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Background: Although oral cancer is multifactorial in origin only few had evaluated the diagnostic parameters for candidal infection in oral squamous cell carcinoma (OSCC). Aims: To compare and assess the accuracy of Calcofluor White (CFW) to that of conventional staining methods to identify the presence of candidal infection in OSCC. Methods: Archival collections of 43 OSCC were retrieved for this investigation. Standard staining protocol was followed for the index test (CFW) and reference standard (Periodic Acid Schiff). Two examiners were blinded for either one of the staining techniques. Diagnostic test evaluation and Kappa statistic was calculated using MedCalc software. Results: The study comprised 37 males, six females, and their mean age at the time of presentation was 51 (range 23 to 75 years). The sensitivity and specificity of CFW was 75.8% (CI 57.7 to 88.9%) and 10.0% (CI 0.2 to 44.5%). While the positive predictive and negative predictive values were 63.1% (CI - 50.6-74.0%) and 67.0% (CI - 49.2-81.0%). Conclusion: Our results show minimal agreement with PAS with a Kappa score of 0.148 (95% CI = 0.39 to 0.09). Overall detection rate was similar for both the index test and reference standard although there was considerable number of intermediate test results. Sensitivity of CFW was comparable to that of earlier studies but specificity was low and the degree of concordance was 60.4%. Although CFW staining can come with high false positive they are a useful test for ruling out candida infection when the test result is negative.
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BACKGROUND: Chronic nail biting is common in children and young adults. Auto inoculation of environmental pathogens can manifest as infection in distant organs. Multi-drug resistance gram negative bacteria are on the rise globally. Several of the foodborne bacteria fall within the Enterobacteriaceae family but very few studies have explored these microbes in the oral cavity of children with chronic nail-biting habit or orthodontic treatment. The study aims to investigate oral load of Enterobacteriaceae in children with chronic nail-biting habit and or those undergoing orthodontic treatment. MATERIAL AND METHODS: 150 children (no nail-biting n=30, nail biting n=60, fixed orthodontic treatment n =30 and a combination of fixed orthodontic appliance use and nail-biting habit n =30) were assessed for culture based microbiological investigation. The concentrated oral rinse technique was used. The rinse was inoculated in MacConkey's and Blood Agar. The gram stained culture was subjected to biochemical tests for sub-species identification using Biomerieux Vitek 2 Compact Automated Microbiological Analyzer. Fisher's exact and Kruskal Wallis with post hoc analysis using Dunn method was performed to test association and difference between groups. RESULTS: Enterobacteriaceae was positive for 72% of the children. Of them, nail biting or orthodontic treatment group comprised 89%. Those with a combination of nail biting and undergoing orthodontic treatment exhibited highest CFU/ml and those without nail biting or orthodontic treatment exhibited the lowest. Three of the four organisms isolated tested positive in the orthodontic treatment group. E. coli was positive in 38% of the children while Klebsiella and E. cloacae were isolated exclusively in the orthodontic treatment group. CONCLUSIONS: Chronic nail biting or the use of fixed orthodontic appliances is associated with higher incidence of Enterobacteriaceae in the oral cavity. Oral health professionals play an important role in preventing multi drug resistance infectious diseases. Key words:Enterobacteriaceae, nail-biting, Onychophagia, orthodontic treatment.
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Prosthodontics is not just confined to replacement of missing teeth but beyond one's scope. The fabrication of any extraoral maxillofacial prosthesis presents the prosthodontist with several phenomenal challenges. Psychologically, these patients are severely affected either by congenital absence or loss of ear due to trauma or burns. Replacement or reconstruction can be done by surgical or prosthetic approach. However, not all situations are favourable to surgical reconstruction. This article emphasises on the steps in fabrication of ear prosthesis for burn deformity.
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BACKGROUND: Recent metallurgical research and advancement in material science has benefited orthodontists in the selection of an appropriate wire size and alloy type, which is necessary to provide an optimum and predictable treatment results. The purpose of the study was to clinically evaluate and compare the surface characteristics of 16 x 22 stainless steel, Titanium molybdenum alloy, timolium, and titanium-niobium before and after placing them in a patient's mouth for 3 months using a scanning electron microscope (SEM). MATERIALS AND METHODS: The total sample size was 40, which were divided into four groups (group 1 - stainless steel wires, 10 samples, group 2 - TMA wires, 10 samples, group 3 - timolium wires, 10 samples, and group 4 - titanium-niobium wires, 10 samples), and these were further subdivided into 5 each. The first subgroup of five samples was placed in the patient's mouth and was evaluated under SEM, and another subgroup of five samples was directly subjected to the SEM. RESULTS: Scanning electron microscopic evaluation of surface characteristics of unused 16 x 22 rectangular stainless steel wire under 500 x magnification showed an overall smooth surface. Stainless steel wire samples placed in the patient's mouth showed black hazy patches, which may be interoperated as areas of stress. TMA unused wires showed multiple small voids of areas and small craters with fewer elevated regions. The TMA wire samples placed in the patient's mouth showed black hazy patches and prominent ridges, making the wire rougher. Timolium unused archwires showed heavy roughness and voids, whereas wires tested in the patient's mouth showed homogeneous distribution of deep cracks and craters. Unused titanium-niobium archwires showed uniform prominent striations and ridges with occasional voids, whereas wires used in the patient's mouth showed prominent huge voids that could be interpreted as maximum stress areas. CONCLUSION: Stainless steel (group 1) used and unused wires showed smooth surface characteristics when compared with all the other three groups followed by timolium, which was superior to titanium-niobium wires and TMA wires. CLINICAL SIGNIFICANCE: Timolium wires are superior to titanium-niobium wires and TMA wires.