Verrucous Carcinoma of Buccal Mucosa in Female: A Rare Case Report of Traumatic Tooth Origin

Verrucous carcinoma or Ackermann’s tumor is considered a low-grade variant of squamous cell carcinoma frequently presenting at the oral mucosa and skin. Oral verrucous carcinoma clinically presents as a proliferative or cauliflower-like lesion or as ulceroproliferative lesion on the buccal mucosa followed by other sites such as the gingiva, tongue, and hard palate. Tobacco in both smoking and smokeless form, alcohol, and opportunist viral infections are the most associated etiologies in most of the reported literature cases. Here, in this paper, we discuss a rare case scenario of a 52-year-old female diagnosed with verrucous carcinoma of the left buccal mucosa with constant traumatic irritation caused by tooth as etiology for the occurrence of lesion, though verrucous carcinoma is described as a benign lesion with minimum aggressive potential but long-standing cases have shown transformation into squamous cell carcinoma. Therefore, early diagnosis and surgical excision of the lesion are the most appropriate treatment modality of verrucous carcinoma

Verrucous Carcinoma of Buccal Mucosa in Female: A Rare Case Report of Traumatic Tooth Origin

Verrucous carcinoma or Ackermann’s tumor is considered a low-grade variant of squamous cell carcinoma frequently presenting at the oral mucosa and skin. Oral verrucous carcinoma clinically presents as a proliferative or cauliflower-like lesion or as ulceroproliferative lesion on the buccal mucosa followed by other sites such as the gingiva, tongue, and hard palate. Tobacco in both smoking and smokeless form, alcohol, and opportunist viral infections are the most associated etiologies in most of the reported literature cases. Here, in this paper, we discuss a rare case scenario of a 52-year-old female diagnosed with verrucous carcinoma of the left buccal mucosa with constant traumatic irritation caused by tooth as etiology for the occurrence of lesion, though verrucous carcinoma is described as a benign lesion with minimum aggressive potential but long-standing cases have shown transformation into squamous cell carcinoma. Therefore, early diagnosis and surgical excision of the lesion are the most appropriate treatment modality of verrucous carcinoma.</jats:p

Effectiveness And Oral Health Status Among Individuals Using Modified Manual Tooth Brush – An Observational Study

Background of the study: Controlling plaque accumulation for prevention of gingivitis, periodontitis and dental caries effectively is determined by a number of personal and oral hygiene practice based factors. Tooth brush manufactures have put forth enormous effort in designing new models to improve performance characteristics. Aim and objective: To evaluate the effectiveness and oral health status among individuals using modified design special tooth brush with beat sound developed to assist ideal brushing technique. Material and methods: The present observational study included 20 study participants of age group between 21 to 45years. All the study participants were educated to use modified special tooth brush with beat sound regularly for a period of 21days and their oral hygiene status were evaluated by using Oral Hygiene Index Simplified (OHI-S) recorded at regular intervals on 1st, 7th and 21st day. Results: It was observed that all the study participants showed significant difference in the distribution of oral hygiene scores (P &lt; .05) irrespective of gender and majority having a fair oral hygiene status with overall mean score of 2.22 ± 0.3259 slightly higher than previous mean score of 2.77 ± 0.468 (P=.00026) and initial visit poor oral hygiene status mean score of 3.755 ± 0.4796 (P=.04579). Conclusion: Within the limitation of this study, not taking consideration of confounding factors it can be concluded that modified special tooth brush with beat sound technique show significant difference in the Oral Hygiene Index score of an individual during the observation period thus improving the overall oral health status.</jats:p

Enabling Communication via APIs for Mainframe Applications

For decades, mainframe systems have been vital in enterprise computing, supporting essential applications across industries like banking, retail, and healthcare. To harness these legacy applications and facilitate their reuse, there is increasing interest in using Application Programming Interfaces (APIs) to expose their data and functionalities, enabling the creation of new applications. However, identifying and exposing APIs for various business use cases presents significant challenges, including understanding legacy code, separating dependent components, introducing new artifacts, and making changes without disrupting functionality or compromising key Service Level Agreements (SLAs) like Turnaround Time (TAT). We address these challenges by proposing a novel framework for creating APIs for legacy mainframe applications. Our approach involves identifying APIs by compiling artifacts such as transactions, screens, control flow blocks, inter-microservice calls, business rules, and data accesses. We use static analyses like liveness and reaching definitions to traverse the code and automatically compute API signatures, which include request/response fields. To evaluate our framework, we conducted a qualitative survey with nine mainframe developers, averaging 15 years of experience. This survey helped identify candidate APIs and estimate development time for coding these APIs on a public mainframe application, GENAPP, and two industry mainframe applications. The results showed that our framework effectively identified more candidate APIs and reduced implementation time. The API signature computation is integrated into IBM Watsonx Code Assistant for Z Refactoring Assistant. We verified the correctness of the identified APIs by executing them on an IBM Z mainframe system, demonstrating the practical viability of our approach

Non-Surgical Endodontic Management of External Root Resorption in a Permanent Maxillary Central Incisor Tooth - A 3 Year Follow-Up of a Rare Case Scenario

Resorption of the tooth represents a multifactorial and a perplexing problem for all clinicians resulting in complete or partial loss of tooth structure. The present clinical demonstration describes management of the permanent maxillary left central incisor (tooth number #21) affected by external root resorption involving the mesial and distal surface of middle one-third of the root. Conventional nonsurgical endodontic treatment followed by MTA (Mineral trioxide aggregate) obturation (PRoRoot MTA, Dentsply, Tulsa Dental Specialties) was planned. The root canal of the affected teeth was debrided with Dual Rinse HEDP (Medcem Weinfelden, Switzerland) containing etidronate powder and chemomechanical preparation of the root canal was performed with XP endo shaper file system (FKG Dentaire, SA, Switzerland). Thirtysix months’ post-operative follow-up revealed complete healing of the external root resorption defect with no clinical and radiological signs and symptoms. In the present case simple non-surgical endodontic management of severe external root resorption was done in a permanent maxillary tooth by using a continuous chelation irrigation technique, intracanal medicament followed by obturation with bio-ceramic material produced satisfactory results in contrast to the recommended surgical management. Resorption of the tooth being a multifactorial and a perplexing problem for all clinicians results in complete or partial loss of tooth structure. According to the Glossary of Endodontic terms, Resorption is defined as a condition associated with either a physiologic or a pathologic process resulting in the loss of dentine, cementum, and/or bone.1 Traditionally resorption can present either as internal or as external resorption.2 External root resorption occurs on the outer surface of the root and are of dissimilar nature such as external surface resorption, external inflammatory root resorption, ankylosis, and external replacement resorption, the most common being external inflammatory root resorption.3 According to the Glossary of Endodontics, “Inflammatory resorption is defined as an internal or external pathologic loss of tooth structure and possibly bone, resulting in a defect; occurs as the result of microbial infection; characterized radiographically by radiolucent areas along the root”.1 It may result due to dental trauma, forceful orthodontic tooth movement, long standing infection of the pulp or periodontal tissues. External resorption presents as a major resorptive condition of the root without any clinical signs and symptoms.2 The non-surgical management of external inflammatory root resorption is based on its aetiology, which needs to be eliminated</jats:p

Soft tissue development around pontic site: A case series

An ideal emergence profile is vital for maintaining gingival health and developing esthetics. The ovate pontic which mimics a natural tooth gives the most appropriate emergence profile. For a successful ovate pontic restoration, an alveolar ridge of sufficient height and width is necessary to enhance the deficient ridge and to achieve an esthetic emergence profile. Interpositional graft was carried out along with ovate pontic to achieve an ideal esthetic restoration. After three months of the postoperative period, there was an increased horizontal dimension in the deficient ridge and an esthetic emergence profile. Interpositional graft technique is a simpler and predictable technique for pontic site development in moderate cases of bucco-lingual ridge deficiency

Management of Unilateral Multiple Impacted Molars- An Interdisciplinary Approach of a Rare Clinical Case

Impaction of first, second and third molars at once comprise a rare clinical scenario with diverse therapeutic approaches and possess a great challenge for the dentist. Early detection of the eruption disturbances helps to manage and produce optimal outcomes. Here, the authors reported a case of 17-year-old male patient who reported with the chief complaint of pain in his lower left back tooth region with difficulty in mouth opening and chewing that revealed impacted mandibular left first, second and third molar on radiographic investigation. A proper decision making is required to satisfy the patient and also get an effective result. As the patient had severe pain in the left side of the jaw near the angle of the mandible, surgical removal of the impacted molars was planned and performed using extra oral submandibular approach. Following the removal of the teeth, implants were placed in the extracted site supported by bone graft material and fixed orthodontic appliance therapy was carried out to correct the supra- erupted upper molars on the left side and arch expansion screw with upper Hawley’s appliance was given to expand the maxillary arch to aid in appropriate occlusion. Restoration of the implant was done after one year of orthodontic treatment using ceramic crowns. The combined surgical, orthodontic and periodontal interdisciplinary approach helped the patient to gain proper occlusion and satisfactory masticatory function.</jats:p