diameter and length of nasolacrimal duct are measured by using Trophy Dicom Ink software programme on axial and mid-sagittal images (DICOM images). Results: The study population consists of 216 study subjects aged between 10 and 84 years with a mean age of 34.28±17.357 years.The t test showed that the length of nasolacrimal duct is statistically significantly (p<0.001). The mean of length of nasolacrimal duct is slightly higher in males than females. The mean of length of nasolacrimal duct is slightly higher in males than females. The mediolateral diameter, length of nasolacrimal duct, antero-posterior diameter were not significant (p>0.05) in the age groups. Conclusion: The age and sex issues in medico-legal cases and forensic anthropology can be resolved by measurements of nasopalatine duct.

Keywords: Nasopalatine Duct; Cone Beam Computed Tomography; Maxilla

Objective: This research article focuses on prediction of age on the basis of maximum ramus breadth, minimum ramus breadth, condylar height, projective height of ramus and coronoid height. (Linear regression analysis). However it also determine sex of individual on the basis of discriminant function analysis using Fischer exact test using maximum ramus breadth, minimum ramus breadth, condylar height, projective height of ramus and coronoid height. Material and Methods: The orthopantomograms of 200 subjects were taken from planmeca promax-dimax4 OPG machine at 66 Kvp, 8mA and exposure time 16 sec. All the measurements are done on digital orthopantomograms using planmeca Romexis 3.2.0R software. The measurements of the mandibular ramus will be subjected to Discriminant function analysis. Results: The study sample consists of 200 subjects aged between 8 to 82 years with a mean age of 38.21±17.12 years. The persons correlation coefficient (r) between age and minimum ramus breadth was not significant correlation however the maximum ramus breadth, condylar height, coronoid height and projective height were directly associated with age and demonstrate a significant positive relation in maximum ramus breadth, condylar height, coronoid height and significant positive relation in projective height. The maximum ramus breadth, min ramus breadth, condylar height, coronoid height and projective height values were greater in males than females. The difference in maximum ramus breadth, minimum ramus breadth, condylar height, coronoid height and projective height values in males and females were statistically significant (P<0.05). Conclusion: Mandibular ramus can be a useful tool for age and sex determination in forensic science.Thus medicolegal cases having age and sex issues can be resolved with measurements of mandibular ramus if panoramic radiograph is available.

Keywords: Mandibular Ramus; Ramus Breadth; Condylar Height; Projective Height of Ramus and Coronoid Height.

Background and Aim: Halitosis or oral malodor affects a large proportion of the population and is often associated with poor oral hygiene practices, smoking habits, oral and systemic diseases. present study was carried out to assess the effect of smoking habits, oral hygiene practices on halitosis and even to evaluate self perceived malodour among college community in Ahmedabad. Materials and Methods: A survey was carried out in a college community of Arts and Science students in Ahmedabad in order to assess smoking habits, oral hygiene practices and self perceived malodour. All the 1200 students were invited to participate in the study but only 650 volunteers participated and a self administered close ended questionnaire was distributed. Descriptive statistics were used to describe the data. Results: Out of 650 students, only 31 (4.8%) had a habit of smoking and 619 (95.2%) were aware of the ill effects of smoking. 464 (71.3%) brushed once daily, 456 (70.1%) rinsed their mouth after eating anything and self perceived malodour was expressed by 59(9%). Conclusion: The habit of smoking was seen in a very small percentage of study subjects and majority of them were aware of its ill effects. There is a need to educate them on brushing techniques and encourage them to visit a physician/dentist whenever they perceive a malodour.

Keywords: Smoking; Oral Hygiene; Oral Malodour; College Community.

Background: The anterior loop is a prolongation of the neurovascular bundle of mandibular canal anterior to the mental foramen. This structure cannot be seen clinically but can be detected in radiographs. It is an important presurgical landmark of the mental interforaminal area during radiographic analysis. Aims: To determine the visibility of anterior loop in the mandible on panoramic radiographs. Material and Methods: Total 480 Panoramic radiographs of dentate patients with completely erupted lower premolars and molars were selected for the study. Subjects were divided into five different age groups. The radiographs were assessed for visibility of anterior loop. Anterior loop status was categorized as present on both sides, present on right side only and present on left side only. Statistical Analysis: Cross tabulations followed by a chi-square test were performed to compare the significance of categorical findings with respect to age group and gender. A P-value of less than 0.05 was considered as statistically significant. Results: One or more anterior loops were visible in 41% of radiographs. Anterior loops were most commonly visible bilaterally in 29.2% of radiographs followed by right side 7.5% and left side 4.3%. Visibility of anterior loop reduced with increased age of the subjects. There was no association between visualization of the anterior loop and subject gender. Conclusion: In our present study, the radiographic appearance of anterior loop was present in significant percentage of cases. Prevalence of the anterior loop can be overlooked and should be carefully identified before any surgical procedures in the mental interforaminal region.

 Keywords: Anterior Loop; Mental Foramen; Panoramic Radiographs.

 “What is the 1st diagnostic finding that a periodontist looks in his patient’s mouth”? Bleeding on probing and “what are the most important diagnostic tests which he tends to miss? Erythrocyte counts, Hb levels,microhematocrit values. These are the diagnostic tests which are missed by dentist and are of paramount importance in medicine for providing multifactorial measures of systemic response to infections/ inflammatory diseases. Epidemiological studies suggest that periodontitis is associated with increased risk of systemic diseases like cerebrovascular disease, cardiovascular ischemia, atherosclerosis. A lot of association of chronic systemic disorders leading to anemia has been totally proven in medicine. In chronic diseases like parasitic infections, bacterial and fungal infections, neoplastic illnesses anemia has been noted and hence it has been given the term anemia of chronic disease. Also periodontitis patients show various acute/ chronic immune activation and may develop anemia called anemia of chronic disease. Despite a lot of association of periodontitis and various systemic conditions very little work has been attempted at association between periodontitis, hemoglobin levels and erythrocyte counts with very few available reports by Scannapieco, Philip et al., JW Hutter. Hence this original research study was undertaken to investigate the possible relation between periodontal disease and Hb levels in systemically healthy subjects compared to chronic severe periodontitis subjects.

Keywords: Periodontitis; Hemoglobin; Anemia of Chronic Disease.

Aim/Background: Ghost cells are seen in calcifying odontogenic cyst (COC) and some other odontogenic and non-odontogenic lesions. There are varying opinions regarding their origin, nature, significance and relation in different lesions. It has been stated that ghost cells represent an abnormal type of keratinisation. This study was done with an aim to demonstrate the ghost cells in COC with one routine stain- hematoxylineosin; and three special stains- Ayoub Shklar, Mallory and van Gieson. Materials and Methods: Four tissue sections were made from paraffin embedded specimens of COC. Sections were stained with hematoxylineosin stain, Ayoub-Shklar stain, Mallory stain and van Gieson stain respectively. The stained sections were evaluated for efficacy of the four staining techniques to stain the ghost cells. Results: The ghost cells could be identified in the sections stained by all the four different stains used in this study. When compared among all the four stains, Ayoub-Shklar stain and Mallory stain appeared to be better than hematoxylineosin stain and van Gieson stain to discern the ghost cells from rest of the cystic epithelium. Conclusion: The ghost cells were stained positively by special stains used to demonstrate keratin. It indicates that they accumulate keratin in their cytoplasm during the pathological transformation process.

Keywords: Ghost Cells; Calcifying Odontogenic Cyst; Keratin

Introduction: Dental caries is one of the most important global oral health problems. The distribution and

severity vary in different parts of the world. This study aimed to determine the caries prevalence among a sample of preschool children and to assess the relation between maternal variables (age, educational level, occupation and family size) and the dental caries status of their preschool children. Subjects and Methods: A cross-sectional pre-school based study for 419 preschool children aged 3-5 years old were   selected randomly from 21 kindergartens in Khartoum North, Sudan.Data were collected through clinical examination and interviews. (dmft) were recorded according to WHO criteria. Face-to- face interviews mothers to determine maternal variables. Results: The majority (71.4 %) of the children examined had caries. The mean dmft± SD was 4.36 ± 4.40. A statistically significant association between dental caries status and child’s age was found (P=0.00). No statistically significant correlations were observed between all maternal variables and the prevalence of dental caries of their preschool children. Conclusion: The prevalence of early childhood caries was high among preschool children in Khartoum North. School dental health programs; obligatory dental examinations and tooth brushing exercises should be implemented in kindergartens and schools to promote dental awareness and help in dental caries prevention.

Keywords: Early Childhood Caries; Preschool Children; Maternal Variables.