Conservative Management of Maxillary and Mandibular Fractures in a Pediatric Patient With a Modified Open Cap Splint: A Case Report.

Pediatric maxillofacial fractures, which are not very prevalent, account for around 5% of all face injuries. Children under the age of 13 are more susceptible to craniofacial injuries because they have a larger cerebral mass-to-body ratio than adults. The fracture pattern in children does not resemble that of adults, due to which the treatment of pediatric fractures differs from that of adults and can pose substantial difficulties to the pediatric dentist due to many factors, including the complex anatomy of the developing jaw. In this case report, a 5-year-old male patient presented with an injury to the upper and lower jaw. A case was managed with a conservative approach by using a modified open cap splint. A radiographic investigation, including CT brain and face, was done, which revealed the mandibular symphyseal fracture, bilateral condyle, and right Lefort II fracture. A modified open cap splint was fabricated and fixed with circummandibular and circumzygomatic wiring under general anesthesia. After two months, the fractured site showed good healing on orthopantomography (OPG), and satisfactory occlusion was achieved. The patient was kept on monthly follow-ups for up to five months. Treatment guidelines for pediatric maxillary and mandibular fractures are different from those for adults in that most pediatric cases are managed by a conservative approach. Cap splints are a versatile treatment option for juvenile mandibular fractures because they can be used to restore function and aesthetics with minimal morbidity, do not impede jaw growth or the development of dentition, and can be applied to patients of a wider range of ages.

Understanding the Distinction Between Traumatic Fibroma and Mucocele in Pediatric Patients: A Report of Two Cases.

Traumatic fibroma is a reactive oral cavity lesion that manifests as a localized, non-neoplastic, inflammatory hyperplastic papule of fibrous connective tissue. Alternatively, mucocele is another frequent oral lesion, caused by mucus pooling in the tissues as a result of trauma to minor salivary glands. This article aims to shed light on traumatic fibroma and mucocele of the lower lip in pediatric patients. Two pediatric patients complained of soft tissue growth on the left side of the lower lip. Appropriate diagnosis, treatment planning, and light amplification by stimulated emission of radiation excision were done for both patients. The excised samples were sent for histopathological analysis. Both patients showed clinical resolution in a short period without any discomfort. A comprehensive understanding of these variances is essential for precise diagnosis and tailored treatment strategies.

Management of Turner's Hypoplasia Using Resin Infiltration: A Case Report.

The causes of enamel discoloration can vary, leading to aesthetic concerns for patients. Injuries to primary teeth can lead to developmental issues in permanent successors, with enamel hypoplasia, commonly referred to as Turner's tooth. Diverse methods are available for addressing tooth discoloration. A case of an 11-year-old pediatric patient with a brown patch on the upper left central incisor was reported to the Pediatric Dentistry Department. A well-demarcated, yellowish-brown lesion was present on the labial surface of 21 and was diagnosed as Turner's hypoplasia. Resin infiltration was done using the Icon Smooth Surface (DMG America Company, Englewood, NJ) resin infiltration kit. The resin infiltration technique provides an approach to meet aesthetic requirements. In this case, the resin infiltration technique was successfully utilized to address the discoloration of the left maxillary central incisor, which was affected by Turner's hypoplasia.

Management of Macroglossia Secondary to Beckwith-Weidmann Syndrome in a Pediatric Patient: A Case Report.

Beckwith-Wiedemann syndrome (BWS) is a rare genetic disorder, distinguished by the following characteristics: macrosomia, macroglossia, abdominal wall deformities such as omphalocele, visceromegaly, hemihypertrophy and elevated risk of developing tumors such as nephroblastoma or hepatoblastoma. A 2.5-year-old female patient came to the Department of Pediatric and Preventive Dentistry with a complaint of abnormally large tongue along with difficulty in swallowing and slurred speech. On clinical examination, the built of the patient was greater than normal. Intraoral examination revealed an enlarged tongue that led to the inability to close her mouth. Preliminary tests like blood tests, ECG, etc., were done before proceeding further to correct the enlarged tongue surgically under general anesthesia. The patient was intubated nasally, and a keyhole incision pattern was marked on the dorsum of the tongue at the central part. Reduction glossectomy was performed using electrocautery and the two parts were thereafter sutured with 5-0 vicryl sutures. The patient was kept under observation for one week and then discharged. Satisfactory healing was observed. Early diagnosis, close monitoring by healthcare specialists, and a thorough treatment plan that includes speech therapy, food support, and dental care can help manage the issues associated with BWS macroglossia.

The Diagnostic Dilemma of an Odontogenic Jaw Lesion in a Pediatric Patient: A Case Report.

This paper presents a case report of a 10-year-old child patient reported with the chief complaint of a painless, hard swelling in the lower right back region of the jaw. The clinical and radiographic examination, including intraoral periapical radiograph (IOPA) and cone-beam CT (CBCT), was performed. Conservative treatment was planned based on the clinical and radiological diagnosis of the cyst. But the histological examination revealed unicystic ameloblastoma (UA). This clinical case of UA, which was misdiagnosed as a combination of a radicular cyst and a dentigerous cyst, is being presented to highlight the importance of histopathologic investigation of all tissue specimens retrieved after surgery, particularly when the clinical and radiological findings are insignificant.

Iontophoresis as an Effective Drug Delivery System in Dentistry: A Review.

Iontophoresis is a non-invasive method to improve drug delivery by the application of an electric field. The iontophoresis process causes deeper penetration of ions using electric current. The drug delivered through iontophoresis was found to be around 10 to 2,000 times more than conventional forms of delivery. The better results were shown by alternating current (AC) than conventional constant current (DC) iontophoresis. The preparation used in iontophoresis should be soluble in water, of a small voltage, and prone to ionization. More mobility is seen with smaller particles. Iontophoresis could increase the diffusion of drugs into dentin, enamel, and other oral tissues. The chief drugs delivered or studied by iontophoresis in dentistry are non-steroidal anti-inflammatory drugs, local anesthetics, anti-bacterial drugs, and fluorides. To enhance the ability of drug transfer nanomaterials were introduced. Under the impact of iontophoresis, remineralizing nanomaterial can be injected at larger concentrations in the deeper layer of incipient caries. Due to the size of nanocomplexes, it is possible that they will diffuse into the body of the subsurface lesion and enter the porosities to improve remineralization utilizing the iontophoresis approach. The concept of the application of an electric current for drug delivery was introduced several years ago in clinical practice, research, and literature. This review focuses on iontophoresis application in dentistry, its mode of action, and how the technique can be utilized in a beneficial way.

Dental and Craniofacial Manifestation of Axenfeld-Rieger Syndrome: A Case Report.

Axenfeld-Rieger syndrome (ARS) is an autosomal dominant syndrome with a prevalence estimated at 1:50000 to 1:100000 in newborns. It is mainly characterized by ocular, craniofacial, and dental abnormalities. From the pediatric dentist's point of view, early diagnosis of the syndrome from the ocular, craniofacial, and dental manifestation can prevent further abnormalities and ocular complications such as glaucoma. This case report presents a brief description of ARS with the characteristics of craniofacial and dental findings.

Quarantine an effective mode for control of the spread of COVID19? A review.

The outbreak of COVID- 19 disease has taken the world by surprise. The disease mainly affects the respiratory system and is caused by a strain of coronavirus named SARS-CoV-2. Due to its high recombination rates the virus has an immense potential to spread rapidly. Within months of the first case being reported in Wuhan China, the disease has turned rapidly into a pandemic. The world health experts are already actively looking for a definite cure or vaccine for the disease, but till that many of the countries across the globe are looking up onto mass quarantine measures as a method to control its spread. This article is an attempt to review the effectiveness of these measures and the possible adverse effects of the same. Other possible modes of prevention and controlling the spread of the disease have also been reviewed in the article.

Surgical Management of Large Radicular Cyst Associated with Mandibular Deciduous Molar Using Platelet-rich Fibrin Augmentation: A Rare Case Report.

Radicular cysts arising from deciduous teeth are rare and usually cause a large bony defect. Autologous platelet-rich fibrin (PRF) is an easily available healing biomaterial in oral surgical defect with the new perspective of accelerated healing of a large bony defect. The present case is of unusually large radicular associated with neglected carious mandibular deciduous second molar in 10-year-old girl and its surgical management with PRF augmentation as a healing biomaterial in the bony defect. One-year follow-up showed uneventful healing and eruption of succedaneous tooth. Healing was relatively faster and facilitated by PRF placement. Furthermore, the importance of anticipatory guidance about the treatment of diseased primary teeth and their preservation gets highlighted.

Evaluation of Aloevera Gel as a Storage Medium in Maintaining the Viability of Periodontal Ligament Cells - An in Vitro Study.

OBJECTIVE: To investigate the effectiveness of aloevera gel as a new storage medium in maintaining the viability of periodontal ligament cells. STUDY DESIGN: Premolars extracted for orthodontic reason were obtained. Confluent monolayers of fibroblasts were grown by cell culture method from the PDL cells isolated from the extracted teeth. One ml of this cell suspension was transferred to wells of culture plates, incubated for 24 hrs, followed by exposure to the three experimental media, Hank's balanced salt solution (HBSS), aloevera gel, and packaged drinking water. These plates were then assessed for viable cells using trypan blue dye exclusion test with haemocytometer after 15, 30, 60, 90 and 120 mins. The results obtained were statistically analysed using one-way analysis of variance (ANOVA). RESULTS: At 15 min, HBSS presented maximum mean percentage of viable PDL cells (89%), followed by aloevera at 81% and packaged drinking water at 10%. Aloevera demonstrated 71%, 59%, 57% viable cells at 30, 60, 90 mins respectively. At 120 min, HBSS presented 57% viable cells followed by aloevera gel (45%) and packaged drinking water (3%). No statistical significant difference was observed between HBSS and aloevera gel. CONCLUSIONS: Within the parameters of this study, both aloevera gel and HBSS were effective in maintaining the viability of PDL cells. Hence, aloevera gel could be used as a storage media for avulsed tooth in situations where availability of HBSS is in question.

Dental aspect of distal tubular renal acidosis with genu valgum secondary to rickets: a case report.

Distal renal tubular acidosis is a disease that occurs when the kidneys do not remove acid properly into the urine, leaving the blood too acidic (called acidosis). Distal renal tubular acidosis (type I RTA) is caused by a defect in the kidney tubes that causes acid to build up in the bloodstream. It ultimately results rickets which include chronic skeletal pain, in skeletal deformities, skeletal fractures. Rickets is among the most frequent childhood diseases in many developing countries. Dental problems in rickets include delayed eruption of permanent teeth, premature fall of deciduous teeth, defects in structure of teeth, enamel defects in permanent teeth (hypoplastic), pulp defects, intraglobular dentine, and caries tooth. Herewith, reported a case of distal tubular renal acidosis with genu valgum secondary to rickets, with pain and extraoral swelling associated with right and left mandibular 1st permanent molars. Teeth were infected with pulp without being involved with caries. Radiographically cracks in enamel and dentin were observed. Pulp revascularization with 46 and root canal treatment was done for 36 with followup of 1 year.

Evaluation of calcium ion, hydroxyl ion release and pH levels in various calcium hydroxide based intracanal medicaments: An in vitro study.

AIMS: Evaluation of calcium ion and hydroxyl ion release and pH levels in various calcium hydroxide based intracanal medicaments. OBJECTIVE: The purpose of this study was to evaluate calcium and hydroxyl ion release and pH levels of calcium hydroxide based products, namely, RC Cal, Metapex, calcium hydroxide with distilled water, along with the new gutta-percha points with calcium hydroxide. MATERIALS AND METHODS: The materials were inserted in polyethylene tubes and immersed in deionized water. The pH variation, Ca(++) and OH(-) release were monitored periodically for 1 week. STATISTICAL ANALYSIS USED: Statistical analysis was carried out using one-way analysis of variance and Tukey's post hoc tests with PASW Statistics version 18 software to compare the statistical difference. RESULTS: After 1 week, calcium hydroxide with distilled water and RC Cal raised the pH to 12.7 and 11.8, respectively, while a small change was observed for Metapex, calcium hydroxide gutta-percha points. The calcium released after 1 week was 15.36 mg/dL from RC Cal, followed by 13.04, 1.296, 3.064 mg/dL from calcium hydroxide with sterile water, Metapex and calcium hydroxide gutta-percha points, respectively. CONCLUSIONS: Calcium hydroxide with sterile water and RC Cal pastes liberate significantly more calcium and hydroxyl ions and raise the pH higher than Metapex and calcium hydroxidegutta-percha points.