A rare presentation of rhinosporidiosis on buccal mucosa − a case report

Introduction: Rhinosporidiosis is a chronic mucocutaneous infection caused by Rhinosporidium seeberi, which mainly affects the mucus membranes of the nose, oropharynx, skin, eyes, and genital mucosa. The purpose of this case report was to illustrate the importance of clinicians in understanding the unusual incidence of this fungal infection, clinical presentation, treatment modalities, and recurrence rate. Observations: A clinical case report showed rare occurrence of rhinosporidiosis in the lower third of the face. The lesion was surgically excised by electrocauterization at its base. Commentaries: The patient showed no signs of recurrence even after 3 years of follow-up. Further research should be carried out to analyze the role of genetic predisposition in causing zoonotic infection. Conclusion: Rhinosporidiosis should also be considered as the differential diagnosis when facial swelling is encountered.

Utility of nail enamel for inking of surgical margins in oral biopsy: a comparative study

Background: India Ink is the most commonly used ink in surgical pathology. The main disadvantages of India Ink are longer drying time, monochrome, toxicity and cost. Because of these disadvantages, alternative materials have been suggested to replace India ink. The aim of this study is to evaluate the effectiveness of nail enamel for inking of surgical margin and to compare it with India ink. Materials and methods: N = 20, which included 10 mucosal and 10 skin samples. Each selected margin is divided into 2 equal halves and one is inked with India ink and the other with nail enamel (Vernis A Ongles: Dark green). After routine processing and staining, the effectiveness of nail enamel and India ink were compared based on macroscopic and microscopic parameters. Results: Less drying time and visibility on paraffin wax block were excellent for nail enamel. Microscopic visibility of nail enamel was comparable with that of India ink. However, processing fluids contamination is the main drawback of nail enamel. Conclusion: Nail enamel can be used as an alternative to India ink because of its less drying time, ease of application, good visibility on wax blocks and microscopically, availability in multiple colours, cost effectiveness and non-toxicity.

Influence of the type of anesthesia on 111 arthrocentesis in temporomandibular joint disorders: results of a prospective study

Aims: Temporomandibular dysfunction is a generic term that covers a large number of clinical problems affecting not only TMJ (Temporomandibular Joint), but also the masticatory musculature and related structures. Arthrocentesis is the most commonly used technique in patients with pain or limitation of the oral opening due to joint causes in which conservative treatment has failed. It is generally performed under local anesthesia and sedation, although depending on the type of patient and the preferences of the surgeon it can also be performed under general anesthesia. Material and method: A prospective, observational, analytical cohort study has been carried out to evaluate if the type of anesthesia, the drugs used for sedation and whether or not anesthetic induction is performed during arthrocentesis influence the results of 111 arthrocentesis performed in patients with TMJ pathology. Results: In patients who arthrocentesis was performed with propofol without midazolam the improvement in pain at one week and one month postarthrocentesis was greater than propofol with midazolam was used. Conclusion: The type of anesthesia could influence the results of arthrocentesis.

An overview on the art of piezosurgery in the maxillofacial practice

Introduction: Piezosurgery is an emerging boom in the field of maxillofacial surgery for precise, safe and effective osteotomies sparing the adjacent vital structures compared to conventional surgery. Corpus: It works on the principle of piezoelectric effect in which crystals in the piezoelectric substances get deformed on the application of an electric field. Various studies gave the evidence of improved wound healing and bone formation compared to conventional approaches. The soft tissue sparing capability with improved patient comfort and decreased blood loss gave the utmost importance for this surgical technique in the present as well as future world of surgery. Conclusion: Piezosurgery has emerging as a promising surgical modality with a wide range of clinical applications throughout the whole field of surgery.

Assessment of cases of lichenoid granulomatous stomatitis in respect to demographics, histological features, and subcategories in known population

Introduction: Lichenoid granulomatous dermatitis (LGD) is widely encountered lesions with both oral as well as dermal manifestation. Present study was done to evaluate lichenoid granulomatous stomatitis cases. Materials and methods: 226 biopsies were exposed to special stains such as acid-fast bacilli (AFB), immunohistochemical staining for CD 68 and Grocott methenamine-silver (GMS), and periodic acid‐Schiff (PAS) stains. Results: Out of 226 patients, males were 84 and females were 142. Maximum cases were seen in age group 40–60 years (122) followed by >60 years (56) and 20–40 years (48). The common site was buccal mucosa seen in 128 (56.6%) cases followed by vestibule in 30 (13.2%), gingiva in 26 (11.5%), tongue in 20 (8.8%), lip in 12 (5.3%) and palate in 10 (4.4%). The common lesion was oral lichen planus seen in 142 (62.8%), carcinoma in situ in 12 (5.3%), squamous cell carcinoma in 8 (3.53%), pemphigus vulgaris in 10 (4.42%), leukoplakia in 24 (10.6%) and pemphigoid in 30 (13.2%) cases. Most lesions were of type I seen in 117 (51.7%) cases. Conclusion: Lichenoid granulomatous dermatitis poses variety of clinical as well as oral features. A long standing follows up and consideration of differential diagnosis is mandatory for better management of patients.

Diagnosis of a plasmoblastic lymphoma of the mandible after renal transplantation: a case report

Introduction: Post-transplant lymphoproliferations (PTL) are a severe complication of solid organ transplants. Their locations can be extra-nodal. Observation: The diagnosis and management of a non-Hodgkin's plasmablastic lymphoma of mandibular localization affecting a 66-year-old kidney transplanted patient are reported here. Comment: The main risk factors for non-Hodgkin lymphoma are immunosuppression and infection with Epstein-Barr virus. Clinical and radiographic examinations, which are not specific, must be supplemented by a histological examination. Treatment which is not consensual will most often consist of a reduction in immunosuppression coupled with chemotherapy. Conclusion: Despite a constant evolution in the incidence and clinical picture of post-transplant lymphomas, the role of the dentist remains essential in the early detection of lesions.

Combined local flap and antrostomy in recurrent oroantral fistula and chronic maxillary atelectasis: a case report

Introduction: Chronic maxillary atelectasis refers to a persistent volume decrease of the maxillary sinus by inward bowing of its walls. When associated with hypoglobus or enophthalmos, some authors use the term “silent sinus syndrome”. We aimed to report a case of accidental diagnosis of chronic maxillary atelectasis while investigating and treating a recurrent oroantral fistula. Observation: CT imaging showed a large bone defect and stage II chronic maxillary atelectasis. Closure of the oroantral fistula was performed with a combined surgical approach: functional endoscopic surgery and buccal fat pad flap. The follow up at 2 months showed no signs of recurrent oroantral fistula. Commentaries: Chronic maxillary atelectasis is separated into three stages, membranous deformity (stage I), bony deformity (stage II), and clinical deformity (stage III). The term silent sinus syndrome should be abandoned for stage III chronic maxillary atelectasis to allow for better collaboration between medical practitioners. Recurrent oroantral fistulas should be treated with a combined approach including endoscopic antrostomy and local flap. Conclusion: The association of functional endoscopic surgery and buccal fat pad flap were the key to success in this case allowing for oroantral fistula closure and treatment of chronic maxillary atelectasis.

Serum vitamin D/25(OH)D associated with toll-like receptor (TLR) 2 expression of immune cells in the saliva of Systemic Lupus Erythematosus: a preliminary study

Objective: Vitamin D deficiency may contribute to Systemic Lupus Erythematosus (SLE) development. Vitamin D may involve in pathogen recognition through Toll-like receptor (TLR) 2 in immune cells in saliva. This study aimed to determine the correlation between serum vitamin D/25(OH)D and TLR2 expression of immune cells in the saliva of SLE. Materials and methods: This cross-sectional study conducted at the the SLE patients who met the inclusion and exclusion criteria. Those who had signed informed consent involved to underwent unstimulated saliva collection and blood samples for TLR2 and vitamin D/25(OH)D examination. The correlation between serum vitamin D/25(OH)D concentration and salivary TLR2 expression was analyzed using the correlation test, linear regression with 95% confidence level. Results: Thirty SLE patients had a mean serum vitamin D/25(OH)D concentration of 9.98 ± 4.64 ng/ml. The mean of TLR2 expression of CD11b+ cells in saliva was 26.03 ± 20.92%. There was a significant positive correlation between serum vitamin D/25(OH)D concentration and TLR 2 expression of CD11b+ cells in the saliva. (r = 0.434; P < 0.05). Vitamin D/25(OH)D was the only predictor for TLR 2 expression. Conclusion: Serum vitamin D/25(OH)D concentrations associated with TLR2 expression of CD11b+ cells in the saliva of SLE.