Oral surgical procedures mainly tooth extraction can be related with an extended hemorrhage owed to the nature of the process resulting in an "open wound." The attempt of this paper is to present a case of massive postoperative clot formation after tooth extraction and highlight on the oral complications of surgical procedures. A 32-year-old male patient reported to the Dental Clinic for evaluation and extraction of grossly decayed 46. Clinical evaluation of 46 revealed root stumps. Extraction of the root stumps was performed, and it was uneventful. Hemostasis was achieved and postsurgical instructions were specified to the patient. The patient reported to the clinic, the very subsequent morning with a criticism of bleeding at the extraction site. On clinical examination, bleeding was noted from the socket in relation to 46. To control bleeding, oral hemostatic drugs Revici - E (Ethamsylate 500 mg) was prescribed and bleeding was stopped in 2 h. However, a massive clot was formed at the extraction site. Further, this clot resolved on its own in 1-week time. Despite the fact that dental extraction is considered to be a minor surgical procedure, some cases may present with life-threatening complications including hemorrhage. Vigilant and significant history taking, physical and dental examinations prior to dental procedures are a must to avoid intraoperative and postoperative complications.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

The cell damage will cause the release of free radicals. These free radicals will play an important role in any bioactive process of the cells. Antioxidants are one of the important components which plays a critical role to maintain the cell functioning and integrity of the cells. Antioxidants play an important role against the reactive oxygen species and maintain the normal activity of the cell. Antioxidants are preventing the free radical configuration tissue damage by preventing the formation of radicals or promoting their breakdown of free radical species. The review article explains the role of antioxidants in normal healthy conditions as well as diseases.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Antimicrobial resistance is a well-known entity and the most common factor leading to this is the irrational use of antibiotics. Several studies from the West have substantiated the irrational use of antibiotics in dentistry. Aims: The aim was to assess the knowledge, attitude, and practice (KAP) of antimicrobial drug use among dental fraternity in a tertiary care teaching dental college and hospital. Materials and methods: A cross-sectional survey of various dental fraternities using a structured validated questionnaire. The study was initiated following approval from Institutional Ethics Committee and interns, junior residents and faculty members of various departments in dentistry were enrolled after obtaining written informed consent. A structured validated questionnaire was developed to assess the above-mentioned objectives. Statistical analysis: Descriptive statistics was used for representing each category of response and kappa statistics were used to assess the reliability in the initial cohort. Chi-square test for independence was used to evaluate the difference in proportion between different professional cadres. Results: A total of 120 participants were recruited out of which 81.6% (98/120) of the participants accepted their frequent antibiotic usage. The most common dental indication of antibiotics among dentists was post dental extraction, attributing to 30.8% (37/120), followed by dental abscess 21.6% (26/120) and 60% (72/120) prescribed antibiotics after most minor surgical procedures. Surprisingly, 37.5% (45/120) of the participants opined that they use antibiotics against viral infection. Regarding the spectrum of antibiotic usage, 74.1% (89/120) preferred broad spectrum instead of narrow spectrum 25.8% (31/120). The commonly prescribed antibiotics were amoxicillin 71.7% (86/120), metronidazole 33.3% (40/120), amoxicillin with clavulanic acid 26.6% (32/120). A total of (43/120) 35.8% opted generic name for mentioning the antibiotics while the rest (77/120) 64.2% preferred to prescribe using their brand name. Furthermore, (76/120) 63.3% did not know about the recent antibiotic policy/guidelines from the Government of India. There was no significant difference observed in any of the responses between various academic levels. Conclusion: We found poor KAP regarding antimicrobial use in dentistry thereby conferring increasing potential for the development of more serious antimicrobial resistance. Immediate constitution of hospital antibiotic committee and scrutinizing the prescription of antibiotics is mandatory in dental hospitals as well.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Aim: To determine whether Triphala (Terminalia bellerica, Terminalia chebula, Emblica officinalis) extract has an antimicrobial activity against Lactobacilli and Candida albicans. Materials and Methods: Ethanolic extract of Triphala was prepared by using the cold extraction method. The extract was diluted with an inert solvent, dimethylformamide, to obtain 15 different concentrations of the extract. 0.2% chlorhexidine was used as a positive control and dimethylformamide was used as a negative control. The extract, along with the controls, was subjected to microbiological investigation to determine which concentration among the 15 different concentrations of the extract gave a wider inhibition zone against Lactobacilli and C. albicans. The zones of inhibition were measured in millimeters using a Vernier caliper. Results and Conclusions: Triphala extract demonstrated antimicrobial property against Lactobacilli and C. albicans with maximum zone of inhibition of 22 mm at 6% and 20 mm at 9%.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

The embryonic development of salivary glands is a complex process that creates compact, highly organized secretory organs with functions essential for oral health. The development is an example of branching morphogenesis, recent research found to involve unexpectedly dynamic cell motility, and novel regulatory pathways. Numerous growth factors, extracellular matrix molecules, gene regulatory pathways, and mechanical forces contribute to salivary gland morphogenesis, but local gene regulation and morphological changes appear to play particularly notable roles. Salivary gland tumors are one of the most complex and relatively rare groups of lesions encountered in oral pathology practice. Their complexity is attributed to the heterogeneity of the cells of origin of these lesions. Frequent overlap of microscopic features among various neoplasms makes us sometimes even to differentiate benign and malignant lesions leading to a diagnostic dilemma. Here, we review and summarize the current concepts regarding the histogenetic and morphogenetic concepts of salivary gland tumors and their relevance to routine diagnosis and classification of these lesions.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Lymphangioma is a benign, hamartomatous tumor of the lymphatic system. It is usually found in the head and neck region and is widely regarded as a developmental lesion rather than a true neoplasia. Most lymphangiomas are present at birth. In head and neck area, the most common location is the submandibular region, followed by the parotid gland. When lymphangioma occurs in the oral cavity, the anterior two third of the tongue is most commonly affected. The occurrence of lymphangioma in other parts of the oral cavity is very uncommon. Here, we report an unusual case of lymphangioma of buccal mucosa in a 45-year-old female.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Many histopathological parameters in oral tongue squamous cell carcinoma (OTSCC) have been identified as predictive factors. Certain tumor-related factors increase the risk of nodal metastasis, and many pathological factors affect survival. Objective: The objective of this study is to identify that tumor-related histopathological prognostic factors that can predict recurrence and potentially influence the decision for adjuvant radiotherapy in early stage OTSCC. Materials and Methods: A total of 51 patients who underwent surgery for early stage OTSCC (stage I, II) from 2007 to 2013 were selected. Demographic and clinical details were retrieved. Histopathological reports were reviewed for the following parameters-Margin status (close <5 mm, positive - Invasive squamous cell carcinoma [SCC], carcinoma in situ, marked dysplasia), microscopic depth of invasion, skeletal muscle infiltration (SMI), tumor differentiation, perineural invasion, lymphovascular invasion. Overall survival and recurrence-free survival (RFS) were calculated using the Kaplan-Meier method. Predictors of recurrence were identified using Univariate analysis. Results: Median follow-up was 22 months (range, 5-89 months), the overall survival and RFS were 88% and 81% respectively. The recurrence rate was 19.5% during this time period. The only significant predictor of recurrence in pathologically early stage OTSCC was SMI (P = 0.003) on univariate analysis. Eighty-seven percentage of the recurrences in our study occurred within the 1 ^st year, with a disease specific mortality rate of 12.5%. Conclusion: In early stage OTSCC, Failure occurred predominantly in patients who had SMI.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Palisaded encapsulated neuroma (PEN) is a benign cutaneous or mucosal neural tumor which, usually, presents as a solitary, firm, asymptomatic, papule or nodule showing striking predilection for the face. It occurs commonly in middle age, and there is no sex predilection. Oral PEN are not common, and these lesions must be distinguished from other peripheral nerve sheath tumors such as the neurofibroma, neurilemma (schwannoma), and traumatic neuroma. The major challenge in dealing with lesions of PEN is to avoid the misdiagnosis of neural tumors that may be associated with systemic syndromes such as neurofibromatosis and multiple endocrine neoplasia syndrome type 2B. Here, we present a case of benign PEN of the gingiva in the left anterior mandibular region, laying importance on immunohistochemical staining in diagnosing such lesions.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Dental trauma till date has been one of the most common injuries affecting school children. Aim: The aim was to evaluate the prevalence and associated factors on dental trauma in 11-16 year old school going children of Davangere city. Materials and Methods: A cross-sectional study was conducted among 2000 school children who were randomly selected. A questionnaire was given to the children that included personal demographic details, place and cause of injury. Ellis and Davis classification was used to record traumatic dental injury. The values were subjected to Chi-square test and multivariate logistic regression analysis. Results: The prevalence of dental trauma was found to be 10.6%. Chi-square test showed significant results obtained with respect to all the variables-age, gender, type of school, profile, and overjet. Most commonly affected teeth were maxillary central incisor (79.6%). Conclusion: The prevalence of dental trauma was found to be comparable when compared to various studies done all over the world.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Lesions of odontogenic origin comprise the heterogeneous group ranging from hamartomatous proliferations, cysts to benign and malignant tumors. Interplay between the epithelium and connective tissue can be assumed to play a significant role in the pathogenesis of odontogenic cysts. Aims and Objectives: A study was taken up to show the role of picrosirius red (PSR) stain to demonstrate the fibers and also to assess the difference in the nature of the fibers (different color patterns) and to find out the role of it, if any in the pathogenesis and biological behavior of the commonly occurring odontogenic cysts. Materials and Methods: Collagen fibers of 30 cases of odontogenic cysts (10 radicular cysts, 10 odontogenic keratocysts (OKC's), and 10 dentigerous cysts) were studied by staining the sections with PSR stain and examining them under bright field and polarizing microscope. Results: Sixty-seven percentage of the thin collagen fibers and 55% of the thick fibers in radicular cyst showed green-yellow birefringence. Fifty-seven percentage of the thin collagen fibers and 15% of the thick fibers in OKC showed green-yellow birefringence. Eighty-two percentage of the thin collagen fibers and 66% of the thick fibers in dentigerous cysts showed green-yellow birefringence. Rest of the fibers showed orange-red birefringence. Statistical analysis with one-way ANOVA was significant with a P < 0.01 only for thick fibers. Moreover, comparison of polarization colors of thick fibers of odontogenic cysts with duration of the lesion gave statistically significant results. Conclusion: The observations in the present study with respect to color profiles of the collagen fibers in the three commonly occurring odontogenic cysts possibly explain the biological behavior of the lesions. The predominant orange-red birefringence in OKC's in comparison to radicular and dentigerous cysts suggests that OKC's exhibit well organized and tightly packed fibers. This may possibly explain the reason for the poorer prognosis of OKC's. It is suggested that though the epithelium plays an important role in the pathogenesis of these lesions, even stroma is likely to play an equally important role in the pathogenesis and biological behavior.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Introduction: Periodontitis is a chronic inflammatory disease manifested as the destruction of tooth supporting tissues, which may progress to tooth loss. The chemical antimicrobial agents are often applied locally into the periodontal pocket as adjuncts to conventional mechanical periodontal therapy, but these have various adverse effects. Root extract of Saussurea lappa has shown anti-inflammatory and anti-bacterial properties. Hence, the present study was aimed to assess and compare the effect of root extract of S. lappa to chlorhexidine gluconate as subgingival irrigant as an adjunct to scaling and root planing (SRP). Materials and Methods: Thirty chronic periodontitis patients in the age group of 25-45 years were selected for the study. Five hundred and forty periodontal pockets were treated by three different procedures: Group1: Subjects treated by SRP only, Group 2: In addition to SRP, irrigation with S. lappa extract was done and Group 3: Chlorhexidine was used as irrigant along with SRP. Periodontal clinical recordings (modified sulcular bleeding index, probing pocket depth, clinical attachment level, and the presence of pus discharge) were done at 0, 7, 14, 28, and 42 days. Results: The periodontal parameters studied improved in all the three groups over the time period. In 4-5 mm pockets, S. lappa treated group showed significant improvement than chlorhexidine treated group. Furthermore, a dramatic decrease in periodontal pockets with pus discharge was seen in this group. Conclusion: Subgingival irrigation with S. lappa might be a promising adjunct to conventional treatment options in the management of periodontal infections.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Aim: The efficacy of a topically applied formulation of tetracaine base (6%) was investigated against benzocaine in achieving pulpal anesthesia in a randomized, placebo-controlled, double-blind study. Materials and Methods: Subjects' baseline pulpal responses to an electric pulp tester were measured, followed by a 10 min application of either tetracaine anesthetic paste (TAP), benzocaine (20%), or placebo. Treatments were removed and pulp testing was performed at 10 min, 15 min, and 20 min postapplication. Results: TAP produced significant pulpal anesthesia at 184% ± 7.2% above baseline versus 14% ± 1.7% above baseline for benzocaine at 15 min (P < 0.03). Differences between treatments were tested with the Wilcoxon test and the Steel-Dwass test, which is the nonparametric version of the all-pairs Tukey's honestly significant difference test. Conclusion: Achieving profound anesthesia with a topical anesthetic paste could lead to injection less procedure, improved postsurgical incisional pain management, and ameliorate pain associated with a variety of lesions.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Background: Gene variability related to activation and detoxification of procarcinogens affects the susceptibility to oral squamous cell carcinoma (OSCC). The results of numerous studies investigating the interrelationship between polymorphisms of glutathione S- transferase enzymes are not conclusive and there are little data regarding this topic on Iranian population. Aims and Objectives: This study aimed to investigate the genetic polymorphisms in glutathione S-transferase Mu 1 (GSTM1), glutathione S-transferase theta 1 (GSTT1), and glutathione S-transferase P1 (GSTP1) and the association with the risk of OSCC in Iranian population. Materials and Methods: The genetic polymorphisms of GSTM1, GSTT1, and GSTP1 genes were investigated in 35 Iranian patients with the OSCC and 60 age-sex matched controls. GSTP1 genotyping was performed by polymerase chain reaction (PCR)-restriction fragment length polymorphism method and GSTM1 and GSTT1 genotyping was amplified with PCR using specific primers. Odds ratios (ORs) and their 95% confidence intervals (CIs) were obtained using SPSS 17 and the risk of OSCC in relation to GSTM1, GSTT1, and GSTP1 polymorphism was defined. Results: The prevalence of GSTM1 and GSTT1 null genotypes in OSCC group were significantly higher than the control group.(OR = 2.6, 95% CI = 1.04-6.5; P = 0.01 for GSTM1) (OR = 11, 95% CI = 9-31; P = 0.001 for GSTT1). The GSTP1 valine polymorphism was not significantly different between the study groups (P = 0.145). Conclusions: GSTM1 and GSTT1 null genotypes may increase the risk for OSCC development in Iranian patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Mercury a popular heavy metal used in dentistry in the form of amalgam is a known clastogen. The assessment of micronuclei in cells is a promising tool for studying the genotoxic effect of mercury on them. Hence, a study was conducted to evaluate the frequency of micronuclei in exfoliated buccal cells of subjects with amalgam restorations. Materials and Methods: A total of 60 subjects (age and gender-matched sample of 30 study group and 30 control group) were included in this study. Smears were obtained with moistened wooden spatula from buccal mucosa in close contact with amalgam restoration and fixed with 100% ethyl alcohol. After staining with Papanicolaou stain, all the slides were examined under ×40 and 1,000 cells were counted for the presence of micronuclei. The data were entered into a spread sheet and subjected to statistical analysis. Results: A statistically significant increase in the number of micronuclei containing cells was observed in the study group when compared to control group (P < 0.05). A positive correlation was observed between the duration of restoration and frequency of micronuclei (P < 0.05). Conclusion: The results showed a definite genotoxic effect of amalgam restorations on the oral cavity which can be attributed to the clastogenic action of mercury in amalgam restorations.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]

Aim: The objectives of the study are to evaluate the changes in third molar angulation during orthodontic treatment with extraction of premolars in Class II malocclusions, and to evaluate the relationship between the angulation of third molars and positional changes of incisors and molars. Materials and Methods: This study was conducted on lateral cephalograms and dental panoramic tomograms of 30 patients (mean age 13.48 years) with skeletodental Class II malocclusion treated with four first premolar extractions. Twenty-four cases were treated with edgewise, and six were treated with Begg technique. The changes in the eruption pattern of the third molars were observed at the beginning of the treatment (T1) and at the end of the treatment (T2). The changes in the anteroposterior position of the incisors and molars, original molar space, and mesiodistal third molar angulation were tested by paired t-test. Results: The positional changes of the upper/lower incisors and first molars and original molar space were found similar in edgewise and Begg technique. Original molar space was increased in both jaws during orthodontic treatment. Long axis angle of the upper right third molar due to occlusal plane was increased nonsignificantly. Lower right third molars uprighted significantly. A positive correlation was found between the inclination of the lower right third molars and position of lower incisors and first molars. Conclusion: Treatment with extraction of premolars result in a greater space in the third molar region as a result of the mesial movement of the molars during space closure.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub]