Sanpreet Singh Sachdev

Hypohidrotic Ectodermal Dysplasia (HED) is characterized by a triad of hypotrichosis (sparse hair), hypodontia (multiple missing teeth), and hypohidrosis (inability to sweat adequately). Consequently, patients’ quality of life is severely affected due to impairments in mastication, speech, and esthetics. Timely oral rehabilitation of patients with HED can enable them to lead a normal life by helping them perform their functions adequately and prevent the psychological ill-effects; in which dental professionals play a key role. The present case report describes the oral rehabilitation and management of a 7-year-old male patient with HED.   Keywords: Developmental Disorders, Genodermatoses, Hypodontia, Oligodontia, Oral Rehabilitation

Supernumerary teeth occurring in between the central incisors are termed ‘mesiodens’ and have a prevalence rate of 3% in the Asian population. Mesiodens in seldom observed in adults with permanent dentition as most of them get extracted within the first decade or early second decade. The present case report describes mesiodens in a 32-year-old male with an emphasis on its radiological and histological aspects. Although a fairly common dental anomaly, mesiodens may present with several complications and have clinical implications in treatment. Retention of mesiodens until the fourth decade is quite unusual and is, therefore, an interesting aspect of the present case. Keywords: Developmental anomaly, Cone beam computed tomography, Mesiodens

Introduction: Alveolar osteitis (AO) is the most common complication of dental extractions, especially, the mandibular third molar. Zinc oxide eugenol (ZOE) is commonly used as a surgical dressing for the treatment of AO. However, the search for better dressing materials is still underway. Therefore, the present study aims to evaluate the impact of the intra-alveolar application of Metronidazole (MN), Chlorhexidine (CHX), and Lignocaine (LC) on the treatment of alveolar osteitis and compare it with that of ZOE. Materials and Methods: A total sample of n=32 patients was randomly assigned into the experimental group treated with MN+CHX+LC combination, while the control group was treated with ZOE paste dressing. Pain, discomfort, and healing were assessed on 3-day and 2-week follow-ups. Results: A statistically significant difference was noted in the number of individuals with pain (p=0.006) and halitosis (p=0.002) on the third day follow-up with higher number of individuals in the control group still experiencing the symptoms. By the end of two weeks, all the patients in the experimental group (n=16) had relief from pain and discomfort while they persisted in n=4 patients and halitosis was noted in n=9 patients treated with ZOE dressing. Conclusion: The experimental combination has a clear advantage as a medicament dressing because of its superior antibacterial and anesthetic properties over ZOE dressings. The combination reduces the time period required for healing the socket in AO, while greatly adding to the patient’s comfort and overall well-being. Keywords: Dry Socket, Dental Extraction, Surgical dressing

Odontogenic myxoma (OM) is a rare benign odontogenic tumor characterized by stellate and spindle-shaped cells dispersed in an abundant myxoid extracellular matrix. The bony invasion by the tumor imparts a characteristic ‘soap bubble’, ‘honeycomb’, or ‘tennis racquet’ radiographic appearance to the lesion. The decision of adopting a conservative or radical approach also depends on various factors such as location, size, and duration of the lesion, and age, gender, and expectations of the patient. Therefore, adequate treatment planning is crucial for the management of cases of OM and varies on an individual basis. The present case report described the management of a case of unusually large OM occurring in a 31-year-old Indian female in the mandibular anterior region crossing the midline. Keywords: Odontogenic tumor, Odontogenic mesenchyme, Oral surgery

A successful outcome of endodontic therapy can be achieved by a thorough knowledge of root canal morphology and its variations. The mandibular canine commonly presents with a single root and a single canal. A few may present with two canals in a single root and even rarer are those with two distinct roots and root canals. The present manuscript describes a case of an atypical bi-rooted mandibular canine. Careful examination of preoperative radiographs revealed a mandibular canine with two distinct roots and two canals. The access cavity was prepared, the working length was determined and the canal was prepared with rotary instrumentation with copious irrigation of sodium hypochlorite and EDTA. This was followed by obturation and post-operative evaluation. Careful assessment of root canal morphology should be done in every case for a successful outcome and to avoid any mishaps.   Keywords: Root canal morphology, Anatomic variations, Root canal treatment

Dentigerous cyst (DC) is an odontogenic cyst that is attached to the cervical region of an unerupted tooth and envelops the crown. It is the most frequently occurring developmental odontogenic cyst. Other odontogenic cysts and tumors exhibit a broad overlap in the clinical and radiographic presentation with DC. Therefore, biopsy plays a key role in resolving the differential diagnosis of DC. Timely intervention can enable the associated teeth to erupt normally, thereby eliminating the need for additional rehabilitation for the patients. Keywords: Odontogenic cysts, Developmental cysts, Impacted teeth, Enucleation

Fibrous dysplasia (FD) is a fibro-osseous lesion characterized by the replacement of normal medullary bone by proliferative fibrous connective tissue. It comprises only 2% of all benign tumors and tumor-like processes of the bone. Craniofacial FD can occur in monostotic or polyostotic forms, and in conjunction with other endocrinal abnormalities. The monostotic FD is of particular importance for dental professionals owing to its propensity to occur in the jawbones. Differentiating FD from other fibro-osseous lesions such as ossifying fibroma and cemento-osseous dysplasia requires a fair amount of expertise, but is much crucial as the treatment plan differs for each. Clinicodemographic and radiological features are equally important in differentiating fibro-osseous lesions from one another. The present case report describes craniofacial monostotic FD in the anterior mandibular region of a 13-year-old Indian male.   Keywords: Fibro­osseous lesions, Chinese letter pattern, Histopathology, Bone pathology

Obstructive sleep apnea (OSA) is a common condition frequently observed among males aged 40 to 65 years that may lead to early mortality.In the present systematic review, we have looked into the various surgical modalities used for the treatment of OSA and their success on the basis of the pre-operative and post-operative apnea-hypopnea index. The systematic review protocol is registered on the PROSPERO database (Reg ID: CRD42020153323). Studies conducted from June 2000 – June 2020 on OSA patients treated by surgery in the age group of 20-65 years and evaluating the impact of surgery on adult OSA patients were included in the review. Studies were collected from PubMed via MEDLINE, Google Scholar, and Cochrane Central Register of Controlled Trials till June 2020, in accordance with the PRISMA guidelines. A total of 17 articles were identified and two of them were eligible for meta-analysis. According to our meta-analysis, the results indicate that the treatment group had a more beneficial outcome as compared to the control group.   Keywords: Airway obstruction, Oropharyngeal Surgery, Apnea­hypopnea Index

Neoplasms of diverse cellular origin usually arise in the oral cavity and among these, the oral squamous cell carcinoma (OSCC) and its variants constitute over 90% of the oral malignancies. India is a global hub of OSCC cases. Throughout the changing trends and rise of different generations various authors have tried to define oral cancer. However, there is no definition that describes it in depth for a better understanding. But none of the definition define OSCC in a nutshell. Therefore, the need of the hour is to elaborately define OSCC. The present paper attempts to propose a new definition for OSCC that comprehensively encompasses the etiological, molecular, biological, histopathological and prognostic aspects of OSCC.   Keywords: Oral Cancer, Definition, Neoplasm, Carcinogenesis

The present case report comprises of an unusual presentation of oral malignant melanoma which occurred in the furcation area of maxillary right first molar. A clinician may not suspect a malignant neoplasm and the histopathological examination of the tissue may be missed out in such cases. Without any obvious clinical or radiological features, the lesion mimicked a periapical granuloma. The diagnosis was achieved after a thorough histopathological examination and extensive immunohistochemistry panel to rule out other similar histopathological entities.   Keywords: Melanocytes, Immunohistochemistry, Diagnosis

Introduction: Apprehension pertaining to adverse events associated with vaccine can create hesitancy in population which undermines their confidence in vaccination programmes. Clarity regarding what could be expected post-vaccination through reliable scientific data helps in allaying the apprehension. Our research aims at gauging the adverse experiences of oral health care professionals following first dose of immunization against COVID-19 with ChAdOx1 nCoV-19 (COVISHIELD™) and BBV152 (COVAXIN®). Materials and Methods: Data was collected by means of e-questionnaire circulated through online media such as social media platforms to oral health care professionals in India. Data was subjected to statistical analysis using Statistical package for social sciences (SPSS v 26.0, IBM). Descriptive statistics like frequencies and percentage for categorical data, Mean & SD for numerical data has been depicted. Comparison of frequencies of categories of variables with groups was done using chi square test. Results: Pain at site of injection (n=243) was the most frequently reported AEFI, followed by fever (n=225), headache (n=185), body ache (n=156) and fatigue (n=146). Majority of the AEFIs were perceived to be of mild (58.22%) to moderate (31.50%) severity by the respondents and resolved within first two days of immunization. Conclusion: AEFIs are almost inevitable when population on a nation-wide scale is involved in the vaccination scheme Availability of scientific data pertaining to AEFIs that could be expected post-vaccination such as our findings could provide clarity to general population about the issue, thereby purging any apprehension developed due to myths circulation through various modes of media. Keywords: AEFI, Adverse experiences, Vaccine, ChAdOx1, BBV152

Oral submucous fibrosis (OSMF) is a potentially malignant disorder characterized by juxtaepithelial inflammation and progressive fibrosis of submucosal tissues. It may affect any part of the oral cavity, as well as pharynx and oesophagus. The pathogenesis of OSMF may be attributable to habitual chewing of areca nut and its products, which is more prevalent amongst young population of South East Asia and India. Various histopathological features in different tissue components- epithelial, connective tissue stroma, muscle and salivary gland may be observed along the course of this chronic disorder. In connective tissue, extensive fibrosis with progressive hyalinization of collagen fibers and muscles accompanied by inflammatory response is considered to be pathognomonic feature. Advanced stages of OSMF may show atrophic changes or even dysplasia in the epithelium which may undergo malignant transformation. Malignant transformation rate of OSMF has been proved to be around 7.5%. Thus, identification of early histopathological changes in OSMF can lead to improved survival rates. The present article illustrates the various histopathological features observed during different stages of development of OSMF. A better understanding of the correlation between histopathological features and corresponding clinical manifestations can aid dental surgeons in prognostication of the lesion and determining response to treatment. Keywords: Oral Submucous Fibrosis, Histopathological features with pathophysiologic correlations

Cystic lesions of jaws are fairly common of which radicular cysts that form as a result of inflammatory changes associated with a non-vital pulp are most frequent. The removal of source of infection by either root canal treatment or extraction of the involved tooth leads to resolution of inflammatory cysts. However, infrequently, certain lesions may persist even after appropriate treatment which are termed as ‘residual cysts’. Although residual cysts are histopathologically indistinguishable from radicular cysts, certain changes may  occur owing to removal of the aggravating stimulus which may lead to a varied histopathological picture. The present case report comprises of a residual cyst with a relatively unusual histopathological presentation. Keywords: Inflammatory cyst, Prosoplasia, Metaplasia.

Introduction: Obesity is one of the leading causes for morbidity and mortality worldwide and various countermeasures to tackle this global malice have been implemented, one of these being low-calorie sweeteners (LCS). However, unbeknownst to many, habitual use of such sweeteners could potentially have several detrimental effects on health of the consumer. The present research was undertaken to assess the awareness about these adverse effects in Indian population. Materials and Methods: An online questionnaire-based survey was carried out on a sample size comprising of 607 individuals of Indian nationality. The questionnaire comprised of 18 closed-ended questions pertaining to use of LCS and awareness about their adverse effects. Results: While majority of respondents declared that they added sugar in their food/beverages regularly, 51.65% of respondents preferred ‘Diet/Low calorie’ products containing LCS in the market over sugaradded products. Sucralose was found to be most popular amongst various commercially available artificial sweeteners. There was a statistically significant difference seen for the responses pertaining to awareness about artificial sweeteners and their uses or benefits between various educational groups (p respondents with lower educational qualification. Conclusion: Although artificial sweeteners are presently being marketed widely as health substitutes, data regarding the possible adverse effects associated with their frequent use is still limited. Case-control studies are required to establish causal relationship between various artificial sweeteners and elicited adverse effects. The general population needs to be cautioned against unwarranted and injudicious use of LCS. Keywords: Artificial sweeteners, Obesity, Body Mass Index, Diet, Nutrition, Sugar substitutes.

Context: The personnel in histopathology, cytology and hematology laboratories are vulnerable to infection by tissue specimens and body fluids in the COVID-19 pandemic. This risk is essentially amplified for Oral Pathologists as they deal with tissues from oropharyngeal region which harbors high viral load. Thus, the pandemic has certain implications for modification in protocol to be followed in these laboratories. The present study gauges knowledge, attitude and awareness of Oral Pathologists with respect to these modifications required. Materials and Methods: A self-constructed e-questionnaire comprising of 22 questions was validated and then circulated online with the aid of messenger applications and e-mails to the eligible participants. All the respondents pursuing a post-graduation course or academic faculty in the subject of Oral Pathology were considered as eligible. The data was analyzed based on age, gender, qualification, affiliation and years of experience for the Oral Pathologist-based survey using Chi-Square test. Results: A relatively low knowledge was discerned amongst Oral Pathologists, regarding modifications required in various laboratory guidelines during the COVID-19 pandemic. Most of the respondents had a healthy attitude towards the preparedness and sustainability of their laboratory and its personnel. Conclusion: Adequate knowledge and training with regards to modifications in protocol in the wake of COVID-19 pandemic is essential for safeguarding Oral Pathologists working in histopathology, cytopathology and hematology laboratories. A healthy attitude of Oral Pathologists towards laboratory and its personnel would ensure a safe and efficient work environment. Keywords: Biosafety, Personal Protective Equipment, Guideline Adherence, Biopsy.

Admixed ameloblastoma comprises of a combination of more than one histomorphological patterns of ameloblastoma. The present case report discusses a case of admixed ameloblastoma extensively involving the entire body of the mandible bilaterally in a 25-year-old male. The case was managed by segmental resection using osteotomy to remove the segment of the mandible along with the right coronoid process. Histopathological examination of the excised tumor revealed highly proliferative odontogenic epithelium in the forms of plexuses and follicles. A fibula reconstructed graft was provided for rehabilitation of the patient with no evidence of disease after a one-year follow-up. Keywords: Odontogenic Tumors, Segmental resection, Fibula graft

Head and neck cancers are one of the most common cancers in India, the majority of which hare comprised of Oral squamous cell carcinoma (OSCC). Managing such tumours necessitates not only astute clinical judgement but also precise imaging and a full understanding of the biology of tumour dissemination paths. Despite the fact that radical excision with adjuvant radiotherapy is the conventional treatment, advanced gingivobuccal tumours have extremely high locoregional failure rates. The current case report describes the presentation and management of OSCC of the lower gingivobuccal complex. It would serve to guide clinicians in the decision-making aspect during the management of extensive gingivobuccal OSCC. Keywords: Head and Neck Cancer, Oncology, Oral squamous cell carcinoma, Hemimandibulectomy

While odontogenic keratocysts (OKC) are fairly common and well-known, orthokeratinized odontogenic cysts (OOCs) are quite rare accounting for less than 1% of odontogenic cysts. The entity is characterized by the presence of a predominant orthokeratinized lining. OOC is much less aggressive as compared to OKC and simple enucleation is discerned as adequate treatment with minimal chances of recurrence. The present case report describes an extensive OOC that involved most of the angle and ramus of the mandible in a 25-year-old female.   Keywords: Odontogenic cyst, Odontogenic keratocyst, Enucleation