Anandh Balasubramanian’s research while affiliated with Center For Oral & Maxillofacial Surgery and other places

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Publications (8)


Prevalence of Temporomandibular Joint Disorder Among Dental Students in Chennai
  • Article

February 2023

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38 Reads

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1 Citation

Journal of Maxillofacial and Oral Surgery

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· Anandh Balasubramanian

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Unlabelled: The objective was to understand the prevalence of temporomandibular joint disorder among dental students. The study was conducted in Tagore Dental College, Chennai. The questionnaire study included a total of 371 students from years I to V, under the age group of 18-30, who had a history of temporomandibular joint disorders on the day of the survey. Each student was given a semi-structured study questionnaire related to assessing possible causes, assessment of habits, assessment of subjective symptoms, and evaluation of pain. It was analysed using an anamnestic scale as 0: no symptoms; I: mild symptoms; II: severe symptoms. An independent t-test was used to compare the variables. The significance level set at 0.05 (p < 0.05) showed that the prevalence of Temporomandibular disorders was insignificant in the study population due to various contributing factors. Supplementary information: The online version contains supplementary material available at 10.1007/s12663-023-01866-y.


Hardware Infection in Fixation of Maxillofacial Region a Case Series

February 2023

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3 Reads

Internal fixation has consistently produced the best outcomes in managing maxillofacial trauma. Mini plates are typically made of stainless steel or titanium. Quick stabilisation and pain-free mastication are the main benefits of internal fixation. Titanium mini plates have surpassed other modalities in popularity in recent years. Microvascular-free tissue bone grafts for surgical site reconstruction have grown in popularity. For patients with mandibular defects, the use of osseocutaneous or osseomyogeneous free flaps, as well as improvements in instrumentation like locking screw technology and low-profile plates, have significantly improved functional and aesthetic outcomes. Despite these improvements, hardware-related complications still pose a severe problem, with 15% of patients reporting such issues. In this review article, we will be presenting a case series and literature review of hardware infection in maxillofacial fixation.


Veracity of universal health coverage of maternal and neonatal health care among slum dwellers in a metropolitan city of India – Factors aiding access to and cost of availing these services to the poorest household

November 2022

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30 Reads

Clinical Epidemiology and Global Health

Background Maternal, newborn and child essential health services are used as tracer indicators for monitoring universal health coverage among countries. This study aims to measure accessibility, factors aiding access, its associated cost of maternal and neonatal health services (M&NHS) among slum dwellers of Chennai. Methodology Cross sectional study design with cluster sampling using Probability Proportion Sampling. The study participants were mothers with at least one child delivered alive in the preceding one year. Result Most women availed antenatal and intranatal services (99% had ten antenatal visits, institutional delivery, immunization, 88.5% had two USG) while Postnatal services was low (34%). Women preferred combination of public and private facility for antenatal out-patient (80%), private for postnatal in-patient (66.7%) and public facilities for intranatal (90%) services. Influencing factor for public facility was free services and claiming cash benefit, for private it was perceived good care and physical proximity. Out of pocket expenditure was highest among users of private facility. Households with catastrophic expenditure were 54.2% (95% CI: 50.03%–58.37%). Use of exclusive private facility had highest risk (OR 60.7 and 73.8) of catastrophic expenditure. Conclusion Although every woman availed M&NHS, proportion of households facing catastrophic health expenditure was high especially among those using private health facilities. This gap in provision of financial risk protection may push households into eternal poverty and fails the effort to achieve Universal Health Coverage for the poorest.


Versatility of Buccal Pad of Fat in the Reconstruction of Oral and Maxillofacial Defects - A Review

September 2021

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93 Reads

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2 Citations

Journal of Evolution of Medical and Dental Sciences

BACKGROUND The maxillofacial region has several congenital and acquired defects. Because of its abundant blood supply and proximity to different intraoral abnormalities, the buccal fat pad flap (BFP) is a simple and reliable flap that can be used to repair a variety of these abnormalities. BFP has remarkable qualities as a scaffold and autogenous dressing in the healing of intraoral defects after excision of oral cavity intraoral lesions. Filling and allowing slippage of fascial spaces between muscles of facial expression, advancement of intermuscular motion, isolating mastication muscles from one another, counteracting negative pressure during suction in the newborn, protection and cushioning of neurovascular bundles from injuries are among the functions of BFP. It also has a dense venous network that facilitates exoendocranial blood flow via the pterygoid plexus. For many years, the BFP was considered a surgical annoyance due to its incidental encounter during various surgeries in the pterygomaxillary space or following injuries to the craniofacial region. However, various clinical applications of BFP have been introduced in recent years. We looked at BFP and its anatomical foundation, surgical procedures, and clinical applications in this review article. The surgical method is easy and effective in a wide range of clinical situations, including oroantral fistula closure, congenital defect rectification, Osteoradionecrosis treatment, and reconstruction of tumor or cyst defect. Thus BFP is a dependable flap that may be used in a variety of therapeutic conditions. KEY WORDS Buccal Fat Pad Flap; Oral Mucosa; Reconstruction; Defect.


Retrograde Spread of Buccal Space Infection into Temporal Space with Temporal Muscle Necrosis in a Medically Compromised Patient - A Case Report

September 2021

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21 Reads

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2 Citations

Journal of Evolution of Medical and Dental Sciences

Superficial temporal space lies between the temporal fasciae. Abscess in the temporal and infratemporal space is very rare. They develop as a result of the extraction of infected maxillary molars. Temporal space infections or abscesses can be seen in the superficial or deep temporal regions. A 65 - year - old male patient reported with a complaint of painful swelling over the right cheek and restricted mouth opening with a history of extraction of second mandibular molar before four weeks. On examination, an ill-defined diffuse swelling was seen. Treatment was started with IV empirical antibiotics and planned for surgical drainage. Surgical drainage of the abscess in the temporal space was done along with debridement of the necrosed temporalis muscle. Infections of the maxillofacial region are of great significance to general dentists and maxillofacial surgeons. They are of clinical importance as they are commonly encountered, and are also challenging as timely intervention is needed to prevent fatal complications. The infections arising from the tooth are initially confined to the alveolar bone and surrounding periosteum. They spread along the path of the least resistance to the cortical plates. Once the infection penetrates the cortical plates, they reach the muscle plane.1 If the infection perforated is above the muscle attachments, it’s confined to an intraoral abscess. If the cortical plates are perforated below the muscular attachments, extraoral swelling develops. The next barrier is the periosteum which is strong and elastic in nature. Once the periosteum is breached, infections reach the soft tissue planes, the fascia. Most of the infections are confined to a particular space and the surrounding fascia. Based on the toxins produced by the microorganisms, the infection can spread to adjacent spaces and even retrograde. Common deep space infections are Ludwig's angina followed by peritonsillar, submandibular, and parotid abscesses. 2 Infratemporal and temporal space infections are rarely compared to other deep space infections. Many etiological factors form the base for the infections of deep spaces, dental caries, extraction of infected, non-infected tooth maxillary sinusitis, tonsillitis, maxillary sinus fracture, temporomandibular arthroscopy, drug-induced infections. Infections of odontogenic origin, spreading along infratemporal and temporal space are most common with maxillary molars followed by mandibular molars. We report a case of retrograde spread of buccal space infection into temporal space secondary to mandibular tooth extraction.



A Novel Mutation in the DNA Binding Domain of NFKB is Associated with Speckled Leukoplakia

January 2016

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21 Reads

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5 Citations

Asian Pacific Journal of Cancer Prevention

Background: Activation and inactivation of nuclear factor of kappa light chain gene enhancer in B cells (NFKB) is tightly regulated to ensure effective onset and cessation of defensive inflammatory signaling. However, mutations within NFKB, or change in activation and inactivation molecules have been reported in a few cancers. Although oral squamous cell carcinoma is one of the most prevalent forms of cancer in India, with a development associated with malignant transformation of precancerous lesions, the genetic status of NFKB and relative rates of change in oral precancerous lesions remain unknown. Hence in the present study we investigated all twenty four exons of NFKB gene in two precancerous lesions, namely oral submucous fibrosis (OSMF) and oral leukoplakia (OL) to understand its occurrence, incidence and assess its possible contribution to malignant transformation. Materials and methods: Chromosomal DNA isolated from twenty five each of OSMF and OL tissue biopsy samples were subjected to PCR amplification with intronic primers flanking twenty four exons of the NFKB gene. The PCR amplicons were subsequently subjected to direct sequencing to elucidate the mutation status. Results: Sequence analysis identified a novel heterozygous mutation, c.419T>A causing substitution of leucine with glutamine at codon 140 (L140Q) in an OL sample. Conclusions: The identification of a substitution mutation L140Q within the DNA binding domain of NFKB in OL suggests that NFKB mutation may be relatively an early event during transformation. To the best of our knowledge, this study is the first to have identified a missense mutation in NFKB in OL.


Figure 1. CpG Island Prediction Analysis of BRD7 Promoter. The methylation finder program identified CpG rich island in the-400 base pair region upstream of transcription start site. CpG rich island is shaded in blue 
Figure 2. Prediction Analysis of BRD7 Promoter. The methylation finder program identified CpG rich islands in the-400 base pair region upstream of transcription start site. CpG rich islands are shaded in blue 
Figure 3. Representative Images of Gel Electrophoresis of HpaII Enzyme Based Methylation Sensitive PCR. 
BRD7 Promoter Hypermethylation as an Indicator of Well Differentiated Oral Squamous Cell Carcinomas
  • Article
  • Full-text available

March 2015

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111 Reads

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10 Citations

Asian Pacific Journal of Cancer Prevention

Promoter hypermethylation mediated gene silencing of tumor suppressor genes is considered as most frequent mechanism than genetic aberrations such as mutations in the development of cancers. BRD7 is a single bromodomain containing protein that functions as a subunit of SWI/SNF chromatin-remodeling complex to regulate transcription. It also interacts with the well know tumor suppressor protein p53 to trans- activate genes involved in cell cycle arrest. Loss of expression of BRD7 has been observed in breast cancers and nasopharyngeal carcinomas due to promoter hypermethylation. However, the genetic status of BRD7 in oral squamous cell carcinomas (OSCCs) is not known, although OSCC is one of the most common among all reported cancers in the Indian population. Hence, in the present study we investigated OSCC samples to determine the occurrence of hypermethylation in the promoter region of BRD7 and understand its prevalence. Genomic DNA extracted from biopsy tissues of twenty three oral squamous cell carcinomas were digested with methylation sensitive HpaII type2 restriction enzyme that recognizes and cuts unmethylated CCGG motifs. The digested DNA samples were amplified with primers flanking the CCGG motifs in promoter region of BRD7 gene. The PCR amplified products were analyzed by agarose gel electrophoresis along with undigested amplification control. Methylation sensitive enzyme technique identified methylation of BRD7 promoter region seventeen out of twenty three (74%) well differentiated oral squamous cell carcinoma samples. The identification of BRD7 promoter hypermethylation in 74% of well differentiated oral squamous cell carcinomas indicates that the methylation dependent silencing of BRD7 gene is a frequent event in carcinogenesis. To the best of our knowledge, the present study is the first to report the occurrence of BRD7and its high prevalence in oral squamous cell carcinomas.

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Citations (5)


... When examining the results, it was found that TMD symptoms were present in 12.8% of the university students. In the general population, more than half of individuals have at least one symptom of TMD, yet very few are aware of these symptoms and report them to a specialist [30]. Although the literature reports a TMD prevalence of approximately 31%, conflicting results have been found regarding the prevalence Table 2 The comparison of the cases regarding TMD of TMD in university students [31]. ...

Reference:

Evaluation of factors associated with the temporomandibular joint dysfunction in university students
Prevalence of Temporomandibular Joint Disorder Among Dental Students in Chennai
  • Citing Article
  • February 2023

Journal of Maxillofacial and Oral Surgery

... Fractures and open wounds can be bandaged with BIPP. Dry sockets can be prevented by using this product [8]. Rutherford Morison was the first to report a paste made of bismuth iodide and paraffin (BIPP). ...

Versatility of Buccal Pad of Fat in the Reconstruction of Oral and Maxillofacial Defects - A Review
  • Citing Article
  • September 2021

Journal of Evolution of Medical and Dental Sciences

... [4][5][6]. We present a case of superficial temporal space infection secondary to submessetric space infection due to a periapical abscess of a lower 3rd molar on the right side. ...

Retrograde Spread of Buccal Space Infection into Temporal Space with Temporal Muscle Necrosis in a Medically Compromised Patient - A Case Report
  • Citing Article
  • September 2021

Journal of Evolution of Medical and Dental Sciences

... Another study noted that mutations in the BRCA1 and BRCA2 genes are often detected in the tissue of LOM [3]. It was pointed out that spotted LOM may be associated with pathogenic variants of the NFKB gene [4]. Various studies have also noted that LOMmay be related to mutations in the TP53 gene [5], p16INK4a and p14ARF genes [6], the CTC1 gene (also associated with congenital forms of LOM) [7], etc. ...

A Novel Mutation in the DNA Binding Domain of NFKB is Associated with Speckled Leukoplakia
  • Citing Article
  • January 2016

Asian Pacific Journal of Cancer Prevention

... BRD7 was con rmed to be a critical tumor suppressor and is expressed at low levels in a variety of tumors, and epigenetic modi cations, transcriptional regulation, and posttranslational modi cations were con rmed to be involved in the regulation of BRD7 expression. For example, hypermethylation of the BRD7 promoter results in low expression of BRD7 in nasopharyngeal carcinoma and highly differentiated oral squamous cell carcinoma [30,31]. C-Myc could bind to the BRD7 promoter and negatively regulate BRD7 promoter activity and mRNA expression [32]. ...

BRD7 Promoter Hypermethylation as an Indicator of Well Differentiated Oral Squamous Cell Carcinomas

Asian Pacific Journal of Cancer Prevention