Aim: The aim of this study is to compare paraffin wax that is used as routine embedding media and beeswax in impregnation and embedding of oral tissues. Materials and Methods: Ten biopsy specimens were impregnated and embedded in paraffin wax, ten biopsy specimens were impregnated and embedded in beeswax. After manual processing, all sections were stained with Hematoxylin and Eosin to compare the effect of beeswax and paraffin wax based on the features of the integrity of the section, uniformity of the stain, staining which includes nuclear details, cytoplasmic details, and background staining. Results: Beeswax showed well impregnation and embedding of the tissues as well as the preservation of the nuclear details, good cytoplasmic appearance, good tissue architecture and no bad effect on staining characteristics of the tissue. In addition, beeswax reduced the time needed for wax cooling. Conclusion: Beeswax can be used as an alternative to paraffin wax. Thus, we recommended using beeswax in our laboratories as they are widely available.

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The aim of this study is to understand the factors that influence the color stability of composite restorations. we live in a world of esthetic dentistry where esthetic tooth-colored restorations are the trend today. Composite restoration which satisfies this need of esthetic tooth-colored restorations has evolved tremendously. Although the material holds good promise in the field of esthetic dentistry, it also possesses certain disadvantages such as discoloration in the long run. This article reviews the various factors that affect the color stability of composite restorations. since patients seek better esthetic restorations, the proper color matching is important not only in the first period of service but also over a long period. Thus, awareness of the various factors that influence the color stability of composite restorations is beneficial.

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Actinomycotic infections of the head and neck, although fairly uncommon, represent an important entity because of its varied presentation, difficult diagnosis, and long course of treatment. A 20-year-old female presented with throat pain and difficulty in swallowing since 1 year. Examination revealed a Grade IV enlargement of the left tonsil. The patient underwent tonsillectomy, and the postoperative histopathology revealed actinomycosis. Actinomyces are anaerobic filamentous bacteria which are known to colonize as commensals in tonsillar crypts which on histology show an outer zone of granulation tissue and a central zone of necrosis containing many sulfur granules that represent microcolonies of actinomyces. Actinomycosis of the head-and-neck region is a significant entity because it can mimic other common lesions especially in the oropharynx. In cases of recurrent tonsillitis and tonsillar hypertrophy, tonsillectomy is the treatment of choice and histopathological examination of resected tissue is strongly advocated. This report supports the view that actinomyces may have a causal association with recurrent acute tonsillitis and tonsillar hypertrophy.

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Cytokeratins are proteins which form the intermediate filaments and form the major cytoskeleton of the epithelial cells. It has an enormous role in providing mechanical support to the cell. There are various kinds of cytokeratins each showing varied expression in the epithelium. The cytokeratins can be broadly classified into type I or acidic and type II or basic proteins. The expression of these plays a role in differentiating different types of epithelial cells, thus enabling us to classify tumors. They help in diagnosing different types of tumors and thus have a vital role in diagnostic pathology.

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Recurrent aphthous stomatitis (RAS) is commonly known as mouth ulcer. RAS is a very common disease of the mouth. Hence, it is important for dental clinicians to know about the clinical features, causes, diagnostic techniques, and the treatment and management of RAS. Clinically, RAS is seen in three forms minor RAS, major RAS, herpetiform RAS, and in HIV patients, the fourth form is seen. Considerable amount of research has been done to elucidate the causes of RAS; local factors, systemic factors, genetic factors, microbial factors, immunologic factors, etc., but to date, no principal etiology has been discovered. There are three lines of treatment suggested for the treatment of RAS but the treatment generally given is symptomatic. This review gives an up-to-date view of the disease.

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Background: Taste, gustatory perception or gustation is one of the five traditional senses that belongs to the gustatory system. Taste is the sensation produced when a substance in the mouth reacts chemically with taste receptor cells located on taste buds in the oral cavity, mostly on the tongue. The different kinds of taste include sweetness, sourness, bitterness and so on. It has been noted that the intensities depreciate with age. Objective: To observe and analyse how the taste intensities differ with respect to age in the Indian Population. Materials and Methods: 20 candidates in the age group of 18-25, 26-40, 40-50, 50 years and above where given different substsnaces to taste and asked to score the substance based on the intensity of taste. Results and Conclusion: The perception of sweet taste was higher in the 18-25 age group. The perception of bitter sensation was more above 40 years. There is a change in the perception of taste with age although the results were not found to be statistically significant. (P = 0.0892).

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Background: Pure Castor oil has been used in the medical field for its healing properties. Its non medicinal uses include it as a food additive, flavoring agent, mold inhibitor, ingredient in skin care products and cosmetics. Its used in manufacturing of lubricants, dyes,resins and paints.Castor oil is a clear colorless viscid oil and has excellent keeping quality and good refractive index. So it was tried as an alternative to DPX as mounting media. Aim: To compare and evaluate the efficacy of Castor oil with DPX as a mounting medium. Materials and Methods: Two sections from each block of 5 histopathologically confirmed cases of mucocele were taken from the archives of the department.Sections were stained with routine H&E protocol. All the processing parameters were the same and done by the same person except for the choice of mounting media.Evaluation was done by two observers who were blinded to the choice of mounting media. Result: The results were tabulated. Student unpaired t test was used for comparing the results.Even though the results were not statistically significant,castor oil showed better details of cellular architecture than DPX. Conclusion: Castor oil showed superior quality and characteristics as a mounting media on basis of clarity of cellular characteristics.But it did not adhere to the slide.It can be used as an excellent alternative if some adhesive agents can be added to it which will help in its adherence and hence help in the preservation of the slides from mechanical damage

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Background and Aim: The awareness of prosthetic treatment among patients has seen an increase lately, and hence surge in the prosthetic treatment. Efficient and regular cleaning of denture is necessary to maintain good oral hygiene conditions and also to maintain the durability of the dentures. The aim of this research is to evaluate the awareness of patients toward denture hygiene using a questionnaire survey. Materials and Methods: A questionnaire was used to reveal the knowledge of 2 groups consisting of 50 each to evaluate their awareness of maintenance of denture hygiene (group 1 – complete denture wearers, group 2 –removable partial denture wearers). The questionnaire consisting of 20 questions collected demographic details of patients, type and duration of the denture worn, cleaning habits employed by the patients, and other details relevant to denture hygiene awareness and knowledge of patients. Results: A total of 100 patients were reviewed with their age ranging from 45 to 75. Among them 44% (25%-RPD,19%-CD) were male and 56% (25%-RPD,31%-CD) were female. Most of the patients (93%) wear their denture for all days in a week except at night. Regarding storage of dentures most patient (90%) immersed their dentures in water, whereas only 10% stored them in the dry environment. When the patients were asked whether they received instruction from their dentist regarding denture cleaning, only 45% are said to have received while 55% replied negatively. About 46% cleaned their denture more than twice per day, whereas 39% were found to clean twice a day and only 15% once per day. Regarding the method of cleaning denture the most common method was found to be with water (45%), with brush and water (40%), water and salt (9%), brush and paste (5%), and finally, brush and solution (1%). More than half of the patients (51%) used denture cleansers. In this study, it was found that only 10% of patients went for regular follow-ups. Conclusion: The denture care practices are said to be satisfactory, but there is a need to increase awareness among dentists on the importance of educating patients about denture hygiene.

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Human papillomavirus (HPV) is associated with the development of most anogenital carcinomas, including cervical cancer and has more recently been suggested to be a risk factor for a subset of head and neck squamous cell carcinoma. The prevalence of HPV in normal oral mucosa ranges from 0.6% to 81%. A 15-year-old female presented with complaints of chronically progressive pain on swallowing since 3 years. Examination revealed bilateral Grade III tonsillar enlargement with multiple warty appearances over the surface of the tonsils. Subsequently, she underwent tonsillectomy, and histopathologic study revealed tonsillar crypts lined by stratified squamous epithelium with focal koilocytic changes. PCR study detected HPV 11 DNA. The presence of HPV in the oral cavity and upper respiratory tract mucosa is of great importance since several studies have demonstrated an association of HPV with a great variety of benign and malignant lesions. The easy access to the tonsillar crypts and the favorable microenvironmental factors of the crypts may be causes of the high prevalence of HPV in nongenital regions. A rare case of benign papillomatosis of the tonsil is presented. The need for a long-term follow-up is highlighted to study the possibility and risk factors for malignant transformation.

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Background: With the busy lifestyle, there is little or no time to look after oneself, both physically and mentally. A balanced diet along with a healthy diet and regular physical exercise can help us combat various nutrition problems andachieve healthy weight goals. Obesity has become one among us. It is one of the most omnipresent, chronic diseases in need of new better strategies for prevention. Children are equipped with smartphones which makes them less active physically. It is the need of the day to have a check on the lifestyle of students, especially in the professional field, since everyday is tedious, and this is the time where tend to inculcate good or bad eating and exercising habits. Hence, this study aimed to evaluate the diet and exercise pattern of students of a well-reputed dental college. Materials and Methods: A structured questionnaire was prepared and given to the dental students of a reputed institution in Chennai, Tamil Nadu. The study was conducted from October 2016 to January 2017. A total of 197 responses were obtained. The obtained data were tabulated and analyzed. Results: This study showed that the diet and exercise habits of the students in majority are not very healthy. 36% of students had their breakfast on time, 42% had their lunch on time, and 51% had their dinner on time. 22.84% always ate more when stressed. A total of 54.3% had the habit of snackingduring studying, 52.1% when they were bored, 34% at parties, and 7.4% due to other reasons which were not stated. Nearly 50% of them exercise 0–1 time/week with light intensity exercises such as walking. A majority of 66.7% did not have the habit even before joining the college. With regard to the level of intensity, 33.3% of them did light workout, and 42% did moderate workout and 7% had the habit of doing heavy workout. The reason for exercising was mainly to maintain or lose weight (45%). 29% for general health, 14% for enjoyment, 9% stated that they worked out to relieve stress, and 3% for other reasons. Conclusion: This study concludes that the students, if given enough guidance, will be able to choose proper diet and exercise patterns, maintain good fitness and follow it regularly. This will prevent obesity and thus, in turn, various chronic diseases.

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Background: Like any other cancer, tumor microenvironment of oral squamous cell carcinoma (OSCC) is closely connected to every step of its tumorigenesis. Periostin is a unique multifunctional extracellular matrix protein found to be overexpressed in various types of human cancers. Objective: The objective of this systematic review is to critically analyze various studies in literature that have reported the expression of emerging novel tumor marker “PERIOSTIN” and to determine its role in OSCC. Materials and Methods: Articles on periostin in relation to OSCC were searched in PubMed, EMBASE, MEDLINE, and a thorough Google search was done. Hand search of Journals was also performed. Of nine potentially relevant articles, four were excluded on the grounds of exclusion criteria, and one was excluded being a review article. However, one article was included by internet search and hand search. Of the total of five relevant articles reviewed, the resulting data were collected and tabulated. Results: All the five studies reviewed demonstrated an upregulation of periostin in OSCC. Among the five, two studies showed a positive correlation of periostin with the invasive patterns of OSCC. Two of the studies correlated the expression of periostin with angiogenesis and lymphangiogenesis. Four of the five articles reviewed, showed a significant correlation of periostin expression with metastasis of OSCC. Conclusion: The inference drawn from this systematic review is that the periostin plays an important role in tumor progression including invasion, angiogenesis, and metastasis of OSCC raising the possibility that it could be used as a molecular target in the therapy of OSCC patients.

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Osteosarcoma (OS), referred to as osteogenic sarcoma, is the most common primary malignant bone tumor excluding plasma cell tumors. It accounts for approximately 15% of all primary bone tumors confirmed at biopsy. It commonly involves the appendicular skeleton. Like, its counterpart in the long bones, OS affecting the head-and-neck region shows the distinct yet diverse clinical, histologic, and prognostic characteristics. Its diagnosis is a challenge to oral pathologists and is especially important in early stages to improve its prognosis. The data have been taken from the published articles and standard books and are summarized. In this review, in addition to summarizing the current understanding of OS etiology and diagnostic methods, various experimental therapeutics have been described that provides evidence to encourage a potential paradigm shift toward the introduction of immunomodulation, which may offer a more comprehensive approach to battling cancer.

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Introduction: Blood grouping has been one of the cornerstones of identification of biological material. Mostly, teeth and bones are the only significant tissues remaining in mass disasters such as aircraft crash or, bomb blasts and hence, used in human identification. It has, also, been suggested that blood group antigens in the pulp and dentine are preserved even up to 2 years after the death of an individual. Aim: In the present study, an attempt was made to determine the ABO blood grouping from the dentine and pulp by absorption-elution (AE) technique. Materials and Methods: The study group included sixty patients requiring extraction due to periodontal or, orthodontic purposes. The extraction procedure was carried out under local anesthesia following an aseptic protocol. After extraction, the socket blood was collected for blood group determination which served as control for the study. The blood grouping was performed by AE technique using powdered dentine and dental pulp. Statistical Analysis: The statistical analysis was carried out using Statistical Package for Social Sciences version 19. The statistical analysis for comparison of teeth component with ABO blood groups with the age period and gender differentiation was done using Chi-square test. P < 0.05 was considered as statistically significant. Results: Out of sixty samples tested for ABO blood grouping, dentine and pulp showed no significant difference with age and gender; results were more positive in the age group in which individuals were <20 years of age with the sensitivity decreasing with increasing age of the individuals, while pulp was better than dentine in expressing ABO antigens. Conclusion: On the basis of the results obtained from the present study, it could be concluded that both dentine and pulp are reliable sources of blood group determination for ABO blood grouping where teeth happen to be the only remnants available for personal identification.

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Context: Since the introduction of preadjusted edgewise appliances, they are being extensively used all over the world including India. There is a need to establish the tip and torque values for Angle's Class II Division 2 patients to find whether they are comparable or, in variance with those established by Andrews which forms the basis of the orthodontic treatment with most of the most preadjusted edgewise appliance systems. The present study was carried out to study tip, torque, and tooth size discrepancies in patients exhibiting Angle's Class II Division 2 malocclusion with no previous history of orthodontic treatment. Materials and Methods: Thirty patients were selected from the outpatient department who were diagnosed as having Angle's Class II Division 2 malocclusion. Alginate impressions of all the thirty patients were made for both maxillary and mandibular arches, and the study models prepared and crown angulation/tip, crown inclination/torque, and tooth size discrepancies using Bolton's analysis were measured. Results: The upper incisor torque obtained in the present study was considerably lower than all the other studies compared. The torque value of the second mandibular molar obtained in the present study differed from all the previous studies in being much higher and following the progressively increasing negative inclination seen in all other studies from canine to second molar. The lower incisors in the present study were found to be more upright than all other studies with a higher negative torque. The other studies either showed positive torque for central incisors or mild negative torque for both lower incisors. Conclusion: The results of the present study showed some similarities with that of the Andrew's and other studies in the overall pattern of tip and torque values, for example, the positive tip of all maxillary teeth except second molars. The torque values showed a pattern of positive torque for maxillary lateral incisors while negative torque for all the other teeth. However, the values for individual teeth showed many variations.

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Lipoma, a benign tumor originating from the adipocytes, is commonly seen in many parts of the human body. Oral cavity is not a favored location for the occurrence of lipomas. Histopathologically, many variants have been described based on the presence of other components. Fibrolipoma is one such variant where the adipocytes are admixed with fibrous component. It appears as an asymptomatic growth anywhere on the oral mucosa in middle-aged individuals. A case of this variant in a 52-year-old male patient is being reported.

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Burning mouth syndrome (BMS), a chronic orofacial pain syndrome is characterized by the presence of burning, stinging, and/or itching of the oral cavity in the absence of specific oral lesion. This condition affects chiefly of middle-aged and elderly woman with hormonal changes or psychological disorders. In addition to burning sensation, patient with BMS can be accompanied by gustatory disturbances such as dysgeusia (distortion in the sense of taste), parageusia, and subjective xerostomia (dry mouth) also complains of oral mucosal pain. This condition is probably of multifactorial origin, involving various local, systemic, and/or psychogenic causes, often idiopathic and its exact etiopathogenesis remains unclear. Female gender, premenopausal, depression and anxiety, Parkinson's disease, and chronic medical conditions including gastrointestinal and urogenital diseases are risk factors for developing BMS. BMS most often involves the tongue with or without extension to the lips and oral mucosa. The present paper discusses several aspects of BMS, updates current knowledge, and provides guidelines for patient management. The aim of this study is to review the current concepts regarding pathogenesis, classification, diagnosis, and treatment for this disorder. A literature review was carried out on Google Scholar and PubMed/Medline about the BMS and the related articles was selected and reviewed. BMS is a painful and often frustrating condition to the patients. There is no universal opinion regarding etiology, diagnosis, and treatment of BMS. BMS is a diagnosis of ejection which plausibly has multifactorial origin. A thorough understanding of the etiology and psychological impact of this disorder is required for better management. Diverse pharmacological and nonpharmacological therapies are available, but it is unmanageable to achieve curative treatment. Compounding of cognitive behavioral therapy, alpha-lipoic acid, and/or clonazepam had shown promising results.

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Salivary glands containing coexisting lipomatous lesions are rare and have only been identified recently as a distinct entity; one of these lesions is a sialolipoma. The characteristic feature of these tumors is a benign proliferation of mature adipose tissue along with normal salivary gland features. We describe a case of a slowly enlarging mass in the submandibular region of a 45-year-old male which on excision was reported as sialolipoma

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Background: Natural teeth are the most durable organs in human body. It helps in the identification of people in mass disasters, accidents, or where the victim's bodies cannot be recognized by visual methods. Forensic odontology is the proper handling, examination and evaluation of dental evidence, which will be then presented in the interest of justice. Through forensic odontology, a dentist plays a very important role in crime investigation of any type. Aim: The aim of this study was to evaluate the knowledge, attitude, and practice of forensic odontology among undergraduate dental students. Materials and Methods: This is a cross-sectional, institution-based survey conducted among 154 undergraduate dental students of age group 19–21 years. Simple random sampling was done. Each participant was given a questionnaire. The questionnaire consisted of a set of 15 questions. Both yes or no and multiple choice questions were present. The answers received were tabulated and statistically analyzed. Results: All the participants were aware of the branch in dentistry called forensic odontology. Eighty-two percent of the participants pointed their source of knowledge about forensic odontology to be from lecture and workshops in college. More than 80% of students had good knowledge about forensic odontology. Eighty-three percent of the participants were interested to undergo a formal training in forensic odontology. 89.6% of participants said that there is a good scope for forensic odontology as a profession. Conclusion: Forensic odontologist plays a major role in medicolegal cases, there is an urgent need to promote this specialty. The dental undergraduates need to be sensitized toward this specialty and encouraged to be part of investigation and identification teams. This can help establish forensic odontology as a separate specialty under dental sciences.

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Probiotics are bacterial cultures or living microorganisms, which on ingestion in a certain quantity, promote, and enhance health benefits. A few conventional foods containing probiotics include yogurt, fermented and unfermented milk, cheese, etc. Strains of genera Lactobacillus and Bifidobacterium are the most widely used probiotic bacteria. Conventionally, probiotics have been associated with the gastrointestinal tract; however, recently several investigators have suggested the use of probiotics for oral health. This article describes the mechanism of action and role of probiotics in general and oral health and discusses the potential benefits of probiotics in oral health.

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Objective: The aim is to assess the prevalence of knowledge of patients' dental radiography and safety measures of radiation. Background: Dental radiographs are being used frequently in dental practice. They are being used excessively. There exists a panic among dental patients about the safety issues about dental radiography. The knowledge and behavior of patients toward radiographic examination can affect the patient's exposure to radiation. This study gathers information about the knowledge of patients have toward dental radiographs. Materials and Methods: A questionnaire with 16 questions regarding dental radiography and radiation protection were asked to the patients. Results: There was 100% response rate. Although most of them (82%) said it was for tooth decay, 54% of the patients believed it was for gum diseases and only 19% of the patients said it was for routine checkup and 22% said they were taken for impacted teeth. A small percentage of the patients mentioned it was for all the reasons (16%). 80% felt radiography should be avoided for pregnant ladies. 37%of the patients felt radiographs should be avoided for children. Conclusion: The results shows the patients do not have a clear understanding why x-rays are taken or their benefits. There is also a definite lack of knowledge regarding the safety of dental radiographs.

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Aim: The aim of this study was to determine the prevalence and frequency of use of alcohol use among dental students in Saveetha Dental College. Materials and Methods: This was a questionnaire-based observational cross-sectional type of study including 500 dental students from Saveetha Dental College. A self-administered questionnaire was given to the students and was designed to collect data on year of study, gender, and use of alcohol among dental students. Results: The results of this survey reflect alcohol usage among dental students. In the present study, a high amount which is nearly 95% of the subjects had experimented with alcohol. In our survey, nearly 23.73% of the subjects were involved in binge drinking, which is similar to the study done by Andrade 27 et al. 19 (21.8%) in the year 2012. The finding of binge drinking in the current study was higher when compared to the study done by Gignon et al. 26 in the year 2015 among 255 s to 5^th year medical students where it was 11%. Conclusion: Nearly two-third of all students were involved in alcohol drinking. Therefore, it is the responsibility of the educators to make sure to spread knowledge regarding substances abuse among the college students. Professional treatment programs should be comprehensive in approach, and should not entirely focus on substance abuse issues but should also include the treatment of dejection, apprehension, situational depression, and awareness about alcohol consumption among college students.

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Adenomatoid odontogenic tumor (AOT) is a relatively rare neoplasm. This tumor most commonly occurs in the maxilla, in the age range of 3–82 years and has a female predilection. Most AOTs occur intraosseously, while few occur within gingival structures. AOT located intraosseously may/may not be associated with an unerupted tooth (extrafollicular variant). This article highlights the unusual presentation of AOT seen in an 11-year-old female patient with a history of trauma 4 years back and a noticeable swelling in the same region 2 years later. The clinical findings were suggestive of traumatic bone cyst, fibroma, central ossifying fibroma, central giant cell granuloma (CGCG), and odontogenic tumor. Based on the radiological features, a differential diagnosis of central ossifying fibroma, CGCG, fibrous dysplasia, and extrafollicular variant of AOT/odontogenic tumor was given. Eventually, radiographic and histopathologic investigations confirmed the case as an extrafollicular variant of AOT.

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Objective: The present study was designed to analyze the morphology of dentinal tubules in carious lesions using confocal microscopy. Materials and Methods: Undecalcified ground sections of human teeth were stained with alizarin red and examined by confocal microscopy. Ten extracted carious teeth (premolar and molar) were collected, disinfected, and simultaneously fixed by storing the teeth in 10% formalin for 5 days. The specimens were later dehydrated and embedded in resin. Longitudinal and cross sections were cut, polished, and then stained with alizarin red. After dehydration, specimens were mounted on a glass slide and examined under confocal microscope using epi-fluorescent mode or transmission light mode at a wavelength of 512 nm. Results: The dentinal tubule morphology and the zones of dentinal caries were studied, and the histopathological changes of dentinal tubules showed areas of demineralized dentin, translucent dentin, and normal area. Conclusion: The current study showed that confocal laser scanning microscope has the ability to focus through a carious lesion into the underlying sound dentin and it is considered to be a nondestructive technique in demonstrating mineral changes in carious dentin.

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Aim and Objectives: The aim is to assess the quality of life (QOL) (any functional limitations, psychological limitations, and pre- and post-treatment anxiety levels) in patients with chronic oral mucosal disease (COMD). Background: Numerous studies have pointed out the incidence and prevalence of chronic oral mucosal lesions, though only a few have explained about QOL of these patients. The occurrence of oral mucosal diseases has a limitation on the QOL of the individual. Studies focusing on the QOL assessment in the Indian population are scanty. Hence, we carried out a study focusing on the QOL assessment. This study focuses on the assessment of QOL in patients with chronic oral mucosal lesions to make dentists aware and improve the holistic care for the patient. Materials and Methods: This study was administered as a closed-ended questionnaire survey to patients with various types of mucosal diseases. The responses collected were analyzed for specific associations between the diseases and the QOL. Results: We observed that COMDs affected a wide range of ages, majority being 51–60 years (28%). Recurrent aphthous ulcers and oral submucous fibrosis (OSMF) adversely affected the QOL more than the other COMDs subgroups did. Among different disease groups, patients with recurrent aphthae had the worst QOL: 73.67 ± 5.68. Significant differences were observed between various groups: leukoplakia and OSMF, leukoplakia and recurrent aphthae, lichen planus and OSMF, and lichen planus and recurrent aphthae. Conclusion: Even after treatment, COMDs negatively affect the patients' QOL. Use of the Chronic Oral Mucosal Diseases Questionnaire may allow physicians to more effectively care for their patients with these diseases.

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Trigeminal neuralgia (TN) is a recognized complication associated with trigeminal nerve. This case report describes a patient with classical unilateral TN. TN or tic douloureux is an idiopathic disorder and the most common cause of unilateral facial pain. There is no specific test to make a diagnosis of TN, and a clinical examination including assessment of cranial nerve function is mandatory. Magnetic resonance imaging can be useful in examining patients with neurological abnormalities. The various hypothesis on the pathogenesis of TN is discussed in the report. The current opinion is now in favor of a “neurovascular conflict:” an artery, most often a loop of the superior or anteroinferior cerebellar artery, has an offending contact with the trigeminal nerve root, which results in localized demyelination and ectopic triggering of neuronal discharges. This hypothesis is in agreement with the relief provided by antiepileptic drugs and is supported by recent neuroimaging data. Medical treatment (particularly carbamazepine) in these patients is very effective in controlling pain symptoms. For patients with continued pain, in spite of adequate medical treatment surgical options can be considered.

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