Data from recent epidemiological studies provide overwhelming evidence that areca nut is the main etiological factor for oral submucous fibrosis (OSF). It is logical to hypothesize that the increased collagen synthesis or reduced collagen degradation is the possible mechanism in the development of the disease. There are numerous biological pathways involved in the above processes and it is likely that the normal regulatory mechanisms are either down regulated or up regulated at different stages of the disease. The copper content of areca nut is high and the possible role of copper as a mediator of fibrosis is supported by the demonstration of the up regulation of lysyl oxidase in OSMF biopsies. The aim of this article is to emphasize that the incorporation of copper into the areca nut is through the Bordeaux mixture, which is sprayed as a fungicide on areca plantations in regions with scheduled monsoons and of which copper sulfate is an important constituent.

Ellis-van Creveld syndrome is a rare congenital genetic disorder having autosomal recessive inheritance. It is a syndrome affecting the Amish population of Pennsylvania in USA with prevalence rate of 1/5,000 live at birth. In non-Amish population, the birth prevalence is 7/1,000,000. The syndrome is characterized by bilateral postaxial polydactyly of the hands, chondrodysplasia of long bones resulting in acromesomelic dwarfism, ectodermal dysplasia affecting nails as well as teeth and congenital heart malformation. There were very rare reports of this syndrome in dentistry. The present case focuses on the striking and constant oral findings of these patients, which are the main diagnostic features of this syndrome. Since the oral manifestations affect the esthetic, speech, and jaw growth of the child, the dentists have an important role to play in proper management of such case.

Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. When the cyst is multilocular and located at the molar ramus area, it may be confused to ameloblastoma. Lots of cases have been reported in the literature where OKC is associated with the nonvital tooth. So trauma could be one of the reasons in inducing this cyst. In our case, it was in the anterior region at the periapex of nonvital tooth having traumatic occlusion. Hence, the diagnosis of radicular cyst was made and endodontic treatment was done.

Osteoma is a benign slow growing osteogenic lesion, composed of well-differentiated mature bone tissue, characterized by the proliferation of compact or cancellous bone, almost exclusively found in the head and neck region. Central, peripheral and extra skeletal are the three variants of osteoma. Trauma, inflammation, developmental disorders and genetic defects are considered as the etiologic factors. Paranasal sinuses are the favourite locations of peripheral osteoma of the craniofacial region; frontal and ethmoidal sinuses being the common ones. Although, peripheral osteomas are usually benign, innocuous lesions, their size and prominent location on the visible parts of the face makes the surgical intervention necessary. We report case of multiple peripheral osteomas of forehead, without involvement of the frontal sinus, which is a rare variety.

Apert syndrome (acrocephalosyndactyly) is a rare congenital disorder characterized by craniosynostosis, midfacial malformation and symmetrical syndactyly. We present a 10-month-old infant having all the features of classical Apert syndrome.How to cite this article: Khan S, Chatra L, Shenai P, Veena KM. Apert Syndrome: A Case Report. Int J Clin Pediatr Dent 2012; 5(3):203-206.