Publications by authors named "Usha Hegde"

17 Publications

  • Page 1 of 1

Surface Nanohardness of Normal and Fluorosed Enamel Adjacent to Restorative Materials: An Study and Polarized Light Microscopy Analysis.

J Contemp Dent Pract 2020 Sep 1;21(9):1034-1041. Epub 2020 Sep 1.

Department of Oral Pathology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Aim And Objective: To evaluate nanohardness of normal and fluorosed enamel in teeth restored with Cention N (CN), Equia forte (EF), glass ionomer cement (GIC), and resin composite using the nanoindentation test.

Materials And Methods: Eighty freshly extracted human premolars were selected. Standardized cavities were prepared on the buccal surface of normal (40) and fluorosed (40) teeth. Based on the type of the restorative material, the teeth were subgrouped into ( = 10): CN, EF, Type VIII GIC, and Tetric N-Ceram (TNC). The teeth were subjected to pH cycle (progressive caries test), which consisted of alternative demineralization (18 hours) and remineralization with artificial saliva (6 hours) for 3 consecutive days. Surface nanohardness was determined using a nanoindenter at distances of 100, 200, and 300 μm from the restoration-tooth margin. A polarized light Microscope was used to correlate the effect of remineralization on the enamel. Data were analyzed by one-way ANOVA with the Scheffe's and independent -test.

Results: Nanohardness values of the fluorosed/normal enamel adjacent to various materials in descending order were as follows: EF 3.67/2.95 GPa, GIC 3.33/3.15 GPa, CN 3.13/3.23 GPa, and TNC 1.17/1.82 GPa, respectively. Statistically significant differences were found among various materials in both types of the enamel ( < 0.05).

Conclusion: Based on the nanohardness test, EF can be a better choice for restoration in fluorosed teeth, followed by CN and GIC; GIC was better in normal enamel; however, this was not significant compared to CN and EF. Tetric N-Ceram composite resin had least influence on increasing the nanohardness of the adjacent enamel.

Clinical Significance: The surface nanohardness of normal and fluorosed enamel can be influenced by the type of restorative material used. The results of present study deserve clinician's attention while selecting restorative materials especially in dental fluorosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2020

Primary intraosseous squamous cell carcinoma ex-odontogenic cyst.

J Cancer Res Ther 2020 Apr-Jun;16(3):683-685

Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysore, Karnataka, India.

Squamous cell carcinomas of the oral cavity are quite common, but primary intraosseous squamous cell carcinomas (PIOSCCs) are rare. Their origin from lining of different odontogenic cysts has been documented. More than 50% of such cases have been reported to occur in periapical inflammatory cysts, and less than 10 cases are reported to arise from odontogenic keratocyst (OKC). One such rare case of a PIOSCC, which presented as an OKC initially, is being reported.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jcrt.JCRT_606_16DOI Listing
October 2020

A clinical evaluation on the effect of astringent on keratinization of oral mucosa before and after the insertion of complete denture.

Indian J Dent Res 2019 May-Jun;30(3):347-351

Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital (Constituent College) Jagadguru Sri Shivarathreeswara University, JSS Medical Institutions Campus, Sri Shivarathreeswara Nagar, Mysuru, Karnataka, India.

Context: Conventional complete dentures still remain a viable method of treatment for many patients in this era of fixed prosthesis like dental implants. All patients undergoing complete denture treatment need nonsurgical preprosthetic treatment for the preparation of healthy denture bearing mucosa as well-keratinized healthy mucosa is desirable for a complete denture.

Aims: To evaluate and compare the keratinization before and after denture insertion at intervals of 1 week and 1 month.

Settings And Design: The present study was conducted on 24 completely edentulous male subjects divided into control and study groups. Each patient in study group was asked to massage with astringent on the denture bearing mucosa over a 4-week period.

Subjects And Methods: Exfoliative cytology was used to collect the surface cells from the palatal mucosa and buccal mucosa. The first smear was taken before the denture insertion. The second and third smears were taken after the stimulation treatment with astringent gel for each patient after 1 week and after 4 weeks. Each smear was stained with the Papanicolaou's technique. The number of basal cells, intermediate cells, and superficial cells were recorded to calculate the degree of keratinization.

Statistical Analysis Used: Descriptive statistics, paired samples t-test, independent t-test, and repeated-measures analysis of variance.

Results: The result showed statistically significant increase in the keratinization of palatal mucosa after 4 weeks of astringent therapy and no effect was noted in the keratinization of buccal mucosa.

Conclusions: Astringent has shown to increase keratinization of palatal mucosa, and so it can be used to increase the quality of the denture bearing mucosa; moreover, the astringent stimulation has no effect on the keratinization of buccal mucosa.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijdr.IJDR_620_17DOI Listing
October 2019

Role of community health worker in a mobile health program for early detection of oral cancer.

Indian J Cancer 2019 Apr-Jun;56(2):107-113

Cochin Cancer Research Center, Kerala, India.

Background: The global incidence of oral cancer occurs in low-resource settings. Community-based oral screening is a strategic step toward downstaging oral cancer by early diagnosis. The mobile health (mHealth) program is a technology-based platform, steered with the aim to assess the use of mHealth by community health workers (CHWs) in the identification of oral mucosal lesions.

Materials And Methods: mHealth is a mobile phone-based oral cancer-screening program in a workplace setting. The participants were screened by two CHWs, followed by an assessment by an oral medicine specialist. A mobile phone-based questionnaire that included the risk assessment was distributed among participants. On specialist recommendation an oral surgeon performed biopsy on participants. The diagnosis by onsite specialist that was confirmed by histopathology was considered as gold standard. All individuals received the standard treatment protocol. A remote oral medicine specialist reviewed the uploaded data in Open Medical Record System. Sensitivity, specificity, positive and negative predictive values were calculated. Inter-rater agreement was analyzed with Cohen's kappa coefficient (κ) test, and the diagnostic ability of CHWs, onsite specialist, and remote specialist was illustrated using receiver operating characteristic curve.

Results: CHWs identified oral lesions in 405 (11.8%) individuals; the onsite specialist identified oral lesions in 394 (11.4%) individuals; and the remote specialist diagnosed oral lesions in 444 (13%). The inter-rater agreement between the CHW and the onsite specialist showed almost perfect agreement with the κ score of 0.92, and a substantial agreement between CHW and remote specialist showed a score of 0.62. The sensitivity, specificity, positive and negative predictive values of CHWs in the identification of oral lesion were 84.7, 97.6, 84.8, and 97.7%, respectively.

Conclusion: The trained CHWs can aid in identifying oral potentially malignant disorders and they can be utilized in oral cancer-screening program mHealth effectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijc.IJC_232_18DOI Listing
September 2019

Pigmented calcifying cystic odontogenic tumor associated with compound odontoma: Report of a rare case and review.

J Oral Maxillofac Pathol 2019 Feb;23(Suppl 1):78-82

Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Sri Shivarathreeshwara Nagar, Mysuru, Karnataka, India.

Calcifying cystic odontogenic tumor (CCOT) is a rare lesion accounting for only 2% of all odontogenic cysts and tumors. CCOTs can occur alone or in association with other odontogenic tumors such as odontomas. Pigmented intraosseous odontogenic lesions are rare. Among them, pigmented CCOT is known to occur with greater frequency. Only six cases of combination of pigmentation CCOT associated with odontoma have been reported in the literature. We herein present such a rare case occurring in the maxillary anterior region in a 13-year-old female patient.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_253_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6421910PMC
February 2019

Chondroid Tenosynovial Giant Cell Tumor of Temporomandibular Joint.

Ann Maxillofac Surg 2018 Jul-Dec;8(2):327-329

Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, Mysuru, Karnataka, India.

Tenosynovial giant cell tumor (TGCT), a benign proliferative lesion arising from the synovial membrane of the joints, is rarely seen in the temporomandibular joint. It frequently presents as a painful, preauricular swelling and affects the jaw functions. Two types of TGCT seen are diffuse TGCT (TGCT-D) and localized TGCT. A case of TGCT-D is described here, the highlight of the case being extensive areas of chondroid metaplasia which mimicked chondroid lesions, but was ruled out based on negative immunohistochemical findings within the tumor cells.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ams.ams_161_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327827PMC
January 2019

Enamel Surface Morphology: An Ultrastructural Comparative Study of Anterior and Posterior Permanent Teeth.

J Microsc Ultrastruct 2018 Jul-Sep;6(3):160-164

Department of Paedodontics and Preventive Dentistry, JSS Dental College and Hospital, Mysore, Karnataka, India.

Introduction: Enamel is one of the most important structures of the tooth, both functionally and aesthetically. Because of the highly mineralized nature of enamel, its structure is difficult to study under routine light microscopy. Since scanning electron microscopy (SEM) offers the possibility of studying structures under very high magnification without altering the gross specimen, it is one of the best methods to study the enamel surface.

Aims And Objectives: To study and compare the surface morphology and morphometry of enamel on various surfaces of permanent dentition.

Materials And Methods: A total of 20 permanent teeth were analyzed under the SEM. In both anterior and posterior teeth, four surfaces - mesial, distal, labial, and lingual - in three thirds - cervical, middle, and incisal - were studied. In addition, the occlusal surface was also studied for the posterior teeth. The different prism morphology and prism dimensions were recorded.

Results: Based on our observations, we could definitely identify striae of retzius, debris, and cracks under ×50 magnification. Three morphological patterns of prism arrangement were identified: Type 1 - shallow prisms, Type 2 - well-defined prisms, Type 3 - microporosities, on analyzing the mesial, distal, labial, lingual, and occlusal surfaces of the permanent teeth, at ×3000 magnification. The prisms were measured under ×6000 magnification and the results showed larger prisms in posterior than in anterior teeth.

Conclusion: The study aided us in categorizing the enamel prism structure based on morphology and morphometry in anterior and posterior teeth of the permanent dentition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/JMAU.JMAU_27_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130241PMC
September 2018

Inter- and Intra-Observer Variability in Diagnosis of Oral Dysplasia

Asian Pac J Cancer Prev 2017 Dec 29;18(12):3251-3254. Epub 2017 Dec 29.

Department of Oral Medicine and Radiology, K.L.E.Society’s Institute of Dental Sciences, Bangalore, India.Email:

Background: Oral potentially malignant disorders (OPMDs) are lesions from which malignancy is more likely to develop that from other tissues. The potential for malignant transformation of OPMDs is estimated by determining the degree of dysplastic changes in the epithelium. Dysplasia grading has been criticized for lack of reproducibility and poor predictive value but is still considered the gold standard for diagnosing OPMDs. Since grading of dysplasia is based on architectural and cytological changes, there can be considerable inter- and intra-observer variability due to subjective impressions. This aim in this study was to assess the degree of agreement between two pathologists grading dysplasia in the same patients and review the existing grading system. Materials and Methods: In this hospital-based cross-sectional study, 100 patients with clinically diagnosed OPMDs were subjected to biopsy followed by histopathological examination. The slides were examined by two pathologists using WHO and binary systems of classification and both were blinded to the clinical and each other’s histological diagnosis. For statistical analysis the Chi square test was applied. Results: Statistical analysis showed poor inter-observer variability with P values of 0.8 using the WHO classification and 0.3 using the binary classification. Conclusion: Our study provides evidence that the existing systems for grading dysplasia are not competent to rule out subjectivity. There is a need for a classification system that can overcome this drawback.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.22034/APJCP.2017.18.12.3251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980879PMC
December 2017

Pseudolymphoma versus lymphoma: An important diagnostic decision.

J Oral Maxillofac Pathol 2016 May-Aug;20(2):328

Department of Conservative Dentistry and Endodontics, Farooqia Dental College, Mysuru, Karnataka, India.

Small innocuous growths on the face usually do not pose difficulty in diagnosis on histopathology. However, some benign inflammatory lesions might mimic malignancy and hence need further investigations for final diagnosis. The distinction between a benign/inflammatory/malignant lesion needs no emphasis as the treatment plan, prognosis and the patient's well-being depends on it. Lymphocytoma cutis, or Spiegler-Fendt Sarcoid, is classed as one of the pseudolymphomas, referring to inflammatory disorders in which the accumulation of lymphocytes on the skin resembles, clinically and histopathologically, cutaneous lymphomas. To obtain an accurate diagnosis, careful clinical evaluation, as well as histopathological and immunohistochemical examination is needed. One such case of an otherwise unassuming growth mimicking malignancy is being presented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0973-029X.185909DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989571PMC
September 2016

Comparison of Microwave Versus Conventional Decalcification of Teeth Using Three Different Decalcifying Solutions.

J Lab Physicians 2016 Jul-Dec;8(2):106-11

Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, JSS University, Mysore, Karnataka, India.

Background: In routine histopathology, decalcification of teeth is an essential and important step during tissue processing. The present study was attempted to decalcify teeth using microwave method and to compare it with conventional decalcification method.

Aim: To compare microwave decalcification with conventional decalcification method with respect to the speed of decalcification, preservation of tissue structure, and efficacy of staining.

Materials And Methods: A total of 72 single-rooted premolars were used for both conventional and microwave decalcification methods. Three different types of decalcifying agents at 5% and 7% were used. Decalcifying agents included nitric acid, formic acid, and trichloroacetic acid, each at 5% and 7%. About 6 teeth were included in each category and were decalcified by both conventional and microwave method. After decalcification, all the teeth were examined macroscopically and microscopically. Cramer's V-test was used to determine the statistical significance.

Results: The results have shown that microwave method using 5% and 7% nitric acid were the fastest. Structural details and good staining characteristics were better in teeth decalcified by 5% nitric acid and 5% trichloroacetic acid by both the methods.

Conclusions: 5% nitric acid by microwave method proved to be the best decalcifying agent as it was fast and gave good structural details and staining characteristics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0974-2727.180791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866380PMC
July 2016

Enriched vascularity in ameloblastomas, an indeterminate entity: Report of two cases.

J Cancer Res Ther 2015 Oct-Dec;11(4):946-9

Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, Mysore, Karnataka, India.

Vascularity is a highly essential element that is required for the growth, development, and functioning of the body and variations in it can cause pathologies. It is one of the prime features of a proliferating lesion, where it aids in the growth of the lesion through its nutrition supply. Highly increased vascularity in a disease can itself affect the prognosis of the lesion, and in malignancies, it can induce tumor seeding and secondaries. Most of the pathologies including tumors, related to blood vessels, and vascularity are well established. There are some conditions, wherein altered vascularity is one of the prime components along with other diagnostic components of an established disease. In such cases, these lesions are diagnosed with special names, with varying biological behavior and prognosis in comparison to that of established entity. However, there still are few similar conditions whose nature is uncertain due to the rarity of the lesion and the insufficient scientific evidence which eludes the diagnostician. Here is the report of two cases of ameloblastoma, an established entity, with significant vascularity whose nature is indeterminate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0973-1482.163737DOI Listing
November 2016

Smokeless Tobacco-associated Lesions: A Mobile Health Approach.

J Contemp Dent Pract 2015 10 1;16(10):813-8. Epub 2015 Oct 1.

Department of Oral Medicine and Radiology, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India.

Aim: Globally, India accounts for the highest number of oral cancer cases. The survival rates are about 30% lower than those in developing countries. The main reason for these dismal figures is the late presentation of patients. In order to downstage oral cancer in such a scenario, screening and diagnosis at an early stage is warranted. A pragmatic approach is needed for an oral cancer screening program, hence a mobile health (mHealth) approach was used. In this approach, health workers were empowered with mobile phones with decision-based algorithm. Risk stratification of tobacco habit enables us to identify lesions associated with particular habits.

Materials And Methods: A specific cohort of factory employees who predominantly had pure tobacco chewing habit was chosen to examine the effect of pure tobacco on oral mucosa. One thousand three hundred and fifty-seven subjects were screened in two phases. In the first phase, habits and oral lesions were identified and photographed. The photographs were remotely diagnosed by an oral medicine specialist and those subjects requiring biopsy were recalled for phase II. Cytology and biopsy were performed in phase II.

Results: The predominant habit was smokeless tobacco (SLT), in 582 subjects. The most commonly encountered lesion was tobacco pouch keratosis seen in 397 subjects. Biopsy was performed for 71 subjects, most cases showed hyperkeratosis and mild dysplasia. One subject had moderate dysplasia.

Conclusion: There was minimal alteration of tissues in our study subjects, which can be considered as low-risk. Use of mHealth empowered frontline healthcare workers to identify subjects with lesions and enabled remote diagnosis by specialist in resource-constrained settings.

Clinical Significance: Use of mHealth enabled us have an electronic record of subject details. This data shall be used for a planned follow-up of the same cohort after 3 years.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5005/jp-journals-10024-1762DOI Listing
October 2015

Treatment guidelines and prognosis of immune reconstitution inflammatory syndrome patients: a review.

J Int Oral Health 2015 Apr;7(4):92-5

Post-graduate, Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, Mysore, Karnataka, India.

Immune reconstitution inflammatory syndrome (IRIS) is an "unmasking" or paradoxical worsening of a pre-existing infection after commencement of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) - infected patients. The use of HAART in the management of HIV patients restores immune responses against pathogens however in few patients, the reconstituted immune system leads to IRIS. As the treatment protocols are not standardized for IRIS, this leads to short-term morbidity or in some cases also mortality. Therefore, treatment in these patients is a huge challenge and further more research regarding the immunopathogenesis, diagnosis and management of IRIS should be well thought-out. To understand the immunopathogenesis of IRIS it will be difficult to elucidate the intrinsic dynamics of immune cells after initiation of HAART but, there are few biomarkers which help to predict or diagnose IRIS and develop specific treatment, following initiation of HIV therapy. This review is an attempt to put light on those patients with IRIS with treatment guidelines for the management of the progression of it.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409807PMC
April 2015

Lipoid proteinosis: a rare encounter in dental office.

Case Rep Dent 2015 19;2015:670369. Epub 2015 Mar 19.

Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, JSS University, Mysore, Karnataka 570015, India.

Lipoid proteinosis is a sporadic congenital metabolic disorder which is characterized by deposition of hyaline material in dermis, submucosal connective tissue, and various internal organs. It has an extremely low prevalence rate with less than 300 cases reported so far. This progressive disease has a vast spectrum of manifestations ranging from asymptomatic lesions to fatal seizures and respiratory obstruction making timely diagnosis of this rare disorder an imperative task for oral health care practitioners. We report a case of characteristic oral manifestations of lipoid proteinosis in a 28-year-old male patient along with a review of relevant prevailing literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2015/670369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383431PMC
April 2015

Dermatofibrosarcoma protuberans - a recurrent lesion with unusual presentation in the parotid region.

J Clin Diagn Res 2014 Mar 15;8(3):130-1. Epub 2014 Mar 15.

Reader, Department of Oral Pathology and Microbiology, JSS Dental College and Hospital , Mysore, Karnataka, India .

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous malignant neoplasm consisting of relatively monomorphous mononuclear spindle cells that show diffuse CD34+ positivity. Management of this lesion poses problem because of its infiltrative margins and high propensity for local recurrence and rare distant metastasis. It is said that clear margins with minimal removal of normal tissues can be achieved by Mohs' micrographic surgery, which is particularly important in head and neck locations where the presence of vital anatomical structures and aesthetic considerations hinders a wide surgical excision. A case of DFSP, at a very uncommon site of parotid region, which recurred within 9 months after initial surgical treatment, is being reported.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7860/JCDR/2014/7068.4133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003608PMC
March 2014

Verruciform xanthoma: A view on the concepts of its etiopathogenesis.

J Oral Maxillofac Pathol 2013 Sep;17(3):392-6

Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India.

Verruciform xanthoma is a very uncommon papillary growth seen chiefly in the oral mucosa. The presence of foam cells in the connective tissue papillae between the epithelial rete ridges forms the hallmark in its diagnosis. There has been wide speculation and various hypotheses put forth in explaining the etiopathogenesis of verruciform xanthoma and the origin of foam cells. This article aims to update the different hypotheses in understanding the pathogenesis of the lesion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0973-029X.125205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927341PMC
September 2013

Gingival cyst of adult--a case report with unusual findings.

Indian J Dent Res 2004 Apr-Jun;15(2):78-80

Department of Oral Pathology and Microbiology, J.S.S. Dental College and Hospital, Mysore 570015.

Gingival cysts of adult are rare odontogenic cysts of developmental origin. They occur as swellings on the gingiva, most commonly between 5th and 6th decade of life and usually do not exceed 1cm in size. The epithelial lining of these cysts are thin non-keratinised and are thought to arise from the rests of dental lamina. We report a case of multicystic variant of a gingival cyst in adult patient with few unusual findings regarding the age of occurrence, size of the lesion and the histopathological appearance. Gingival cyst of adult occurring in an 18-year-old male patient, measuring about 3 x 4 sq. cms on the facial attached gingiva in relation to 42, 43, and 44 was observed. The histopathological findings were that of the rare multicystic variant with keratinised lining and epithelial plaques in the lining. The lumen of the cyst showed keratin with one of the lumen showing calcifications within it. This case documents many interesting and unusual findings in gingival cyst of adults. It appears to be the first documentation of gingival cyst of adult containing calcifications within the cystic lumen.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2005