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   Table of Contents - Current issue
Coverpage
July-December 2018
Volume 8 | Issue 2
Page Nos. 55-139

Online since Tuesday, December 18, 2018

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PRESIDENTS MESSAGE  

President's message p. 55
K Sadashiva Shetty
DOI:10.4103/ijohs.ijohs_50_18  
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SECRETARYS MESSAGE Top

Secretarys message p. 56
Dhanyakumar Budihal
DOI:10.4103/ijohs.ijohs_51_18  
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GUEST EDITORIAL Top

Children and their gadgets: A pedodontist perspective p. 57
Saraswathi Vishnu Naik
DOI:10.4103/ijohs.ijohs_45_18  
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EDITORIAL Top

Editorial p. 59
GP Sujatha
DOI:10.4103/ijohs.ijohs_52_18  
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REVIEW ARTICLES Top

Hollow complete denture for resorbed ridges p. 60
U Krishna Kumar, Sanjay Murgod
DOI:10.4103/ijohs.ijohs_55_18  
The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased inter-arch space provide decreased support, retention, and stability and pose a clinical challenge to the success of complete denture prostheses. The consequent weight of the processed complete denture only compromises them further. This article highlights a technique for the fabrication of a hollow maxillary complete denture in situation where there is excessive resorption of the maxillary residual alveolar ridge and thereby greatly reducing the weight of an exceptionally heavy maxillary denture. Weight of a denture may be a contributing factor to the successful resolution of a patient's problem; the hollow denture can be considered as one of the treatment modalities.
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Grossing of tissue specimens in oral pathology - Elemental guidelines p. 63
Ruthushree Theresa, M Harsha, Vikram S Amberkar
DOI:10.4103/ijohs.ijohs_32_18  
Grossing is a gross examination of surgical specimens in which pathologists inspect the excised specimen with the bare eye to obtain diagnostic information. It refers to the examination and dissection of surgical specimens, along with preparation of sections from those tissues requiring processing, and is the initial step in surgical pathology dissection. Careful handling of the tissue with proper fixation and tissue processing will enable a confident histopathological diagnosis.
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Probiotics and periodontal disease p. 68
Anjhana Asok, Rahul Bhandary, Mamatha Shetty, Nina Shenoy
DOI:10.4103/ijohs.ijohs_10_18  
Probiotics are live microorganisms that when administered in adequate amounts confer health benefits to the host. Lactobacillus acidophilus was the first probiotic species. Elie Metchnikoff reported fermented dairy products to have beneficial properties. Probiotics have been used in combination with prebiotics to produce synbiotics. Probiotics have been widely used in the medical field to combat various diseases. Probiotics have been found to be helpful in periodontal tissue destruction by altering the host defense mechanism and inhibiting the secretion of proinflammatory cytokines that can mediate tissue destruction. Probiotics have been demonstrated to produce high ecological pH and have inhibitory effect on volatile sulfur compounds that help to control halitosis. The concept of guided tissue recolonization has emphasized the increased use of probiotics in periodontal management. Although probiotics also include side effects, further longitudinal studies are required to provide substantial data on the use of probiotics.
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ORIGINAL ARTICLES Top

Age estimation using tooth cementum annulations method by different types of microscope: A comparative study p. 73
HL Geetha, Venkat P Baghisath, Hari B Vinay, B Sudheer, Vijay J Kumar, CH Gayathri
DOI:10.4103/ijohs.ijohs_56_18  
Introduction: Age is an essential factor in establishing the identity of a person. Age estimation through dental parameters can be of valuable assistance in human identification as teeth can survive in most conditions encountered at death and during decomposition. Tooth cementum annulations are one of the many methods for determination of an individual's age. Incremental lines in cementum are counted in this method. Objective: The aim of this study was to examine the correlation between chronologic age and estimated age and to find the most accurate method of calculating cemental annulations using different types of microscopes (light microscope, phase contrast microscope, polarized, and stereomicroscope). Methodology: The extracted teeth were cleaned and polished. Block was prepared by embedding two third of each tooth root horizontally in self-cure acrylic. Using a hard tissue microtome (SP 1600) longitudinal sections of 100 μm thickness were made. The sections were cleaned in alcohol and were mounted on a glass slide. These sections were observed under different types of microscopes (light microscope, phase contrast microscope, polarized, and stereomicroscope) to count cemental annulations. Results: The relationship between chronological age and estimated age using light microscope, phase contrast and polarized microscope showed stronger correlation while stereo microscope showed a weaker correlation. Conclusion: The use of polarized microscope increases the accuracy and thus, can predict the near estimate of the age for all the age groups.
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A comparative study of cone-beam computed tomography and intrasurgical measurements of intrabony periodontal defects p. 81
Santosh R Patil, Ibrahim A Al-Zoubi, Ravi Gudipaneni, Kuraym Khalid Kuraym Alenazi, Nidhi Yadav
DOI:10.4103/ijohs.ijohs_16_17  
Objective: The objective of this study was to analyze the correlation between cone-beam computed tomography (CBCT) measurements and intrasurgical measurements of intrabony periodontal defects. Materials and Methods: Thirty-two patients with intrabony defects, who underwent periodontal therapy and were advised for surgical therapy, were included in this study. Diagnostic images were obtained by periapical radiographs and CBCT before the surgical procedure. The distance from the cementoenamel junction to the base of the periodontal defect (CEJ–BD), the distance from the crest of bone to the deepest point of the defect, and mesiodistal (M-D) width of the periodontal defect were measured on CBCT and periapical radiographs during the surgical procedure. The faciolingual width of the defect was only measured on CBCT images during the surgical procedure. The linear measurements obtained during the surgical therapy were compared with that obtained by intraoral radiographs and CBCT imaging. Results: The M-D width of the defect measured during the surgical procedure was similar to that measured on the periapical radiograph. The distance of CEJ to BD and the distance from the crest of bone to the deepest point of the defect measured on the periapical radiographs were less than that of intrasurgical measurements. No significant difference was noted regarding the CBCT measurements of the faciolingual width and M-D width of the defect when compared with the measurements obtained during the surgical procedures. A significant difference was noted in the CBCT measurements from the CEJ to BD and the distance from the crest of bone to the deepest point of the defect when compared with the intrasurgical measurements. Conclusion: CBCT may lend comparatively discriminative dimensions of the periodontal defect similar to that of intrasurgical measurements.
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A review of oral and maxillofacial biopsies from a new academic health facility in remote Northwestern Nigeria p. 86
Adebayo Aremu Ibikunle, Abdurrazaq Olanrewaju Taiwo, Ramat Oyebunmi Braimah, Mohammed Sambas Umar
DOI:10.4103/ijohs.ijohs_25_18  
Background: Histological diagnosis is invaluable in charting the overall management of human pathologies. Knowledge of the general trend of histological diagnosis in a population may impact the clinician's practice as well as public health policy formulation. There is a paucity of literature on biopsy-driven epidemiology of oral and maxillofacial lesions, especially in sub-Saharan Africa. Objective: This study aims to determine the pattern of biopsied oral and maxillofacial lesions at a Nigerian tertiary hospital. Materials and Methods: A 5-year retrospective review of the histological diagnoses of patients who had biopsies of oral and/or maxillofacial lesions done at our teaching hospital was done. Biopsy reports obtained within the study period were retrieved and analyzed. Analysis was performed using the IBM SPSS statistics for windows version 20 (IBM Corp, Armonk, NY) software. Results: Three hundred and sixteen biopsy reports were included in this review. A slight male preponderance was observed, with a male-to-female ratio of 1:0.96. The age ranged from 6 months to 90 years (mean ± standard deviation, 33.3 ± 19.9). The posterior mandible was the most commonly affected site 13.9% (44). Most of the lesions were neoplastic 70.9% (224) with a slight majority being malignant. Squamous cell carcinoma (SCC) was the most frequently diagnosed malignancy 11.7% (37). Most nonneoplastic lesions were inflammatory/infectious 52.8% (47). Conclusion: Nearly equal gender prevalence for oral and maxillofacial biopsies was observed. In contrast to several studies, malignancies were more frequently diagnosed than benign neoplasms. The high incidence of SCC suggests the need for population interventions targeted at screening and early diagnosis.
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Assessment of knowledge, attitude, and practice toward oral hygiene among governmental secondary school students in Debre Tabor Town, Amhara Region, North Central Ethiopia 2018: Institutional-based cross-sectional survey p. 92
Yilkal Tafere Gualie, Asnakew Tigabu Tayachew
DOI:10.4103/ijohs.ijohs_37_18  
Introduction: Oral health is significantly related to oral hygiene behaviors and their knowledge. Poor oral hygiene can have a profound effect on the quality of life. Oral hygiene practices are those measures taken to ensure that the mouth is clean. Oral hygiene practices are essential for the prevention of dental and other associated systemic diseases. The aim of this study is to determine the level of knowledge, attitude, and oral hygiene practices among secondary school students in Debre Tabor town, Amhara region, North Central Ethiopia 2018. Materials and Methods: An institution-based cross-sectional study was conducted among 422 systematically selected students using stratified random sampling technique from January 20 to 30, 2018. Data were collected using a pretested questionnaire on 422 selected students in three secondary schools found in Debre Tabor town. Variables collected included the frequency of brushing teeth and the use of toothpaste, knowledge of plaque, and students' perception of the importance of oral hygiene practices. The data were entered into Epi-Info version 3.5 and cleaned and analyzed using SPSS version 20. Results: A total of 422 patients participated in the study; among whom 216 (51.2%) were female students. The study revealed that 253 (60%) of the respondents had good knowledge with regard to oral hygiene, more than half 281 (66.6%) of the students had positive attitude toward oral hygiene, but their oral hygiene practices were still low that 260 (61.6%) of the students had poor oral hygiene practice. Conclusions: The study showed that more than half of the respondents had good knowledge and positive attitude toward oral hygiene to maintain proper oral health, but their practices toward oral hygiene were remain poor. The majority of students were aware that teachers and parents had not an important role to play in their oral hygiene. Establishment of oral health education programs in the school curriculum that will help a life-long oral hygiene practice in the school environment and at large in the community with the support of teachers and parents are crucial.
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Assessment of mandibular retrognathism and maxillary prognathism as contributory factors for skeletal Class II malocclusion: A cephalometric study p. 99
Suraj Prasad Sinha, Krishna U S Nayak, Crystal Runa Soans, PS Murali, Akhil Shetty, MS Ravi
DOI:10.4103/ijohs.ijohs_3_18  
Aim: The aim of this study is to evaluate the skeletal factor (maxillary excess and/or mandibular deficiency) contributing for the skeletal Class II malocclusion. Materials and Methods: Lateral cephalograms of 100 individuals (50 males and 50 females) in the age group of 18–30 years, having skeletal Class II malocclusion with ANB of more than 4, were evaluated. The parameters to be used for prediction of maxillary prognathism include linear measurement of Nasion perpendicular to point A, and for the mandibular retrognathism, it is linear measurement of Nasion perpendicular to Pogonion, as suggested by Burstone analysis. Results: The 34% of the studied sample size had the Class II skeletal pattern (ANB >4), but their observed values for the maxilla and the mandible (with respect to the cranium) were in the normal range according to Burstone's cephalometric norms. Mandibular retrognathism with 68% prevalence in the final studied sample size is the major contributory factor for the skeletal Class II malocclusion which is followed by maxillary prognathism with 27% prevalence in the studied sample size, and the last contributory factor is the combination of the above two which accounts for the 5% of the studied sample size. Conclusion: The cephalometric study of skeletal Class II participants suggests mandibular retrognathism to be the major component in the given sample size. The other important conclusion from this study is that the ANB angle is not a reliable indicator to assess the skeletal malocclusion.
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CASE REPORTS Top

Management of flabby ridge case: An arduous task in undergraduate practice p. 104
Jnanashree Chiplunkar, Masrie Tumbil, MD Chethan, DB Nandeeshwar, Disha Patel
DOI:10.4103/ijohs.ijohs_41_18  
A fibrous or flabby ridge is a superficial area of mobile soft tissue affecting the maxillary or mandibular alveolar ridges. It can develop when hyperplastic soft tissue replaces the alveolar bone and is a common finding particularly in the upper anterior region of long-term denture wearers. Masticatory forces can displace this mobile denture-bearing tissue, leading to altered denture positioning and loss of peripheral seal. Unless managed appropriately, such “flabby ridges” adversely affect the support, retention, and stability of complete dentures. Many impression techniques have been proposed to help overcome this difficulty. This paper presents case report for prosthodontic rehabilitation of a patient with flabby ridge with McCord and Ahmad impression technique.
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Multivariant lichen planus of lips and gingiva: Report of a case and a review p. 109
SM Rekha, Apeksha Basawant Annigeri, Sushama R Galgali, P Jagadish
DOI:10.4103/ijohs.ijohs_18_18  
Oral lichen planus (OLP) is a relatively common inflammatory mucocutaneous disorder that frequently involves the oral mucosa. There are many etiological factors, and some among them are stress, diabetes mellitus, and hypothyroidism. An important complication of OLP is the development of oral squamous cell carcinoma, which led the World Health Organization to classify OLP as a potentially malignant disorder. This article reports a multivariant (reticular, erosive, and papular) case of lichen planus that has affected a 40-year-old medically compromised female who was managed successfully and still under follow-up.
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Colonic phenotype of adenocarcinoma base of the tongue: An entity rarely reported and treated with definitive chemoradiation p. 116
Neelam Sharma, Abhishek Purkayastha, Chhavi Arora, Kavita Sahai
DOI:10.4103/ijohs.ijohs_55_17  
The predominant histological type of oropharyngeal cancer is squamous cell carcinoma and approximately 9 times more frequent when compared with other types. Adenocarcinoma common histopathology for digestive system is very rarely reported in this region. In literature, there are limited data about the clinical presentation, histopathology, and treatment modalities for the primary adenocarcinoma of the base of the tongue (BOT). To the best of our knowledge, five cases of adenocarcinoma of the BOT with colonic differentiation have been reported in the world literature till date, and this is the first case report from India. The challenge in these type of cases is to differentiate between the primary adenocarcinoma of BOT which is extremely rare, metastatic lesion to this site from any other site, or its origin from minor salivary glands which is a more common possibility because all these situations have different treatment implications.
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A case report of unusual presentation of mucoepidermoid carcinoma with review of literature p. 120
Gadadasu Swathi, Tatapudi Ramesh, Moturi Kishore, Govind Raj N Kumar
DOI:10.4103/ijohs.ijohs_24_18  
Head-and-neck cancers constitute about 30% of cancers in India, of which salivary gland tumor such as mucoepidermoid carcinoma (MEC) was the most common malignant salivary gland tumor. The parotid gland was the most common site of origin in both benign and malignant tumors, followed by submandibular and sublingual glands. Salivary gland tumors comprise a morphologically diverse group of rare tumors. Their multifaceted clinical presentation, varied morphologic configuration, and relatively unpredictable prognosis attract significant medical interest. Here is a rare case report of an asymptomatic swelling in the cheek region which was thought to be pleomorphic adenoma at the outset which on further investigations proved as MEC of early detection.
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Hemorrhagic bulla on the lip: A diagnostic dilemma p. 124
Aravinda Konidena, Hena Shaw, Mansimran Kaur Uppal
DOI:10.4103/ijohs.ijohs_17_18  
Angina bullosa hemorrhagica (ABH) is a rare benign disorder characterized by the sudden onset of painless blood-filled blister in the oral cavity that rupture in 24–48 h. We recently encountered an interesting case of ABHon the lower lip of 68-year-old female patient referred back from the prosthodontic department following the procedure of impression making. This case will be presented along with a review of previous case summaries reporting four or more cases.
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Actinomycotic infection of the tonsils: A case report and review of the literature p. 129
Stavanger Singh Bakshi, Ramiya Ramachandran Kaipuzha, Suriyanarayanan Gopalakrishnan, A Govindarajan
DOI:10.4103/ijohs.ijohs_43_17  
Actinomycotic infections of the head and neck, although fairly uncommon, represent an important entity because of its varied presentation, difficult diagnosis, and long course of treatment. A 20-year-old female presented with throat pain and difficulty in swallowing for 1 year. Examination revealed a Grade IV enlargement of the left tonsil. The patient underwent tonsillectomy, and the postoperative histopathology revealed actinomycosis. Actinomyces is anaerobic filamentous bacteria which are known to colonize as commensals in tonsillar crypts which on histology show an outer zone of granulation tissue and a central zone of necrosis containing many sulfur granules that represent microcolonies of Actinomyces. Actinomycosis of the head-and-neck region is a significant entity because it can mimic other common lesions, especially in the oropharynx. In cases of recurrent tonsillitis and tonsillar hypertrophy, tonsillectomy is the treatment of choice, and histopathological examination of resected tissue is strongly advocated. This report supports the view that Actinomyces may have a causal association with recurrent acute tonsillitis and tonsillar hypertrophy.
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The course of double mandibular canal - confront to dentist p. 133
Jayasheela Mallappa, Neeharika Sree, B H Dhanya Kumar, Dhoom Singh Mehta
DOI:10.4103/ijohs.ijohs_40_18  
The mandibular canal is usually a single canal that begins with mandibular foramen on the medial surface of the ascending mandibular ramus. It transmits the inferior alveolar artery, vein, and the inferior alveolar nerve. The identification of the mandibular canal and its anatomic variations is of great importance in many branches of dentistry, especially in implant dentistry. Sometimes, there may be variations in the normal anatomic structures; one of the rarest among them is double mandibular canal. The clinician should be aware of such variations to avoid complications during the treatment. In the present case report, we have discussed about a case with double mandibular canal and the complications that can arise during the treatment.
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Clear-cell squamous cell carcinoma: An uncommon variant of very common malignancy in the head and neck p. 136
Lopa Mudra Kakoti, Debanwita Mahanta, Jagannath Dev Sharma, Zachariah Chowdhury
DOI:10.4103/ijohs.ijohs_23_18  
Clear-cell squamous cell carcinoma (SCC) is an extremely rare and incompletely understood entity. Clear-cell change occurs due to cytoplasmic accumulation of glycogen, water, intermediate filaments, immature zymogen granules, or a paucity of cellular organelles. Clear-cell change can be seen in any of the neoplasms, but as pure form variant, it is difficult to find in head-and-neck SCC. The World Health Organization has recognized clear-cell SCC as separate entity at other few sites such as penis but not in the head-and-neck SCC, and these are known to aggressive variant. We, hereby, present a case of clear-cell variant of squamous carcinoma in lower gingivobuccal mucosa in a 59-year-old male patient. Histopathology showed sheets of clear cell separated by fibrous septa and foci showing squamous cells with malignant features. Periodic acid–Schiff and immunohistochemistry (IHC) were done to rule out differentials of clear-cell variants of different sites such as salivary gland, odontogenic origin, and cutaneous adnexal origin. To establish the prevalence, biological nature, significance, and clinical course of clear-cell SCC in the head-and-neck region, more number of case reports are expected to be published in future. We concluded by emphasizing on the need of further analysis of all clear-cell tumors in the head and neck with histochemistry and IHC investigations to arrive at the proper diagnosis.
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