Journal of Advanced Clinical and Research Insights


Pathogenesis of Ewing sarcoma: A review

P. S. Vidya Rani, K. Shyamala, H. C. Girish, Sanjay Murgod
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:164–168] [No. of Hits: 916]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.70]


Ewing sarcoma is a rare sarcoma of bone and soft tissue that uncommonly involve the head and neck. It is the second most common malignant tumor seen in children and young adults. It is most common observed during the second or third decade, with a male predilection. In the head and neck region, it involves skull, clavicle, maxilla, and mandible. The reported incidence of this tumor is only 1-3 cases per million of population per year and skull tumors constitute about 2% of it. The cell of origin is still unclear as there are several literature supporting both the neural crest mesenchymal progenitor/stem cells hypothesis. Ewing sarcoma is believed to be derived from recurrent EWS/E-twenty six (ETS) oncogenic fusions, which result in altered gene expression in the cell and other mechanisms. This altered gene expression is followed by the abnormal regulation in the expression of several genes and non-coding RNAs. In Ewing sarcoma, the translocation of t(11;22)(q24;q12) is considered as the primary mechanism for tumorigenesis. The tumor is characterized by the rearrangement of EWS gene on chromosome 22q12 and the fusion partners from the ETS oncogene family, chimeric transcription factor, which is responsible for the Ewing sarcoma oncogenic program. A hybrid gene is formed by the fusion of EWSR1 in 22q12 with the FLI1 gene in 11q24. EWS/FLI is the common chimeric protein that is expressed in Ewing’s sarcoma. The expression of this protein results in the growth arrest and cell death, when they are expressed in primary cell lines. The expression of these proteins in primitive cell or tumor cell causes differentiation defects resulting in oncogenesis. In this review, we have made an attempt to have an insight into the possible mechanism of pathogenesis and cell of origin of Ewing sarcoma.

Keywords Chimeric protein, Ewing sarcoma, EWS/E-twenty six oncogenic fusions, EWS/FLI, oncogenesis

How to cite this article: Rani PS, Shyamala K, Girish HC, Murgod S. Pathogenesis of Ewing sarcoma: A review. J Adv Clin Res Insights 2015;2:164-168.

Received 11 May 2015;
Accepted 20 June 2015


Radiation protection in dentistry - Do we practice what we learn?

Sumona Pal, Preeti Tomar Bhattacharya, Rupam Sinha
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:155–159] [No. of Hits: 750]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.68]


Aim: Easy availability, overuse, and lack of reinforcement of the radiation hazards facts have unknowingly resulted in overlooking of as low as reasonably achievable (ALARA) among many dentists. The current survey was designed to assess the awareness, concern, and practice of radiation protection in general dental practice.

Materials and Methods: The survey involved 156 dentists in West Bengal, India. A cross-sectional self-administered questionnaire consisting of a total of 28 items was employed. The obtained data were compiled systemically and significance of difference was calculated by Chi-squared test using Statistical Package for Social Sciences 17.

Results: Bisecting angle technique and use of E-speed films with manual processing were the most common. The majority of the participants had no idea about the type of cone used (37.2%), tube current (37.8%), kVp 56.4% (88). Exposure time was equally variable with maximum variability in the case of digital radiographs. Use of lead barriers and aprons were poor.

Conclusion: The knowledge and practice of radiation protection are not satisfactory. Repeated reinforcement and training and the most importantly change in attitude to follow ALARA is required.

Keywords Dentists, questionnaire survey, radiation, safety measures

How to cite this article: Pal S, Bhattacharya PT, Sinha R. Radiation protection in dentistry - Do we practice what we learn? J Adv Clin Res Insights 2015;2:155-159.

Received 10 May 2015;
Accepted 16 July 2015


Minimally invasive preparations: Contact lenses

Adhara Smith Nobrega, Ana Flavia Silva Signoreli, Jose Vitor Quinelli Mazzaro, Ricardo Alexandre Zavanelli, Adriana Cristina Zavanell
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:176–179] [No. of Hits: 1675]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.73]


Conservative aesthetic dental treatment methods have been increasingly requested in clinical practice, especially when the anterior region presents aesthetics problems, such pigmentations, malpositioning, and problems of proportion and size of the teeth. Thus, this work aims to conduct a brief literature review on esthetic restorations with minimally invasive preparations and describe step by step, by reporting a case, the clinical protocol to be followed by the professional for making dental contact lenses. Currently, what is more conservative in aesthetic treatments are ceramic fragments, usually made of lithium disilicate ceramics, which are 0.2-0.5 mm thick and, therefore, require minimal tooth preparation. Such treatment was selected for a male patient aged 17-year-old who was admitted in the Aracatuba Dental School, Universidade Estadual Paulista, complaining of unsatisfactory aesthetics due to dental problems of size and proportion. The achieved result was very satisfactory for both the patient and professional. We conclude that the contact lenses are currently the best treatment option for elective aesthetic cases, once it is an extremely conservative rehabilitation that faithfully mimics the dental structure and shape, besides being a very predictable treatment.

Keywords Ceramics, dental, dental porcelain, diastema, esthetics

How to cite this article: Nobrega AS, Signoreli AF, Mazzaro JV, Zavanelli RA, Zavanell AC. Minimally invasive preparations: Contact lenses. J Adv Clin Res Insights 2015;2:176-179.

Received 01 May 2015;
Accepted 10 July 2015


Transforming growth factor-ß - The master switch in oral submucous fibrosis

Roopa S. Rao, Shankargouda Patil, B. S. Ganavi
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:153–154] [No. of Hits: 1184]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.67]


Oral submucous fibrosis (OSMF) is a chronic progressive, debilitating disorder of oral cavity, oropharynx and upper third of the esophagus. Scientific data confirms the etiological role of areca nut. Submucosal fibrosis due to excessive abnormal collagen being the hallmark, OSMF is accepted beyond doubt as a potentially malignant disorder.[1,2]


Early diagnosis of osteoporosis in male and female patients between 30 and 75 years using orthopantomography

Tejavathi Nagaraj, T. V. Bhavana, Leena James, Rahul Dev Goswami, N. Sreelakshmi, Noori Ghouse
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:160–163] [No. of Hits: 1515]
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  • [Abstract]
  • [DOI : 10.15713/ins.jcri.69]


Background: Osteoporosis is a systemic bone disease that is characterized by a generalized reduction of the bone mass. This bone disease exhibits microarchitectural degradation/disintegration of the bone scaffold that leads to increased bone fragility and more prone to fracture. Dental radiographs are one of the commonly used imaging modalities for teeth and jaw pathology.

Aims and Objectives: The aim of this study was to assess the mandibular bone quality in panoramic radiographs for an initial evaluation of osteoporosis in male and female patients between 30 and 75 years using mental index (MI), which measures the cortical bone thickness of mandible.

Materials and Methods: Hundred digital panoramic radiographs were screened. MI was used to evaluate the mandibular cortical bone thickness bilaterally. In males and females average MI scores were then assessed by using the t-sample independent test.

Results: The study was statistically significant with P < 0.001 which showed differences of mandibular bone quality between the groups based on MI measurements.

Conclusion: Using MI for assessment of mandibular bone quality in panoramic radiograph showed a significant difference between males and females. Correlation between MI and age showed elderly females were most affected by osteoporosis. Thus, panoramic radiographs can act as a diagnostic aid for early detection of osteoporosis.

Keywords Bone marrow density, mental index, osteoporosis, panoramic radiography

How to cite this article: Nagaraj T, Bhavana TV, James L, Goswami RD, Sreelakshmi N, Noori. Early diagnosis of osteoporosis in male and female patients between 30 and 75 years using orthopantomography. J Adv Clin Res Insights 2015;2:160-163.

Received: 08 May 2015;
Accepted: 15 July 2015


Role of oral physician in Indian public health system

Pragati B. Hebbar
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:169–171] [No. of Hits: 991]
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  • [DOI : 10.15713/ins.jcri.71]


The Indian public health scenario is gradually receiving the due attention it deserved at least in the academic front. Oral medicine and radiology in itself is a very vast branch concerned with the diagnosis and non-surgical management of diseases of oral and paraoral structures. The specialty of oral medicine and radiology being in this crucial position as a link between medicine and dentistry can contribute much more to strengthen public health efforts than it is currently contributing. This branch covers diseases not only related to the teeth, surrounding jaws, joints, and salivary glands but also systemic diseases, their inter-relation to oral health and their manifestations in the oral cavity. This vast bank of knowledge can be exploited with integrated oral and general health programs. With the growing burden of non-communicable diseases globally as well as nationally a greater role for the oral physician needs to be carved out. In a three-tier health care delivery system the oral physicians could be taken up into the secondary care facilities to diagnose oral cancer, precancers, indications of systemic diseases and management of their oral manifestations, counsel on tobacco cessation, etc. Academics, health care delivery and research are viewed as distinct fragmented structures. Breaking these silos to achieve integrated people-centered care should be our long-term vision. This article delves into each of the silos to examine the gaps and propose some solutions to delineate the optimal role of an oral physician in the complex health care landscape of India.

Keywords Dentistry, non-communicable diseases, oral health, oral medicine, public health

How to cite this article: Hebbar PB. Role of oral physician in Indian public health system. J Adv Clin Res Insights 2015;2:169-171.

Received 05 May 2015;
Accepted 20 June 2015


Compound odontoma causing impaction of permanent maxillary incisors with associated ghost cell keratinization: A case report

K. M. Parveen Reddy, N. H. Praveen Kumar, Santosh Hunasgi, Anila Koneru, R. Surekha, M. Vardendra
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:172–175] [No. of Hits: 2068]
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  • [DOI : 10.15713/ins.jcri.72]


Many times compound odontomas are found associated with unerupted teeth. The canines, followed by maxillary central incisors and third molars are the major teeth which are impacted by odontomas. Herewith, this paper reports a case of compound odontoma associated with impacted permanent right maxillary central and lateral incisors. An 11-year-old girl reported with a chief complaint of retained primary tooth. Intraoral examination revealed that primary maxillary right central and lateral incisors were retained while permanent maxillary left central and lateral incisors were erupted and well accommodated. A non-specific swelling was there on labial aspect of 51 and 52 tooth region, which was measuring about 0.5 cm × 1 cm, enlarging mesiodistally from distal of permanent left central incisor tooth to distal aspect of over retained right primary lateral incisor. Digital orthopantomograph showed calcified masses in the form of tooth-like structures present above the root apex and distal aspect of 51 and 52, causing root resorption. On the source of the past, clinical and radiographic assessment a final opinion of compound odontoma was made.

Keywords Compound odontoma, ghost cells, incisors, maxillary

How to cite this article: Reddy KMP, Kumar NHP, Hunasgi S, Koneru A, Surekha R, Vardendra M. Compound odontoma causing impaction of permanent maxillary incisors with associated ghost cell keratinization: A case report. J Adv Clin Res Insights 2015;2:172-175.

Received: 29 May 2015;
Accepted: 30 June 2015


Atypical presentation of non-Hodgkins lymphoma of the mandible: A rare case report and literature review

Soujanya Reddy, N. R. Diwakar
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:180–183] [No. of Hits: 1961]
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  • [DOI : 10.15713/ins.jcri.74]


Non-Hodgkin’s lymphoma (NHL) and HL are neoplasm’s originating from cells of the lymphoid lineage. It is the third most frequent childhood malignancy, and NHL accounts for about 7% of malignancy in children younger than 20 years. Lymphoblastic lymphoma is a type of NHL largely affects children and teenagers. It begins when lymphocytes, a form of white blood cell, grow bizarrely. Malignant NHLs of the mandible are regularly misdiagnosed owing to their low frequency and non-specific symptoms. This paper reports of an unusual presentation of NHL in the mandible and reviews the current literature.

Keywords B-lymphoblastic lymphoma, mandible, non-Hodgkin lymphoma

How to cite this article: Reddy S, Diwakar NR. Atypical presentation of non-Hodgkins lymphoma of the mandible: A rare case report and literature review. J Adv Clin Res Insights 2015;2:180-183.

Received 01 Jun 2015;
Accepted 28 Jul 2015


Esthetic rehabilitation of non-syndromic oligodontia: An innovative approach

P. Poornima, Meghna Bajaj, K. P. Bharath, N. B. Nagaveni
[Year:2015] [Month:July-August] [Volume:2 ] [Number:4] [Pages No:184–188] [No. of Hits: 1338]
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  • [DOI : 10.15713/ins.jcri.75]


This case report describes the esthetic rehabilitation of a 13-year-old girl presenting with non-syndromic oligodontia, who had compromised esthetics, occlusal function, development, and retarded skeletal growth. The esthetic rehabilitation was completed with direct composite restoration using thermoformed templates along with reinforced polyethylene fibers. The present technique is a viable alternative to reestablish the masticatory function, esthetics with improved self-esteem.

Keywords Composite restoration, oligodontia, reinforced polyethylene fibers, thermoformed template

How to cite this article: Poornima P, Bajaj M, Bharath KP, Nagaveni NB. Esthetic rehabilitation of non-syndromic oligodontia: An innovative approach. J Adv Clin Res Insights 2015;2:184-188.

Received 02 May 2015;
Accepted 20 June 2015