Cultural Beliefs on Cleft lip and/or Cleft Palate and Their Implications on Management: A Systematic Review.

OBJECTIVE: This article examines and summarizes the published epidemiological literature on cross-cultural variations. Particular emphasis was put on addressing cross-cultural beliefs on the causes, management, and attitude toward cleft lip and/or cleft palate. A healthcare provider's awareness of these cross-cultural attitudes and beliefs is vital for promoting effective collaboration with patients' families and ensuring a favorable medical outcome. DESIGN: Systematic review. SETTING: Not applicable. PARTICIPANTS: Patients with cleft lip and/or cleft palate, their families, their communities, and healthcare providers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: All relevant and eligible studies were identified using PubMed and Google Scholar databases. The cultural belief was categorized and measured using Murdock's Theories of Illness. The study was reported in compliance with PRISMA guidelines. The quality of the selected studies was evaluated in accordance with the Critical Appraisal Skills Programme criteria (CASP). Fourteen articles covering thirteen countries on four continents met the inclusion criteria. In diverse communities, cleft lip and/or cleft palate was attributed to natural (infection, medication, improper diet, smoke, or radiation) or supernatural (God, eclipse, ancestral spirit, and curse) causes. Reported consequences include stigmatization, inappropriate treatments, leaving patients untreated, and infanticide. CONCLUSION: Cultural beliefs are the main cause of misconceptions surrounding a cleft lip and/or cleft palate. There is also a need for public health care providers' intervention to educate society about the natural causes and ease of management, thereby increasing opportunities for patients substantially.

Incidental Paranasal Sinus Findings on Computed Tomography Images of Pediatric Patients: A Cross-sectional Prevalence Study.

Objectives: The study was conducted to assess the prevalence of incidental paranasal sinus pathologies in children on computed tomography (CT) scans. Materials and methods: A nonrandomized retrospective study was done on CT scans of 232 pediatric patients taken in the past 6 months duration. These scans were evaluated in different age groups from 0-13 years who had visited or were admitted to the hospital for various other head and neck-related problems. Each scan was examined for incidental pathologic findings in all the paranasal sinuses. The data were analyzed using descriptive statistics and Fisher's exact test to determine non-random associations between variables. Results: A total of 232 subjects were examined, amongst which 72 (31.03%) had incidental sinus pathologies. Multiple sinus pathologies were found in 36 subjects, 28 had single sinus involvement, and four showed no development of frontal sinus at the age of 11 years. Four subjects had pathology in multiple sinuses as well as no development of frontal sinus at the age of 6-7 years age range. Conclusion: Sinus pathologies are not unusual in the asymptomatic children population, and the incidence is almost equivalent to that of the adult population. Early identification can aid in diagnosing orofacial pain of unknown origin and also if children are susceptible to upper respiratory tract infections and their secondary effects like sleep apnea, mouth breathers, etc. How to cite this article: Talwade P, Deshpande PS, Pene S, et al. Incidental Paranasal Sinus Findings on Computed Tomography Images of Pediatric Patients: A Cross-sectional Prevalence Study. Int J Clin Pediatr Dent 2023;16(2):292-294.

Diagnosis of the misdiagnosed: Mucormycosis depicting periodontitis.

Oral cavity is habitat for plethora of micro-organism causing various diseases. The most common includes dental caries, periodontal diseases, etc. Dental practice may rarely encounter unusual and subtle symptoms with nonpathognomonic clinical signs of several fatal diseases which may pretend like a common oral disease. Hence, the knowledge and clinical acumen of diagnostician are necessary for the early diagnosis of such fatal infections to prevent untoward consequences. Mucormycosis is an angioinvasive necrotic fungal infection with a high morbidity and mortality rate. It commonly occurs in patients with debilitating diseases and immunocompromised individuals. Clinically, it manifests as rhino-orbito-cerebral, pulmonary, cutaneous, gastrointestinal, renal, and disseminated form. Disease affecting the facial region is a challenge as it often disseminates with orbital and cranial involvement at the time of diagnosis. This article presents a case of mucormycosis which mimicked as severe periodontitis in a patient leading to delay in the diagnosis and challenges during the treatment.

Lipoid proteinosis: a rare encounter in dental office.

Lipoid proteinosis is a sporadic congenital metabolic disorder which is characterized by deposition of hyaline material in dermis, submucosal connective tissue, and various internal organs. It has an extremely low prevalence rate with less than 300 cases reported so far. This progressive disease has a vast spectrum of manifestations ranging from asymptomatic lesions to fatal seizures and respiratory obstruction making timely diagnosis of this rare disorder an imperative task for oral health care practitioners. We report a case of characteristic oral manifestations of lipoid proteinosis in a 28-year-old male patient along with a review of relevant prevailing literature.

Intraosseous adenoid cystic carcinoma of maxilla: A rare case report.

Adenoid cystic carcinoma (ACC) accounts for approximately 6-10% of all salivary gland tumors. Palatal minor salivary glands, parotid, and sub-mandibular glands are usually affected. Rarely, these lesions arising intraosseously have been reported. Mandible is commonly involved than maxilla. The present case is a giant ACC involving the right maxilla. A thorough clinical and radiographic evaluation was performed to assess the involvement of surrounding vital structures along with a meticulous metastatic work-up. Computed tomography showed a giant lesion in maxilla encroaching the left nasal fossa, antrum, buccal space, and oral cavity. No metastasis was noted. Histological evaluation from multiple sites showed both cribriform and solid patterns. Radiotherapy was given as patient did not comply for surgery. Though central ACC is extremely rare, especially in maxilla, it should be included in the differentials for lesions in maxilla. A prompt diagnosis with treatment and long-term follow-up is advised in such cases.

Dual lesions: a diagnostic dilemma.

Glandular odontogenic cyst (GOC) is a rare aggressive developmental cyst of the jaw. It most commonly occurs in middle-aged people with mandible anterior region being the most affected site. This lesion can present as a unilocular or multilocular radiolucency and has high recurrence rate. The histopathologic features of the GOC are complex and often coincide with the features of dentigerous cyst, radicular cyst, and low-grade central mucoepidermoid carcinoma (CMEC). At times, the microscopic features are so similar to central low-grade mucoepidermoid carcinoma that it becomes highly impossible to distinguish the two entities even with various advanced investigations. The reported case represents one such diagnostic dilemma occurring in the maxilla which is a rare site, and the lesion/s appeared as two distinct entities, that is, GOC and CMEC on either aspects of the same side of maxilla clinically, yet showing continuity on advanced imaging and demonstrating histopathological perplexity.

Proximity of impacted mandibular third molars to the inferior alveolar canal and its radiographic predictors: a panoramic radiographic study.

PURPOSE: To assess the radiographic proximity of impacted mandibular third molars to the inferior alveolar canal on panoramic radiographs. The radiographic distance between the impacted mandibular third molars and inferior alveolar canal and the reliable radiographic risk predictor signs that indicate close proximity between these two structures were evaluated. METHODS: The study comprised of 64 subjects with 68 symptomatic impacted mandibular third molars for whom panoramic radiographs were made. The radiographs were interpreted for type of impaction, radiographic distance between impacted mandibular third molars to inferior alveolar canal and presence of one or more of the seven radiographic risk predictor signs. Further, these teeth were surgically removed and the proximity was assessed based on the exposure of inferior alveolar canal/nerve which was considered as Gold standard. RESULTS: The overall mean distance from the impacted mandibular third molars to inferior alveolar canal was -0.50 mm. Most of the samples (61.8 %) extended beyond the superior border of the inferior alveolar canal with a mean distance of -1.40 mm. Mesioangular impactions were found to be in the close proximity (-1.14 mm) to inferior alveolar canal than any other type. Interruption of the white line was the only statistically significant radiographic risk predictor sign p = 0.006 (< 0.05) that indicated close proximity of impacted mandibular third molars to inferior alveolar canal. CONCLUSION: It can be concluded that panoramic radiographs are reliable in assessing the proximity of impacted mandibular third molars to inferior alveolar canal. Mesioangular impactions are more closely placed to inferior alveolar canal and interruption of the white line is the most reliable risk predictor sign on the panoramic radiographs.

Spirulina and pentoxyfilline - a novel approach for treatment of oral submucous fibrosis.

BACKGROUND: Oral submucous fibrosis is a habit associated insidious precancerous condition of the oral cavity commonly found in Asian countries. Many treatment modalities have been attempted in treating the condition apart from steroids which have been the main stay. Hence the present study was designed to assess the efficacy of spirulina and pentoxyfilline and also to compare them in oral submucous fibrosis. MATERIAL AND METHODS: Fourty Patients with clinico-histological diagnosis of oral sub mucous fibrosis were selected and divided into two groups with 20 in each group by simple randomization method. Group I received Pentoxyfilline and Group II Spirulina for period of 3 months. The efficacy was assessed by parameters like mouth opening, burning sensation and tongue protrusion using vernier caliper, visual analog scale and a metric scale respectively along with the side effects. RESULTS: Student's t-test was applied to obtain the results. Both Pentoxyfilline and Spirulina groups showed statistically significant results (p=0.000) in all the three parameters namely mouth opening, burning sensation and tongue protrusion. On comparing both the drugs statistically insignificant results were obtained for mouth opening (p=0.35) and tongue protrusion (p=0.25) but statistically significant difference was seen in subjective parameter i.e burning sensation (p=0.04). Side effects like bloating of stomach, nausea and gastritis were noted in the pentoxyfilline group in contrast to Spirulina group. CONCLUSION: Newer drugs Pentoxyfilline and Spirulina showed promising results in treatment of Oral sub mucous fibrosis. Spirulina was used for the first time for treatment of Oral submucous fibrosis (OSMF) and it proved to be superior than pentoxyfilline as no side effects were observed. Also it was superior in reducing burning sensation and hence can be advised in OSMF patients suffering from severe subjective symptoms.