Pre-surgical Nasal Molding of a Two-Day-Old Neonate With Complete Unilateral Cleft Lip and Palate Using Passive Nasoalveolar Molding Technique: A Case Report.

The occurrence of congenital deformities like cleft lip and palate is not uncommon and is often a traumatizing experience for families. The entire rehabilitation process includes frequent hospital visits and the brunt of numerous procedures. Early intervention with pre-surgical infant orthopedics facilitates better surgical outcomes and additional psychosocial benefits to the infant's family. The present clinical report addresses the pre-surgical management of a non-syndromic two-day-old female baby whose parents presented with the chief complaint of deformed lips, nose, and difficulty while feeding. The neonate had a complete left-sided cleft lip, alveolus, and cleft palate on examination. Early management with pre-surgical passive nasoalveolar molding (PNAM) has favorable outcomes, including desired upper lip, alveolus, and nose shape. Non-invasive pre-surgical intervention with PNAM reduces the severity of the deformities before the primary surgical repair, thus decreasing the overall cost of cleft care and the number of secondary revisions, thus increasing the probability of favorable outcomes.

Clinical, Demographic, and Oral Presentations of COVID-19 Associated Mucormycosis from a Tertiary Care Hospital in India: A Cross-Sectional Study.

Background: The black fungus, mucormycosis, is on the list of lethal complications reported in recent times in COVID patients. Methodology: This cross-sectional study included all cases of post-COVID-19 mucormycosis. Patients' demographics, clinical presentations, and general health information were collected using a pre-designed form. Results: The study included 171 participants with the mean (SD) age as 49 (10) years with the sex distribution as 71% (122/171) male and 29% (49/122) females. About half of the admitted patients (47%) were known cases of Diabetes Mellitus type II with a median (IQR) Glycosylated Haemoglobin (HbA1c) of 9.1% (7-11.1%). Only 28% (48/171) had received the first COVID vaccination, and 2.9% (5/171) were fully vaccinated with two doses. During COVID-19, 76% (130/171) required hospitalisation for a mean (SD) stay of 11 (6.4) days. Eighty percent of the patients (136/171) received steroids during therapy, while 87% (150/171) and 51% (88/171) received antibiotics and antivirals, respectively. Oxygen was administered to 71% of hospitalised patients (120/171), with 39.1% (47/120) receiving it for more than 7 days. About the development of the first symptoms of mucormycosis (headache, nasal congestion, black crusts in the nose, facial pain, swelling in cheeks and eyes, and loss of vision) after being diagnosed with COVID-19, 16% (28/171) reported it within 7 days, 75% (127/171) between 8 and 30th days and 9% (16/171) after a month. On examination, 20% of mucor patients had hard palate findings, eschars, fistulas, and perforations, 38% had periodontal abscesses, and 5% reported tenderness to percussion. Conclusion: Generally, oral manifestations involved the palate and included varying degrees of mucosal discolouration, swelling, ulcers, superficial necrotic areas, and bone exposure and necrosis with dark eschars.

Large erupted complex odontoma mimicking maxillary osteomyelitis.

Odontoma is the most common benign odontogenic hamartoma. Odontomas are of two types, such as viz compound and complex odontoma. The complex type is a conglomeration of hard tissues of dental origin. They are primarily intraosseous and usually present in the second decade of life. Most odontomas are asymptomatic, but those erupting in the oral cavity may cause severe infection. They are often associated with impacted teeth and are present with the anterior maxilla showing the highest propensity.The present case report is of a male patient in his early 60s with a substantial solitary sclerotic odontoma of the middle and posterior segments of the maxilla erupted into the oral cavity communicating with the right maxillary sinus. The delayed presentation, size, location and active suppuration can misguide clinicians.

Does the Tooth Sectioning Method Impact Surgical Removal of the Distoangular Impacted Mandibular Third Molar?

PURPOSE: Distoangular impacted teeth are considered challenging to remove due to their anatomic position. Proper tooth sectioning ensures the removal with minimal bone removal. This study aimed to compare the outcomes of 2 different tooth sectioning methods. MATERIALS AND METHODS: Patients with distoangular-impacted mandibular third molar were included in this single-blinded randomized controlled trial. Patients with Class III-impacted, grossly decayed teeth and who were ASA III and above were excluded. The subjects were randomly allocated into Group-A conventional method, where tooth sectioning at the cementoenamel junction, and Group B, the modified method, where tooth sectioning removes only the distal portion of the crown. The primary predictor variable was the tooth sectioning method. The primary outcome variable was the operative time and the secondary outcomes included postoperative pain, trismus, and edema assessed on postoperative days 3 and 7. The effect of treatment on operative time was assessed using a t-test and Chi-squared test was used to compare the categorical data. RESULTS: Thirty eight patients were included in this study. With a 1:1 allocation ratio, 18 (50%) patients were included in each group. No statistically significant differences were observed in the 2 groups for gender allocation (P = .32), age (P = .34), tooth classification (P = .97), and side of extraction (P = .32). The mean operative time was 31.61 ± 14.13 minutes for group A and 22.72 ± 10.79 minutes for group B, at the 95% confidence interval had a P value of .04 (P < .05), favoring group B. Secondary outcomes of pain measured by visual analogue scale 3.83 ± 3.06 for group A and 3.88 ± 3.06 for group B (P = .95), facial edema 22.79 ± 2.08 and 22.88 ± 1.32, respectively (P = .88), and the maximal interincisal opening of 33 ± 8.59 and 31.33 ± 7.42 on day 3 (P = .54) and 36.16 ± 11.62 and 39.05 ± 6.08 on day 7 (P = .36). However, the difference in need for rescue analgesia 2.05 ± 2.15 and 0.44 ± 0.85 (P < .01) was statistically significant, suggesting the superiority of the conventional sectioning method. CONCLUSIONS: The results show that both methods of tooth sectioning yield comparably acceptable results. However, the tooth removal was faster by the modified sectioning and the need for rescue analgesia was minimal in this group, suggesting it to be a preferred technique over the conventional method.

Inflammatory Dentigerous Cyst in a 10-year-old Child Treated by Marsupialization: A Case Report.

Aim: To describe the successful eruption of an unerupted premolar associated with a dentigerous cyst without the use of any appliances. Background: Inflammatory dentigerous cyst is a variant of dentigerous cyst occurring in the mixed dentition due to stimulation of the reduced enamel epithelium of a developing permanent tooth by periapical inflammation from its carious, nonvital deciduous precursor. Marsupialization is the preferred treatment to preserve the permanent tooth. Case description: A 10-year-old patient presented to us with a well-defined, tender swelling involving the left mandibular body with buccal cortical expansion. Following imaging, marsupialization was performed involving wide excision of the alveolar mucosa overlying the region along with the cystic lining. At follow-up, spontaneous eruption of permanent teeth into occlusion was noted. Conclusion: This suggests that marsupialization along the crest may allow for successful eruption of the associated permanent teeth with the resolution of the cyst. Clinical significance: Marsupialization along the crest provides a conservative option that allows spontaneous, unassisted eruption of permanent teeth in cases of inflammatory dentigerous cysts. Careful preoperative assessments must be used to make treatment decisions. The successful eruption of permanent teeth and the total resolution of the disease both depend on adequate follow-up. How to cite this article: Jayam C, Yerragudi N, Kumar N, et al. Inflammatory Dentigerous Cyst in a 10-year-old Child Treated by Marsupialization: A Case Report. Int J Clin Pediatr Dent 2023;16(6):871-874.

Site-Based Comparative Analysis of Sample Collection Through Direct Biopsy and Nasal Swabs for Early Diagnosis of Post-COVID Rhinomaxillary Fungal Infection Using Potassium Hydroxide Mounting: A Retrospective Cohort Study.

Aim: To perform site-based comparative analysis for samples collected from the nasal region and oral cavity subjected to microscopic detection of fungal hyphae in KOH mount in a group of patients with rhinomaxillary mucormycosis. Methodology: Forty patients fulfilled eligibility criteria. The diagnostic outcome of detection of fungal hyphae from the KOH samples obtained was the primary endpoint of the study. Based on this, the samples were grouped into three groups viz-oral, nasal and both. The secondary outcome was to check if there was any diagnostic delay in these three groups of patients. Results: The mean number of days for delayed diagnosis for oral site involvement was 56.33 ± 37.53, for nasal involvement was 32.86 ± 19.53 and for both oral and nasal involvement was 22.00 ± 12.94. This difference was statistically significant at p = 0.03. The mean delay in diagnosis was significantly less when both oral and nasal regions are involved as compared to the only oral region involved at P = 0.01. Conclusion: To avoid the chance of delayed diagnosis or false-negative results, it is best to collect samples from both nasal tissues and the most representative site in the dentoalveolar segment depending on the extensiveness of the disease.

Oral Melioidosis in Odontogenic Keratocyst of Mandible.

Melioidosis is a potentially fatal, life-threatening infection caused by the gram-negative saprophytic organism Burkholderia. It is a disease endemic to Southeast Asia and Northern Australia. This infection transmits through direct contact, cutaneous inoculation, inhalation, or ingestion, and patients clinically exhibit abscesses in single or multiple organs. It is clinically under-reported due to a low index of suspicion, lack of diagnostic facilities, and misdiagnosis as tuberculosis. Infections of the musculoskeletal system are exceedingly rare, and clinical presentation may vary from the involvement of femoral bone, palmar tenosynovitis, and parietal bone osteomyelitis secondary to central nervous system involvement. The rarity of the melioidosis to secondarily infect a developmental odontogenic cyst leading to focal osteomyelitis of mandible prompts the clinician toward thorough evaluation for early diagnosis and treatment.

Extrapulmonary tuberculosis and COVID-19 infection coexisting in concurrent necrotising fasciitis with deep space infection of neck: an unusual presentation.

Ludwig's angina is a rapidly spreading, potentially fatal infection of deep fascial spaces of the neck leading to airway oedema and death. This, in recent times when associated with COVID-19 infection, possess treatment challenges making the patient susceptible to opportunistic infections with reduced healing potential. Owing to the multifactorial aetiology in our case and addressing them at the earliest, it is important to achieve favourable outcomes. The space infection that seeded with untreated trivial dental caries progressed to necrotising fasciitis of neck with mycobacterial growth on cartridge-based nucleic acid amplification test for tuberculosis testing. The presence of Mycobacterium organisms should be speculated in patients with pulmonary signs of tuberculosis (TB) because a suppurative TB lymphadenitis of neck could also have the same presentation. The decisive moment in successful outcome was identification of mycobacteria in COVID-19 infected patient, thereby allowing to initiate the antitubercular therapy along with surgical debridement. Thus, medical management of patient with cohabiting infections is difficult task and needs appropriate addressal.

An In Vitro Study Comparing the Antimicrobial Efficacy of 0.2% Chitosan, 3% Sodium Hypochlorite, 2% Chlorhexidine against Enterococcus faecalis, Alone and in Conjunction with Diode Laser.

The aim and objective of this study was to compare the antimicrobial efficacy of 0.2% chitosan, 3% sodium hypochlorite, 2% chlorhexidine against Enterococcus faecalis, alone and in conjunction with diode laser. Materials and methods: The root canals of 72 extracted intact human single-rooted teeth with single canals were prepared, and E. faecalis was incubated in the root canals for 7 days. The teeth were then randomly divided into the following four experimental groups: group I: Saline, group II: 0.2% Chitosan, group III: 3% Sodium hypochlorite, and group IV: 2% Chlorhexidine. These groups were further subdivided into three groups: (1) 10 mL irrigant only, (2) 10 mL irrigant, dried and irradiation with diode laser, (3) Diode laser was used for activation of irrigant solution. Samples were obtained from subgroups in each group and checked for turbidity. The effect of each irrigant was evaluated by counting the number of colony-forming units observed on inoculation with samples taken from the irrigated canal on bile esculin azide agar. The data thus obtained was recorded and put to statistical analysis. Results: Significant reductions were noted in E. faecalis colony counts in all groups (p < 0.05). The greatest reduction in colony count (0%) was noted in group IV followed by group II. Also, samples disinfected with diode laser after root canal irrigation showed less number of colony-forming units per mL as compared to the samples irrigated with root canal solutions alone or diode laser alone. Conclusion: Chitosan has the capability for use as an accessory for disinfection of the root canal system. The application of an 810-nm diode laser by itself did not have the adequate antimicrobial activity to be used as an adjunct in root canal therapy. Irradiation with diode laser ought to be used in conjunction with the irrigant to gain maximum antibacterial effect against E. faecalis. How to cite this article: Goel P, Galhotra V, Makkar S, et al. An In-vitro Study Comparing the Antimicrobial Efficacy of 0.2% Chitosan, 3% Sodium Hypochlorite, 2% Chlorhexidine against Enterococcus faecalis, Alone and in Conjunction with Diode Laser. Int J Clin Pediatr Dent 2022;15(1):109-114.

Talon's cusp in a primary maxillary central incisor: A report of a rare odontogenic anomaly.

Talon's cusp, a type of dens evaginatus (DE) in a primary tooth, is a rare odontogenic anomaly which is reported sparingly in the literature. We report this case describing the presence of a talon's cusp on the right primary maxillary central incisor in a 2-year-old boy precipitating discomfort, owing to occlusal interference. The treatment plan involved pulpectomy and reduction of the lingula DE extension under general anesthesia.

Oral Submucous Fibrosis Secondary to Buccal Mucosal Graft for Urethroplasty.

Oral submucous fibrosis is a collagen disorder commonly seen in the population with areca nut chewing habit, which is more prevalent in the Indian subcontinent. Various studies have suggested a multifactorial origin with a high incidence of the disease in association with consumption of the areca nut. However, it has never reported being secondary to buccal mucosal graft procedures. We are presenting a case of submucous fibrosis secondary to buccal mucosal graft for urethroplasty.

Maxillary labial frenum morphology and midline diastema among 3 to 12-year-old schoolgoing children in Sri Ganganagar city: A cross-sectional study.

INTRODUCTION: Dentofacial aesthetics plays an important role in social interaction and psychological well-being because it affects how people perceive themselves and how they are perceived by society. The maxillary labial frenum is a fold of tissue, usually triangular in shape, extending from the maxillary midline area of the gingiva into the vestibule and mid portion of the upper lip. Maxillary anterior spacing or diastema is a common aesthetic complaint of patients and is frequently seen in children especially in the mixed dentition stage. AIMS AND OBJECTIVES: 1. To estimate the prevalence of different morphologic types of maxillary labial frenum among children of age 3 - 12 years. 2. To find out the relationship between the level of insertion of the frenum and age of the child.3. To evaluate the correlation between frenum morphology, insertion and midline diastema in children. MATERIALS AND METHODOLOGY: The direct visual method under natural light was used and the upper lip was lifted with the index finger and thumb of both hands which allowed for the observation and classification of the labial frenum morphology according to Sewerin's typology and its attachment according to Placek et al. The midline diastema was determined by measuring the distance between the midpoints of the mesial surfaces of both central incisors with the help of divider and ruler. The values were recorded in the prepared schedule. SUMMARY AND CONCLUSIONS: The presence of an abnormal frenum can be a cause in persistent midline diastemas. Tooth movement usually is deferred until eruption of the permanent canines but can begin early in certain cases with very large diastemas.

Effect of unintentional periapical extrusion of metapex in immature teeth- a case report.

The paper discusses a case of an immature premolar tooth with a large periapical lesion, in which Metapex (calcium hydroxide paste containing iodoform and barium sulphate as a radiopacifier) was used. There was an un-intentional extrusion of calcium hydroxide during application. The patient was evaluated for periapical healing at 12 and 24 months. The follow up revealed that the accidental extrusion of metapex did not have any detrimental effect on periapical healing. However, delayed resorption of Metapex as well as healing of the periapical lesion may be attributed to the presence of BaSO4 and iodoform as compared to plain Calcium hydroxide.

Dentin hypersensitivity following tooth preparation: A clinical study in the spectrum of gender.

OBJECTIVE: The objective of this study was to estimate and compare the incidence of dentin hypersensitivity among men and women in an adult population who required replacement of missing tooth/teeth with a fixed partial prosthesis (FPD). MATERIALS AND METHODS: The study population included 124 subjects (62 men and 62 women), who visited the out-patient department in need of FPD for replacement of missing teeth. After conducting routine examinations, each abutment tooth received two stimuli: Tactile and thermal to assess the sensitivity. The measurement of sensitivity was carried out by using a 10 cm visual analog scale before preparation and after preparation. The results were analyzed statistically using the Mann-Whitney U test. RESULTS: The results showed that women reported more dentin hypersensitivity than men before and after tooth preparation. CONCLUSION: The results of the present study demonstrated that women reported more dentin hypersensitivity than men before and after tooth preparation. More studies are needed to explore this nature on gender basis.

Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students.

OBJECTIVE: The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour. MATERIALS AND METHODS: A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. RESULTS: The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students. CONCLUSION: A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.

Segmental neurofibromatosis.

Segmental neurofibromatosis is a rare disorder, characterized by neurofibromas or cafι-au-lait macules limited to one region of the body. Its occurrence on the face is extremely rare and only few cases of segmental neurofibromatosis over the face have been described so far. We present a case of segmental neurofibromatosis involving the buccal mucosa, tongue, cheek, ear, and neck on the right side of the face.

Comparative evaluation of microleakage of various retrograde filling materials: An in vitro study.

OBJECTIVE: The present study is envisaged to evaluate and compare the microleakage of mineral trioxide aggregate (MTA) with commonly used retrograde filling materials, like light-cured composite with dentin-bonding agents, light-cured glass ionomer cement (LC GIC) and resin-modified zinc oxide eugenol. MATERIALS AND METHODS: Ninety freshly extracted non-carious single-rooted human anterior teeth were used in the study. They were randomly divided into four experimental groups and two control groups of 15 each. Following the biomechanical preparation, all teeth were obturated and then the apices of the obturated teeth were resected by removing 3 mm of each apex at 90° to the long axis of the tooth with a straight fissure bur in a high-speed air-rotor handpiece with water coolant. A 3-mm-deep root end cavity was prepared and the root end fillings were placed as per the manufacturer's instructions and according to the groups divided. The samples were then immersed in 1% methylene blue at room temperature for 72 h, 96 h and 1 week and the dye penetration was measured. RESULTS AND CONCLUSION: All the four materials used in the study showed some microleakage throughout the experimental period. The sealing ability in terms of microleakage can be summarized as: MTA > Composite resin with dentin bonding agent > LC GIC > Resin modified zinc oxide eugenol.

An analysis of the vertical bone loss in edentulous mandibles by using the mental foramen as a reference: a radiographic study.

OBJECTIVES: To analyze the amount of vertical bone loss in edentulous mandibles by using the mental foramen as a reference. METHOD: Ninety subjects who consisted of thirty dentulous (males I MD and females II FD) and sixty edentulous (males I ME and females II FE) subjects were selected and they were subjected to digital panoramic radiography. Among the dentulous subjects, in both the groups, the ratio between the height of the mandible and the distance from the mental foramen and the lower border of the mandible (A/B) were calculated by using inbuilt software. This ratio A/B was applied in the edentulous subjects to measure the original height of the mandible before resorption. The amount of vertical bone loss was then calculated. RESULTS: In the dentulous subjects, the A/B ratio in males was 2.94 and in females, it was 3.09. In the edentulous subjects, the vertical bone loss in males was 3.55mm and in females, it was 6.59mm. CONCLUSION: The ratio of the distance from the inferior border of the mandible to the superior border of the mandible(A) and the distance from the inferior border of the mandible to the inferior margin of the mental foramen (B) were less in the dentulous males than in the dentulous females. The comparison of the ratios was nonsignificant. The mean bone loss in edentulous females was found to be greater than the mean bone loss in edentulous males on comparison.

Non-syndromic oligodontia in permanent dentition: a rare case report / Oligodontia não sindrômica nad entição permanente: relato de caso raro

Tooth agenesis is one of the most common congenital anomalies seen in humans. Although absence of one or more teeth is common, absence of multiple teeth is rare. Oligodontia is a rare developmental anomaly, involving agenesis of six or more permanent teeth, excluding the third molars. The reported prevalence of oligodontia in permanent dentition is 0.14%. Oligodontia can be presented as an isolated condition or as a part of a syndrome. Discussion: The present case report highlights a unique case of non-syndromic oligodontia, with agenesis of four permanent incisors, left permanent canine and right second premolar in the mandibular arch and its management with a novel fixed functional prosthetic appliance. Conclusion: Prosthetic rehabilitation is an urgent need for these kind of patients so that they do not suffer from masticatory and esthetic problems which can eventually lower the self esteem of individuals...

A agenesia dentária é uma das anomalias congênitas mais comuns em humanos. Embora a ausência de um ou mais dentes seja comum, a ausência de vários dentes é rara. A oligodontia é uma anomalia de desenvolvimento rara, envolvendo agenesia de seis ou mais dentes permanentes, excluindo os terceiros molares. A prevalência de oligodontia na dentição permanente é de 0,14%. A oligodontia pode apresentar-se como uma condição isolada ou como parte de uma síndrome. Discussão: O presente relato destaca um caso único de oligodontia não sindrômica, com agenesia de quatro incisivos permanentes, canino permanente esquerdo e segundo pré-molar direito no arco inferior, e seu manejo com um novo aparelho de prótese fixa funcional. Conclusão: A reabilitação protética é uma necessidade urgente para este tipo de paciente para que ele não sofra de problemas de mastigação e estética, os quais podem eventualmente reduzir a autoestima do indivíduo...

Endodontic treatment of a multirooted permanent maxillary canine.

The purpose of this paper was to report an unusual case of multirooted permanent maxillary canine. A 16-year-old female patient presented with pain and swelling related to the upper right permanent canine. Radiographic examination revealed a multirooted permanent maxillary canine--an unusual finding. Endodontic treatment was performed after amputation of 2 extra roots, and then the tooth was intentionally reimplanted. The prevalence of birooted permanent mandibular canines in the Japanese population has been reported, but the prevalence of this 3-rooted maxillary canine is still unknown. This report also states the potential etiological factors, effects on the developing dentition, and various treatment options for the multirooted maxillary permanent canine.