Objective: To know the prevalence three-rooted mandibular first molars in a Saudi Arabian population by using CBCT. Material and Methods: A total of 428 CBCT scans in the database of the College of Dentistry, Jouf University, Kingdom of Saudi Arabia were analyzed. All well-developed permanent mandibular first molars were analyzed for the presence of extra root in three dimensions and the reconstructed volumetric images by two qualified and experienced observers. The total incidence, distribution and comparison regarding gender, bilateral and unilateral appearance, and the side of occurrences of these permanent three-rooted mandibular first molars were analyzed by the Chi-square test. The level of significance was set at 5%. Results: The CBCT scans of 14 subjects had three rooted mandibular first molars with a prevalence of 3.27%. The prevalence in males and females was 2.96% respectively, with no significant differences between genders (p=0.865). The frequency of bilateral three-rooted mandibular first molars was 1.16%, with unilateral frequencies of 1.40% and 0.70% on the right and left sides, respectively. No significant relationship between sides (p=0.981) and the bilateral prevalence of three-rooted mandibular first molars (p=0.668) was observed. Conclusion: Dental practitioners must be aware of the fact that though it is rare, an extra or third root can be present in mandibular first molars and CBCT can aid in accurate diagnosis of the presence of third root.

Malignancy is characterized by anaplasia, invasiveness, and metastasis. Primary oral squamous cell carcinoma is the most prevalent oral malignancy, but secondary malignancy from distant sites have also been reported. Hepatocellular carcinoma (HCC) is a common primary liver malignancy that frequently metastasizes during the course of the disease, but < 1% of cases show oral involvement. Such secondary neoplasms do not have any pathognomonic clinical or radiologic findings, and therefore they pose a diagnostic challenge. Hence, in the differential diagnosis of malignant tumors of the oral cavity, it is essential to consider the occurrence of both primary as well as metastatic tumors despite the low incidence of the latter. A rare case of HCC metastasizing to both the maxilla and mandible is presented, in which the patient succumbed to the disease as a result of the delay in diagnosis.

Objective: To compare the efficacy of oxitard and lycopene in the management of Oral Submucous Fibrosis (OSMF). Material and Methods: 120 subjects with clinicpathologically diagnosed OSMF were included in the study and divided equally in 2 groups, Group A (oxitard) and Group B (lycopene). Group A was administered 2 oxitard capsules twice daily and Group B was given 8 mg lycopene in 2 divided doses of 4 mg for 3 months. Gingival index and plaque index were documented for all patients and compared. Evaluation for different clinical parameters was done at regular intervals and data was analyzed using the Student's paired t test and Chi-square test. P-value <0.001 was considered to be statistically significant. Results: Clinical improvements in mouth opening and tongue protrusion was significant in Group A (p<0.001). Subjective symptoms of pain associated with the lesion (p=0.0001), difficulty in swallowing (p=0.0004) and speech (p=0.0002) significantly improved in the Group A. However, there was no significant improvement in burning sensation (p>0.001) among the 2 groups. Although the mean gingival index and plaque index in group A was reduced but it was found to be not statistically significant. Conclusion: Oxitard capsules can bring about significant clinical improvements in the symptoms like mouth opening, tongue protrusion, difficulty in swallowing and speech and pain associated with the lesion when compared to lycopene, thereby improving the quality of life of the affected individuals.

Background: Oral Mucositis(OM) is an acute debilitating dose limiting toxicity of Radiotherapy/ Radiochemotherapy(RT/RCT) in management of Head and Neck Cancer (HNC). Curcumin/Turmeric may reduce OM in patients. Aim: Efficacy of Curcumin/Turmeric for preventing and ameliorating the onset and severity of RT/RCT induced OM was analysed in this review. Methods: A systematic literature search with meta-analysis were performed using Mesh terms in PubMed, Google scholar, Science Direct, Cochrane library and manual searching, articles published from 2010 to April 2021 were included. Clinical trials that studied the efficacy/effects of turmeric / curcumin in management of RT/RCT induced OM in HNC patients were included. Statistical Analysis were done to calculate the pooled Risk ratio at 95%confidence interval with significance at p <0.05. Results: Nine studies with overall 582 patients with HNC undergoing RT/RCT were included qualitatively. From evidence, orally 1,500-2,000 mg/day of Curcumin/Turmeric, (80mg/day/0.1%mouthwash) of nanocurcumin, topically gel/mouthwash used with increase in frequency prior and the entire course of RT/RCT with long follow ups are beneficial with no serious adverse effects. Meta-analysis of 5 prophylactic trials favoured curcumin/turmeric in reducing the severity of OM (RR 0.48 at 95% CI=0.23,0.99,P=0.05), did not prevent the overall incidence of OM (RR 0.99 at 95%CI=0.95,1.03,P=0.67) but delayed the onset of OM (RR 0.38 at 95% CI=0.18,0.80, P=0.01) during RT/RCT compared to control. Mean mucositis grade (Grade 3) was reduced in curcumin/turmeric with a mean difference of (-0.85 at 95%CI=-1.02,0.67, P<0.00001) over control. Pooling of 2 therapeutic trials favoured Curcumin/Turmeric with significant reduction of pain score at a mean difference of -2.17 at 95%CI =-2.77, -1.58,P<0.00001 over chlorhexidine. Conclusion: Curcumin/Turmeric are safe, efficacious, well tolerated in preventing the delay in onset and severity of OM, therapeutically ameliorated pain in patients with cancer therapy induced OM. We recommend novel curcumin formulations, high quality randomised controlled trials to further improve its therapeutic effects.

To determine the maximum bite force (MBF) in oral submucous fibrosis (OSMF) patients and to compare them with that of healthy subjects. Material and Methods: Twenty patients who were clinically confirmed, as OSMF and 20 healthy controls matched for age, gender, and number of intact functional teeth were included in this study. For each subject, age, gender, weight, height and body mass index (BMI) were recorded. The MBF registration was carried out by the two evaluators, who were previously calibrated. Bite force was measured in the first molar region using a force transducer occlusal force meter for each subject seated at the upright position, with Frankfort's plane nearly parallel to the floor, and no head support. The Student's independent t-test was used to determine the statistical significance in relation to mean height, weight, BMI and the presence of number of intact teeth and MBF between the healthy subjects and OSMF individuals. A comparison of grades of OSMF with all variables was carried out by one-way ANOVA test. Results: No significant difference was found in mean age, mean height, weight, BMI and the presence of the number of intact teeth between healthy individuals and OSMF patients. The mean MBF in healthy subjects was 628.23 ± 24.39 N and 635.47 ± 31.22 N in OSMF patients. Even though the healthy subjects reported a higher MBF than OSMF patients did, the difference was statistically non-significant. With regards to sides, no significant difference was observed in mean MBF in healthy subjects and OSMF patients on the right (p=0.7818) and left side (p=0.6154). Conclusion: The healthy subjects reported higher MBF values than OSMF patients did and the difference was statistically non-significant.