Frequency of Developmental Dental Anomalies in the Indian Population

Objectives: To evaluate the frequency of developmental dental anomalies in the Indian population.

Methods: This prospective study was conducted over a period of 1 year and comprised both clinical and radiographic examinations in oral medicine and radiology outpatient department. Adult patients were screened for the presence of dental anomalies with appropriate radiographs. A comprehensive clinical examination was performed to detect hyperdontia, talon cusp, fused teeth, gemination, concrescence, hypodontia, dens invaginatus, dens evaginatus, macro- and microdontia and taurodontism. Patients with syndromes were not included in the study.

Results: Of the 20,182 patients screened, 350 had dental anomalies. Of these, 57.43% of anomalies occurred in male patients and 42.57% occurred in females. Hyperdontia, root dilaceration, pegshaped laterals (microdontia), and hypodontia were more frequent compared to other dental anomalies of size and shape.

Conclusions: Dental anomalies are clinically evident abnormalities. They may be the cause of various dental problems. Careful observation and appropriate investigations are required to diagnose the condition and institute treatment. (Eur J Dent 2010;4:263-269)

Correlation between maxillary sinus floor topography and relative root position of posterior teeth using Orthopantomograph and Digital Volumetric Tomography

Background: Maxillary sinus and its close proximity to the oral cavity make it a common clinical concern for medical and dental practitioners. Due to anatomical complexities, it is difficult to evaluate the relation between the root apices of maxillary posterior teeth and the floor of maxillary sinus which is essential for diagnosis of sinus pathology, understanding the path of dental infection and planning of dental treatment.Aims and Objectives: To correlate the topographic relationship of the maxillary sinus floor to the maxillary posterior teeth roots as imaged by pairs of Orthopantomograph (OPG) and Digital Volumetric Tomography images (DVT).Materials and Methods: A total of 510 maxillary teeth from 85 patients were classified according to their topographic relationship to the maxillary sinus and measured according to their projection lengths on the sinus cavity using OPG and DVT modalities.Results: In cases of classification 0, 85% and in classification 1 , 55.3% cases shows similar classification in both OPG and DVT. 28.5% of cases in both imaging modalities show classification 2. Only 15.9% of teeth roots exhibits classification 3. 11.1% of cases showed classification 4.The panoramic radiograph showed a statistically significant 2.24 times longer root projection on the sinus cavity in  OPG comparison to DVT images.Conclusion: Teeth roots projecting in to the sinus in OPG, shows no vertical protrusion in to the sinus in DVT images. Hence DVT was better than OPG with measurements that were more exact and closer to anatomical reality.Asian Journal of Medical Sciences Vol.8(1) 2017 26-31

Quantification of telomerase activity in normal oral mucosal tissue and oral squamous cell carcinoma

BACKGROUND AND OBJECTIVE

The role of telomeres and telomerase in oral cancer is an area of much recent interest. The understanding of the role of telomere biology, the end replication problem leading to genomic instability and the reactivation of telomerase, is absolutely critical to our understanding of oral cancer, and more so, to our ability of early diagnosis and developing novel therapies and cancer prevention approaches. The aim of the present study was to quantify telomerase activity (TA) in oral squamous cell carcinoma (OSCC) and normal oral mucosa and assess the role of telomerase as diagnostic and prognostic marker of oral malignancy.

MATERIALS AND METHODS

We quantified TA in 45 patients with OSCC and 20 normal oral mucosal specimens using polymerase chain reaction-based telomeric repeat amplification protocol assay and compared it with the clinical status and grade of malignancy.

RESULTS

TA was detected in 89% of malignant and 5% of normal oral mucosal tissue. The TA levels ranged from 0.28 to 6.91 (mean 2.05, standard deviation [SD] 1.33) in OSCC and 0.21 to 1.09 (mean 0.54, SD 0.27) in normal oral mucosa. There was no relationship between TA levels and clinical stages, site of the lesion, history of adverse habits, or sex of the patient. However, under the WHO classification, there were significant differences (P < 0.00) between Grades I, II, and III. Furthermore, increasing age of the patient significantly correlated with TA.

INTERPRETATION AND CONCLUSION

The results of the present study indicate that activation of TA is frequent in OSCC. Statistically significant difference in quantified telomerase levels of OSCC and normal oral mucosa (P < 0.00) demonstrates the significant clinical usefulness of telomerase activation as a valuable marker for diagnosis while significant correlation of TA with grades of malignancy indicates its effectiveness as marker for prognosis of OSCC.

Age estimation by pulp-to-tooth area ratio using cone-beam computed tomography: A preliminary analysis

Background:

Age estimation of living or deceased individuals is an important aspect of forensic sciences. Conventionally, pulp-to-tooth area ratio (PTR) measured from periapical radiographs have been utilized as a nondestructive method of age estimation. Cone-beam computed tomography (CBCT) is a new method to acquire three-dimensional images of the teeth in living individuals.

Aims:

The present study investigated age estimation based on PTR of the maxillary canines measured in three planes obtained from CBCT image data.

Settings and Design:

Sixty subjects aged 20–85 years were included in the study.

Materials and Methods:

For each tooth, mid-sagittal, mid-coronal, and three axial sections—cementoenamel junction (CEJ), one-fourth root level from CEJ, and mid-root—were assessed. PTR was calculated using AutoCAD software after outlining the pulp and tooth.

Statistical Analysis Used:

All statistical analyses were performed using an SPSS 17.0 software program.

Results and Conclusions:

Linear regression analysis showed that only PTR in axial plane at CEJ had significant age correlation (r = 0.32; P < 0.05). This is probably because of clearer demarcation of pulp and tooth outline at this level.

Familial florid Cemento-osseous dysplasia - case report and review of literature

Familial Florid cemento-osseous dysplasia is a very uncommon condition. Cemento-osseous dysplasia is totally asymptomatic in many cases, in those conditions, lesions are detected in a radiograph taken for other purposes. In this report, we describe a family in which mother and daughter exhibited clinical, radiographic, and histologic features of florid cemento-osseous dysplasia.

Secondary Metastasis to the Mandible From Breast Carcinoma -A Rare Case Report

Regardless of the rare occurrence of metastatic lesions to the jaw, it should be taken into consideration in the individuals with a history of malignancy. Early detection requires accurate examination, and microscopic evaluation is essential. In this paper we report a case of breast carcinoma to the mandible as female breast cancer is the most frequent metastatic lesion to the mandible and its metastasis is well documented. The patient's medical history revealed that she had undergone mastectomy on the left breast three years ago. As this condition is infrequently described, documentation of new cases will augment the existing knowledge.

Heat shock protein (HSP70) as a marker of epithelial dysplasia in oral dysplastic lesions: A clinicopathological study

Objective:

In the present study, expression of heat shock protein (HSP70) was evaluated and compared in oral dysplastic lesions, in particular leukoplakia (study group) and in normal mucosal tissues (control group). Additionally, correlation of HSP70 expression with clinical disease status was investigated.

Subjects and Methods:

A total of 60 fresh tissue specimens were obtained from the oral cavity, consisting of 30 dysplastic cases and 30 normal mucosal tissues. The presence of epithelial dysplasia and its histologic grading was evaluated. Immunohistochemistry was carried out with the monoclonal HSP70 antibodies and expression of cytoplasmic HSP70 within the epithelium was compared between dysplastic and normal mucosal samples using Student's t-test.

Results:

Expression of HSP70 was detected in 93% of the oral dysplastic tissues and 20% of the normal mucosal tissues. Statistical significant difference in the HSP70 expression was seen between oral dysplastic tissues and normal oral mucosal tissues (P < 0.000). The interexaminer reliability was 93.3%. Statistical significant difference was seen in the HSP70 expression between controls and different grades of dysplasia (mild, moderate and severe). There was no relationship of HSP70 expression with clinical parameters like age, sex, site of the lesion, history of adverse habits and duration of adverse habits.

Conclusion:

In the present study, HSP70 activity was significantly higher in oral dysplastic (leukoplakia) group than in the control group. Further, as the grade of dysplasia increased, the staining intensity and/or distribution increased, indicating that enhanced HSP70 expression occurs during oral carcinogenesis. Hence, it is concluded that increased HSP70 immunoexpression could be an objective marker for the presence of epithelial dysplasia.

Hurler syndrome: orofacial, dental, and skeletal findings of a case

Hurler syndrome is a disorder of mucopolysaccharide metabolism caused due to inherited deficiencies of lysosomal α-l-iduronidase activity. We present a case of a 15-year-old male patient presenting with clinical and laboratory characteristics of the syndrome. A rare combination of skeletal, ophthalmologic, and dental findings was observed in this patient. Mucopolysaccharides excretion spot test of urine was positive and an assay of alpha-l-iduronidase enzyme was deficient, confirming the clinical diagnosis of Hurler syndrome.

Kabuki Make-up Syndrome - A Case Report with Electromyographic study

Kabuki make-up syndrome (KMS), also called Niikawa-Kuroki syndrome reported in 1981, is a rare congenital disorder of unknown aetiology. It is know to occur in many other ethnic groups, though initially described in Japan. We report a 24-year-old girl of Asian origin diagnosed with Kabuki syndrome based on characteristic clinical features. It is characterized by distinctive facial features (eversion of the lower lateral eyelid, arched eyebrows with the lateral one-third dispersed or sparse, depressed nasal tip, and prominent ears), skeletal anomalies, Dermatoglyphic abnormalities, short stature. As per our knowledge there is no literature which gives information about the importance of electromyographic study in the diagnosis and treatment of the KMS. Hence, this report emphasizes on the role of the same.

Molecular screening of lysyl oxidase G473A polymorphism in oral submucous fibrosis

Aim:

To investigate the presence of lysyl oxidase (LOX) G473A polymorphism in group 1 {Oral submucous fibrosis (OSMF) patients}, group 2 (betel quid chewers without OSMF) and group 3 (healthy individuals).

Materials and Methods:

A total of 60 patients were taken for the study, which included 20 OSMF patients (group 1), 20 betel quid chewers without OSMF (group 2) and 20 healthy individuals without OSMF and betel quid chewing habit (group 3). DNA was isolated using Qiagen kit. The isolated DNA was quantified using spectroscopic methods. Polymerase chain reaction (PCR) was carried out at annealing temperature of 67^o C. PCR amplification was checked on 2% agarose gel. Further, the amplified PCR products were subjected to automated DNA sequencer, to assess LOX G473A polymorphism.

Results:

The gene sequence data generated from the automated DNA sequencer was received as colored electropherograms. These gene-sequencing results did not show LOX G473A polymorphism in any of the 3 groups.

Conclusion:

In our study, gene-sequencing results did not show LOX G473A polymorphism in OSMF patients. Since only one study in the literature has shown the association of LOX gene polymorphism and OSMF patients, we conclude that further studies are required to unveil the role of LOX gene polymorphism in OSMF.

Oral leukoplakia - is biopsy at the initial appointment a must?

BACKGROUND

Oral leukoplakia is a potentially malignant disorder of the oral cavity. Leukoplakias with chances of undergoing malignant transformation owing to the presence of dysplastic changes may not be clinically distinguishable from leukoplakias without dysplasia. The study was carried out to evaluate the usefulness of biopsy in assessing the clinico-pathologic correlations of oral leukoplakia at the patient's initial visit.

MATERIALS AND METHODS

Hospital records with clinical diagnosis of oral leukoplakia were retrospectively analysed. All these patients had undergone biopsy in their initial visit. Histopathological slides were reviewed and reported by a single pathologist. Diagnosis agreement was considered to be present if the clinical diagnosis matched the histopathological diagnosis. Misdiagnosis was considered if the clinical diagnosis did not match the histopathological diagnosis and underdiagnosis when malignancy was detected on histopathological examination.

RESULTS

A total of 115 patients were clinically diagnosed with oral leukoplakia. According to clinical appearance of the leukoplakia patch was categorized in to three types viz homogeneous leukoplakia (n= 24 i.e. 20.87%), speckled leukoplakia (n=76 i.e. 66.08%) and verrucous leukoplakia (n=15 i.e. 13.04%). Histopathological examination confirmed clinical diagnosis in 88 cases (a diagnosis agreement of 76.52%). Histopathological examination of 19 cases revealed a different diagnosis, thus categorized as misdiagnosis (16.52%) and 8 cases had unexpected malignancy which accounted for underdiagnosis in 6.96% cases. There was dysplasia in 45 (51.13%) of the histopathologically confirmed cases of leukoplakia.

CONCLUSION

The clinical appearance of suspicious white lesions does not provide a true nature of its disease status and malignant changes may be missed.

Pleomorphic adenoma of submandibular gland: A case report with review of literature

Neoplasms that arise in the salivary glands are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Approximately 70% of the salivary gland tumors affect parotid gland with the submandibular gland being affected in 5-10% of the cases, sublingual gland in 1% and minor glands in 5-15% of the cases. Submandibular gland tumors are relatively rare and very few studies have been reported in the literature that is exclusively conducted on tumors affecting submandibular gland. In this paper, we describe a case of pleomorphic adenoma affecting submandibular gland with brief review of current literature on submandibular gland tumors.

Anatomy and morphology of the nasopalatine canal using cone-beam computed tomography

Purpose

This study was performed to evaluate the general anatomy and morphology of the nasopalatine canal using cone-beam computed tomography (CBCT) and to determine the human anatomic variability of the nasopalatine canal in relation to age and gender.

Materials and Methods

The study included 100 subjects aged between 20 and 86 years who were divided into the following 3 groups: 1) 20-34 years old; 2) 35-49 years old; 3) ≥50 years old. The subjects were equally distributed between the genders. CBCT was performed using a standard exposure and patient positioning protocol. The data of the CBCT images were sliced in three dimensions. Image planes on the three axes (X, Y, and Z) were sequentially analyzed for the location, morphology and dimensions of the nasopalatine canal by two independent observers. The correlation of age and gender with all the variables was evaluated.

Results

The present study did not reveal statistically significant differences in the number of openings at the nasal fossa; diameter of the nasal fossa openings; diameter of the incisive fossa; shape, curvature, and angulation of the canal as viewed in the sagittal sections; antero-posterior dimensions and length of the canal in the sagittal sections; or the level of division of the canal in the coronal plane by age. However, males and females showed significant differences in the length of the canal in the sagittal sections and level of the division of the canal in the coronal plane.

Conclusion

The present study highlighted important variability observed in the anatomy and morphology of the nasopalatine canal.

Disseminated non-Hodgkin's lymphoma presenting as bilateral salivary gland enlargement: a case report

Non-Hodgkin's lymphoma (NHL) constitutes a group of malignancies those arises from cellular components of lymphoid or extranodal tissues. The head and neck is the most common area for the presentation of these lymphoproliferative disorders. Primary involvement of salivary glands is uncommon. This report described a case of a 73-year-old female patient who presented with involvement of both nodal and extranodal sites, with predominant involvement of salivary glands. The tumor staging worked up along with imaging, histopathological, and immunohistochemical findings were discussed. Computed tomographic images showed the involvement of Waldeyer's ring, larynx, orbit, and spleen. This report described imaging and prognostic tumor markers in diagnosing, treatment planning, and prognosis.

The usefulness of Belgian formulae in third molar-based age assessment of Indians

The third molars are one of few useful predictors for assessing the degree of maturity in adolescence and young adulthood. It has application in age estimation in the age group of 14-23 years, in general, and in juvenile/adult status prediction, in particular. Using a 10-stage grading of third molars, Gunst et al. developed regression formulae on a large sample of Belgians (n=2513) for estimating age. Their research has been recommended as a 'reference study' in age estimation guidelines. The present study has ventured to determine if estimating age in Indians using the Belgian formulae produced results comparable to those reported in the Belgian study; in addition, this study attempts to determine if the same formulae predicted juvenile/adult status (age </≥ 18 years) accurately in Indians. The sample comprised 268 orthopantomograms (OPGs) of subjects aged between 14 and 23 years. The OPGs included a mix of one, two, three and four third molars. In total, 916 teeth were assessed using the same 10-stage grading. Age in each OPG was estimated by applying the relevant Belgian regression formulae (regression formulae are available for one, two, three and four third molars). To determine if the formulae produced age estimates comparable to those in the Belgian study, the percentage of Indian subjects whose actual age fell within the 68% confidence interval (CI) (calculated from the ± 1 S.D. value available for each Belgian formula) was ascertained. If ≥ 68% of Indian subjects' age fell inside this interval, it indicates that the Belgian formulae are applicable in Indians. To assess the suitability of the Belgian formulae in predicting juvenile/adult status in Indians, the accuracy of the age estimation per se was not considered, rather, the number of correct </≥ 18 years age predictions only was noted. Overall, ≈ 74% of Indian subjects' actual age fell within the 68% CI; with regards to the Belgian formulae being able to correctly predict juvenile/adult status, 78% of all subjects were categorized to the correct age group (</≥ 18 years). This was marginally better in males (79.4%) than females (77.3%), and in juveniles (80.3%) than adults (76.1%). These suggest that Belgian formulae are valid in age estimation per se of Indians; however, the formulae's accuracy rate in determining whether a subject is </≥ 18 years old in the Indian context, while similar to other statistical approaches, indicate that it may not be reliable-enough, and must be applied carefully and judiciously in juvenile/adult identification.

Are frontal sinuses useful indicators of sex?

Accurate sex prediction of skeletonised human remains excludes one-half of the population, enabling a more focussed search of missing persons' files. The skull is useful in sex assessment of skeletonised remains; however, its fragmentation precludes the use of all conventional craniofacial markers. The frontal bone may be recovered intact in fragmented remains and the sinuses therein may be useful in sex differentiation. A total of 100 paranasal sinus view radiographs of 50 males and females each were evaluated for potential differences in frontal sinus configuration following the methods of Yoshino et al. (Forensic Sci Int 1987; 34:289-99.) and Tang et al. (Forensic Sci Int 2009; 183:104.e1-3.). Data were assessed through univariate and multivariate statistics. The univariate Mann-Whitney U-test revealed statistically insignificant sexual dimorphism (p > 0.05) for the frontal sinuses. Moreover, multivariate logistic regression equations allowed correct sex identification in 60% of cases only. Possible reasons for the low sexual dimorphism may be frontal sinus' high inter-individual variability; also, existing techniques that employ frontal sinus classification systems may lead to a loss of information when features that require visual observation are grouped and assigned class numbers. The results herein suggest that frontal sinuses may have limited application as the sole predictor of sex.

Comparison of radiovisiography and digital volume tomography to direct surgical measurements in the detection of infrabony defects

OBJECTIVES

To compare the linear measurements of Radiovisiography (RVG) and Digital volume tomography (DVT) to direct surgical measurements in the detection of periodontal infrabony defects.

STUDY DESIGN

RVG and DVT images were taken prior to periodontal surgery for 28 infrabony periodontal defects. After defect debridement, direct bony defect measurements were made from the cemento enamel junction (CEJ) to the base of the defect (CEJ-BD) and to the alveolar crest (CEJ-AC) with a periodontal probe. These same measurements were made on the RVG and DVT images and then compared to the direct surgical values.

RESULTS

DVT correlated strongly with surgical measurements, whereas RVG correlated less favorably (P=0.0109, P=0.0193 respectively).No significant difference for CEJ-AC (P=0.0599) was seen between DVT and surgical measurements; however, there was a significant difference for the distance CEJ-BD (P=0.0105).

CONCLUSION

DVT technique is significantly more accurate than RVG in the detection of infrabony periodontal defects. Key words:Tomography, volume computed, dental radiovisiography, periodontal diseases.

Primary intraosseous carcinoma of mandible: a case report

Primary de novo intraosseous carcinoma is a rare neoplastic lesion which commonly occurs in the jaws. It is an epithelial odontogenic malignancy arising from odontogenic epithelial residues in the bone rather than from a preexisting epithelial lesion. In the present case report, the clinical, radiological and histological features of primary de novo intraosseous carcinoma are discussed and its aggressiveness and local invasiveness are highlighted.

Congenital Syngnathia: Case Report and Review of Literature

Congenital bony fusion of the maxilla and mandible, especially as an isolated occurrence, is a very rare condition. The very few cases reported in the literature are mostly inadequate in description and confusing in nomenclature. An isolated case of syngnathia in a 60-year-old female patient with unilateral bony fusion (synostosis) of the maxilla and mandible associated with fibrous adhesions (synechiae) of the opposite site is reported. The existent literature is also reviewed.

Familial hypophosphatemic rickets

Rickets is the failure of mineralization of osteoid and newly formed bones in a child skeleton. It is commonly associated with vitamin D deficiency; however, it can be because of a decrease in the serum phosphate levels leading to inadequate mineralization of cartilage and bone, consequent skeletal deformities, and growth retardation. The hypophosphatemic conditions that interfere in bone mineralization comprise many hereditary or acquired diseases. One of the hereditary types of hypophosphatemic rickets is the familial hypophosphatemic rickets. This rare variety was diagnosed in a 9-year-old patient who had come with a chief complaint of a missing tooth. In the present case, radiographic aspects of oral and systemic manifestations of familial hypophosphatemic rickets are highlighted.

Frequency of developmental dental anomalies in the Indian population

OBJECTIVES

To evaluate the frequency of developmental dental anomalies in the Indian population.

METHODS

This prospective study was conducted over a period of 1 year and comprised both clinical and radiographic examinations in oral medicine and radiology outpatient department. Adult patients were screened for the presence of dental anomalies with appropriate radiographs. A comprehensive clinical examination was performed to detect hyperdontia, talon cusp, fused teeth, gemination, concrescence, hypodontia, dens invaginatus, dens evaginatus, macro- and microdontia and taurodontism. Patients with syndromes were not included in the study.

RESULTS

Of the 20,182 patients screened, 350 had dental anomalies. Of these, 57.43% of anomalies occurred in male patients and 42.57% occurred in females. Hyperdontia, root dilaceration, peg-shaped laterals (microdontia), and hypodontia were more frequent compared to other dental anomalies of size and shape.

CONCLUSIONS

Dental anomalies are clinically evident abnormalities. They may be the cause of various dental problems. Careful observation and appropriate investigations are required to diagnose the condition and institute treatment.

Malignant melanoma of the mandibular gingiva

Oral malignant melanoma is an infrequent neoplasia making up less than 1% of all melanomas, which exhibits much more aggressive behavior than those found on the skin. We present an aggressive case of oral malignant melanoma located on the mandibular gingiva in a 24-year-old male patient, who developed metastases to not only the regional lymph nodes but also the lungs and liver. The advanced stage of the disease contraindicated any surgical intervention and palliative chemotherapy was planned.

Thurston syndrome: oral and systemic manifestations. Case report and review of the literature

Orofaciodigital (OFD) syndrome is a generic name for a variety of different but possibly related genetic disorders that result in malformations of the mouth, teeth, jaw, facial bones, hands, and feet and are therefore categorized as oroacral disorders. Nine subtypes of OFD syndromes have been identified. OFD type V is known as Thurston syndrome, of which only 11 cases have been reported to date. A case is reported of a 19-year-old man with this syndrome. A brief review of previously reported cases and discussion of anomalies of the syndrome is presented.

Lingual ulceration in disseminated histoplasmosis

Histoplasmosis is a rare systemic fungal infection commonly presenting as mucosal ulceration of the oral cavity. It has been increasingly reported in India as disseminated disease with lesions in the oral cavity as a consequence of rapid spread of HIV infection. The authors report a case of disseminated histoplasmosis with oral manifestation in a 40-year-old male patient.

Orofacial rehabilitation of patients with post-cancer treatment--an overview and report of three cases

According to World Health Organisation statistics, individuals of the Indian subcontinent have the highest prevalence of orofacial cancer. Surgery, radiation, chemotherapy or combination therapies are commonly administered treatment modalities for treatment of oral cancer. Surgical resection can be mutilating, disfiguring and may deeply affect self-image of patients. Orofacial defects have unique limitations and challenges. A coordinated effort from the surgeon, oral physician and the maxillofacial prosthodontist to treat such patients is the need of the hour. This article presents an overview of the orofacial rehabilitation of postcancer treatments along with case reports.

Melkerson Rosenthal Syndrome – A Case Report

Melkersson-Rosenthal Syndrome (MRS) is a rare syndrome consisting of a triad of persistent/ relapsing facial palsy, recurrent orofacial edema and fissured tongue. The syndrome does not manifest in complete triad at all times and diagnosis is often difficult. We present a case of a 40-year-old male with a complete triad of all the manifestation of this syndrome. This case highlights the need to consider MRS as one of the differential diagnosis of recurrent facial palsy and also stressing the importance of a thorough intraoral examination when patients presents with relapsing facial palsy.

Sturge-Weber syndrome: physician's dream; surgeon's enigma

Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome consisting of port wine stain (facial nevus flammeus), congenital glaucoma and underlying anomalous leptomeningeal venous plexus with lack of normal cortical venous drainage. Neuromuscular, ocular, dermatologic and oral manifestations are variously present with this syndrome. The syndrome presents with various oral findings and the diagnosis of these cases is based primarily on clinical findings. Considering the complications that may be encountered during the treatment and the patient's own perception of the condition, it is imperative that the diagnostician and surgeon have thorough knowledge of the condition. Here we report a case of SWS with facial angiomas, seizures and intracranial calcifications.

Hemifacial microsomia. A report of two cases

Hemifacial microsomia (HFM) is an asymmetrical congenital deformity of the head and face caused by anomalous development of the structures derived from the first and second branchial arches. Oral and maxillofacial malformations present diagnostic and treatment challenges unique to the dental profession. The etiology, a report of two cases and a brief description of treatment modalities are discussed in this article.