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INTRODUCTION: Tobacco cessation is a challenging arena for healthcare professionals. Many patients seem to be unable to quit tobacco despite of knowing its ill-effects and several efforts. It has been speculated that patients' psychosocial status may be associated with his/her dependence on tobacco and there could be some amount of psychiatric morbidity associated with chronic and compulsive use of tobacco. However, very few studies have been conducted to explore this aspect of tobacco dependence. AIM: To assess psychiatric morbidity in tobacco users as compared to non-users of tobacco. MATERIALS AND METHODS: This cross-sectional study included 200 patients reporting to a Dental College who consented to participate in the study. The study consisted of two groups; first consisting 100 tobacco users and another age and gender matched group of 100 non-users of tobacco. Dependence to tobacco products amongst the study group was assessed using International classification of Diseases-10 (ICD-10) criteria. General Health Questionnaire - 28 (GHQ-28) was used to assess the psychological morbidity amongst both the groups. Statistical analysis was done using SPSS 21.0 version. Chi square test and Pearson's correlation coefficient were used to assess the difference in proportion and correlation between variables respectively. RESULTS: A 79% of tobacco users showed dependence on tobacco according to ICD-10 criteria. GHQ-28 scores analysis revealed that 61% of tobacco users with a score of 24 or above in contrast to only 17% of non-tobacco users. Tobacco users were observed to be 7.63 folds at a higher risk of developing psychiatric morbidity than non-users of tobacco (p-value< 0.001). CONCLUSION: There appears to be a significant risk of psychiatric morbidity prevalent amongst tobacco users. Hence, psychosocial counselling must be considered as a part of tobacco cessation strategy.

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Ameloblastic carcinoma (AC) is a rare malignant odontogenic tumor with poor prognosis. It has an aggressive clinical course with extensive local destruction. It occurs primarily in the mandible. It may clinically present as a cystic lesion with benign clinical feature or as a large mass with ulceration, significant bone resorption and mobility of teeth in the affected region. Reliable evidence of it's biological activity along with extensive local destruction, direct extension of tumor, lymph node involvement and metastasis to various sites (frequently lung) have been reported. Wide local excision is the treatment of choice along with regional lymph node dissection. Because of recurrence close periodic assessment of the patient is advocated. The authors discussed a rare case of AC of mandible; with metastasis to regional lymph nodes in a 45 year old male along with a long-term follow up.

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Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination.

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Verrucous hemangioma (VH) is an uncommon, congenital, vascular malformation that involves dermis and subcutaneous connective tissue of skin. VH lesions are initially present at birth, and therefore, the diagnosis in the elderly may be difficult. Review of literature reveals that VH lesions are commonly located unilaterally on the lower extremities. VH may clinically present as keratotic, papular, nodular, or plaque-like lesions that are reddish-blue in color. VH does not resolve spontaneously and has a tendency to relapse. The diagnosis of VH is generally done on the basis of histopathology. Early diagnosis is important to get a better cosmetic result. VH requires a large, deep excision to avoid recurrence because of frequent extension into subcutaneous fat planes. Intra-oral lesions of VH have rarely been reported in the literature. We present an extremely rare case of VH occurring in the retromolar triangle area of oral cavity.

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Pindborg tumor/Calcifying Epithelial Odontogenic Tumor (CEOT) is a benign epithelial odontogenic tumor which shows locally aggressive behavior and accounts for less than 1% of all odontogenic tumors. The most frequent location is the mandibular premolar and molar area; less frequently the lesion is found in the maxilla. Since histopathology remains the main method for definitive diagnosis, this lesion presents an enigma to a clinician when lesions occur in atypical locations. The authors report a case of CEOT in the maxillary anterior region associated with an impacted supernumerary tooth (mesiodens).

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Malignant melanomas represent one of the most life-threatening forms of cancer. Arising from melanocyte precursors, they have the ability to invade or readily metastasise to any organ. Intra-oral melanomas represent 1-2% of all oral malignancies, and 0.2-8% of all melanomas. Prognoses and eight-year survival rates for intra-oral malignant melanomas are poorer than for cutaneous malignant melanomas (20% and 60% survival, respectively) because of: the absence of symptoms in the early stage of the disease delaying diagnosis; difficulty in determining the width of the radical surgical excision due to anatomic limitations; and the rich blood supply to the region, which may facilitate haematogenic propagation. We report a case of a 65-year-old man with malignant melanoma of the anterior maxillary gingiva. Considering the poor prognosis associated with oral melanomas, it also emphasises the fact that suspicious pigmented lesions should be surgically removed and investigated further.

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A case of angiosarcoma of maxilla is presented. The occurrence of angiosarcoma in the oral cavity is a rare incidence and maxilla is one of the rarest sites to be involved. The purpose of this article is also to emphasize the fact that sometimes small, innocent-looking masses in the oral cavity might actually turn out to be a highly destructive malignant tumor. Hence, a complete radiographic and histopathologic examination is mandatory.

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OBJECTIVE: The purpose of this article is to discuss the general and oral findings in a patient with Fahr's disease, an uncommon disorder. CLINICAL PRESENTATION AND INTERVENTION: A patient presented with the complaint of partial anodontia, but further clinical and radiographic investigations showed a myriad of findings including stunted growth, osteoporosis and pathological calcifications. Oral findings included oligodontia and advanced periodontitis in relation to the present teeth. Full-mouth rehabilitation was eventually planned for the patient. CONCLUSION: This case shows the necessity for dentists to be aware of symptoms associated with Fahr's syndrome in order to make appropriate referrals and to enable diagnosis and treatment.

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An increase in the marginal discrepancy is seen after cementation with a luting agent and provision of cement space with a die-spacer is the most preferred method to avoid it. Recommended thickness of die-spacer is 25-40 µm. Smaller die-spacer thickness was consistently found at the axio-occlusal line angles as compared to the other surfaces which has been postulated to that the spacer paint tends to flow away from the sharp line angles and cusp tips as a result of increased surface tension. The absence of adequate relief spaces in these areas impedes the flow of cement beyond the occlusal portion of the casting, which would result in incomplete seating because of hydraulic pressure. Fifty stone dies were duplicated from a steel die and were divided into five groups of sample size 10, where the die-spacer was selectively placed. Measurements were taken at four points, 90° apart from each other with the help of optical microscope. Later all the castings were cemented using Glass Inomer cement as a luting agent, under a 10 kg static load and measurements were recorded. Statistical analysis showed samples with no spacer had the maximum pre and post cementation gap while the least discrepancy was seen in group with additional layer of die-spacer painted over the axio-occlusal line angle. The results were highly significant which clearly indicated the superiority of this group over others. Within limitations of the study, it can be said that application of additional layer of die-spacer at the axio-occlusal line angle will help in decreasing the post cementation marginal discrepancy in full cast metal crowns.