It is well known, pain is the most common reason why people seek healthcare. Pain is a personal, unpleasant sensory experience reflecting the physiologic, biologic, genetic and psychosocial factors. Some orofacial pain conditions are very complex and perplexing. With regular diagnosis, misdiagnosis and medical interventions which unfortunately later prove to be deceptive, such atypical orofacial pains are seemingly untreatable and puts the physician in a fix. In this article various facets of orofacial pain, peripheral mechanism, central sensitization, the absurd referral patterns and altered peripheral receptive field of chronic odontogenic pain are discussed with ample clinical evidences implicating the fact that all trigeminal pains are not trigeminal neuralgic pains. Treatment by classic drugs for trigeminal neuralgia in such cases cause more harm than any benefit to the patients. This article depicts cases showing how unremitting pain in trigeminally mediated areas secondary to dental causes is a unique challenge for the doctor and patient alike.

Branchial cleft cysts typically present as a unilateral, fluctuant soft tissue swelling that are mostly localised deep to the anterior border of sternocleidomastoid in the lateral aspect of the neck at the junction of its upper third and lower two third. Diagnosis is usually straightforward and can be made clinically however FNAC facilitates diagnosis.Unusually they can mimic as an abscess or metastatic node and less commonly present at an unusual location. We encountered 3 cases where patients presented with neck swelling either with unusual presentation or atypical location or inconclusive FNA. This report describes a series of patients in which the diagnosis of branchial cysts was not straightforward and posed a diagnostic challenge.

There have been a few establishments to prove the hypothesis, that oral infection has influences in cardiovascular health of an individual. Among many chronic dental infections, periodontal infections in particular have been said to have an impact on various cardiovascular diseases, including atherosclerosis, fatal and non-fatal myocardial infarctions, venous thrombosis, peripheral artery disease and stroke. Various studies including epidemiological, novel research approaches, direct and indirect immunological and microbiological studies have been performed to confirm or eliminate this association. This article reviews the discussions to whether periodontal infection and its influence in cardiovascular disease are, in fact relevant or is a mere coincidence.

Different patterns of malignant change may occur in pleomorphic adenoma; carcinoma ex-pleomorphic adenoma is one such malignant entity.Although in most instances, the features of malignant transformation are evident, some very well-differentiated cancers such as myoepithelial carcinoma or cancers that exhibit morphologically limited nuclear atypia may be somewhat challenging to diagnose. A 45 year old man presents to us with a recurrent swelling over the upper lip for ten years. It had been excised twice during this period; the histopathology being consistent with pleomorphic adenoma. This time, however, there was a co-existent ipsilateral submandibular swelling. He underwent wide local excision of upper lip swelling with primary reconstruction of lip defect and supraomohyoid neck dissection.Diagnosis of myoepithelial carcinoma could only be made by histopathological examination of the resected specimen. Myoepithelial differentiation of tumor cells was established by showing positivity for CK7 and SMA. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the upper lip.

Aim: To find the role of PET-CT scan in management of locally advanced head & neck cancers. Materials & Methods: A prospective study was performed in 21 patients suffering from locally advanced head & neck cancers reporting to our centre from January 2014 to December 2015. All the patients who had T3- T4 lesions with metastatic lymph node disease were included in the study. They underwent PET-CT scan and the results were tabulated to check whether there was distant metastasis thereby altering the clinical staging of the disease. Results: Out of 21 patients, who under PET-CT scan, 9(42.8%) patients had distant metastasis to various organs. 8(38%) patients had more than one metastatic lymph nodes and 4(19%) patients had locally advanced disease with only one metastatic lymph nodal involvement. Conclusion: Though incidence of distant metastasis is less than 10 % in head and neck cancers, sometimes the clinician fail to identify the distant metastasis due to non-availability of PET-CT scan equipment or due its financial cost when the patient is not affordable. But appropirate steps must be taken based on the clinical symptoms of the patients which must not be ignore by the Surgeon and PET-CT scan needs to be done which can change the whole treatment management of the patient.

Salivary duct carcinoma (SDC) is a rare and high-grade malignant tumor that arises predominantly in a major salivary gland and bears a striking histological resemblance to high grade ductal adenocarcinoma of breast. The sarcomatoid SDC is a rare subtype that comprises of both epithelial and sarcomatoid components. The authors describe a case of sarcomatoid SDC of parotid gland. Its histological features have been discussed. The patient was treated by total parotidectomy with wide local excision of the involved skin and ipsilateral neck dissection followed by adjuvant radiotherapy.

NOE injuries have been the most complex and difficult facial fractures to treat. These types of fractures are routinely encountered by practicing oral and maxillofacial Surgeons. For optimal results, an accurate assessment of the injury and a comprehensive treatment plan is to be formulated as early as possible, as management of facial fractures and injuries remains a mainstay of the specialty. The intricate anatomy and difficulty in fracture fixation makes Naso-orbital-ethmoidal fractures the most complex of all facial fractures to diagnose and treat, so a thorough knowledge of facial norms, surgical anatomy, and reconstruction techniques is mandatory for successful treatment. The purpose of this article is to give a general overview NOE fractureswith diagnosis, classification, and management with review of literature.

The search for an ideal polishing agent for dental composite is ongoing. Several polishing tools have been used over the years ranging from multiple step system using fine and super fine diamond finishing burs, abrasive disks, diamond and silicon impregnated soft rubber cups, to one step polishing system. The present study evaluates two polishing system i.e SofLex (multistep polishing system) and PoGo (single-step polishing system) on a composite material namely Filtek Z-100.

Platelet-rich fibrin (PRF) or leucocyte- and platelet-rich fibrin (L-PRF) is a second-generation PRP where autologous platelets and leucocytes are present in a complex fibrin matrix to accelerate the healing of soft and hard tissue. A platelet-rich fibrin (PRF) membrane containing bone growth enhancing elements can be stitched over the wound or a graft material or scaffold is placed in the socket of an extracted tooth at the time of extraction. The socket is then directly closed with stitches or covered with a non-resorbable or resorbable membrane and sutured. It is known that platelets are involved in the process of wound healing through blood clot formation and release of that promote and maintain the wound healing. In this article we have discussed a case treated with PRF after surgical removal of mandibular third molar.

AIM: To find the prevelance and Incidence of head and neck cancer cases of other total body malignancies in our cancer centre. MATERIALS & METHODS: This is a retrospective analysis which was done in curie Manavata cancer centre in northern Maharashtra from 14th May 2007 to 30th November 2014. Total cases operated were 14368 out of which 2017 were head and neck cancers. RESULTS: Incidence of Head & Neck cancer cases in our 7 years study was around 14.03% of other total body malignancies. Males are more affected by Head & Neck cancer for around 82.01% than females contributing which is around 17.9%. Oral cavity malignancies contribute around 76.6% out of all head & neck cancer cases. Tongue cancers are more commonly affected which is around 33.4% followed by Buccal mucosa which is 29.77%. The mortality rate is high in buccal mucosa (32.35%) followed by tongue (27.4%). CONCLUSION: This retrospective study hopes to quantify and analyze the spectrum of Head and neck cancer out of the other total body malignancies. A tremendous effort is needed to identify such high prevelance, generate awareness and establish treatment modalities to meet this challenging statistical analysis.

Trauma to the mid-facial region commonly causes ocular injuries of varying degrees. Majority of the patients suffer injury to the eye who have sustained trauma to the mid-facial region. Orbital contusion or fractures have been reported in as many as 30% of the cases and approximately 15% have decreased vision. Only 2 ocular emergencies require treatment within minute's I.e.: chemical burns of the eye and central retinal artery occlusion. Apart from these there is adequate of time for thorough history taking and examination. Isolated orbital blow-out fractures will have an associated eye injury in up to one third of patient. Both prospective and retrospective studies of patients who have sustained bifacial fractures indicate that as many as 20% may sustain serious ocular injury that warrants ophthalmological referral.

Botryoid odontogenic cyst (BOC) is considered a rare multilocular variant of the lateral periodontal cyst, usually involves the mandibular premolar-canine area, followed by the anterior region of the maxilla. A 42-year-old male patient with botryoid odontogenic cyst (BOC) was treated by surgical removal. BOC have been widely regarded as variants of the lateral periodontal cyst. The conservative enucleation of the BOC is the treatment of choice, a significant recurrence rate has been reported for BOC. An extended post-surgical follow-up is necessary for a patient who has been diagnosed with BOC.

Neurofibroma is a benign slow growing tumour of the peripheral nerve sheath; frequently associated with neurofibromatosis type I. Solitary neurofibroma of maxillary sinus is exceedingly rare tumour, with only seven cases described in the literature. We report a case of a 14-year-old male patient presented in our ENT department with a painless swelling of the left cheek for the last six months. The diagnosis was a solitary neurofibroma of the maxillary sinus and we try to describe the clinical, histopathological and radiological characteristics of this tumour. CT scan showed a heterogeneous expansive lesion in the left maxillary sinus destroying the lateral, medial, anterior and posterior walls with infiltration of the fosse infratemporalis. A maxillary resection was performed to excise the tumour. Histological examination of the specimen showed a neurofibroma. No sign of recurrence was noted after 6 months of follow-up. Despite the rareness and the difficulty diagnosing this disease, otolaryngologists should keep this diagnosis in mind within the range of tumours of the paranasal sinuses.

Mucoepidermoid carcinoma (MEC) is a malignant epithelial neoplasm composed of both mucus secreting cells and epidermoid-type cells. Mucoepidermoid carcinoma arising from mucous glands of maxillary sinus is extremely rare and accounts for 13% of all malignancies occurring in maxillary sinus. While the high-grade MEC is a highly aggressive tumor, its low-grade counterpart usually demonstrates a more benign nature. However, both local recurrence and an aggressive clinical course have been reported to occur even with low-grade tumors. We report a case of low grade mucoepidermoid carcinoma of the maxillary sinus who presented to us with a recurrence 20 years after undergoing a total maxillectomy and post-operative adjuvant radiotherapy. The patient was successfully managed with wide excision of the tumor.

Ameloblastoma is a benign but locally invasive tumour of odontogenic epithelial origin with several histological variants. Basal cell ameloblastoma is the rarest histological subtype with only a few cases reported till date. It shows remarkable similarity to basaloid squamous cell carcinoma (BSCC), cutaneous basal cell carcinoma (BCC) and solid-type adenoid cystic carcinoma (ACC). This report describes an interesting case of basal cell ameloblastoma of the left maxilla in a 37 year old man. He had undergone enucleation of a maxillary lesion 2 years back without a pre-operative tissue diagnosis, which was later established to be an ameloblastoma. The tumor recurred after 6 months and was managed by a standard partial (infrastructure) maxillectomy. We review the literature on this rare entity with emphasis on the appropriate treatment modality.

OCT, a type of optical imaging non-invasive technique, reproducing the cross sectional 2D and 3D images of the tissues. It's based on low coherence interferometry, employs near infrared light (long wavelength) which penetrates into the scattering media (e.g.: oral tissues) and capture sub-micrometer resolution. Already an established medical imaging technique, it can be used for a wide range in dentistry for early detection of oral cancer (initial dysplastic changes), periodontal diseases, including dental caries. This paper reviews the understanding of the OCT, its basics, systems & setup, uses, limitations with the focus of it as a diagnostic imaging tool for oral lesions.