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Background: Panoramic radiography is a routinely advised extraoral radiograph in a dental practice due to its diverse implications in the field of oral and maxillofacial diagnosis. The visibility of normal structures in the panoramic radiographs is of paramount importance as their margins should be delineated clearly from pathological structures that will aid in the correct diagnosis and treatment planning. Aims and Objective: The study aimed to compare the subjective image quality of selected anatomical landmarks on CCD-based panoramic images with and without processing. The objective was to highlight the importance of processed images, which are frequent in day-to-day practice. Materials and Methods: The study comprised 60 subjects with a complete complement of permanent teeth excluding third molars. Selected subjects were clinically examined, and a digital panoramic examination was done. The radiograph obtained was assessed for the subjective image analysis based on the visibility of six major anatomical landmarks using a 3-point scale, and the overall image assessment was done using a 4-point scale. The data was tabulated for statistical analysis. Results: Digital panoramic radiographs with post-processing showed superior visibility with regard to the six anatomical landmarks as well as for overall image assessment which was found to be statistically significant (P

Optical coherence tomography (OCT) is a non-invasive, real time diagnostic modality that enables detection of oral lesions at an early, relatively harmless stage with improved resolution. OCT gives quantitative and qualitative information of hard and soft tissue by providing a cross-sectional ′optical biopsy′ of tissue up to 3 mm in depth from the surface. In the present scenario, OCT has emerged as one of the forefront imaging modality because of the wide variety of information and the three dimensional (3D) data it can provide. This article focuses on the basic sciences of OCT with its potential dental applications

Angioleiomyomas are vascular variant of leiomyomas which are benign tumors of smooth muscle. They are exceedingly rare in the oral cavity. Malignant transformation of these tumors has also been reported occasionally which warrants knowledge of this soft tissue tumor. A 57 year old male patient reported with a 15 day history of an asymptomatic growth that had started insidiously in his lower left back tooth region. Clinical examination revealed a solitary, oval, sessile growth in the mandibular left retro molar region. Excisional biopsy was suggestive of Angioleiomyoma. A recurrence of the same was noted two months later which was also histopathologically reported as Angioleiomyoma. The same was confirmed using special stains. This case reports an unusual presentation of Angioleiomyoma with regards to both recurrence as well as rapid growth. It is important to be well aware of this uncommon entity as these tumors often can mimic or transform into malignancy. Precise clinicopathological examinations are therefore invaluable in establishing an accurate diagnosis and delivering suitable treatment.

Background and Objective: Digital photo stimulable phosphor (PSP)-based radiography has many known theoretical advantages over conventional film radiography but its diagnostic efficacy has to be assessed clinically. This study compared the efficiency of conventional film-based panoramic radiographs with that of digital PSP-based panoramic radiographs in the assessment of position and morphology of impacted mandibular third molars. Materials and Methods: We selected a total of 80 impacted mandibular third molars that fulfilled the inclusion and exclusion criteria of this study. Both conventional film-based panoramic radiographs and digital PSP-based panoramic radiographs were taken of all the study samples and the teeth were later surgically removed. Conventional film-based and digital PSP-based panoramic radiographs were compared for their relative efficiencies in the assessment of impaction status, position of tooth, number of roots, root morphology, and proximity to mandibular canal of impacted mandibular third molars. An oral surgeon graded these same factors during/after surgical exploration and this assessment was considered the gold standard. The data obtained were statistically analyzed using descriptive statistics, chi-square test, and McNemar′s test. Results: There was no statistically significant difference between conventional film-based radiographic assessment and digital PSP-based panoramic radiographic assessment of impaction status, position of tooth, number of roots, and proximity to mandibular canal of impacted mandibular third molars (P>0.05). However, there was significant difference between the two methods with regard to assessment of root morphology of impacted mandibular third molars (P=0.00). Interpretation and Conclusion : Conventional film-based panoramic radiographs and digital PSP-based panoramic radiographs were comparable in their accuracy in the preoperative study of impacted mandibular third molar with regard to impaction status, tooth position, number of roots, and proximity to the mandibular canal. Digital PSP-based panoramic radiographs were more accurate than conventional film-based panoramic radiographs in the assessment of root morphology of impacted mandibular third molars. Hence, we conclude that digital PSP-based panoramic radiographs can be used as an effective alternative to conventional film-based panoramic radiographs for assessment of position and morphology of impacted mandibular third molars.

Objectives: To assess the reliability of ultrasonography as a diagnostic aid for diagnosis of swellings in orofacial region. Study design: The study consisted of 40 patients with orofacial swellings, and all these patients were subjected to clinical, ultrasonographical and histopathological examination and respective diagnoses were obtained. Ultrasonographic diagnosis correlated with clinical and histopathological examinination. Chi-square test and contingency coefficient tests were used for statistical evaluation. Results: A significant association was observed between clinical and ultrasonographic diagnoses (contingency = 0.938 and p< 000) and between ultrasonographic and histopathological diagnoses (contingency = 0.943 and p< 000). Conclusion: Ultrasonography revealed as a valuable adjunct in the diagnosis of orofacial swellings.

Osteochondroma, also known as osteocartilaginous exostosis, is a benign cartilage capped outgrowth attached to the underlying skeleton by a short stalk. Osteochondroma is frequently seen in the axial skeleton but rarely occurs in the craniofacial skeleton. We report a case of osteochondroma arising from the right mandibular condyle.

Rendu-Osler-Weber syndrome is a rare genetic condition characterized by mucocutaneous and visceral fibrovascular dysplasia leading to multiple macular or papular vascular lesions of skin, mucosal surfaces and occasionally viscera that show tendency towards hemorrhage. The orofacial features of the condition in an affected family and in particular a 33-year-old Indian male patient, are illustrated along with summarization of management aspects in a dental setup.

Cherubism is a non-neoplastic, rare, hereditary childhood disease of bone characterized by bilateral enlargement of the jaws caused by bone degradation and replacement by fibrous tissue. The affected child is reminiscent of the cherub portrayed in Renaissance art. We report the clinicopathological and radiographic features of cherubism and review of literature.

Mucoepidermoid carcinoma is a malignant epithelial tumour of the salivary glands. It is an unusual type of a tumour in that it varies in its aggressiveness from a low-grade slow growing to high-grade rapidly growing behaviour. Low grade mucoepidermoid carcinomas maybe masqueraded in their clinical presentation, thus need to be looked at with a suspicious eye. We present two intraoral cases of this unique tumour.

Odontomas are the most common non-cystic odontogenic lesions representing 70% of all odontogenic tumors. Often small and asymptomatic, they are detected on routine radiographs. Occasionally they become large and produce expansion of bone with consequent facial asymmetry. We report a case of such a lesion causing expansion of the mandible in an otherwise asymptomatic patient.

Drug abuse is a growing trend, with people in every walk of life and at every economic level abusing drugs. Prescription drugs are those that are both legal and sanctioned by doctors. Most of these drugs are accurately labeled so those who want to use them to get ′high′ know exactly what is in them. Among the various known routes of prescription drug abuse, snorting, smoking and oral use of drugs are the ones that concern us the most because of their possible oral clues. The patient may present to us with a complaint of dry mouth or a characteristic pattern of caries or even perforation of the palate. Drug abusers are known to be psychologically unstable and often do not disclose the habit and tend to fake symptoms as well. It thus becomes a highly challenging task for the oral diagnostician to recognize such lesions and correlate them to the abuse of drugs. Also, extreme caution should be taken while prescribing drugs with a potential for abuse.

Interferons are a family of proteins and glycoproteins that have a variety of biologic actions. Interferons were first discovered in 1957 and several clinical trials have been conducted since then to unravel the action and clinical applications of different types of interferons. This paper reviews the mechanism of action and clinical uses of different types of interferons.

The bifid mandibular condyle has also been termed as Double Headed Condyle or Condylar Duplication. Bifid condyle was first reported by Hrdlicka in 1941. Since then, to the best of our knowledge, about 49 cases of bifid condyle have been reported in medical literature. We present here six cases of bifid mandibular condyle that we encountered during the span of one year. These were incidental findings on panoramic radiographs and were later confirmed with coronal computed tomographs. This article also reviews the relevant literature.

Amyloidosis is a rare disease of unknown origin characterised by extracellular deposition of fibrillar proteinaceous substance called amyloid having common morphological, structural and staining properties but variable protein composition. Oral manifestations have been reported in 39% of patients with amyloidosis and it manifests frequently as macroglossia. A rare case of Primary Systemic Amyloidosis presenting as Macroglossia in a patient with no known antecedent or coexistent disease is being presented and discussed.

Histoplasmosis is a granulomatous fungal disease caused by the dimorphic fungus Histoplasma Capsulatum, which was first described by Samuel Darling of Panama in 1905. The clinical presentation of Histoplasmosis is varied, ranging from the more common asymptomatic form to the rare and potentially fatal disseminated form. The disseminated form usually occurs in infants, elderly and immunocompromised individuals including those infected with HIV Oral lesions of Histoplasmosis are quite rare. When encountered, they are usually found in association with the disseminated form of the disease. However cases of isolated Oral Histoplasmosis without systemic or pulmonary involvement have also been reported. Here we report one such case of isolated Oral Histoplasmosis occuring in a 28 year old HIV infected male who visited the Department of Oral Medicine & Radiology, J.S.S. Dental College & Hospital, Mysore.

Heck′s Disease also termed as Focal Epithelial Hyperplasia is an uncommon benign oral condition characterized by multiple circumscribed, sessile, soft, elevated nodules having the same colour as the oral mucosa. It occurs commonly in younger individuals of certain racial groups. A case of Heck′s Disease manifesting in a 5 year old male Tibetan refugee child in India is presented and discussed.

Background: Morphometric analysis of teeth on radiographs for age estimation are considered to be simple, reliable and non-invasive. The aim of this study was to analyse the efficacy of tooth coronal index (TCI) to estimate age in Indian population and to assess the influence of diet and masticatory habit on TCI. The study comprised of 160 subjects in the age range of 21-71 years, categorized into groups based on chronological age, gender, diet and masticatory habit. Coronal Height (CH) and Coronal Pulp Cavity Height (CPCH) of permanent mandibular first molars was measured on digital panoramic radiographs using Planmeca Romexis software measurement tools. TCI was calculated using the formula: TCI= (CPCH ×100)/CH. Statistical analysis was performed, ANOVA and Pearson correlation was applied along with regression analysis to obtain an estimated age using TCI. Results: A negative correlation was obtained between the chronological age and TCI. Three-way ANOVA exhibited a significant difference in TCI within the age groups and dietary groups (p value = <0.05). There was no significant difference within the sexes, sides and masticatory groups. The most precise estimated age using the regression formula was in individuals between 31 – 40 years with an error of +/- 5 years in 55% of females, 65% of males. Conclusions: This study suggests that although TCI is a good predictor of age, it is most suitable to determine age of individuals between 31-40 years with the least error in estimation. This study also throws a light on the influence of diet on TCI. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to assess the reliability of age estimation using the radiographic visibility of periodontal ligament surrounding the roots of completely erupted mandibular 3rd molar. Materials and Methods: Visibility of periodontal ligament was assessed in completely erupted mandibular third molars, in a sample of 135 panoramic radiographs, of which 55 belonging to females and 80 to males, from a Mysore population aged 18to 32 years. A classification of four stages based on the visual phenomenon of disappearance of the periodontal ligament of fully mineralized third molars was used. For each stage, mean, standard deviation, minimal & maximal age were assessed. Results: The relationship between age and stage of periodontal ligament had a statistical significance for both sexes.In this population, stage 1 can be used for predictability of age above 19 years and stage 3 for predictability of age above 23 years. No significant correlation exists between periodontal ligament visibility and gender of the individual. Conclusion: This technique is advocated for determining age above 19 years as it is a relatively simple and reliable method. Differences exist in different ethnicities demanding specific population standards. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to establish if any correlation exists between individual’s chronological age and lambdoid sutures closure status in mortals through modified reverse panoramic radiograph. Materials and Methods: Total number of 140 subjects, 10 years and beyond were included in the study, and divided into seven groups with an age interval of 5 years. Assessment of lambdoid suture closure was done according to Frederic Rating Scale on modified reverse panoramic radiographs. Data obtained was subjected to statistical analysis using Cramer’s V test. Results: A significant correlation was observed between the age group and suture closure. Cramer’s test gave value of 0.000, and was interpreted as a good correlation between the age and suture closure status with a P value of <0.05 Conclusion: Lambdoid suture can be very effective and reliable practical tool for age assessment in mortalsthrough modified reverse panoramic radiography (ectocranially). [ABSTRACT FROM AUTHOR]

Intraoral schwannomas are uncommon and intraosseous ones are even rarer. The intrabony lesions account for less than 1% of the central neoplasms. According to the literature, there have been reports of 44 cases of intrabony neurilemmomas that occurred in either of the jaws. In theis case report. we report a case of central schwannoma of the mandible in a 23-year-old female, who presented with a swelling involving the right body of the mandible. Radiographs revealed a well defined, unilocular radiolucency with bicortical expansion. Histopathology and immunohistochemistry confirmed the diagnosis of schwannoma arising from right inferior alveolar nerve. The lesion was treated by segmental resection and reconstructed with autogenous iliac bone graft. [ABSTRACT FROM AUTHOR]

Burkitt's lymphoma (BL) is a rare monoclonal proliferation of B-lymphocytes and is classified as a poorly differentiated lymphocytic lymphoma. This tumor was first noted in Africans. The cause of this tumor is debatable, but strong evidence implicates Epstein-Barr virus in its development. This tumor predominantly affects children and is probably the fastest growing tumor in humans, with exuberant proliferation. It is a very rare malignancy accounting for only 0.76% of solid malignant tumors among Indian children. A case of BL of the mandible in a 9-year-old girl of Indian origin is reported. [ABSTRACT FROM AUTHOR]

Objectives: To compare and analyze the perceived clarity and diagnostic value of Conventional periapical Radiographs (CRs) with those of their Digitized Periapical Images (DIs) and Processed Digitized Periapical Images (PDIs) counterparts., Material and Methods: Forty two intraoral periapical radiographs of patients with clinically suspected periapical pathosis were made to constitute the group of CRs. These were photographed by using a Canon Power Shot SD500 (7.1 Megapixel) digital camera and the unaltered images were transferred to a computer laptop, to form the group of DIs. Subsequently, the contrast and brightness of these images were modified to represent the group of PDIs. Two experienced oral radiologists independently evaluated 5 specific apical and periapical region parameters of all the 42 CRs, DIs and PDIs for perceived image quality and diagnostic value and graded them on a three point grading scale. Conventional radiographs served as the control. Data were analyzed by using paired t-test and Kappa analysis., Results: The clarity and diagnostic quality of the PDIs were statistically significant as compared to those of their conventional counterparts. In comparison, the DIs group fared badly, with deterioration of the image quality. The interobserver agreement was good and all the results were statistically significant., Conclusion: Indirectly digitizing the radiographs by employing a digital camera and further digitally processing the images resulted in an improvement in their perceived clarity and they enhanced their diagnostic properties.