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Background: Diabetes mellitus, a chronic metabolic disorder affecting millions worldwide, is associated with microvascular complications, including diabetic retinopathy (DR) and periodontitis. Understanding their interrelationship is crucial for comprehensive patient care., Objective: This systematic review and meta-analysis aim to investigate the association between DR and periodontitis in patients with Type 1 and Type 2 diabetes., Methodology: Using the PECO framework, we searched PubMed/MEDLINE, Scopus, EMBASE, Google Scholar, and Web of Science databases (Inception to April 2023) for studies on the association between DR and periodontitis. Ten studies (n = 1828 participants), including observational and cross-sectional studies, met the inclusion criteria. We conducted qualitative synthesis, risk of bias analysis using the ROBINS-E tool, Grading of Recommendations, Assessment, Development, and Evaluations assessment (GRADE), and random-effects meta-analysis., Results: Eight studies found a significant association between severe periodontitis (pocket depth ≥5 mm) and DR, while two found no association. Meta-analysis of 843 participants showed diabetics with periodontitis had 4.48 times higher odds (95% confidence interval: 1.67-12.07, P = .003) of developing retinopathy compared to diabetics without periodontitis. High heterogeneity was observed (I 2 = 86%). Subgroup analysis by diabetes type showed no significant difference. The overall GRADE level of evidence was very low., Conclusion: While most included studies suggest an association between severe periodontitis and increased DR risk, the overall certainty of evidence is low. These findings highlight the potential importance of periodontal health in diabetic patients. High-quality longitudinal studies with adequate control of confounders are required to determine if periodontitis contributes to the progression of DR or if the conditions are merely coincidentally related., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Tobacco and areca-nut are risk factors for oral cancer and potentially malignant disorders. Oral cancer is ranked as the commonest among males in Sri Lanka (18.4 %). This research aims to determine the prevalence of tobacco and areca-nut use and its association with oral lesions., Method: It is a cross-sectional study using 368 patients attending the Dental Diagnostic Clinic. Details of tobacco and areca-nut use were collected and participants were examined for mucosal lesions., Results: It revealed that 23.9 % had tobacco use. Out of these, 41.1 %, 22.2 % and 36.7 % had smokeless-tobacco use, smoking and both, respectively. Similarly, 25.3 % had areca-nut/betel-quid use and majority (72.8 %) added tobacco to it. Tobacco (93.2 %) and areca-nut (79.6 %) use was higher among males (p < 0.05). Significant associations of areca-nut use with age (p = 0.001) and education level (p = 0.025) were noted. Oral lesions like de-pigmentation, white patches, ulcers, growths and oral sub-mucous fibrosis (OSF) had prevalences of 2.4 % each. Prevalence of pigmentation, lobulated tongue and erosive lesions was 10.6 %, 4.6 % and 1.4 %, respectively. 32.6 % had abnormalities like linea-alba, periodontal problems, pericoronitis and hairy tongue. The study revealed that >90 % of those who used tobacco and areca-nut had oral lesions (p < 0.05)., Conclusion: The prevalence of tobacco and areca-nut use is high among patients attending the Dental Teaching Hospital, and its association with mucosal lesions is significant. Hence regular awareness programs on the adverse effects of tobacco and areca-nut use should be carried out at the Diagnostic clinic as a preventive measure., (© 2023 The Authors.)

Oral cancer is the most common cancer among males in the Sri Lankan population. The aim of this study was to assess the health seeking behaviors and associated factors for OPMD. A hospital based descriptive cross-sectional study was conducted among Out Patients Department attendees of the Institute of Oral Health, Maharagama, from July 1, 2018 to December 31, 2019 by administering a questionnaire followed by an intra oral examination. The total number of 110 OPMD/oral cancer patients were identified. Awareness on OPMD was that 40 ​%. Majority were unaware of the danger of areca nut and alcohol use. Out of the identified cases during oral examination, 47.3 ​% were incidental findings while only 7.3 ​% were referred by the General Medical Practitioners (GMP). None were referred by the Primary Health Care (PHC) staff. The level of awareness on OPMD and its risk factors were very low. Incidental findings during the dental screening being the main mode of detection of OPMD, highlights the importance of conducting opportunistic screening at dental settings. Implementation of the Risk Factor Model (RFM) approach for the early detection of oral cancer through PHC staff and GMP is validated to encourage more early referrals., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Craniofacial Research Foundation. Published by Elsevier B.V. All rights reserved.)

This study was aimed to assess the prevalence and factors associated with second hand smoking (SHS) and tobacco use among pregnant women in Yatinuwara Medical Officer of Health area in Kandy district, Sri Lanka. This was a descriptive cross-sectional study using 390 pregnant women. Data were collected through a pre-tested, self-administered questionnaire. Fifty-four-point four percent were exposed to the SHS. Prevalence of smoking during pregnancy was 0.5% and eight women used smokeless tobacco (SLT). SHS was significantly associated with the age of the mother and family income. Women's age, monthly income, husband's education, husband's occupation, women's age at marriage and trimester of pregnancy were significantly associated with tobacco use. In conclusions, prevalence of SHS was high but tobacco use was low in pregnant women. An effective training program should be designed to educate pregnant women as well as their husbands on adverse effects of tobacco use and SHS during pregnancy., (© 2021 Craniofacial Research Foundation. Published by Elsevier B.V. All rights reserved.)

Objectives: To determine the size and position of the Greater Palatine Foramen using CBCT., Materials and Method: GPF was evaluated on 50 CBCT's which were obtained at the Division of Oral Medicine and Radiology, FDS, University of Peradeniya, The distance of each GPF to the mid maxillary suture (MMS), Anterior Nasal Spine (ANS), relationship of the GPF to the molar teeth and diameter were measured in different orthogonal planes using measurement tools integrated to the CBCT software., Results: Mean diameter of the GPF in females and males were 3.72 mm for the right and 3.31 mm for the left and 4.56 mm and 4.30 mm. The antero-posterior distance measured from the ANS to mid GPF in axial sections among females was 45.70 mm and 44.81 mm for the right and left respectively whereas for males it was 48.37 mm and 47.6 mm. The distances in axial sections were 14.82 and 15.14 mm for right and left sides in females whereas in males it was 15.50 and 15.67 mm from the MMS. The same measurement in the coronal plane was 14.93 mm and 15.22 mm for females for the right and left GPF and was 15.63 mm and 15.49 mm in males respectively. There was a significant difference between the distance of ANS to the GPF on both sides and the diameters of GPF in both males and females (p < 0.005)., Conclusion: A significant difference was seen between the mean distance from the ANS to the GPF in left and right sides and the diameter of the GPF on the sides among the genders.

Objective: The objectives of this study were to evaluate the normal radiographic length of the styloid process (SP), prevalence and type of elongation, and angulation of the styloid process in relation to sex and side on digital panoramic radiographs in a Sri Lankan population., Methods: A total of 100 digital panoramic images selected from the database at the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka were evaluated for the radiological features of the styloid process. Lengths greater than 30 mm were consider as elongated. Elongated styloid processes were also classified into three types based on Langlais classification (elongated, pseudo articulated; and segmented)., Results: The mean radiological length of the SP on the right and left side was 25.8 mm ± 7.5 mm and 23.2 mm ± 9.0 mm respectively. The prevalence of elongated styloid process in males and female were 34.9% and 24.6%. The maximum length observed on right and left sides were 43.2 mm and 41 mm respectively. However, the differences between the genders and the sides were statistically not significant (P = 0.199). The most frequently observed type of elongation was type I (elongated) according to the Langlais classification., Conclusion: This study provides valuable knowledge of the anatomical variations of the SP which may help clinicians from various specialties to diagnose the Eagle syndrome.

Objectives: Oral submucous fibrosis (OSF) is a chronic debilitating disease of the oral mucosa, associated with an increased risk of malignancy. The primary objective of this study was to evaluate the effectiveness of intralesional corticosteroid injection as a treatment modality for OSF. We also studied the correlation between the treatment outcome and a number of individual variables., Study Design: A total of 230 histologically confirmed patients with OSF were included in the study, of which 116 patients with a 30 mm or less interincisal mouth opening were subjected to intralesional injections of 40 mg methylprednisolone at monthly intervals for 6 consecutive months. The effect of the treatment was assessed by evaluating the degree of improvement in mouth opening., Results: All patients included in the study had a history of chewing areca nut. In paired comparison, statistically significant difference (t = -8.78; df = 115; P < .001) was observed in mouth opening over a period of 12 months in the patients who had corticosteroid injections., Conclusions: Intralesional corticosteroid injection is one of the most widely implemented interventions for OSF at present, particularly for those patients with palpable fibrous bands. The present study provides justification for the use of corticosteroids in improving mouth opening., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Oral submucous fibrosis (OSF), a common disease in South Asia, is a chronic disorder, and there is a lack of proper scientific understanding about many aspects of the disease. Carcinogenesis in the background of dense fibrosis is considered the most significant aspect of the disease that needs investigation, as the transformation rate is also remarkable compared with other oral potentially malignant disorders. Verrucous growths are a common finding in patients with OSF. We highlight a group of patients who presented with clinically malignant verrucous growths. However, despite the highly suspicious clinical appearance, there was no histologic evidence of invasion. This subgroup of patients with OSF and the inability of the lesion to invade the underlying corium need to be investigated., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The regions of Durham and York in Ontario, Canada have partnered to construct an energy-from-waste thermal treatment facility as part of a long term strategy for the management of their municipal solid waste. This paper presents the results of a comprehensive human health risk assessment for this facility. This assessment was based on extensive sampling of baseline environmental conditions (e.g., collection and analysis of air, soil, water, and biota samples) as well as detailed site specific modeling to predict facility-related emissions of 87 identified contaminants of potential concern. Emissions were estimated for both the approved initial operating design capacity of the facility (140,000 tonnes per year) and for the maximum design capacity (400,000 tonnes per year). For the 140,000 tonnes per year scenario, this assessment indicated that facility-related emissions are unlikely to cause adverse health risks to local residents, farmers, or other receptors (e.g., recreational users). For the 400,000 tonnes per year scenarios, slightly elevated risks were noted with respect to inhalation (hydrogen chloride) and infant consumption of breast milk (dioxins and furans), but only during predicted 'upset conditions' (i.e. facility start-up, shutdown, and loss of air pollution control) that represent unusual and/or transient occurrences. However, current provincial regulations require that additional environmental screening would be mandatory prior to expansion of the facility beyond the initial approved capacity (140,000 tonnes per year). Therefore, the potential risks due to upset conditions for the 400,000 tonnes per year scenario should be more closely investigated if future expansion is pursued., (© 2013.)