Journal of Indian Academy of Oral Medicine and Radiology

From the desk of the business manager Rama Raju Devaraju Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):337-337

Correlation of blood glucose level in gingival crevicular blood and finger capillary blood using glucometer Supreet Jain, Mathod C Shashikanth, Jaideep Sur, Fatima Khan, Sheetal Mujoo, Deeplaxmi Dewangan Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):338-342 Aim: The aim of the study was to assess the reliability of gingival crevicular blood (GCB) glucose level compared with finger capillary blood (FCB) glucose level using a glucose self-monitoring device (Contour ® TS). Materials and Methods: One hundred randomly selected patients with gingivitis (45 subjects) and periodontitis (55 subjects) were included in the study. The mean age of the study group subjects was 35.39 ± 11.97 years (range 17-70 years). The blood glucose values obtained from GCB elicited during routine periodontal probing and those of peripheral finger stick blood glucose were recorded using a glucose self-monitoring device (glucometer) during fasting and postprandial phases. Statistical analysis was done using Student's "t" test and Karl Pearson's product moment correlation. The regression analysis was then performed to compare the GCB and FCB blood glucose readings using the approach of Bland and Altman. Results: There was no statistically significant difference (t = 1.443, P = 0.152) between the fasting GCB and FCB glucose values, but it was significant during postprandial measurement (t = 6.893, P < 0.001). Pearson's correlation showed a positive correlation between the two measurements (r = 0.893, P < 0.001). Bland-Altman regression analysis revealed sufficient agreement between the two values. Conclusion: The results suggest that GCB collected during diagnostic periodontal examination may be an excellent source of blood for glucometric analysis. Thus, it can be used as a chairside investigative procedure.

A study on the radiographic features of jaws and teeth in patients with thalassemia major using orthopantomograph Neera Ohri, Mubeen Khan, Nikita Gupta, Garima Bhatt, Parul Malhotra, Abhishek Ranjanpati Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):343-348 Aims and Objectives: Thalassemia is the most common gene disorder caused by mutations that decrease the rate of synthesis of α- or β-globin chains. Every year approximately 100,000 children with thalassemia major are born the world over, of which 10,000 are born in India. This study aimed to compare the radiographic findings of jaws and teeth, as well as crown body and root lengths of the mandibular first permanent molar in thalassemia major patients. Materials and Methods: Panoramic radiographs of 50 thalassemia major patients and 50 controls were made. The radiological changes in the jaws and teeth and the dimensional changes in the teeth were evaluated and compared between the two groups. Two observers were involved in evaluating the specific changes and findings were subjected to statistical analysis using chi-square test (χ2 ) test. Differences in crown body height, root length, and crown:root (C:R) ratio were found using independent t-test. Results: A significant difference was found between the two groups in the occurrence of short spiky roots, taurodontism, faint lamina dura, large bone marrow spaces, obliteration of maxillary sinus (haziness), indistinct inferior alveolar canal, thin mandibular cortex (P < 0.001), nutrient canals (P < 0.02), and between mean crown body and root values of the two groups (P < 0.05). However, there was no statistically significant difference in prominent antegonial notch (P = 0.860) and C:R ratio (P = 0.989). Conclusion: Taurodonts, short spiky roots, thin mandibular cortex, enlarged bone marrow spaces, and obliterated maxillary sinuses were found to occur with high frequency in thalassemia major, followed by indistinct inferior alveolar canal and attenuated lamina dura.

Estimation of serum antioxidant enzymes in histopathological grades of oral leukoplakia, oral submucous fibrosis, and oral cancer: A clinicopathologic study Shalu Rai, Akshay Sharma, Vikash Ranjan, Deepankar Misra, Sapna Panjwani Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):349-353 Introduction: This study was undertaken to assess the levels of malondialdehyde (MDA), superoxide distmutase (SOD), beta carotene, and vitamin E in oral submucous fibrosis (OSMF), oral leukoplakia (OL), and oral cancer patients. Though several studies have been done on the levels of antioxidants in these disorders, there are very few available reports in patients with various histological staging of these disorders. Materials and Methods: Blood samples were collected from 40 patients who were divided into three groups: Group I as control with 20 normal individuals, group II with histopathologically confirmed different stages of OSMF and OL, and group III with histopathologically confirmed different stages of oral squamous cell carcinoma (OSCC). Standard methods for estimation of serum values were used and statistical comparisons were performed using SPSS software 16.0 version and the level of significance was calculated. Results: The mean levels of vitamin E, beta carotene, MDA, and SOD among Group I subjects were 9.89 ± 0.75, 112.10 ± 11.97, 2.92 ± 0.36, and 189.45 ± 14.17, respectively. In group II patients with OL having mild dysplasia, serum vitamin E, beta carotene, MDA, and SOD levels were found to be 7.89 ± 0.87, 70.75 ± 2.82, 9.89 ± 0.92, and 119.63 ± 24.97, respectively. In moderate dysplasia, these values were 7.16 ± 0.55, 69.80 ± 5.54, 10.56 ± 0.46, and 115.20 ± 23.03, respectively. Serum vitamin E, beta carotene, MDA, and SOD levels were 7.70 ± 0.57, 70.50 ± 3.54, 9.81 ± 0.11, and 115.00 ± 8.49, respectively, in grade I OSMF and 7.32 ± 0.29, 69.67 ± 3.43, 9.76 ± 0.38, and 113.67 ± 8.32, respectively, in grade II OSMF. In group III patients with well-differentiated squamous cell carcinoma (WDSCC), serum vitamin E, beta carotene, MDA, and SOD levels were 7.01 ± 0.36, 64.32 ± 3.42, 12.98 ± 0.67, and 59.22 ± 4.01, respectively, and in patients with moderately differentiated squamous cell carcinoma (MDSCC), the values were 6.54 ± 0.41, 61.87 ± 2.03, 13.34 ± 0.42, and 58.43 ± 2.26, respectively. The P-value was calculated and the results were highly significant. Conclusion: A decrease in the levels of antioxidants like beta carotene, vitamin E, and SOD and an increase in MDA level in these disorders have been previously reported in the literature.

Fractal analysis in oral leukoplakia Prashant Bhai Pandey, Srinivas Kandakurti, Vasu S Saxena, Payal Tripathi, Ratnakar Pamula, Monu Yadav Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):354-358 Introduction: Fractal analysis (FA) quantifies complex geometric structures by generating a fractal dimension (FD), which can measure the complexity of mucosa. FA is a quantitative tool used to measure the complexity of self-similar or semi-self-similar structures. Aim and Objective: The study was done to perform the FA of oral mucosa with keratotic changes, as it is also made up of self-similar tissues, and thus, its FD can be calculated. Results: In oral leukoplakia, keratinization increases the complexity of mucosa, which denotes fractal geometry. We evaluated and compared pretreated and post-treated oral leukoplakia in 50 patients with clinically proven oral leukoplakia and analyzed the normal oral mucosa and lesional or keratinized mucosa in oral leukoplakia patients through FA using box counting method. Conclusion: FA using the fractal geometry is an efficient, noninvasive prediction tool for early detection of oral leukoplakia and other premalignant conditions in patients.

Efficacy of scintigraphy as a diagnostic aid in oral and maxillofacial pathologies: A comparative radionuclide-radiographic study Ankur Singh, Nitin Agarwal, Kamala Rawson, Basavaraj N Kallalli, Abhishek Sinha, Yatriben Sandesara Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):359-365 Aims and Objectives: The aim of this study was to investigate various lesions involving the oral and maxillofacial region by using scintigraphy and to compare the findings with those of conventional radiograph. Materials and Methods: Nineteen subjects of all age groups and both sexes who reported to the outpatient department of Oral Medicine and Radiology and had been clinically diagnosed with diseases of oral and maxillofacial region were selected. Conventional radiography and scintigraphy were performed for all the subjects. Biopsy and histopathological investigations were preformed to confirm the diagnosis and on the basis of which sensitivity, specificity, positive predictive value, and efficiency of conventional radiography and scintigraphy were evaluated. Results: Conventional radiography was found to have 94.11% sensitivity, 50% specificity, 94.11% positive predictive value, and 89.47% efficiency. Scintigraphy was found to have 100% sensitivity, 14.28% specificity, 66.66% positive predictive value, and 68.42% efficiency. Conclusion: Scintigraphy is a very sensitive diagnostic aid, but lacks in specificity. Conventional radiography, on the other hand, has good sensitivity and relatively better specificity. For a proper diagnosis, scintigraphic findings must be correlated with clinical, radiological, and histopathological findings.

Correlation of morphological variants of soft palate and types of malocclusion: A digital lateral cephalometric study Deepak Samdani, Anjali Saigal, Esha Garg Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):366-371 Aims and Objectives: The morphology of soft palate has variable presentations on lateral cephalometry. The aim of our study was to investigate the correlation between various shapes of soft palate and types of malocclusion in different gender groups among North Indian individuals. Materials and Methods: The study sample comprised randomly selected 250 healthy North Indian individuals (125 males and 125 females) seeking orthodontic treatment for malocclusion without any speech abnormality or any other syndromes or diseases and with age ranging from 14 to 28 years. Clinically, in all subjects, the type of malocclusion was examined and categorized according to Angle's classification of malocclusion. The morphological variants of soft palate were also assessed on digital lateral cephalogram and were allocated to one of the six patterns as described by You et al. The differences in the proportion of each type were studied and variation of malocclusion and soft palate morphology between gender groups was also assessed. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate and types of malocclusion in different gender groups. Results: In our study, the frequency of rat tail (37.2%) type of soft palate was seen in highest proportion, whereas the frequency of distorted S-shape (6.80%) was least in both the genders. Angle's class II malocclusion (51.2%) was the most common, followed by class I (43.2%), whereas class III (5.6%) was found to be the least prominent type in both the genders. Patients with Angle's class I malocclusion were most frequently found to have rat tail type soft palate, those with Angle's class II had leaf-shaped soft palate, and those with Angle's class III had crooked shaped soft palate. Angle's class II and class III malocclusions were significantly correlated with soft palate shapes, whereas Angle's class I malocclusion was highly significantly correlated with the shape of soft palate. Conclusion: It was found in our study that there was a significant correlation between variants of soft palate and types of malocclusion.

Determination of salivary flow rate, pH, and dental caries during pregnancy: A study Amruta A Karnik, Sandeep S Pagare, Vasavi Krishnamurthy, Sonal P Vahanwala, Mandavi Waghmare Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):372-376 Introduction: Saliva is an important diagnostic biofluid and the salivary composition is affected by various systemic conditions including pregnancy. Aims: The study was conducted to evaluate the salivary flow rate and pH in pregnant and non-pregnant Indian women and, consequently, to compare and correlate the salivary flow rate, pH, and prevalence of dental caries in both groups. Settings and Design: A cross-sectional study was conducted in our institute on a sample of 30 pregnant and 30 non-pregnant women. Materials and Methods: The clinical findings for Decayed-Missing-Filled Teeth (DMFT) index were recorded. Unstimulated whole saliva was collected to determine the salivary flow rate and pH. Statistical Analysis Used: Data were statistically analyzed using Student's t-test. Results: Salivary flow rate was lower in pregnant women (0.63 ml/min) as compared to that in non-pregnant women (0.81 ml/min) (P < 0.05) and the pH was also lesser in pregnant women (6.56) than in non-pregnant women (6.86) (P < 0.05). DMFT index showed a strong negative correlation with pH in pregnant women and non-pregnant women (P < 0.05). Conclusion: A difference was observed between the salivary parameters of pregnant and non-pregnant women in this sample. However, all the values were within the normal range. A significant inverse relation was found between salivary pH and dental caries for both the groups.

Detection of human papilloma virus (HPV) and human immunodeficiency virus (HIV) in oral squamous cell carcinoma: A polymerized chain reaction (PCR) study Suresh Dirasantchu, Manjula Marthala, Sameeulla Shaik, Raviraj Jayam, Suman Sreeram Venkata, Vijaykumar Bokkasam Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):377-381 Aims and Objectives: Certain strains of human papillomavirus (HPV) have been shown to be etiologically related to the development of uterine, cervical, and other genital cancers, but their role in the development of malignancies at other sites is less well established. Previous studies have shown HPV in tumors of the head and neck, but its prevalence has varied depending on the detection methods and the types of tumor and/or tissue examined. This study was undertaken for the detection of high-risk HPV types 16 and 18 and human immunodeficiency virus (HIV) in oral squamous cell carcinoma. Materials and Methods: Twenty-five patients histologically diagnosed with oral squamous cell carcinoma and 10 apparently normal persons as controls were selected for the present study. Two biopsy specimens were removed surgically by incision biopsy for histopathological examination and polymerized chain reaction (PCR) study. Results: Out of 25 oral squamous cell carcinoma subjects, 8 were found to be HPV positive in PCR. Out of these eight subjects, four had HPV 16 and the other four had other genotypes, and one subject was HIV positive. Conclusion: The conclusion drawn from the present study was that well-defined risk factors like HPV may play a prominent role in the development of oral squamous cell carcinomas, in addition to other risk factors. Further studies with a larger sample size are necessary to arrive at conclusions and to explore the relationship of HPV and HIV in oral squamous cell carcinoma.

Prevalence of oral soft tissue lesions and medical assessment of geriatric outpatients in North India Sameer Rastogi, Pallak Arora, Shalini Kapoor, Sartaj Singh Wazir, Shirin Vashishth, Vandana Sharma Journal of Indian Academy of Oral Medicine and Radiology 2015 27(3):382-386 Introduction: Oral health reflects overall well-being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in old age. Oral health evaluation should be an integral part of the physical examination, and dentistry is essential to qualify geriatric patient care. Aim: To determine the prevalence of oral soft tissue lesions and systemic diseases in institutionalized geriatric population in North India. Materials and Methods: Geriatric patients were clinically evaluated using a standard questionnaire and assessed for known medical illnesses and prevalence of oral soft tissue lesions. Four hundred patients (71% males and 29% females) with age ranging from 60 to 100 years were considered in the study group. Twenty-two (33.8%) patients were edentulous and seven patients (10.8%) were denture wearers. Forty-four (67.69%) patients reported with tobacco habits. Results: Most prevalent medical illness reported was diminished vision (15.5%), followed by hypertension (10%) and diabetes mellitus (6.25%). Several oral soft tissue lesions were reported among the study population. The most prevalent lesions were leukoplakia (12%), smoker's melanosis (10%), smoker's palate (9%), pigmentation on tongue (6%), frictional keratosis (5%), lichen planus (3%), denture stomatitis (2.5%), aphthous ulcers (2%), angular chelitis (1.5%), oral submucous fibrosis (1.5%), melanotic macule (1.5%), candidiasis (1.5%), irritation fibroma (1%), geographic tongue (1%), median rhomboid glossitis (1%), and traumatic ulcer (1%). Conclusion: The findings observed in this population are important and can have a determinant effect on the overall quality of life in this population. This information is a crucial prerequisite for health awareness programs involving the community health workers, oral physicians, and medical professionals.

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