The occurrence of OSMF is related to areca nut and its products. The duration and frequency of its use and type of areca nut product has effect on the incidence and severity of OSMF. Gutkha and pan masala have more deleterious and faster effects on oral mucosa. The gutkha-chewing habit along with the other habits does not have any significant effect on the rate of occurrence and incidence and severity of the OSMF.
Background:Trigeminal neuralgia is a commonly diagnosed neurosensory disease of head, neck and face region, involving 5th cranial nerve. Carbamazepine is the first line drug if there is decrease in efficacy or tolerability of medication, surgery needs to be considered. Factors such as pain relief, recurrence rates, morbidity and mortality rates should be taken in to account while considering which technique to use. Peripheral neurectomy is a safe and effective procedure for elderly patients and in rural and remote centers where neurosurgical facilities are not available. It is also effective in those patients who are reluctant for major neurosurgical procedures. Although loss of sensation along the branches of trigeminal nerve and recurrence rate are associated with peripheral neurectomy, we consider it as the safe and effective procedure in rural practice, which can be done under local anesthesia.Aims:The aim of this prospective study is to evaluate the long term efficacy of peripheral neurectomy with and without the placement of stainless steel screws in the foramina and to calculate the mean remission period after peripheral neurectomies for different branches of trigeminal nerve.Setting and Design:The sample was divided into 2 groups by selecting randomly the patients, satisfying inclusion criteria. Both groups were operated under local anesthesia by regional nerve blocks. In one group of patients after peripheral neurectomy, the proximal nerve stump was left alone in the foramina, and in another group of patients, obturation of foramina was done with stainless steel screws after peripheral neurectomy.Materials and Methods:Peripheral neurectomy was done on the terminal branches of trigeminal nerve in 14 patients. We selected only those cases that were experiencing pain after Carbamazepine therapy, all our patients were from rural and remote areas where facilities to neurosurgical centers are limited. Elderly patients who were unfit for surgical procedures and those patients who were reluctant for major neurosurgical treatments were considered for the study.Results:Post-surgical pain relief varied from 15 months to 24 months in cases where neurectomy was done without placing stainless steel screws in the foramina. Those cases where peripheral neurectomy was done along with the placement of stainless steel screws in the foramina, none of the patient had painful symptoms even after minimum 2 years of follow-up. Student's `t`-test of 2 groups showed the remission period to be statistically highly significant in patients with stainless steel screw obturation, having P-value <0.0005.Obturating the foramen with stainless steel screws can prevent nerve regeneration. Thus, remission of pain can be prolonged.Conclusion:Peripheral neurectomy is thus a safe and effective procedure for elderly patients, for those patients living in remote and rural places that cannot avail major neurosurgical facilities, and for those patients who are reluctant for major neurosurgical procedures.
The dentigerous cyst is a developmental odontogenic cyst which usually occurs in the second and third decade of life. Dentigerous cyst is one of the most prevalent types of odontogenic cysts associated with partially erupted, developing, or impacted teeth. The mandibular third molars have a high predictability followed by maxillary canines. Occurrence of dentigerous cyst bilaterally is generally observed in syndromic cases. Non-syndromic dentigerous cyst occurring bilaterally or involving both arches at the same time is very rare. This presented case is rare and unique in which all four quadrants shows the presence of dentigerous cyst. In this case there are well-defined cysts associated with impacted molars as well as with supernumerary teeth in all the four quadrants of jaws. The clinical documentation of such a case in available literature is found to be first time.
In the last three decades great strides in Hyperbaric Oxygen research has raised the value of this unique therapy. Studies have expanded the list of conditions usefully treated with compressed oxygen. Despite the promising experimental and clinical data, the major criticism to most HBO studies has been the lack of controlled prospective analysis for its use. This article discusses the use of HBO, including staffing and equipment considerations, side effects and reviews the published experience in this subject.
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