Download pmnm dental college and hospital

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR SYNOPSIS
1. NAME OF THE CANDIDATE AND ADDRESS
DR. REKHA PUTTANNAVAR
P.M.N.M DENTAL COLLEGE AND HOSPITAL
BAGALKOT- 587101
KARNATAKA.
2. NAME OF THE INSTITUTION
P.M.N.M DENTAL COLLEGE AND HOSPITAL
BAGALKOT-587101
KARNATAKA.
3. COURSE OF THE STUDY AND SUBJECT
M.D.S (MASTER OF DENTAL SURGERY)
ORAL MEDICINE AND RADIOLOGY
4. DATE OF ADMISSION
24TH MAY 2010
5. TITLE OF THE TOPIC
“PREVALENCE OF ORAL MUCOSAL LESIONS DURING ROUTINE
CLINICAL EXAMINATION IN BAGALKOT POPULATION”.
6.BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY:
When planning measures for improving oral health, the lack of data may lead to risk
of overlooking diseases of the soft tissues in and adjacent to the oral cavity.Prevalence
data of oral mucosal lesions are available from many countries, but studies in the Indian
population are scarce. For planning of national or regional oral health programs as well as
to prevent and treat oral health problems, baseline data about magnitude of the problem is
required. India has a vast geographic area, divided into states, which differ with regard to
their socioeconomic, educational, cultural and behavioral traditions. These factors may
affect the oral health status.Hence to obtain nationwide representative data, a nationwide
study is required. A more practical alternative is to develop regional databases and review
data from various regions which may give an understanding of the national scenario1.
Prevalence ratio have been reported for specific oral lesions such as denture
related lesions, leukoplakia, pigmented lesions, submucous fibrosis, lichen planus,
leukoedema, precancerous soft tissue changes, oral cancer. In addition, associations have
been described between oral mucosal lesions and betel nut chewing, tobacco and alcohol
use and age. Prevalence rates for these conditions and the identified risk factors cannot be
generalized and applied to all geographical areas and ethnic population2.
Very few studies with sufficiently large number of
individuals have presented
data on a broad spectrum of oral mucosal lesions in a general population.Hence the aim
of the study is to evaluate the prevalence of oral mucosal lesions in Bagalkot, north
Karnataka, south India.
6.2 REVIEW OF THE LITERATURE
In a study consisting of sample size of 1573, 35 to 44 years old and 1515, 65 to 74
years of from both urban and rural areas.The subjects were interviewed by trained
interviewers and underwent a clinical examination of the oral mucosa performed
according to WHO guidelines. Among the 35-45years old subjects, the overall prevalence
of OML was found to be 13% in urban men,6% in urban women, 15% in rural men and
4% in rural women. The corresponding figures for the 65-75 years olds were 22%,12%,
26%&19%.Tongue lesions and white lesions were relatively common, but denture related
lesions were not.No malignancies or erythroplakia was observed. Age and gender were
found to relate to the occurrence of OML.In elderly men, smoking was significantly
p(<0.05) associated with some white lesions and tongue lesions,and alcohol drinking
was also associated with some white lesions.In conclusion tongue lesions and white
lesions were relatively common in men,but precancerous lesions were not prevalent3
A study of 1190 subjects who came with various oral complaints over a period of
3 months were interviewed and clinically examined for oral mucosal lesions.The result
showed the presence of oral mucosal lesions in (41.2%) of the population.Fordyces
condition was observed
most frequently (6.55%) followed by frictional keratosis
(5.79%), fissured tongue (5.71%) , leukoedema (3.78%), smokers palate (2.77%),
recurrent aphthae, oral submucous fibrosis (2.01%), oral malignancies (1.76%),
leukoplakia (1.59%), median rhomboid glossitis (1.50%), candidiasis (1.3%), lichen
planus
(1.2%),
varices
(1.7%),
traumatic
ulcer
and
oral
hairy leukoplakia
(1.008%),denture stomatitis, geographic tongue,betel chewers mucosa and irritational
fibroma (0.84%),herpes labialis,angular cheilitis (0.58%) and mucocele (0.16%).Tobacco
related lesions were more prevalent among men than women.Denture stomatitis, herpes
labialis and angular cheilitis occurred more frequently in female population4.
In a study of oral soft tissue lesions in geriatric patients a sample size of 340
patients were clinically evaluated, of these 266 were institutionalized and 74 were seen at
the outpatient clinic, age ranging 60 to 104 years. 212 were females and 128 males.The
statistical analysis was done using SPSS software(11.0) to a significant level of 5%
(p<0.05).Result was as follows:57% of the studied population presented one or more oral
lesions, associated to prosthetic use, trauma and tobacco consumption.Females were
more affected than males.Lesions were more frequently observed b/w 60 to 74years of
the institutionalized group of patients of these,34% exhibited only one oral lesion.Few
cases presented upto four oral lesions. The most common alterations observed were
denture stomatitis, oral leukoplakia, hemangioma, oral melanotic macule,traumatic
fibroma,inflammatory fibrous hyperplasia and angular cheilitis5.
A group of investigators carried out a study to determine the prevalence of oral
soft tissue lesions in patients and to assess their clinicopathological attributes.3030
subjects belonging to semi urban area were screened .Statistical analysis was done using
SPSS software.8.4% of the population studied had one or more oral lesions associated
with prosthetic use,trauma and tobacco consumption.With reference to the habit of
tobacco use, 635(21%)were smokers,1272(42%)tobacco chewers,341(11%)smokers and
chewers,while 1464(48%) neither smoked nor chewed.256 patients were found to have
significant mucosal lesions.Of these 216 cases agreed to undergo scalpel biopsy
confirmation.88 had dysplasia,2 patients had Squamous cell carcinoma while there was
one patient with lichenoid reaction,angina bullosa hemorrhagica,allergic stomatitis and
nutritional stomatitis.Findings in this population revealed a high prevalence of oral soft
tissue lesions and a rampant misuse of variety of addictive substances in the community1.
In another study the data were collected from 17 mass oral screenings in various
communities for 15 years. From the 32,391 patients examined during those years, 23,616
detailed examination
cards were available.Oral and maxillofacial surgeons or oral
pathologists (or both) were available at each screening to confirm the clinical diagnosis
of difficult lesions and to recommend or perform biopsies.The examiners performed 349
biopsies of lesions found in this group of examinees, which represented 1.5% of the
group and 11.6% of all of the lesions reported.The dentists reported finding 3,783 oral
mucosal and connective tissue lesions during the examination of the sample population
(8,477 males;15,139 females).The most common clinical appearance of oral lesions in
this population was that of a single, exophytic mass,which accounted for 37.4% of all
reported lesions. Of these masses, 5.5% were cystic- usually mucoceles.Of the mucosal
surface lesions, most were white, keratotic entities,accounting for 37.6% of such lesions,
34.5% of the lesions in the miscellaneous category were of the nondiagnostic lesion
types, and the other 65.5% were identified in 32 different diagnosis that were difficult to
categorize (for example,angular cheilitis,scar tissue, and fissured tongue)6.
6.3 OBJECTIVES OF THE STUDY
1. To evaluate the prevalence of oral soft tissue lesions in patients visiting the
Department of Oral Medicine and Community dental camps of P.M.N.M Dental
College
& Hospital, Bagalkot.
2. To evaluate the risk factors responsible for the oral soft tissue lesions.
3. To gain more knowledge about oral soft tissue diseases and possibly identify new
avenues of research in this area.
7. MATERIAL AND METHODS
7.1 SOURCE OF DATA
The study sample includes screening of 5000 patients randomly selected from
ORAL MEDICINE DEPARTMENT OF P.M.N.M
DENTAL COLLEGE &
HOSPITAL AND COMMUNITY DENTAL CAMPS conducted in and around
BAGALKOT for a period of 18 months.
a. INCLUSION CRITERIA:
Patients of age 21yrs and above, both genders and all racial/ethnic groups with
oral diseases or systemic diseases with oral manifestations will be included for the study.
Pregnant patients will also be included.
7.2 METHOD OFCOLLECTION OF DATA:
Collection of samples:-Patients visiting the Department of Oral Medicine and Radiology
for routine dental checkup and at dental camps will be randomly screened and the case
history of the patients
presenting with oral mucosal lesions will be recorded on a
proforma. Patients with any oral mucosal changes/lesions will be diagnosed clinically and
if needed will be further investigated.
7.3 DOES YOUR STUDY REQUIRE ANY INVESTIGATION INTERVENTIONS
TO BE CONDUCTED ON PATIENTS OR HUMANS OR OTHER ANIMALS? IF
SO DESCRIBE BRIEFLY
If required, the patients will be subjected for investigations like biopsy, lab
investigations (Hematology /serology /other tests)
7.4
HAS
ETHICAL
INSTITUTION?
YES
CLEARANCE
BEEN
OBTAINED
FROM
YOUR
8. REFERENCES
1. Ravi Mehrotra,Shaji Thomas, Preeti Nair,Shruti Pandya,Mamta Singh, Niraj S
Nigam et al. Prevalence of oral soft tissue lesions in Vidhisha. BMC Research
notes 2010, 3:23
2. Jed S.Hand, J Michael Whitehill, Prevalence of oral mucosal lesions in an elderly
population, JADA 1986;112:73-76.
3. H.C.Lin, E.F.Corbet ,E.C.M.Lo. Oral mucosal lesions in Adult Chinese J Dent
Res 2001;80(5):1486-1490.
4. Anuna
Laila
Mathew,Keerthilatha
M
Pai,Amar
A
Sholapurkar,Manoj
Vengal.Prevalence of oral mucosal lesions in patients visiting a dental school in
Southern India,Indian J Dent Res 2008;19(2):99-103.
5. Valentina Mujica, Helen Rivera,Maria Carrero.Prevalence of Oral soft tissue
lesions in an Elderly Venezuelan population.Med Oral Patol Oral Cir Bucal 2008
May1;13(5):E270-4
6. Jerry E. Bouquot,Common oral lesions found during a mass screening
examination. JADA,1986;112:50-56
9. SIGNATURE OF THE CANDIDATE:
10. REMARKS OF THE GUIDE:
11. NAME AND DESIGNATION OF GUIDE
DR MANGALA METI
PROFESSOR
DEPT OF ORAL MEDICINE AND RADIOLOGY
P.M.N.M DENTAL COLLEGE & HOSPITAL
BAGALKOT.
12. SIGNATURE OF GUIDE :
12.1 SIGNATURE OF HEAD OF THE DEPARTMENT:
12.2 REMARKS OF CHAIRMAN AND PRINCIPAL:
13. SIGNATURE OF THE PRINCIPAL
DR SRINIVAS VANAKI
PRINCIPAL
P.M.N.M DENTAL COLLEGE & HOSPITAL,
BAGALKOT-587101
KARNATAKA