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Yuvaraj V.,Indira Gandhi Institute of Dental science
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2015

Odontogenic fascial space infections are commonly encountered by the oral and maxillofacial surgeon. A retrospective study of the epidemiological characteristics, microbiological analysis and treatment response to odontogenic infections treated in the oral and maxillofacial unit of a Dental school is presented. A retrospective analysis of case records of all odontogenic infections that reported to the oral and maxillofacial surgery unit in a Dental school over a period of 2 years was performed. Epidemiological data, microbiological profile and treatment responses were analysed. All data were subjected to statistical analysis using SPSS statistical package. Mann–Whitney U test, Kruskal–Wallis test and nonparametric tests were carried out. A total of 2,140 patients were included in this study. Mandibular third molars were the offending tooth in nearly 40 % of cases with 107 patients becoming symptomatic following a dental extraction procedure. All patients were treated with surgical incision and drainage, antibiotics and local wound care. More than 95 % cases needed intraoral incisions. Penicillin was the drug in most of the cases. The pterygomandibular space was the most commonly involved with 15 % reporting with multiple fascial space involvement. Microbiological analysis showed a predominance of aerobic gram positive organisms with Streptococcus sanguis most commonly isolated. Peptostreptococci and Propionibacterium were the common anaerobes isolated. More than 80 % of the strains isolated were sensitive to penicillin. The average length of stay was 6.3 days. Inadequate documentation with regards to referral patterns, antibiotic history was commonly observed in case records. Penicillin continues to remain the drug of choice for a vast majority of maxillofacial infections of odontogenic origin. A delay in reporting can lead to worsening of symptoms with consequent increase in surgical morbidity and costs of treatment. Preventive dental care remains the best option available to mitigate the consequences of poor oral hygiene. Poor awareness among patient population for regular dental reviews and oral hygiene maintenance emphasises the need for sensitisation and education programs. © 2015 Association of Otolaryngologists of India

Vidyalakshmi S.,Indira Gandhi Institute of Dental science | Aravindhan R.,SRM University
Journal of Clinical and Diagnostic Research | Year: 2014

Minor salivary gland neoplasms of the buccal mucosa are relatively uncommon. Adenoid cystic carcinoma (ACC), a well-defined entity, occurs most of the times in the parotid, submandibular glands and palate, as far as the intraoral site is concerned. Adenoid cystic carcinoma tends to have an indolent, extended clinical course with wide local infiltration and late distant metastases. We are presenting a case of an adenoid cystic carcinoma of the buccal mucosa in a 48-year-old female patient.

Sudhakar R.,Sri Venkateshwaraa Dental College | Pratebha B.,Indira Gandhi Institute of Dental science
Journal of Oral and Maxillofacial Pathology | Year: 2015

Background: The cementodentinal junction (CDJ) forms a biological and structural link between cementum and dentin. This biological link is regarded as a distinct tissue in its own right. Certain important proteins responsible for periodontal regeneration are said to be present in this tissue. Few studies have described the structure and composition of this layer by light and electron microscopy. Scanning electron microscopic studies pertaining to CDJ in health and disease are few and documentation of periodontal pathological changes of CDJ is unclear. In the first phase of our study, the collagenous architecture of CDJ of healthy teeth has been reported. Aim: The objective of this study is to observe and report periodontal pathological changes in the fibrous or collagenous architecture of CDJ of periodontitis-affected teeth and discuss the probable clinical implications of CDJ in disease.Materials and Methods: Twenty periodontitis-affected teeth were collected and processed for observing under a scanning electron microscope. Results: The results are as follows: Increased width of interface at CDJ in periodontitis samples (7.1 μ) compared to that of healthy samples; fewer areas of fiber intermingling at CDJ in periodontitis samples as compared to healthy samples; frequent detachment of cementum from dentin during sodium hydroxide maceration of samples. Conclusion: It may be inferred from results that there is a possibility of a definite weakening of CDJ in periodontally affected root surfaces and we believe that clinical procedures such as scaling and root planning may have a detrimental effect on the cementodentinal attachment of periodontally involved root surfaces. © 2015 Journal of Oral and Maxillofacial Pathology.

Shivasakthy M.,Indira Gandhi Institute of Dental science | Ali S.A.,Annamalai University
Journal of Clinical and Diagnostic Research | Year: 2011

The branch of Prosthodontics is not only a science but also an art of handling patients who present with limitations in continuing with normal procedures. One such limitation is the difficulty in mouth opening of the patient due to various reasons like fracture due to trauma, oral sub mucous fibrosis, TMJ ankylosis, etc. Impressions can be made for patients with restricted mouth opening, with a sectional impression tray that can be assembled and disassembled in the mouth and reassembled outside the mouth. This article describes a sectional stock tray system for making preliminary impressions. It may be used not only for individual dental arches, but also for patients with microstomia or constricted oral openings. This system allows many combinations of the right and left tray sizes and the forms to be assembled into a well-fitted anatomically-conforming tray in spite of the individual anatomic discrepancies.

Asokan G.S.,Tagore Dental College and Hospital | Jeelani S.,Indira Gandhi Institute of Dental science | Gnanasundaram N.,Saveetha Dental College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2014

Purpose of the Study: The present study was conducted to evaluate epigenetic alteration of five tumour suppressor genes in the oral precancer and cancer patients.Materials and Methods: The study was carried out in three groups namely control group of five people (normal healthy individuals), 10 oral leukoplakia patients and 10 oral squamous cell carcinoma patients. Incisional biopsy was done and part of the tissue sent for histological examination and part of tissue sent for hypermethylation study of p16, p15, hMLH, MGMT, E-cadherin tumour suppressor genes. Methylation specific polymerase chain reaction was carried out for detecting methylation in promoter regions of tumour suppressor genes. The resultant PCR products were run in a 2.5% Agarose gel and the promoter hypermethylation status of the five tumour suppressor genes were analysed.Results: In oral Leukoplakia patients, 60% of methylation in the case of p16 gene, 30% of methylation in the case of MGMT gene and 60% of methylation in the case of E-cadherin gene. In oral Squamous cell carcinoma patients, 60% of methylation in the case of p16 gene, 40% of methylation in the case of MGMT, 60% of methylation in the case of E-cadherin gene, 20% in case of p15,10% in case of hMLH gene.Conclusion: Our results suggest that epigenetic mechanisms of inactivation of tumour suppressor genes, such as aberrant methylation of p16 and E-cadherin genes occur early in head and neck tumourigenesis and might play a role in the progression of these lesions. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.

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