Sandhya Tamgadge - Academia.edu (original) (raw)

Papers by Sandhya Tamgadge

Research paper thumbnail of Oral squamous cell carcinoma: A case report with scanning electron microscopy, Mallory’s, Masson’s trichrome, orcein, and Papanicolaou staining

Journal of Academy of Dental Education, Feb 21, 2024

Research paper thumbnail of Odontome – A Single-institutional Cross-sectional Study of 31 Years from Mumbai and Case Report with Modified Gallego’s Stain

Journal of Microscopy and Ultrastructure, Dec 11, 2023

Research paper thumbnail of A Survey Based Pilot Study on Three Dimensional Images and Animated Videos in Oral Histopathology

Background: Oral Histopathology is the study of diseased tissues in a lifelike manner. Unfortunat... more Background: Oral Histopathology is the study of diseased tissues in a lifelike manner. Unfortunately biopsy tissue gives two dimensional and static images. Additionally the descriptions of such images are in three dimensional terms such as cords, arcading, organoid etc., which most of the time is confusing to the students and readers. Therefore it becomes very difficult to correlate the descriptions mentioned in the textbooks with the images viewed under microscope. Researchers have been trying to develop various softwares to convert two dimensional images into three dimensional but again such images would still be static. Therefore three dimensional animation videos which would depict the etiopathogenesis in life like manner, should be available at each university to promote e-learning especially for oral histopathology speciality, popularity of which has been vanishing day by day. Such videos are already available for other speciality of dentistry. With this concept, a preliminary effort was been taken to design such animations for histopathological aspect of ameloblastoma and shown to students. Methods: A survey was conducted amongst bachelor of dental surgery students, interns and master of dental surgery students using questionnaire, to know the understanding level of oral histopathology through traditional teaching methods. Additionally few images and videos have been created using various softwares and feedback was evaluated. Results: Three dimensional videos were perceived as effective and efficient as E-learning tools for oral histopathology education. Conclusion: User feedback on the educational content was helpful. A website exclusively for this work was suggested and planned for E-learning.

Research paper thumbnail of Hybrid Odontogenic Tumor with COC and Multiple Variants of Ameloblastoma-A Rare Case Report

Journal of Oral Hygiene & Health, 2014

Ameloblastomas do not generally show evidence of induction, however rare cases associated with od... more Ameloblastomas do not generally show evidence of induction, however rare cases associated with odontome have been reported and are referred to as odontoameloblastoma. This article presents an unusual case of multiple histopathological variants of ameloblastoma with evidence of induction of dentinoid by tumor cells but without concomitant formation of enamel along with features of ghost cells. The lesion occurred on the left side of the maxilla in a 31-year old female. Case management has been described and implications are discussed.

Research paper thumbnail of A Survey Based Pilot Study on Three Dimensional Images and Animated Videos in Oral Histopathology

International Journal of Oral and Maxillofacial Pathology, 2015

Background : Oral Histopathology is the study of diseased tissues in a life-like manner. Unfortun... more Background : Oral Histopathology is the study of diseased tissues in a life-like manner. Unfortunately biopsy tissue gives two dimensional and static images. Additionally the descriptions of such images are in three dimensional terms such as cords, arcading, organoid etc., which most of the time is confusing to the students and readers. Therefore it becomes very difficult to correlate the descriptions mentioned in the textbooks with the images viewed under microscope. Researchers have been trying to develop various softwares to convert two dimensional images into three dimensional but again such images would still be static. Therefore three dimensional animation videos which would depict the etiopathogenesis in life like manner, should be available at each university to promote e-learning especially for oral histopathology speciality, popularity of which has been vanishing day by day. Such videos are already available for other speciality of dentistry. With this concept, a prelimina...

Research paper thumbnail of Possible Link between Acidic Interstitial Fluid and Various Mineralization Disorders of Teeth: Evidence-based Hypothesis

Effects of pH fluctuation of blood and interstitial fluid have a tremendous effect on bone which ... more Effects of pH fluctuation of blood and interstitial fluid have a tremendous effect on bone which leads to osteoporosis. This evidence has been widely mentioned in dental and medical literature. However, the same interstitial fluid enters teeth too through the apical foramen and periodontal space. Thus, it will have a similar effect in teeth too. This article is about the effect of interstitial fluid and its effect on teeth on the basis of evidence mentioned in the literature. Various databases have been researched such as PubMed, MEDLINE, and Google for literature search.

Research paper thumbnail of Oral malignant melanoma of the lower jaw—a case report with immunohistochemical investigations

Ecancermedicalscience, Jun 15, 2023

Oral mucosal melanoma is a type of pigment-producing cell malignancy that primarily affects the s... more Oral mucosal melanoma is a type of pigment-producing cell malignancy that primarily affects the skin and oral mucosa, but can also affect the ears, eyes, gastrointestinal tract and vaginal mucosa. Oral mucosal melanoma has several different clinical manifestations. Even though it frequently manifests as a black-brown patch, macule, or nodular lesion with varying tones of red, purple or depigmented tissue, the clinical characteristics and pathobiological behaviour of oral mucosal melanomas differ from those of cutaneous melanomas. The prognosis for oral melanomas is exceedingly bad because they frequently exhibit no symptoms, which may delay diagnosis. The case of a 65-year-old male patient with a primary complaint of blackened gums in the right lower back region of the jaw is presented here.

Research paper thumbnail of Effect of aromatherapy on dental patient anxiety: A cross-sectional study

International journal of clinicopathological correlation, 2021

Background: The pure essence of the aromatic essential oils provides both psychological and physi... more Background: The pure essence of the aromatic essential oils provides both psychological and physiological beneficial effects. These oils are known for their unwinding, carminative, and sedative effects. Hence, an endeavor was made to investigate the olfactory impacts of these oils on the state of mind, physiology, and behavior during dental treatment. Methods: In this cross-sectional study, the patients were divided into two groups (study and control group). Both the groups comprising patients of various ages. A total of 45 patients were assessed. In the study group, the aromatic odor of lavender essential oil was maintained with the help of scented perfumes and candles in the waiting area, and in the control group, normal candles were used as the armamentarium for aromatherapy. A questionnaire comprising demographic information and the Modified Dental Anxiety Scale was given to patients in the waiting room, and data regarding anxiety levels were recorded. Observations and Results: Various observations were made based on the recordings made by the patients in both the groups, and it was found that the anxiety levels in patients in the study group reduced slightly with aromatherapy as compared to those in the control group. Conclusion: Inhalation aromatherapy had positive effects on reducing anxiety in patients before the treatments. Hence, this should be recommended as a new and alternative way to reduce anxiety in patients before treatment. This will thus improve the behavior and approach of the patients to the treatment.

Research paper thumbnail of Field Cancerization in Lichen Planus – an Unusual Case Report

DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2012

Research paper thumbnail of Pleomorphic adenoma in an immunocompromised patient

Journal of Microscopy and Ultrastructure, 2023

Research paper thumbnail of Tumor microenvironment in oral squamous cell carcinoma: Special stains and scanning electron microscopic study

Journal of Microscopy and Ultrastructure, 2023

Research paper thumbnail of Glandular odontogenic cyst: a case report in an asymptomatic patient

PubMed, Dec 1, 2019

Glandular odontogenic cyst is an extremely rare lesion of the jaw. Its aggressive behavior and hi... more Glandular odontogenic cyst is an extremely rare lesion of the jaw. Its aggressive behavior and high recurrence rate makes it important while excising. Both clinical and radiographic features were nonspecific due to the similarities with other lesions therefore it can be misdiagnosed very easily. This article presents another case of Glandular odontogenic cyst in 17 year of male patient who was unaware of the lesion which was detected on routine examination.

Research paper thumbnail of Carcinoma Ex Pleomorphic Adenoma: Rare Malignant Salivary Gland Neoplasm

Journal of Oral Hygiene & Health, 2014

Carcinoma ex-pleomorphic adenoma (CXPA) is a rare, aggressive, poorly understood malignancy of th... more Carcinoma ex-pleomorphic adenoma (CXPA) is a rare, aggressive, poorly understood malignancy of the salivary gland. The clinical findings typical of this tumor include history of a slow growing, ulcerated, painless mass that enlarges rapidly. Histologically, CXPA is characterized by the presence of carcinomatous transformation in pleomorphic adenoma which includes abnormal nuclear changes with mitoses, dystrophic calcification, vascular or neural invasion or both by lesional cells along with local and distant metastasis. Immunohistochemical staining in the carcinoma areas revealed positive reaction for epithelial membrane antigen and p63 protein but negative for vimentin. We report a case of a CXPA in the hard palate and discuss its clinical and histopathological findings.

Research paper thumbnail of Odontogenic Keratocyst of the Mandible - A Case Report

International journal of current research and review, 2021

Introduction: The odontogenic keratocyst (OKC) is a unique type of developmental odontogenic cyst... more Introduction: The odontogenic keratocyst (OKC) is a unique type of developmental odontogenic cyst. In addition to having aggressive nature and a high recurrence rate, it also exhibits specific histopathologic characteristics.OKC tends to develop in an antero-posterior direction inside the marrow cavity of the bone without noticeably enlarging the bone. In 1956, OKC was first described by Phillipsen. Case Report: This case study discusses an odontogenic keratocyst that affected the mandible in a 35-year-old patient. Conclusion: Due to its unique histopathologic characteristics and clinical behavior, the developmental odontogenic cyst known as the odontogenic keratocyst merits special attention.

Research paper thumbnail of Cancer-associated fibroblasts and FAP-Alpha: Its applications in odontogenic tissues

Journal of Datta Meghe Institute of Medical Sciences University, 2022

Research paper thumbnail of Role of sign language in oral health education: A review

International journal of community dentistry, 2021

Hearing and speech impaired patients are often illiterate; and communicate using Sign Language; w... more Hearing and speech impaired patients are often illiterate; and communicate using Sign Language; which hinders dental care and causes increased levels of oral morbidity; followed by feeling of unfairness by the dental staff. It is very difficult for dentists to communicate and treat them. A dentist who has learned Sign Language can help understand and communicate with these patients and treat them effectively. This review aims to study the need of dentists to learn sign language to communicate with such patients for effective diagnosis, treatment, and even oral health education. If oral health education such as oral cancer and other oral diseases is given in sign language too, it will surely contribute in the prevention of various diseases.

Research paper thumbnail of Evaluation of Ki-67 expression in oral submucous fibrosis and its correlation with clinical and histopathological features

Journal of Microscopy and Ultrastructure, 2020

Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although it shows... more Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although it shows atrophic epithelium, it has a high proliferative capacity. Therefore, this study correlates the Ki-67. (The name “ki” is derived from the city of origin [Kiel, Germany] expression with functional grading and epithelial thickness in OSMF). Methods: The study group comprised of thirty patients of OSMF, divided randomly into Group A, Group B, Group C, and Group D as per mouth opening (functional staging). Five participants without OSMF formed the negative control group. The positive control group comprised of five patients of diagnosed cases of squamous cell carcinoma. All the sections of biopsy were subjected for hematoxylin and eosin and immunohistochemistry staining and observed for expression of Ki-67. Epithelial thickness was evaluated using image analysis software of Leica research microscope. Images were analyzed by three independent observers who were blindfolded. All the findings were tabulated and statistically analyzed. Results: In the present study, as the functional staging increased, the Ki-67 expression also increased. Ki-67 expression was highest in severe functional staging/severely decreased mouth opening (100.78) and is least in mild functional staging/mild decreased mouth opening (10.39). However, there was no significant correlation between epithelial thickness and functional staging/mouth opening (P = 0.05). Conclusion: A decrease in functional staging (mouth opening) showed a greater expression of Ki-67, and there was no significant correlation between functional staging and epithelial thickness.

Research paper thumbnail of Odontoma – Basic third dimensional histopathology model using 3D animation software and clay model

Journal of Microscopy and Ultrastructure, 2023

Research paper thumbnail of Odontoblasts in health and disease with an additional note on its three-Dimensional histological perspective

Journal of the Scientific Society, 2023

Research paper thumbnail of Oral mucous membrane pemphigoid

Journal of Microscopy and Ultrastructure, 2023

... 6 Leena Philipose Page 18. KDJ-Vol. 33, No. 3, July 2010 153 diagnosis. As oral manifestation... more ... 6 Leena Philipose Page 18. KDJ-Vol. 33, No. 3, July 2010 153 diagnosis. As oral manifestations are common in MMP and cause significant morbidity dentists should be able to recognize and manage it, or refer the patients when needed. References 1. Chan LS, Ahmed AR ...

Research paper thumbnail of Oral squamous cell carcinoma: A case report with scanning electron microscopy, Mallory’s, Masson’s trichrome, orcein, and Papanicolaou staining

Journal of Academy of Dental Education, Feb 21, 2024

Research paper thumbnail of Odontome – A Single-institutional Cross-sectional Study of 31 Years from Mumbai and Case Report with Modified Gallego’s Stain

Journal of Microscopy and Ultrastructure, Dec 11, 2023

Research paper thumbnail of A Survey Based Pilot Study on Three Dimensional Images and Animated Videos in Oral Histopathology

Background: Oral Histopathology is the study of diseased tissues in a lifelike manner. Unfortunat... more Background: Oral Histopathology is the study of diseased tissues in a lifelike manner. Unfortunately biopsy tissue gives two dimensional and static images. Additionally the descriptions of such images are in three dimensional terms such as cords, arcading, organoid etc., which most of the time is confusing to the students and readers. Therefore it becomes very difficult to correlate the descriptions mentioned in the textbooks with the images viewed under microscope. Researchers have been trying to develop various softwares to convert two dimensional images into three dimensional but again such images would still be static. Therefore three dimensional animation videos which would depict the etiopathogenesis in life like manner, should be available at each university to promote e-learning especially for oral histopathology speciality, popularity of which has been vanishing day by day. Such videos are already available for other speciality of dentistry. With this concept, a preliminary effort was been taken to design such animations for histopathological aspect of ameloblastoma and shown to students. Methods: A survey was conducted amongst bachelor of dental surgery students, interns and master of dental surgery students using questionnaire, to know the understanding level of oral histopathology through traditional teaching methods. Additionally few images and videos have been created using various softwares and feedback was evaluated. Results: Three dimensional videos were perceived as effective and efficient as E-learning tools for oral histopathology education. Conclusion: User feedback on the educational content was helpful. A website exclusively for this work was suggested and planned for E-learning.

Research paper thumbnail of Hybrid Odontogenic Tumor with COC and Multiple Variants of Ameloblastoma-A Rare Case Report

Journal of Oral Hygiene & Health, 2014

Ameloblastomas do not generally show evidence of induction, however rare cases associated with od... more Ameloblastomas do not generally show evidence of induction, however rare cases associated with odontome have been reported and are referred to as odontoameloblastoma. This article presents an unusual case of multiple histopathological variants of ameloblastoma with evidence of induction of dentinoid by tumor cells but without concomitant formation of enamel along with features of ghost cells. The lesion occurred on the left side of the maxilla in a 31-year old female. Case management has been described and implications are discussed.

Research paper thumbnail of A Survey Based Pilot Study on Three Dimensional Images and Animated Videos in Oral Histopathology

International Journal of Oral and Maxillofacial Pathology, 2015

Background : Oral Histopathology is the study of diseased tissues in a life-like manner. Unfortun... more Background : Oral Histopathology is the study of diseased tissues in a life-like manner. Unfortunately biopsy tissue gives two dimensional and static images. Additionally the descriptions of such images are in three dimensional terms such as cords, arcading, organoid etc., which most of the time is confusing to the students and readers. Therefore it becomes very difficult to correlate the descriptions mentioned in the textbooks with the images viewed under microscope. Researchers have been trying to develop various softwares to convert two dimensional images into three dimensional but again such images would still be static. Therefore three dimensional animation videos which would depict the etiopathogenesis in life like manner, should be available at each university to promote e-learning especially for oral histopathology speciality, popularity of which has been vanishing day by day. Such videos are already available for other speciality of dentistry. With this concept, a prelimina...

Research paper thumbnail of Possible Link between Acidic Interstitial Fluid and Various Mineralization Disorders of Teeth: Evidence-based Hypothesis

Effects of pH fluctuation of blood and interstitial fluid have a tremendous effect on bone which ... more Effects of pH fluctuation of blood and interstitial fluid have a tremendous effect on bone which leads to osteoporosis. This evidence has been widely mentioned in dental and medical literature. However, the same interstitial fluid enters teeth too through the apical foramen and periodontal space. Thus, it will have a similar effect in teeth too. This article is about the effect of interstitial fluid and its effect on teeth on the basis of evidence mentioned in the literature. Various databases have been researched such as PubMed, MEDLINE, and Google for literature search.

Research paper thumbnail of Oral malignant melanoma of the lower jaw—a case report with immunohistochemical investigations

Ecancermedicalscience, Jun 15, 2023

Oral mucosal melanoma is a type of pigment-producing cell malignancy that primarily affects the s... more Oral mucosal melanoma is a type of pigment-producing cell malignancy that primarily affects the skin and oral mucosa, but can also affect the ears, eyes, gastrointestinal tract and vaginal mucosa. Oral mucosal melanoma has several different clinical manifestations. Even though it frequently manifests as a black-brown patch, macule, or nodular lesion with varying tones of red, purple or depigmented tissue, the clinical characteristics and pathobiological behaviour of oral mucosal melanomas differ from those of cutaneous melanomas. The prognosis for oral melanomas is exceedingly bad because they frequently exhibit no symptoms, which may delay diagnosis. The case of a 65-year-old male patient with a primary complaint of blackened gums in the right lower back region of the jaw is presented here.

Research paper thumbnail of Effect of aromatherapy on dental patient anxiety: A cross-sectional study

International journal of clinicopathological correlation, 2021

Background: The pure essence of the aromatic essential oils provides both psychological and physi... more Background: The pure essence of the aromatic essential oils provides both psychological and physiological beneficial effects. These oils are known for their unwinding, carminative, and sedative effects. Hence, an endeavor was made to investigate the olfactory impacts of these oils on the state of mind, physiology, and behavior during dental treatment. Methods: In this cross-sectional study, the patients were divided into two groups (study and control group). Both the groups comprising patients of various ages. A total of 45 patients were assessed. In the study group, the aromatic odor of lavender essential oil was maintained with the help of scented perfumes and candles in the waiting area, and in the control group, normal candles were used as the armamentarium for aromatherapy. A questionnaire comprising demographic information and the Modified Dental Anxiety Scale was given to patients in the waiting room, and data regarding anxiety levels were recorded. Observations and Results: Various observations were made based on the recordings made by the patients in both the groups, and it was found that the anxiety levels in patients in the study group reduced slightly with aromatherapy as compared to those in the control group. Conclusion: Inhalation aromatherapy had positive effects on reducing anxiety in patients before the treatments. Hence, this should be recommended as a new and alternative way to reduce anxiety in patients before treatment. This will thus improve the behavior and approach of the patients to the treatment.

Research paper thumbnail of Field Cancerization in Lichen Planus – an Unusual Case Report

DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2012

Research paper thumbnail of Pleomorphic adenoma in an immunocompromised patient

Journal of Microscopy and Ultrastructure, 2023

Research paper thumbnail of Tumor microenvironment in oral squamous cell carcinoma: Special stains and scanning electron microscopic study

Journal of Microscopy and Ultrastructure, 2023

Research paper thumbnail of Glandular odontogenic cyst: a case report in an asymptomatic patient

PubMed, Dec 1, 2019

Glandular odontogenic cyst is an extremely rare lesion of the jaw. Its aggressive behavior and hi... more Glandular odontogenic cyst is an extremely rare lesion of the jaw. Its aggressive behavior and high recurrence rate makes it important while excising. Both clinical and radiographic features were nonspecific due to the similarities with other lesions therefore it can be misdiagnosed very easily. This article presents another case of Glandular odontogenic cyst in 17 year of male patient who was unaware of the lesion which was detected on routine examination.

Research paper thumbnail of Carcinoma Ex Pleomorphic Adenoma: Rare Malignant Salivary Gland Neoplasm

Journal of Oral Hygiene & Health, 2014

Carcinoma ex-pleomorphic adenoma (CXPA) is a rare, aggressive, poorly understood malignancy of th... more Carcinoma ex-pleomorphic adenoma (CXPA) is a rare, aggressive, poorly understood malignancy of the salivary gland. The clinical findings typical of this tumor include history of a slow growing, ulcerated, painless mass that enlarges rapidly. Histologically, CXPA is characterized by the presence of carcinomatous transformation in pleomorphic adenoma which includes abnormal nuclear changes with mitoses, dystrophic calcification, vascular or neural invasion or both by lesional cells along with local and distant metastasis. Immunohistochemical staining in the carcinoma areas revealed positive reaction for epithelial membrane antigen and p63 protein but negative for vimentin. We report a case of a CXPA in the hard palate and discuss its clinical and histopathological findings.

Research paper thumbnail of Odontogenic Keratocyst of the Mandible - A Case Report

International journal of current research and review, 2021

Introduction: The odontogenic keratocyst (OKC) is a unique type of developmental odontogenic cyst... more Introduction: The odontogenic keratocyst (OKC) is a unique type of developmental odontogenic cyst. In addition to having aggressive nature and a high recurrence rate, it also exhibits specific histopathologic characteristics.OKC tends to develop in an antero-posterior direction inside the marrow cavity of the bone without noticeably enlarging the bone. In 1956, OKC was first described by Phillipsen. Case Report: This case study discusses an odontogenic keratocyst that affected the mandible in a 35-year-old patient. Conclusion: Due to its unique histopathologic characteristics and clinical behavior, the developmental odontogenic cyst known as the odontogenic keratocyst merits special attention.

Research paper thumbnail of Cancer-associated fibroblasts and FAP-Alpha: Its applications in odontogenic tissues

Journal of Datta Meghe Institute of Medical Sciences University, 2022

Research paper thumbnail of Role of sign language in oral health education: A review

International journal of community dentistry, 2021

Hearing and speech impaired patients are often illiterate; and communicate using Sign Language; w... more Hearing and speech impaired patients are often illiterate; and communicate using Sign Language; which hinders dental care and causes increased levels of oral morbidity; followed by feeling of unfairness by the dental staff. It is very difficult for dentists to communicate and treat them. A dentist who has learned Sign Language can help understand and communicate with these patients and treat them effectively. This review aims to study the need of dentists to learn sign language to communicate with such patients for effective diagnosis, treatment, and even oral health education. If oral health education such as oral cancer and other oral diseases is given in sign language too, it will surely contribute in the prevention of various diseases.

Research paper thumbnail of Evaluation of Ki-67 expression in oral submucous fibrosis and its correlation with clinical and histopathological features

Journal of Microscopy and Ultrastructure, 2020

Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although it shows... more Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although it shows atrophic epithelium, it has a high proliferative capacity. Therefore, this study correlates the Ki-67. (The name “ki” is derived from the city of origin [Kiel, Germany] expression with functional grading and epithelial thickness in OSMF). Methods: The study group comprised of thirty patients of OSMF, divided randomly into Group A, Group B, Group C, and Group D as per mouth opening (functional staging). Five participants without OSMF formed the negative control group. The positive control group comprised of five patients of diagnosed cases of squamous cell carcinoma. All the sections of biopsy were subjected for hematoxylin and eosin and immunohistochemistry staining and observed for expression of Ki-67. Epithelial thickness was evaluated using image analysis software of Leica research microscope. Images were analyzed by three independent observers who were blindfolded. All the findings were tabulated and statistically analyzed. Results: In the present study, as the functional staging increased, the Ki-67 expression also increased. Ki-67 expression was highest in severe functional staging/severely decreased mouth opening (100.78) and is least in mild functional staging/mild decreased mouth opening (10.39). However, there was no significant correlation between epithelial thickness and functional staging/mouth opening (P = 0.05). Conclusion: A decrease in functional staging (mouth opening) showed a greater expression of Ki-67, and there was no significant correlation between functional staging and epithelial thickness.

Research paper thumbnail of Odontoma – Basic third dimensional histopathology model using 3D animation software and clay model

Journal of Microscopy and Ultrastructure, 2023

Research paper thumbnail of Odontoblasts in health and disease with an additional note on its three-Dimensional histological perspective

Journal of the Scientific Society, 2023

Research paper thumbnail of Oral mucous membrane pemphigoid

Journal of Microscopy and Ultrastructure, 2023

... 6 Leena Philipose Page 18. KDJ-Vol. 33, No. 3, July 2010 153 diagnosis. As oral manifestation... more ... 6 Leena Philipose Page 18. KDJ-Vol. 33, No. 3, July 2010 153 diagnosis. As oral manifestations are common in MMP and cause significant morbidity dentists should be able to recognize and manage it, or refer the patients when needed. References 1. Chan LS, Ahmed AR ...