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Introduction: Osteoarthritis (OA) is a degenerative disorder characterized by chronic inflammatory response of cartilage and articular surface involving Temporomandibular Joint (TMJ). Pain as one of the major symptom of osteoarthritis affects the quality of life and is usually managed by Non Steroidal Anti Inflammatory Drugs (NSAIDs) such as diclofenac sodium. Bromelain, trypsin and rutoside trihydrate formulation can be used to treat this disease because of anti-inflammatory and anti-oxidant effects. Aim:To assess the effectiveness of oral bromelain, trypsin, rutoside trihydrate enzymes and diclofenac sodium combination therapy over diclofenac sodium for the treatment of TMJ osteoarthritis. Materials and Methods:Thirty Patients with symptomatic TMJ osteoarthritis were randomly divided into three groups. 10 patients were treated with diclofenac sodium (Group 1), 10 were given oral enzymes (bromelain, trypsin, rutoside trihydrate) and diclofenac sodium combination (Group 2), and 10 were treated with oral enzyme preparation (bromelain, trypsin, rutoside trihydrate) (Group 3). Patients were evaluated on day 1, day 4, day 7 and day 10. Comparison of pain rating within three groups was assessed using numeric rating scale. The efficacy criteria were analysed applying ANOVA followed by post-hoc test.

Dilated odontoma is the most extreme form of dens invaginatus. The lesion appears as a roughly spherical mass that does not resemble a tooth but in a way appears tooth - like on radiographs due to somewhat similar radiodensity. The lesion is mostly spherical in appearance and hence the term “dilated.” Occasionally, we come across cases of simultaneous pathologies. Here, we report two cases of a dilated odontoma one of which is associated with dentigerous cyst and in other case dilated odontoma pushing the maxillary sinus superiorly. Histologically, the mass was composed of dentinal tubules. These morphological and histological features are compatible with those of a dilated odontoma.

A 30-year-old female patient reported to the Department of Oral Medicine and Radiology with a chief complaint of swelling below the left eye for one year and pain associated with swelling for past one and a half months. The patient gave history of the swelling slowly increasing to the present size. The patient also gave history of trauma at the same region one and a half year back with no history of visual complaints. On extraoral examination, on inspection, marked facial asymmetry was present with a solitary, localized swelling of size 2×2 cm at superior aspect of the left zygoma with ill defined borders. Skin over the swelling was normal. The swelling was bony hard, fixed, moderately tender and non compressible on palpation. The patient was having normal vision. Correlating the history and clinical findings, the case was provisionally diagnosed as osteoma. The patient was subjected to radiological investigations. Paranasal Sinus (PNS) view revealed a localized radiopacity involving lower border of the left orbit and the left zygoma with distinct border. Maxillary sinus appeared normal [ [

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