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The central giant cell granuloma displays a varied biologic behaviour ranging from simple reactive lesions to aggressive neoplasms. The pathogenicity still remains enigmatic and needs to be differentiated from other giant cell containing lesions. Both maxilla and mandible are affected and 80% involve the region anterior to the first premolar region. CGCL arises centrally within bone, whereas PGCG is a gingival soft tissue lesion. Clinical and radiographic correlation is required to rule out a peripheral giant cell granuloma. The case described here was a rare presentation of a large epulis clinically with involvement of maxilla radiographically and was histologically diagnosed as a central giant cell lesion.

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CONTEXT: Canal shaping abilities such as canal transportation, centering ability, and preparation time are important and have to be considered before using any Nickel-Titanium file system. AIM: This in vitro study aimed to evaluate and compare the amount of canal transportation, centering ability, and time required for the shaping of severely curved canals with WaveOne Gold (WOG) Primary Reciprocating file and One Curve (OC) Rotary file using the micro computed tomography (µCT). MATERIALS AND METHODS: Thirty intact mesial roots of extracted human mandibular first molars having severe curvature (25°-35°) were selected. Samples were divided into two groups. Samples in Group I and II were shaped with WOG primary reciprocating files and OC rotary files, respectively, to the working length. Time required to prepare each canal was recorded. µCT pre- and post-instrumentation scans of all samples were taken. The cross-sectional images at 3, 6, and 9 mm from the radiographic apex were selected for analysis. Statistical analysis was performed using the Kruskal-Wallis and unpaired t-test. RESULTS: At 3 mm, OC showed statistically lower canal transportation with mean value (0.17 ± 0.10) than WOG (0.55 ± 0.42). Furthermore, OC showed statistically significant better centering ability (0.59 ± 0.25) than WOG (0.39 ± 0.20) at 3 mm level. However, the differences between both instruments were not statistical significant at 6 and 9 mm level for canal transportation and centering ratio. WOG reciprocating file required less time for canal preparation than OC file. CONCLUSIONS: OC rotary file showed less canal transportation and better canal centring ability than WOG file, during the preparation of severely curved canals. However, WOG required less time for canal preparation.

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UNLABELLED: Inflammatory lesions, like periapical/odontogenic abscesses, are by far the most common pathologic condition of the jaws. Radiographically, these lesions commonly manifest as widening of periodontal ligament space, discontinuity of lamina dura and ill-defined periapical radiolucency. There are some rare disorders which could cause similar radiographic changes in the jaw bone. With careful scrutiny of periapical radiolucency, regular periodic follow-up radiographs and histo-pathologic examination, the periapical abscess or infection can be differentiated from rare fatal disorders. CLINICAL RELEVANCE: This paper highlights the need for vigilant examination of even the commonest, innocuous-appearing periapical changes which sometimes are produced by some rare fatal disorders.

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OBJECTIVES: The aim of the study was to compare the effectiveness of vasodilator isoxsuprine to dexamethasone with hyaluronidase injections and physiotherapy in the treatment of oral submucous fibrosis. MATERIALS AND METHODS: Forty patients with oral submucous fibrosis were randomly assigned into three groups. Group A patients (n = 15) received 10 mg isoxsuprine tablets four times per day, group B (n = 15) biweekly dexamethasone with hyaluronidase intralesional injections, and group C (n = 10) placebo tablets. In addition, all patients were instructed physiotherapy exercises. The treatment time was 6 weeks and patients were followed-up for 4 months thereafter. The effect of the treatment was evaluated by measurements of inter-incisal distance and oral burning sensation and evaluation of histological findings of the diseased mucosa. RESULTS: Mouth opening increased and burning sensation decreased significantly in all groups, but the effects were significantly greater in groups receiving either oral isoxsuprine or dexamethasone with hyaluronidase injections in addition to physiotherapy. The decrease in burning sensation occurred more rapidly in patients receiving intralesional dexamethasone with hyaluronidase. Histological improvement was not observed in any of the groups. CONCLUSIONS: Oral isoxsuprine as well as dexamethasone with hyaluronidase injections combined to physiotherapy alleviate symptoms of oral submucous fibrosis significantly more efficiently than physiotherapy alone. CLINICAL RELEVANCE: Oral isoxsuprine can be considered as a new candidate drug for the treatment of oral submucous fibrosis. Physiotherapy exercises provide relief of symptoms and should be instructed to all patients.

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Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Due to its bloodstream dissemination, most of them are a consequence of the follicular variant of thyroid carcinomas. We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy.