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Objectives: This study was aimed at determining the specific signs of close relationship between impacted mandibular third molar (IMTM) root and inferior alveolar nerve (IAN) canal as visualised on digital panoramic radiograph or orthopantomograph (OPG) which should indicate as well as contraindicate the need for cone beam computed tomography (CBCT) imaging based on hierarchical model of Fryback and Thornbury. Materials and Methods: The sample consisted of 120 individuals (200 IMTM) who had undergone OPG as well as CBCT imaging as preoperative radiographic evaluation before surgical extraction. On panoramic radiographs; Rood and Sheehab's radiographic signs of IMTM root and IAN canal, impacted third molar position based on Winter's classification and depth of impaction based on Pell and Gregory's classification were evaluated. On CBCT; presence/absence of corticalization and the status of the buccal and lingual cortices (thinning/perforation) were evaluated. These findings of OPG were compared to CBCT findings to determine the better modality based on hierarchical model of Fryback and Thornbury. Results: Statistically significant association was found between radiographic signs of Rood and Sheehab such as 'no relation' and 'superimposition' on OPG and presence of corticalization between IMTM root and IAN canal on CBCT. Statistically significant association was also found between 'mesioangular' and 'vertical' positions of Winter's classification as well as 'class 1A' of Pell and Gregory's classification of IMTM on OPG and presence of corticalization on CBCT. CBCT was found to be having lesser variance and greater F value as compared to OPG for evaluation of IMTM. Conclusions: On OPG; Rood and Sheehab's radiographic signs such as 'no relation' and 'superimposition', Winter's 'mesioangular' and 'vertical' and Pell and Gregory's 'Class 1A' are not indicative for CBCT examination before surgical extraction is attempted. On OPG; Rood and Sheehab's radiographic signs such as interruption of white line, darkening of root, darkening of canal, deflection of root, narrowing of canal as well as diversion of canal are all frequently associated with absence of corticalization between IMTM root and IAN canal and hence require CBCT examination before surgical extraction is attempted so that post-operative neurological complications can be minimised. Also, Winter's horizontal, distoangular and others as well Pell and Gregory's classes 1B,1C,2A,2B,2C,3A,3B,3C are indicative for CBCT examination before surgical extraction is attempted. Fryback and Thornbury model-based comparison proves that CBCT is a better radiographic modality as compared to OPG for evaluation of IMTM relation with IAN canal.

Context: Saliva performs multiple functions and is of paramount importance for the maintenance of oral health. Hence, alterations in its physical properties like salivary flow rate, buffering capacity and pH can be deleterious to the oral cavity. Areca nut and smokeless tobacco products are known to alter the mucosa as well as the saliva. Aims and Objectives: The study is aimed to compare the alteration in the salivary properties like stimulated salivary flow rate, pH, and buffering capacity between subjects with areca nut and smokeless tobacco habit and without in subjects without habit. A correlation between the habit frequency, duration, and exposure on the same parameters was also ascertained. Settings and Design: It is a comparative study using purposive sampling, comprising of 100 subjects within age group 18–50 years of any gender. The sample size constituted of 50 subjects (group A) with a habit of areca nut and smokeless tobacco and 50 subjects (group B) without any habit. Salivary properties like salivary flow rate, buffering capacity, and pH were analyzed in both groups to test a hypothesis that the habit results in changes in the salivary properties and that there is a correlation between the changes and the frequency, duration, and exposure of the habit. Materials and Methods: Saliva samples were collected from these subjects for analysis of salivary flow rate (SFR), pH, and buffering capacity using the GC Saliva Check Buffer Kit™. Statistical Analysis Used: Data were analyzed by using the SPSS software program, version 27.0. Results: The mean stimulated salivary flow rate among group A was 3.34 ± 1.32 and pH was 6.50 ± 0.54. The mean stimulated salivary flow rate among group B was 4.42 ± 1.48 and the pH was 7.04 ± 0.47. The difference in these values was found to be statistically significant. Conclusion: Alterations in SFR and salivary pH and buffering capacity are observed in habitual chewers of areca nut alone and areca nut with other products. The alteration is dependent on the type of habit and the habit exposure frequency and duration.

Introduction: Oral cancer is one of the ten most common causes of mortality in developing countries like India. A micronucleus (MN) is a small extra nucleus separated from the main one, generated during cellular division by late chromosomes or by chromosome fragments. Micronucleus is a potential biomarker for malignancy. Aim and Objectives: The study attempts to analyze micronuclei in buccal smear from patients with tobacco and related habits; and to determine its reliability as a biomarker for carcinogenesis. Study Design: A total of 400 consisting of normal subjects, patients with potentially malignant lesions and patients with malignant lesions were included in the study. Oral exfoliated cells were collected by scrapings of buccal mucosa of both control and study groups with a tooth brush. The scrapings collected from right and left buccal mucosa of each subject were studied under two separate slides. A total of 500 cells were examined from each slide. All the micronucleus cells located on each slide were examined again under the 100X magnification. Results: The P value for intergroup difference in average number of micronuclei in cells of buccal mucosa among all groups was <0.001 which was highly significant. The P value for micronucleated cells of buccal mucosa among all groups was <0.001 which was highly significant. Conclusion: A stepwise increase in MN counts from normal to potentially malignant to carcinoma suggested a link of this biomarker with neoplastic progression. Micronuclei can be used as a biomarker for early detection of premalignant and malignant lesions of the oral cavity.

The diagnosis between different diseases may be impaired by clinical and histopathologic similarities, as observed in the oral lichen planus (OLP) and oral lichenoid lesion (OLL). Inspite of similar clinicopathological features; etiology, diagnosis and prognosis differ which mandates separation of OLL from OLP. Hence, it is essential for the oral physician and oral pathologist to be familiarized with the individual variations among clinicopathological features of OLP and OLL as well as to obtain a thorough history and perform a complete mucocutaneous examination in addition to specific diagnostic testing. The difficulties faced to establish the diagnosis between these two pathologies are widely investigated in the literature with a lack of definite conclusion. This review is an attempt to throw some light on these clinicopathologic entities with the aim to resolve the diagnostic dilemma.

Background and Aims: Replacing missing teeth is one of the most common challenges faced by the dental surgeon. The invention of dental implants has brought about a great change in successfully delivering a fixed prosthesis to the patient. Precise radiographic assessment of available alveolar bone is of prime importance for dental implant placement. Panoramic radiograph provides an overview of the jaw bones and is considered adequate in the initial evaluation of the implant site; however, they do not provide the buccolingual dimension of the implant site. CBCT provides volumetric imaging with the ability to visualize the imaged region in virtually any plane. The objective of this study was to compare panoramic radiography (OPG) with cone-beam computed tomography (CBCT) for pre-surgical implant site evaluation. Materials and Methods: A total of 150 potential implant sites in 94 patients who were subjected to OPG and CBCT imaging previously were selected for the study. The height, width, and length of the available bone were measured for all the implant sites (except bone width which was measured on CBCT alone). Out of these, OPG & CBCT findings of 60 potential implant sites were evaluated by comparison with the surgical gold standard dimensions of actual dental implant placed. A comparison of all the values obtained with the two imaging modalities was done and the data was tabulated for statistical analysis. Results: The mean value of bone height using OPG and CBCT were found to be 12.15 mm and 11.99 mm, respectively. The mean value of the length of the edentulous jaw segment using OPG and CBCT was found to be 8.10 mm and 8.98 mm respectively. The mean value of the width of the crestal bone below the height of the crest using CBCT was found to be 5.46 mm. Conclusion: The overall results suggested that CBCT is better in depicting the bone height and bone width as compared to OPG; however, the length of the edentulous jaw segment is better depicted by OPG as compared to CBCT.

Introduction: Stature is the height of a person in the upright posture. Based upon the principle that the various long bones correlate positively with stature, stature correlation to skull and jaw dimensions has been frequently reported among various populations. Objective: The study was conducted to investigate the possibility of predicting the height of an individual using selected odontometric parameters as a forensic tool. Materials and Methods: The study sample consisted of 100 randomly selected subjects. Measurements of maxillary intercanine width (IC), maxillary interpremolar width (IP), and mesiodistal width of six permanent maxillary anterior teeth (CW) were made directly on the subject by means of a digital vernier caliper. Height (H) of patients was measured with anthropometer. Results: Significant correlation was observed between height and maxillary IC width (P < 0.05), whereas correlation between height and the combined width of six anterior teeth as well as IP width was found to be nonsignificant. Conclusion: The maxillary IC width can be used successfully to calculate the stature of an individual from fragmentary remains.

Introduction: Panoramic radiography is frequently used for dental diagnosis and treatment planning. While smallest radiation exposure also being harmful to patients, every attempt must be made to reduce it as much as possible. Aims: The aim of the study was to assess effects of dose reduction on image quality of panoramic radiographs. Materials and Methods: The sample of 75 patients was selected from the patients coming at the outpatient department of the institute. Two panoramic radiographs were taken for each patient. A total of 150 panoramic radiographs were taken which were evaluated by two blinded observers for image quality. Results: Statistically nonsignificant difference was found between the image qualities of radiographs of the same patient with recommended exposures and those with altered exposure. Conclusion: Dose reduction did not cause significant loss of image quality using digital panoramic radiography machine when the dose was reduced by 36% by decreasing exposure time only.

Oral submucous fibrosis (OSMF), a precancerous condition, is highly prevalent in the Indian subcontinent. Among many trace elements, copper and iron are required for the functioning of numerous enzymes. The biochemical alterations of these trace elements in the serum of patients with premalignant conditions can help in determining the staging of the disease, its appropriate treatment and as an indicator for prognosis. The objective of the study was to evaluate the role of iron and copper as well as to identify the better predictor of the two in the diagnosis and progression of OSMF. The study sample consisted of 150 patients, out of which the cases group consisting of 100 OSMF patients and control group consisting of 50 individuals. All the cases were confirmed of having OSMF by histopathological examination. The blood sample was obtained from all 150 patients and evaluated by digital autoanalyzer photometer for serum level of copper and iron by the colorimetric method. The results obtained for cases and controls were compared by statistical analysis. The mean serum copper level increases while the mean serum iron level decreases with the advancement in the severity of clinical and histological stages of OSMF. Biopsy is the gold standard to diagnose OSMF, but it is an invasive and time-consuming technique. However, nowadays, many recent advances are used to diagnose OSMF at an early stage and reduce its progression into late and reversible stages. The trace elements serve as potential prognostic and diagnostic markers for OSMF patients.

Background and Aims: Replacing missing teeth is one of the most common challenges faced by the dental surgeon. The invention of dental implants has brought about a great change in successfully delivering a fixed prosthesis to the patient. Precise radiographic assessment of available alveolar bone is of prime importance for dental implant placement. Panoramic radiograph provides an overview of the jaw bones and is considered adequate in the initial evaluation of the implant site; however, they do not provide the buccolingual dimension of the implant site. CBCT provides volumetric imaging with the ability to visualize the imaged region in virtually any plane. The objective of this study was to compare panoramic radiography (OPG) with cone-beam computed tomography (CBCT) for pre-surgical implant site evaluation. Materials and Methods: A total of 150 potential implant sites in 94 patients who were subjected to OPG and CBCT imaging previously were selected for the study. The height, width, and length of the available bone were measured for all the implant sites (except bone width which was measured on CBCT alone). Out of these, OPG & CBCT findings of 60 potential implant sites were evaluated by comparison with the surgical gold standard dimensions of actual dental implant placed. A comparison of all the values obtained with the two imaging modalities was done and the data was tabulated for statistical analysis. Results: The mean value of bone height using OPG and CBCT were found to be 12.15 mm and 11.99 mm, respectively. The mean value of the length of the edentulous jaw segment using OPG and CBCT was found to be 8.10 mm and 8.98 mm respectively. The mean value of the width of the crestal bone below the height of the crest using CBCT was found to be 5.46 mm. Conclusion: The overall results suggested that CBCT is better in depicting the bone height and bone width as compared to OPG; however, the length of the edentulous jaw segment is better depicted by OPG as compared to CBCT.

Apert's syndrome (AS), a form of acrocephalosyndactyly, is a rare congenital disorder with autosomal dominant mode of transmission; characterized by craniosynostosis, midface hypoplasia, and syndactyly of hands and feet. The rarity of the syndrome and similarity of features with other craniosynostosis syndromes makes it a diagnostic dilemma. Genetic counseling and early intervention form an essential part of treatment. Because of the paucity of reported cases in Indian literature and typical features in oral cavity, a dentist should be competent to diagnose and form a part of the multidisciplinary management team. Here, we report a case of a 14-year-old boy with AS.