Issue : 01 DOI :
INTERNATIONAL
JOURNAL
OF
DIAGNOSTICS
AND
RESEARCH
Volume : 02
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
28
Abstract
Ayurveda conceptualizes diseases as imbalances within the dosha–dhatu–mala system rather than
pathological entities. Adhimamsa represents abnormal proliferation of Mamsa Dhatu, commonly
categorized as Granthi or Arbuda.Pericoronitis, an inflammation of the soft tissues around a partially
erupted mandibular third molar, arises when insufficient space forms a pericoronal flap, predisposing to
food impaction and microbial colonization.This study correlates the Ayurvedic understanding of
Adhimamsa with pericoronitis and employs Orthopantomogram (OPG) to evaluate associated soft tissue
and bony changes. Integrating classical knowledge with radiological evidence enhances diagnostic
precision and promotes a holistic approach to managing localized oral tissue proliferations.
Keywords- Adhimamsa, Pericoronitis, Orthopantomogram.
P
ISSN No. : 2584-2757
Volume : 03
Issue : 01
DOI
: 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 8 803
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Deepali Amale
Article Info: Published on : 15/10/2025
Impact Factor : 1.013
Observational Single Case Study Of Adhimamsa(Pericoronitis) On
Orthopantomogram (OPG).
Dr. Deepali Amale
1
, Dr.S.S.Sapkal
2
, Dr. A.M. Deshmukh
3
1
Professor, Guide & H.O.D. of Rognidan Evum Vikruti Vigyan. C.S.M.S.S. Ayurveda Mahavidyalaya and
Rugnalaya, Kanchanwadi, Chh. Sambhajinagar.
2
PG Scholar, Rognidan Evum Vikruti Vigyan. C.S.M.S.S. Ayurveda Mahavidyalaya and Rugnalaya,
Kanchanwadi, Chh. Sambhajinagar.
3
Associate Professor, Rognidan Evum Vikruti Vigyan. C.S.M.S.S. Ayurveda Mahavidyalaya and Rugnalaya,
Kanchanwadi, Chh. Sambhajinagar.
Cite this article as: - Dr. Deepali Amale (2025) ;Observational Single Case Study Of Adhimamsa (Pericoronitis) On
Orthopantomogram (OPG). ;Inter .J. Dignostics and Research 3 (1) 28-35 , DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 8 803
G
A
R
V
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
29
Introduction :
Ayurveda, the ancient science of life, views
diseases not just as pathological entities but as
imbalances within the dosha-dhatu-mala system.
[1]
Among the various pathological conditions outlined
in classical texts, Adhimamsa stands out as a
significant condition marked by the excessive
growth of Mamsa Dhatu (muscular tissue), often
categorized as either Granthi (benign tumor-like
swelling) or Arbuda (neoplastic swellings).
[2]
Pericoronitis is an inflammatory condition affecting
the soft tissues around the crown of a partially
erupted tooth, most frequently the lower third molar
(wisdom tooth). This condition typically arises
when there is insufficient space for the tooth to
fully erupt, resulting in a flap of gum tissue
(operculum) that traps food and bacteria.
[3]
Adhimamsa can be associated with Pericoronitis.
[4]
The soft tissue covering a partially erupted tooth is
referred to as the pericoronal flap or gingival
operculum. Pericoronitis involves inflammation of
the soft tissue surrounding the crown of a partially
erupted tooth, which includes the gums and the
dental follicle.
[5]
Modern science utilizes radiodiagnostic tools such
as the Orthopantomogram (OPG) to visualize these
tissue abnormalities, particularly in the head and
neck area.OPG is a panoramic dental X-ray of the
upper and lower jaws, commonly employed to
identify bony expansions, cystic lesions, or other
pathological tissue growths.
[6]
This article aims to
connect the conceptual understanding of
Adhimamsa from Ayurvedic texts with
contemporary radiographic evidence through OPG.
By reviewing literature and interpreting
radiological images in light of Ayurvedic
philosophy, the study aspires to improve diagnostic
accuracy and foster a synergistic approach to the
pathology of Adhimamsa.
Ayurvedic review of Adhimamsa :
Ayurveda classifies swellings under
[7,8,9]
:
Granthi: Benign, encapsulated swellings.
Arbuda: Malignant, progressive, infiltrative
swellings.
Adhimamsa: Often considered a non-
malignant but proliferative pathology due to
Kapha and Mamsa Dhatu vitiation.
Nidana Sevana (Causative factors)
↓
Kapha Dosha ↑ + Agnimandya (Dhatvagni
Mandya)
↓
Mamsa Dhatu Dushti (Abnormal proliferation)
↓
Srotorodha (Obstruction in Mamsavaha Srotas)
↓
Local Mamsa Accumulation / Vriddhi
↓
Formation of a Firm, Cold, Painless Granthi or
Mass
↓
→ Adhimamsa (as per Granthi/Arbuda
classification)
Pathogenesis (Samprapti of Adhimamsa)
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
30
Clinical Features of Adhimamsa
( Nidana, Lakshana)
a. Nidana (Causative Factors):
Guru Ahara (heavy foods)
Kapha Prakopaka Aahara and Vihara
Agnimandya (low digestive/metabolic fire)
Dhatvagnimandya
Local trauma or repeated strain (similar to
trigger factors in modern pathology)
b. Purvarupa (Premonitory Symptoms):
Local heaviness
Mild swelling
Sensation of dullness or numbness
Lack of pain in early stages
c. Rupa (Clinical Features):
Localized, firm swelling
Non-tender or mildly tender
Well-encapsulated or sometimes infiltrative
Skin over swelling remains normal
Minimal functional interference unless
compressive
d. Upashaya-Anupashaya
Cold compresses may increase heaviness
(Kapha nature)
Heat and scraping therapies show temporary
relief
Modern review of Pericoronitis :
Pericoronitis is defined as an inflammation of the
overlying gingiva associated with infection in the soft
tissues surrounding a partially erupted tooth.
[10]
Mandibular third molars are most commonly
affected.
[11]
This pathological condition is most
prevalent in young adults, although patients of any age
group may present with pericoronal inflammation.
[12]
Modern review of Orthopantomogram :
a. Orthopantomogram (OPG)-OPG is a diagnostic
imaging tool used widely in dentistry and oral
surgery. It provides a two-dimensional
panoramic view of the upper and lower jaws,
temporomandibular joints (TMJ), teeth, and
surrounding bones.
b. Findings Similar to Adhimamsa-Soft tissue
masses in gingival, mandibular or maxillary
regions,Bony expansions (localized or
diffuse),Radiolucent lesions (e.g., cysts),Mixed
radiopaque/radiolucent areas (suggestive of
abnormal tissue proliferation),Non-painful
swellings identified accidentally during routine
OPG.
Aim :
To assess the relationship between OPG findings and
the Ayurvedic understanding of Adhimamsa, aiming to
integrate traditional and modern diagnostic perspectives.
Objective :
To study the Ayurvedic concept of Adhimamsa.
To study the concept of Pericoronitis.
To evaluate the significance of Orthopantomogram
(OPG) in the assessment of Adhimamsa.
To correlate radiological indicators of soft tissue
pathology on OPG with features of Adhimamsa
described in Ayurvedic literature.
Material and Methods :
This research is based on review of literature ,
Ayurvedic books including Sushruta Samhita, Charak
Samhita and Madhav Nidan.
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
31
Diagnosed patient of Adhimamsa vyadhi.
⇓
Enrolled patient in study and written informed
consent obtained.
⇓
Patient was assessed for subjective and objective
criteria
⇓
Obtained data correlated
⇓
Discussion about findings
⇓
Conclusion drawn
Study Design
Subjective criteria:-Adhimamsa vyadhi
lakshanas:
1 . Hanu Paschim Dantamul Shoth [ Oedema at
3rd Molar Tooth ]
Grade
Hanu Paschim Dantamul Shoth
[ Oedema At 3
rd
Molar Tooth ]
1
Barely visible Hanu Paschim Dantamul
Shoth
2
Visible Hanu Paschim Dantamul Shoth
3
Hanu Paschim Dantamul Shoth in large
area
2 . Hanu Paschim Dantamul Shool [Pain at 3rd
Molar Tooth ]
Grade
Hanu Paschim Dantamul Shool
[Pain at 3
rd
Molar Tooth ]
1
Tolerable pain at Dantamul
2
Pain at Dantamul can be relieved by
Analgesic
3
Pain at Dantamul can not be relieved by
Analgesic
3 . Abhyavarhan Samayi Vedana [ Pain during
swallowing ]
Grade
Abhyavarhan Samayi Vedana [ Pain
during swallowing ]
1
Tolerable pain during swallowing
2
Pain during swallowing can be relieved
by Analgesic
3
Pain during swallowing can not be
relieved by Analgesic
Pain Scale ( VAS)
4.Abhyavarhan Samayi Pratihani [Difficulty
during swallowing ]
Grade
Abhyavarhan Samayi Pratihani
[Difficulty during swallowing ]
1
Difficulty during initial phase of
swallowing
2
Difficulty during occasionally
swallowing
3
Continues difficulty during swallowing
5 . Karnamul Ruja [ Earache ]
Grade
Karnamul Ruja [ Earache ]
1
Tolerable Earache on affected side
2
Earache on affected side can be
relieved by Analgesic
3
Earache on affected side can not be
relieved by Analgesic
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
32
Pain Scale ( VAS)
6.Hanu Ruja [ Pain at Temporomandibular
Joint ]
Grade
Hanu Ruja [ Pain at
Temporomandibular Joint ]
1
Tolerable pain at Temporomandibular
Joint
2
Pain at Temporomandibular Joint can be
relieved by Analgesic
3
Pain at Temporomandibular Joint can
not be relieved by Analgesic
Pain Scale ( VAS)
Objective criteria:- OPG :
Grade
Clinical Findings
Grade 1
Partially Erupted Tooth
No Bone Loss
Soft Tissue/ Gingival Flap
Grade
Clinical Findings
Grade 2
Tooth Angulated / Partially
Impacted
Surrounding Bone Level
Slightly Reduced
Radiolucency Around Crown
May Be Visible
Grade 3
Complete Impacted Tooth
Marked Bone Resorption
Radiolucency With Signs Of
Infection / Abscess
Correlation of Adhimamsa on radiological
findings :
Parameter
Ayurvedic
Perspective
(Adhimamsa)
Modern
Radiological
(OPG)
Pathology
Mamsa Dhatu
Dushti due to Kapha
Benign mass
growth.
Samprapti
Agnimandya →
Srotorodha →
Mamsa vriddhi
Slow tissue
proliferation,
cystic or
solid
Location
Predominantly in
Mukhapradesha,
Gala, Kapha sthana
Oral cavity,
mandible,
maxilla
Lakshana
Oedema and pain at
3 rd Molar Tooth,
Pain during
swallowing,
Difficulty during
swallowing,Earache,
Pain at TMJ Joint.
Non-tender,
encapsulated
swelling
Diagnostic
Tools
Sparshana, Nadi
Pariksha, Roga
Lakshana
OPG
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
33
Observation :
Patient Information:-
Name: XYZ
Age: 25 years, Sex: Female
OPD No: 24097, Date: 20-07-20
Subjective Criteria :
Sr.
No
Subjective
Criteria
Observation
In Patient
Grade
1
Hanu
Paschim
Dantamul
Shoth
[ Oedema At
3rd Molar
Tooth ]
Visible
Hanupaschim
Dantamul
Shoth
2
2
Hanu
Paschim
Dantamul
Shool [Pain
At 3rd Molar
Tooth ]
Pain At
Dantamul
Can Be
Relieved By
Analgesic
2
3
Abhyavarhan
Samayi
Vedana [ Pain
During
Swallowing ]
Pain During
Swallowing
Can Be
Relieved By
Analgesic
2
4
Abhyavarhan
Samayi
Pratihani
[Difficulty
During
Swallowing ]
Difficulty
During
Occasionally
Swallowing
2
5
Karnamul
Ruja
[ Earache ]
Earache On
Affected Side
Can Not Be
Relieved By
Analgesic
3
6
Hanu Ruja [
Pain At
Temporoman
dibular Joint ]
Pain At
Temporoman
dibular Joint
Can Not Be
Relieved By
Analgesic
3
Objective Criteria :
Sr.
No
Observation
In Patient
Grade
1
Tooth Angulated /
Partially Impacted
Surrounding Bone Level
Slightly Reduced
Radiolucency Around Crown
Visible
2
Adhimamsa(Pericoronitis) correlated with
OPG Grade 2 findings.
Discussion :
Adhimamsa, though described in ancient Ayurvedic
texts, continues to have relevance in modern
pathology. Ayurveda perceives diseases through
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
34
Doshic and Dhatu-based alterations. Radiological
science, particularly tools like OPG, gives a clear
visual access to such pathologies.
This interdisciplinary evaluation allows several key
insights:
a. Holistic Understanding of Adhimamsa
Pathology: Ayurveda identifies the root
cause through Doshic imbalance and tissue
dysfunction. Modern imaging identifies the
location, size, and extent of pathology.
Together, they offer a complete view —
internal cause and external manifestation.
b. Importance of Kapha and Mamsa Dushti in
Adhimamsa:-Adhimamsa shows all Kapha-
predominant features. Thus, interpreting
such lesions as Adhimamsa becomes
contextually appropriate.
c. OPG’s Role in Adhimamsa: Though
Ayurveda does not originally include
imaging, modern practitioners can adopt
OPG as a supportive diagnostic tool to
visualize Adhimamsa-like conditions. This
brings better documentation, prognosis, and
cross-referral with modern medicine. On an
OPG (Orthopantomogram) radiograph,
Adhimamsa (pericoronitis), an inflammation
of the gum tissue around a partially erupted
tooth (usually a wisdom tooth), can reveal
several findings. These include the position
of the impacted or partially erupted tooth,
the presence of bone loss around the tooth,
and potentially signs of infection like soft
tissue swelling.
Conclusion :
The correlation of Adhimamsa - a classical
Ayurvedic concept of abnormal tissue growth —
with radiological findings seen on OPG images
opens a new realm in diagnostic integrative
medicine. OPG serves as a modern extension of
Darshana Pariksha, offering visual confirmation of
Doshic changes described in Ayurvedic texts.
This approach not only increases clinical clarity for
Ayurvedic practitioners but also fosters
interdisciplinary respect and communication.
Through conceptual understanding, clinical pattern
recognition, and modern radiological validation,
Adhimamsa can be interpreted, managed, and
researched with greater depth and evidence.
The future lies in embracing tools like OPG as
supportive, not contradictory, to Ayurvedic thought
thereby building a bridge between Shastra and
Science.
OPG plays a vital role in the evaluation of
Adhimamsa (pericoronitis) by revealing the
position of the impacted or partially erupted tooth,
detecting associated bone loss, and indicating
possible signs of infection such as soft tissue
swelling. Thus, it serves as an essential diagnostic
aid for clinical decision-making.
References :
1. 3544_3548.pdf
https://share.google/wjl4wyVKPVe3X1EZM
2. Kaviraj Kunja Lal Bhishagratna (Trans.). (1907-
1916). The Sushruta Samhita (Vols. 1-3).
Calcutta: Sri Satguru Publications. (Original
work dated circa 600 BCE).
Issue : 01
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 03
Copyright @ : - Dr.Deepali Amale Inter. J.Digno. and Research IJDRMSID00070 |ISSN :2584-2757
35
3. Fragiskos D . Oral Surgery . Berlin springer ;
2007 .
4. International Journal of Development Research ,
Vol . 05 , Issue , 02 , pp . 3616 - 3620 , February
, 2015 , Full Length Research Article – Day to
day dentistry in Ayurvedic language-An
Appealing concept in Periodontal practice . By
Rath Sunil Kumar & Chaturvedi, T . P . ISSN:
2230 - 9926 .
5. Etiology, Evaluation, and Treatment of
Pericoronitishttps://share.google/hfvdpb0qKg9H
kbOOb
6. Panoramic Dental X-ray
https://share.google/Ll4tH06AHbwUC7CNj
7. Charak Samhita of Agnivesha Vol . 1 ,
Elaborated by Charak and Drudhabala . By Dr .
Brahmanand Tripathi . Chaukhambha Prakashan
Varanasi , ISBN 978 - 93 - 81484 - 75 - 3
Sutrasthan , Chapter 28 , Verse 14 and 26 , Page
no . 450 - 451 , 2021 .
8. Sushrut Samhita Illustrated Written by Prof . K .
R . Srikanatha Murthy Chaukhambha
Orientalia Varanasi Vol 1 , Nidansthan ,
Chaptere 16 , Verse 25 , Page no. 566 - 567 ,
Edition- Reprient , 2007 .
9. Vagbhats Astang Hridayam [ Text with English
Translation , Notes , Appendix and Indices ] By
Prof . K . R . Srikantha Murthy . Vol . 3 , Uttar
Sthan , Chapter 21 , Verse 27, Page no. 1039
,Edition - Reprint , 2016 .
10. Pericoronitis - StatPearls - NCBI Bookshelf
https://share.google/x26mWWnP5APgSWevd.
11. An Insight into Pericoronitis . Review Article ,
By Roshan P . Dhonge , R . M. Zade , V
.Gopinath , Ramesh Amirisetty Chattisgarh
Dental college and Research Institute ,
Rajnandgaon , Chhattisgarh [India ] ISSUE 6 ,
Vol 1 .
12. Nitzan DW , Tal 0 , Sela MN , Shteyer A .
Pericoronitis : a reappraisal of its clinical
microbiologic aspects . J Oral Maxillofac Surg
1985 ; 43 [4] : 510 - 16.
Declaration :
Conflict of Interest : None
ISSN: 2584-2757
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 8 803
Dr.
Deepali Amale
Inter. J.Digno. and Research
This work is licensed under Creative
Commons Attribution 4.0 License
Submission Link : http://www.ijdrindia.com
Benefits of Publishing with us
Fast peer review process
Global archiving of the articles
Unrestricted open online access
Author retains copyright
Unique DOI for all articles
https://ijdrindia.com