Correlation of Mandibular Foramen to Occlusal Plane as a Clinical Guide for Inferior Alveolar Nerve Block in Children: A Digital Panoramic Radiographic Study.

AIM: The study aimed to correlate the position of mandibular foramen with occlusal plane as a clinical guide for inferior alveolar nerve block (IANB) injection in children from 3 to 13 years of age. MATERIALS AND METHODS: The study was carried out on 180 children visiting our department and required orthopantomogram as a routine diagnostic aid. Mandibular casts were obtained and radiographs were digitally analyzed to obtain linear and angular measurements. STATISTICAL ANALYSIS: The measurements were correlated with the position of mandibular foramen with Karl Pearson's correlation test. RESULTS: The results of the study suggest that the needle for IANB should be placed below the occlusal plane in 3-4-year-old children (1.26 mm approximately), almost at the level of occlusal plane in 5-7 years (0.33 mm), above the occlusal plane in 7-9 years (1.54 mm), 9-12 years (1.64 mm), 11-12 years (1.98 mm), and 12-13 years (2.9 mm), respectively. The distance of the mandibular foramen from anterior border of mandible was greater than that from posterior border. The gonial angle values decrease with increasing age. CONCLUSION: The bony landmarks within the jaws keep changing their relative positions along with the skeletal growth. It is therefore necessary to modify the placement of needle during local anesthesia techniques with advancing age.

To assess and create awareness among anesthetists regarding prevention and management of injuries to the teeth and their associated structures during general anesthesia.

AIMS: The aim of this study was to assess the awareness among anesthetists regarding prevention and management of injuries to the teeth and their associated structures during anesthesia. STUDY DESIGN, MATERIALS AND METHODS: Fifty anesthetists practicing in various hospitals in Mumbai participated in this study. A questionnaire was devised and distributed among them. The completion of the questionnaire by the respondents was taken as their consent to participate in the study. STATISTICAL ANALYSIS: The data thus collected was analyzed using statistical package Medcalc (Version 12.7.0.0). RESULTS: The results showed that the injury to the oro-dental tissues is a common finding during anesthesia. The maxillary incisors underwent injuries more commonly than the mandibular incisors. Padding of the teeth was the most common precaution taken to prevent injuries to the teeth which, however, is not adequate. The management for such injuries was inadequate and in many cases, the patients' referral to a dentist was not considered post-operatively. CONCLUSION: Pediatric dentists can play a major role in creating the awareness among the anesthesia providers regarding prevention of oro-dental injuries during anesthesia.

Nonsurgical treatment of periapical lesions using intracanal calcium hydroxide medicament--a report of 2 cases.

Periapical pathology is the most common sequelae of pulpal necrosis due to traumatic injury. For the success of endodontic treatment, healing of periapical pathology is necessary and can be achieved by maintaining a sterile root canal system. Calcium hydroxide has the potential to maintain a sterile root canal by its antibacterial and tissue-dissolving property. Two case reports of periapical pathology that healed within a period of 3 to 6 months after intracanal calcium hydroxide dressing are presented.

Apexogenesis of a symptomatic mandibular first permanent molar with calcium hydroxide pulpotomy.

Vital pulp therapy of immature, symptomatic permanent posterior teeth presents a challenge in pediatric endodontics. A case report is presented in which cervical pulpotomy with calcium hydroxide was performed on a cariously exposed mandibular first permanent molar. The patient was seen every 3 months for a total of 18 months for a clinical and radiographic follow up. During the follow-up period, root development, as evidenced by root lengthening, was observed. Apical closure was evident at the end of 19 months. As the root canals showed a tendency toward calcification, root canal treatment was carried out, followed by restoration of the tooth with a stainless-steel crown. The success of this single-visit apexogenesis procedure supports the contention that young pulp possesses remarkable reparative capacity, as well as resistance to bacterial infection due to greater vascularity, and that apexogenesis with calcium hydroxide apical closure pulpotomy can be attempted for continued root development of symptomatic, vital, permanent teeth.