Unusual clinical presentation, microscopy and immunohistochemistry of oral pyogenic granuloma in a paediatric patient.

An unusual clinical presentation of any pathology prompts a diagnostic dilemma, which further brings challenges in treatment planning. Pyogenic granuloma (microscopically lobular capillary haemangioma) is a benign vascular tumour that commonly involves the skin and mucous membranes and usually manifests as a solitary papule with a friable pedunculated base. Rapid exophytic growth and an ulcerated surface with bleeding on provocation are characteristic, with a gingival predominance for the site. This case report aims to elaborate on an unusual clinical presentation of oral pyogenic granuloma in a middle-childhood female patient. The clinical and radiographic characteristics of the lesion were unremarkable to the diagnosis but rather mimicked other intraoral lesions. It is histopathology that could solve the puzzle with the microscopic and immunohistochemical findings that rendered the final diagnosis of lobular capillary haemangioma.

Dentofacial manifestations of a Paediatric patient with Goltz-Gorlin Syndrome.

Goltz-Gorlin syndrome is a rare X-linked inherited disorder associated with PORCN (porcupine homolog-Drosophila) gene mutation. It primarily affects the skin and its appendages. The characteristic cutaneous features include a blaschko-linear pattern, skin atrophy, pigmentary changes, and telangiectasia. The oral manifestations have been reported in more than half of the affected individuals. The most common oral findings include enamel hypoplasia, hypodontia, supernumerary teeth, microdontia, vertical grooving of the teeth, taurodontism, fusion, and abnormal root morphology reported in sporadic cases. The objective of this case report is to describe the dentofacial characteristics of a middle childhood aged girl with Goltz-Gorlin syndrome.

Long-term effects of chemotherapy and radiation received during early childhood on the developing dentition of pediatric cancer patients.

INTRODUCTION: The short-term effects of chemotherapy and irradiation are well documented; however, there is paucity regarding their long-term effects, especially in children and adolescents. CASE DESCRIPTION: This paper discusses the long-term effects of chemotherapy and/or radiation received by the patients during their early childhood on the developing dentition. It comprises the compilation of 11 cases with alteration in the dental development screened from 138 cases of the childhood cancer patients who received the chemotherapy and/or radiation as a part of anticancer therapy. RESULTS AND CONCLUSION: The findings revealed that the age of initiation of anticancer therapy along with the synergistic effect of chemo-irradiation, and the dose of radiation used were the principal determinants for the dental abnormalities. The root-related abnormalities were found to be varied and more common as compared to the missing teeth and defects related to the tooth crown.

Long-Term Effect of Anticancer Therapy on Dentition in Childhood Cancer Survivors: An Observational, Cross-Sectional Study.

OBJECTIVES: To evaluate the presence of developmental dental anomalies, like microdontia, hypodontia, abnormally shaped teeth (AST), and developmental defects of enamel (DDE) in childhood cancer survivors and compare it with the healthy controls. METHODS: This cross-sectional analytical study was conducted in 2 groups: childhood cancer survivors (CCS) group including children (> 12 y, m/f) who had undergone anticancer therapy (ACT) before 8 y of age and healthy control group (> 12 y, m/f) without any systemic disease. Pearson chi-square test was used to analyze the difference between the CCS group and the control group for microdontia, hypodontia, AST, DDE and for intragroup analysis in CCS group. Odds ratio was also calculated. RESULTS: A total of 120 and 121 children were included in CCS and control group, respectively. The prevalence of microdontia, hypodontia, abnormally shaped teeth, and DDE was 17.5% (21), 5% (6), 8.33% (10), and 37.5% (45), respectively in CCS group. It was 8.2% (10), 2.5% (3), 1.65% (2), and 22.3% (27), respectively in the control group. A statistically significant difference was seen in microdontia (p = 0.032), abnormally shaped teeth (p = 0.017) and DDE (p = 0.01). Higher prevalence was seen when ACT began at an early age. CONCLUSION: An association between developmental dental anomalies and anticancer therapy (ACT) exists with significantly higher difference in microdontia, abnormally shaped teeth and DDE among survivors of childhood cancer as compared to healthy population. These known adverse effects of ACT on developing teeth should be considered during treatment planning of the children having cancers.

Evidence mapping and quality analysis of published dental literature on COVID-19 - A systematic review.

A large number of scientific articles have been published regarding impact of COVID-19 infection on dental practice, dental professionals, and the mode of spread of infection via dental procedures. The present systematic review was planned with an aim of evidence mapping and quality analysis of published research on the dental aspects of COVID-19 infection. The protocol was registered at https://share.osf.io/registration/46221-C87-BA8. The search was performed in Scopus, PubMed, Cochrane, and Embase databases till 15th July 2020. There was no restriction of year of publication and language. All types of published articles related to Dentistry, Dentist, Dental practice, and Oral health education on COVID-19 were included. The Joanna Briggs Institute's (JBI) Critical Appraisal Tools were used for the risk of bias analysis of included studies. A total of 393 articles were short-listed and were checked for eligibility and finally, 380 articles were included. Among the 380 research articles published (till July 15, 2020), the majority of the included articles belonged to the lowermost strata of the evidence pyramid. There were 54 original research articles with no randomized clinical trial, systematic review or, meta-analysis pertaining to the dental perspective of COVID-19 infection. The level of available evidence about dentistry and COVID-19 infection is very low with a lack of researches of highest quality. The guidelines/recommendations for dental professionals, proposed by the different scientific organizations/societies regarding COVID-19 infection are only consensus-based necessitating the need to formulate evidence-based guidelines. There is a need to identify essential research questions and strengthen the study designs in most of the aspects related to the dentistry and COVID-19 pandemic.

Orofacial characteristics and dental management in a child with moyamoya disease.

Moyamoya disease is a chronic, progressive intracranial arteriopathy. It is characterised by progressive stenosis/occlusion of distal intracranial carotid and cerebral arteries. It is associated with a high risk of ischaemic and haemorrhagic stroke. Hereditary, infectious and inflammatory factors have been found to be associated with this condition; however, its aetiology is still unclear. The estimation of disease prevalence is approximately 1.6 to 16.1 in 100 000 live births. This article presents the case of a 5-year-old girl child diagnosed with moyamoya disease, placing emphasis on the clinical and radiographic orofacial characteristics of the case and its dental management.

Dental considerations in a paediatric patient with Diamond-Blackfan anaemia.

Diamond-Blackfan anaemia (DBA) is a rare genetic disorder characterised by a decrease in the production of red blood cells due to bone marrow malfunction. The estimation of disease occurrence is approximately 1 in 100 000-2 00 000 live births. This paper presents the case of a 7-year-old male child diagnosed with DBA at the age of 4 months. The diagnosis was established with haematological findings, bone marrow biopsy and molecular testing. The case was managed successfully for dental symptoms without any complication.

Rare case report of idiopathic gingival fibromatosis in childhood and its management.

Idiopathic gingival fibromatosis (GF), also known as gingivomatosis, is a rare condition in childhood, with an unknown aetiology. The oral manifestations of the condition are varied and depend on the severity and age of involvement. This paper describe the case of a 5-year-old male child with extensive gingival enlargement covering almost all the maxillary and mandibular teeth resulted in difficulty with speech, mastication and poor aesthetics. Clinical and radiographic examination along with haematological investigations ruled out any systemic association. The case was managed with conventional scalpel blade surgery along with electrocautery under general anaesthesia yielding good results without any recurrence after a 12-month follow-up. The results revealed that the oral manifestations of GF depend on its severity and the age of onset. Timely intervention can help to prevent associated complications in a growing child.