Maharagama, Sri Lanka
Maharagama, Sri Lanka

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Dissanayake R.K.G.,University of Peradeniya | Jayasooriya P.R.,University of Peradeniya | Siriwardena D.J.L.,Dental Institute | Tilakaratne W.M.,University of Peradeniya
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology | Year: 2011

Objectives: The rare malignant odontogenic tumor, metastasizing (malignant) ameloblastoma (METAM) is reviewed with the aim of analyzing the pattern of disease and treatment of cervical metastasis based, on 2005 World Health Organization classification. Study design: A total of 65 cases, including reported cases from 1923 to 2009 compatible with the current classification and a new case are reviewed. Results: METAM occurred mostly in lungs (71%), followed by cervical lymph nodes (28%). Female-to-male ratio was 1:1.1. Primary tumor was diagnosed in 28% of cases at ages ≤20 years, and maxilla-to-mandible ratio was 1:5.2. The mean disease-free interval and survival for pulmonary metastasis were 14.37 years and 3 years, respectively, and 12.96 years and 6 years for cervical METAM. Five-year survival rate for cervical metastasis treated purely surgically was 71.43%. Conclusions: According to the available literature, neck dissection is the treatment of choice for cervical METAM. Evidence for the role of chemotherapy and radiotherapy is not conclusive. © 2011 Mosby, Inc. All rights reserved.


Perera R.,Dental Institute | Ekanayake L.,University of Peradeniya
Community Dental Health | Year: 2012

Objectives: To determine the prevalence of oral impacts and the association between tooth loss and oral impacts in Sri Lankan adults. Basic Research Design: A cross-sectional study where the data were collected by means of a pre-tested interviewer administered questionnaire and an oral examination. Participants: 916 ≥40 year olds from the Colombo district. Main outcome measures: Oral impacts were assessed using a validated Sinhalese translation of the Oral Health Impact Profile-14. Results: The prevalence of oral impacts was 27%. The most commonly reported impacts were in the domain of physical pain: "pain" and "uncomfortable to eat". Of the 14 oral impacts, tooth loss was associated with only 6 impacts. According to the multiple logistic regression analysis, the prevalence of oral impacts was independently associated with the number of missing teeth, missing anterior teeth and the number of natural occluding premolar pairs. Conclusions: The number of missing teeth and the position of teeth were associated with the reporting of oral impacts in this sample of adults. As the position of missing teeth was related to oral impacts, it could be concluded that all missing teeth do not have the same adverse effect on the physical and psychosocial well-being of the subjects. © BASCD 2012.


Perera R.,Dental Institute | Ekanayake L.,University of Peradeniya
Gerodontology | Year: 2012

Objective: To determine the relationship between tooth loss and nutritional status in older individuals in Sri Lanka. Background: In developing countries, both the prevalence of malnutrition and oral disease are high among older individuals. Materials and methods: Four hundred and eighty subjects aged 60 years and above were selected to be included in the sample, of which 437 responded giving an overall response rate of 91%. Data were collected by means of an interviewer administered questionnaire, an oral examination and a physical examination to determine height and weight to calculate the body mass index (BMI). Results: Based on the WHO cut-offs for BMI, 62, 20 and 18% of the sample were normal, under- and over-weight, respectively. A multinomial logistic regression analysis with normal weight as the reference category revealed that missing teeth and denture status were associated with being underweight but not with being overweight. Conclusion: In older individuals, tooth loss is significantly associated with being underweight. © 2011 The Gerodontology Society and John Wiley & Sons A/S.


Kumarihamy S.L.M.,University of Peradeniya | Subasinghe L.D.,University of Peradeniya | Jayasekara P.,Dental Institute | Kularatna S.M.,Ministry of Health | Palipana P.D.,Dental Institute
BMC Research Notes | Year: 2011

Background: ECC remains a problem in both developed and developing countries and ECC has been considered to be present in epidemic proportions in the developing countries. The aetiology and associated factors of ECC should be studied adequately to overcome this health hazard. The objective of this study is to determine the prevalence of ECC in 1 to 2 years old children in some selected MOH areas (semi-urban) in the district of Colombo, Sri Lanka. Methods. This study was conducted as a cross sectional study. A total of 422 children aged 1-2 years were selected using systematic sampling technique in Maharagama, Piliyandala, Nugegoda and Boralesgamuwa MOH areas in Colombo district, Western province, Sri Lanka. The pre-test was done initially with 10 children aged 1 1/2 year olds. Prior to the clinical examination of each child, a questionnaire consisting questions regarding tooth brushing, dietary habits, breast and bottle feeding, long term medications(Sweetened medications taken more than 3 months), attending a dental clinic during pregnancy of mother and socio-economical status of the family was administered to mothers of those children. Sterile dental mouth mirrors were used to detect ECC in children. Results: The prevalence of ECC of the whole sample of 410 children aged 1-2 years was 32.19% and the mean dmft was 2.01 and the mean dmfs was 3.83. From the children who had ECC 95% were untreated. There were significant relationships between dmft and long term use of medications (p < 0.000), intake of sugar with milk (p = 0.013), sweet consumption (p = 0.013), employment of mothers (p < 0.000) and visiting a dental clinic during pregnancy (p < 0.000). Conclusions: This study documents high prevalence and severity of ECC among 1-2 years old children in four selected MOH areas of Colombo district and caries in most of the children with ECC (95%) were untreated. Results reveal an urgent need to increase awareness among the public about ECC and institute preventive strategies. © 2011 Kumarihamy et al; licensee BioMed Central Ltd.


Amarasinghe H.K.,Dental Institute | Usgodaarachchi U.S.,Dental Institute | Johnson N.W.,Griffith University | Lalloo R.,Griffith University | Warnakulasuriya S.,King's College
Oral Oncology | Year: 2010

We investigated the prevalence of, and risk factors for, oral potentially malignant disorders (OPMDs) in rural Sri Lanka. A cross-sectional community-based study was conducted by interview and oral examination of 1029 subjects aged over 30 years. A community-based nested case-control study then took those with OPMDs as 'cases', "controls" being those with no oral abnormalities at time of initial screening. The prevalence of OPMD was 11.3% (95% CI: 9.4-13.2), after weighting for place of residence and gender. Risk factors were betel-quid (BQ) chewing daily [OR = 10.6 (95% CI: 3.6-31.0)] and alcohol drinking daily or weekly [OR = 3.55 (1.6-8.0)]. A significant dose-response relationship existed for BQ chewing. Smoking did not emerge when adjusted for covariates. A synergistic effect of chewing and alcohol consumption existed. The attributable risk (AR) of daily BQ chewing was 90.6%, the population AR 84%. This study demonstrates high prevalence of OPMD, betel-quid chewing with or without tobacco being the major risk factor. © 2010 Elsevier Ltd.


Amarasinghe H.K.,Dental Institute | Amarasinghe H.K.,Griff Ith University | Johnson N.W.,Griff Ith University | Lalloo R.,Griff Ith University | And 2 more authors.
British Journal of Cancer | Year: 2010

Background:Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is needed. We aimed to validate a model for screening so that only high-risk individuals receive the clinical examination.Methods:A community-based case-control study (n1029) in rural Sri Lanka assessed risk factors and markers for oral potentially malignant disorders (OPMD) by administering a questionnaire followed by an oral examination. We then developed a model based on age, socioeconomic status and habits of betel-quid chewing, alcohol drinking and tobacco smoking, with weightings based on odds ratios from the multiple logistic regression. A total, single score was calculated per individual. Standard receiver-operator characteristic curves were plotted for the total score and presence of OPMD. The model was validated on a new sample of 410 subjects in a different community.Results:A score of 12.0 produced optimal sensitivity (95.5%), specificity (75.9%), false-positive rate (24.0%), false-negative rate (4.5%), positive predictive value (35.9%) and negative predictive value (99.2%).Conclusion:This model is suitable for detection of OPMD and oral cancer in high-risk communities, for example, in Asia, the Pacific and the global diaspora therefrom. A combined risk-factor score of 12.0 was optimal for participation in oral cancer/OPMD screening in Sri Lanka. The model, or local adaptations, should have wide applicability. © 2010 Cancer Research UK All rights reserved.


Amarasinghe H.K.,Dental Institute | Amarasinghe H.K.,Griffith University | Usgodaarachchi U.S.,Dental Institute | Johnson N.W.,Griffith University | And 2 more authors.
Community Dentistry and Oral Epidemiology | Year: 2010

Amarasinghe HK, Usgodaarachchi US, Johnson NW, Lalloo R, Warnakulasuriya S. Public awareness of oral cancer, of oral potentially malignant disorders and of their risk factors in some rural populations in Sri Lanka. Community Dent Oral Epidemiol 2010; 38: 540-548. Ǎ 2010 John Wiley & Sons A/S Abstract-Objective: The aim of this study was to investigate the level of public awareness of oral cancer, of oral potentially malignant disorders (OPMD) and of risk factors for developing these diseases in a province of Sri Lanka, a country with one of the highest incidences of these diseases in the world. Methods: A cross-sectional community-based survey was carried out in Sabaragamuwa province by interviewing 1029 subjects above 30years of age, over a 1-year period from November 2006. Results: The level of public awareness of oral cancer was 84%, but only 23% for OPMD. Awareness was especially poor in low socioeconomic groups. The majority of subjects were not aware of the symptoms of oral cancer and of OPMD. Thirty-two percent were unaware that chewing betel quid was a risk factor for these diseases, as were 65% for tobacco smoking and 81% for heavy consumption of alcohol. Overall, 76% were not aware of any of the dangers inherent in the frequent use of areca nut. The majority of smokers, betel quid chewers and alcohol consumers were not aware that their lifestyles were placing their long-term health at serious risk. Conclusions: Knowledge of oral cancer, OPMD and their associated risk factors was poor among this population, indicating an urgent need to implement public health education and promotion strategies. © 2010 John Wiley & Sons A/S.


Richardson J.P.,Dental Institute | Moyes D.L.,Dental Institute
Virulence | Year: 2015

Fungal infections are becoming increasingly prevalent in the human population and contribute to morbidity and mortality in healthy and immunocompromised individuals respectively. Candida albicans is the most commonly encountered fungal pathogen of humans, and is frequently found on the mucosal surfaces of the body. Host defense against C. albicans is dependent upon a finely tuned implementation of innate and adaptive immune responses, enabling the host to neutralise the invading fungus. Central to this protection are the adaptive Th1 and Th17 cellular responses, which are considered paramount to successful immune defense against C. albicans infections, and enable tissue homeostasis to be maintained in the presence of colonising fungi. This review will highlight the recent advances in our understanding of adaptive immunity to Candida albicans infections. © 2015 The Author(s). Published with license by Taylor & Francis Group, LLC.


Johanson Z.,Natural History Museum in London | Kearsley A.,Natural History Museum in London | den Blaauwen J.,University of Amsterdam | Newman M.,Llanstadwell House | And 2 more authors.
Seminars in Cell and Developmental Biology | Year: 2010

Palaeospondylus gunni (Devonian, Scotland) is an enigmatic vertebrate, assigned to various jawless and jawed groups since its original description. New sections through the whole body allow description of a novel skeletal tissue for Palaeospondylus, comprising the entire skeleton. This tissue is mineralized cartilage and is characterized by large cell spaces embedded in minimal matrix. Bone is completely absent. Calcium phosphate mineralization has a differential topography of deposition within the cartilage that reflects a biogenic origin, despite subsequent diagenetic modification. This combination of hypertrophied cell spaces surrounded by regionalized mineralized matrix differs from all other cartilage in fossil and extant vertebrates. However, it compares most closely to gnathostome endochondral bone in early developmental stages. For example, Palaeospondylus skeletal histology differs from the Devonian agnathan Euphanerops and extant lamprey cartilage. Comparison with mineralized cartilage of armored fossil agnathans and placoderms shows the histology is not comparable to globular calcified cartilage. It also differs from that in extant chondrichthyan mineralized tesserae, which is restricted to a subperichondral zone. Amongst this diversity of calcified cartilage types we discuss various interpretations, including one that implicates tissue either in developmental stasis, before osteoblasts can deposit bone, or at a phylogenetic stage when this step has not evolved. These very different hypotheses highlight difficulties in interpreting fossil ontogenies when phylogenetic relationships are uncertain. Nevertheless, we propose that the composition of the Palaeospondylus skeleton represents a fossilized ontogenetic stage of endochondral bone, a type of bone characteristic of osteichthyan vertebrates. Crown Copyright © 2009.


Karunachandra N.N.,Dental Institute | Perera I.R.,Dental Institute | Fernando G.,Dental Institute
Rural and Remote Health | Year: 2012

Introduction: Sri Lanka is a middle income country and 80% of its population lives in rural areas. There is a well organized maternal and child health program and oral health care has recently been incorporated. The aim of this study was to report the oral disease burden of rural and urban antenatal women in the Western Province of Sri Lanka, thus highlighting the need to provide oral health care to this group. Methods: The sample consisted of 459 rural pregnant women in their second trimester and 348 urban pregnant women in their third trimester. Data were collected using interviewer administered questionnaires and a clinical oral examination conducted by calibrated examiners. Results: The mean Decayed Missing and Filled Teeth (DMFT) among rural antenatal women were 5.4 ± 3, with 2.27 (± 2.31) decayed teeth, 1.25 (± 1.97) missing teeth, and 1.90 (± 1.89) filled teeth. Among urban antenatal women, the mean DMFT was 3.69 (± 3.62) with 1.04 (± 2.15) decayed teeth, 1.07 (± 1.59) missing teeth and 1.59 (± 2.06) filled teeth. Rural antenatal women had a significantly higher experience of decayed teeth (p=0.001) and filled teeth (p=0.026), and twice as many untreated dental caries, compared with urban women. Moreover, almost 60% of rural women presented with bleeding gums. Similarly, the prevalence of calculus was 30.3% for rural women and 13.5% for urban women. The most significant finding was 3.5% prevalence of shallow periodontal pockets (4-5 mm) for rural women but 73.0% for urban women (p=0.0001). In the final model of multiple logistic regression analysis, significant predictors for dental caries experience were age (adjusted OR [95% CI]: 2.51 [1.55-4.06], p=0.0001) and location (urban vs rural adjusted OR [95% CI)]: 0.25 [0.11-0.55], p=0.001). However for periodontal status the only significant association was between age and Community Periodontal Index of Treatment Needs (CPITN): CPITN=0 versus CPITN>0 in bivariate analysis for the overall sample (p=0.001). Conclusion: Antenatal women in Sri Lanka have a high burden of dental caries and periodontal disease. Rural women had as twice as many untreated dental caries compared with urban women, but were unlikely to use oral healthcare services due to concerns about safety in receiving dental care during pregnancy. Oral healthcare provision to antenatal women in Sri Lanka can be improved. © NN Karunachandra, IR Perera, G Fernando, 2012.

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