Effect of Obstructive Sleep Apnea on Condylar Malformation, Vertebral Column, and Head Posture: A Cephalometric Evaluation.

AIMS AND OBJECTIVES: Obstructive sleep apnea (OSA) is by far the most common sleep-related breathing disorder, affecting 2-4% of the adult population. The present study aims to compare the descriptive morphology of the cervical column in subjects with normal craniofacial morphology with those having condylar hypoplasia with OSA and to evaluate a positive correlation between the cervical columns, the cranial base angle, and the posture of the head and neck in subjects of condylar hypoplasia. MATERIALS AND METHODS: The present study comprised of lateral cephalogram of 40 subjects divided into two equal groups-control groups (n = 20) and OSA with condylar hypoplasia (n = 20). RESULTS AND OBSERVATION: The condylar hypoplasia group has fusion anomalies of 65% and 35% has a posterior arch deficiency. The cervical lordosis, inclination of the cervical column is found to have a positive statistically significant correlation in condylar hypoplasia subjects. CONCLUSION: Morphological deviations and deviation pattern of the cervical column occurred significantly more often in subjects with condylar hypoplasia as compared with normal craniofacial morphology which can be verified by the increased cranial base angle, cervical lordosis, the inclination of the upper cervical spine, and cranial base angle were positively correlated with a fusion of cervical column. CLINICAL SIGNIFICANCE: Specific types of craniofacial morphology and head postures such as a reduced posterior airway space, an abnormally long soft palate, a low position of the hyoid bone, and an extended head posture are considered predisposing factors of OSA. As posture of the head and neck is considered to be associated with OSA, OSA may be associated with fusion of the cervical column. Hence, to know the result of malformation in the cervical column prove to be important with regard to phenotypical subdivision, diagnosis, and treatment of OSA. HOW TO CITE THIS ARTICLE: Divya, Navit P, Singh R, et al. Effect of Obstructive Sleep Apnea on Condylar Malformation, Vertebral Column, and Head Posture: A Cephalometric Evaluation. Int J Clin Pediatr Dent 2020;13(S-1):S64-S68.

Nature's Benefaction as a Life Saver for an Avulsed Tooth: An In vitro Study.

INTRODUCTION: Dentoalveolar trauma is a very common and avulsion is the most frequent injury. Treatment of choice following avulsion is immediate reimplantation. However, in cases where this might not be possible the prognosis of reimplanted teeth can be improved by the selection of an appropriate storage media. Prevention of ankylosis and replacement resorption depends more on the potential of storage media to maintain cell viability rather than the extraalveolar time period. AIM: To compare and evaluate the efficacy of different storage media in maintaining the viability of Periodontal Ligament (PDL) cells in an avulsed tooth. MATERIALS AND METHODS: A total of 58 freshly extracted human premolar teeth were divided into four experimental groups and two control groups. The positive and negative controls corresponded to 0 minute and an eight hours dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of the four media: Hank's Balanced Salt Solution (HBSS), coconut water, aloe vera and saline for 45 minutes. The teeth were then treated with Collagenase Type II and Dispase for 30 minutes. The number of viable PDL cells were counted with a haemocytometer and analysed. The statistical analysis was done using SPSS version 15.0. The Analysis of Variance (ANOVA) and Post-hoc tests (Tukey-HSD) were performed to reveal the statistical significance. The values were represented in number (%) and mean±SD. RESULTS: Statistical analysis demonstrated that among the experimental groups maximum percentage of viable cells were seen in HBSS (87.33%) followed by coconut water (79.87%), aloe vera (70.59%) and saline (50.56%). CONCLUSION: Within the parameters of this study, it can be concluded that the HBSS is the most effective storage media in maintaining the viability of PDL cells. However, in Indian scenario where availability of HBSS is questionable, coconut water can be considered as the best natural storage media for an avulsed tooth followed by aloe vera.

Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study.

BACKGROUND: Fluoridation of drinking water, despite being regarded as one of the top ten public health achievements of the twentieth century, has remained a much debated concept. Various studies on animals and aborted human fetuses have confirmed that excessive fluoride intake during infancy and early childhood, causes a number of irreversible structural and functional changes in the CNS leading to memory, learning and intellectual deficits. AIM: To compare the IQ levels of school children of two different locations, having different fluoride levels in water, and to establish a relationship between fluoride levels, prevalence of fluorosis and its effect on IQ levels. MATERIALS AND METHODS: A cross-sectional study was conducted among 429 children aged 6 - 12 years, selected by stratified random sampling from two different areas with different levels of fluoride in drinking water in and around Lucknow district. Dental fluorosis was measured using Dean's Fluorosis Index. Intelligence Quotient was measured using Raven's Coloured Progressive Matrices (1998 edition). RESULTS: Majority of the fluorosis free children (76.3%) had an IQ grade 2 (definitely above the average). Majority of the children suffering from very mild and mild dental fluorosis were found to have IQ grade 3 (Intellectually average). Children with moderate cases of dental fluorosis were found to have IQ grade 4 (Definitely below average). Only 5 children with severe fluorosis were included in the study and they all were found to have an IQ grade 5. Hence, a trend of increase in the IQ grade (decrease in intellectual capacity) was observed indicating a strong correlation between fluorosis grade and IQ grade. CONCLUSION: Findings of this study suggest that the overall IQ of the children exposed to high fluoride levels in drinking water and hence suffering from dental fluorosis were significantly lower than those of the low fluoride area.

The Mystery of Handprints: Assesment and Correlation of Dermatoglyphics with Early Childhood Caries A Case-Control Study.

BACKGROUND: It has been acknowledged that genetics play a significant role in determination of dermatoglyphic patterns. Since caries is a multifactorial disease with the influence of genetic pattern, this study was undertaken to assess dermatoglyphic patterns and correlate them with early childhood caries. AIM: The aim of the study was to determine the association and correlation of dermatoglyphic patterns with early childhood caries. MATERIALS AND METHODS: The study sample consisted of 100 children aged between 3 and 6 years, divided into two groups of 50 children each. The deft score was evaluated to select the experimental group and control group. Finger and palm prints were recorded using the ink method described by Cummins and Midlo. The handprints obtained were checked for their clarity with a magnifying glass (×2) and coded. The presence of core and the triradii of the dermatoglyphic pattern were checked thoroughly to include the handprint in the study. A total of 1000 digital prints and 200 palmar prints were obtained. RESULTS: The presence of whorls in the index finger of the right hand predicts significantly lower risk of caries in children (male and female; combined). Presence of whorls in the ring finger of the right hand predicts significantly lower risk of caries in female children. Statistically no correlation between atd angle and early childhood caries was obtained from the present data. CONCLUSION: The results obtained from the present study creates a notion on the validity of the results of the previous studies and point them to be chance findings. Due to increasing acceptability of dermatoglyphics as a diagnostic tool for congenital diseases, further large scale extensive research should be undertaken to evaluate the role of the same in children with Early Childhood Caries (ECC).

Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients.

BACKGROUND: Dental anxiety is a widespread phenomenon and a concern for paediatric dentistry. The inability of children to deal with threatening dental stimuli often manifests as behaviour management problems. Nowadays, the use of non-aversive behaviour management techniques is more advocated, which are more acceptable to parents, patients and practitioners. Therefore, this present study was conducted to find out which audio aid was the most effective in the managing anxious children. AIMS AND OBJECTIVES: The aim of the present study was to compare the efficacy of audio-distraction aids in reducing the anxiety of paediatric patients while undergoing various stressful and invasive dental procedures. The objectives were to ascertain whether audio distraction is an effective means of anxiety management and which type of audio aid is the most effective. MATERIALS AND METHODS: A total number of 150 children, aged between 6 to 12 years, randomly selected amongst the patients who came for their first dental check-up, were placed in five groups of 30 each. These groups were the control group, the instrumental music group, the musical nursery rhymes group, the movie songs group and the audio stories group. The control group was treated under normal set-up & audio group listened to various audio presentations during treatment. Each child had four visits. In each visit, after the procedures was completed, the anxiety levels of the children were measured by the Venham's Picture Test (VPT), Venham's Clinical Rating Scale (VCRS) and pulse rate measurement with the help of pulse oximeter. RESULTS: A significant difference was seen between all the groups for the mean pulse rate, with an increase in subsequent visit. However, no significant difference was seen in the VPT & VCRS scores between all the groups. Audio aids in general reduced anxiety in comparison to the control group, and the most significant reduction in anxiety level was observed in the audio stories group. CONCLUSION: The conclusion derived from the present study was that audio distraction was effective in reducing anxiety and audio-stories were the most effective.

Comparative Evaluation of Shear Bond Strength of Recycled Brackets using Different Methods: An In vitro Study.

BACKGROUND: Debonding of brackets commonly occurs during orthodontic treatment. Due to increase in costs replacement of a damaged bracket is not liked by the dentist. This study is done to assess the shear bond strength of recycled brackets using different methods. MATERIALS AND METHODS: This study was conducted using five groups of orthodontic brackets (0.022" × 0.028", MBT prescription) bonded on the premolars mounted in cubes. Other materials required were cubical trays, bonding material, light cure unit, universal testing machine, digital camera and sandblasting unit. RESULTS: From the result of ANOVA test we observed the test is significant (F = 20.79, P < 0.01) and the test is rejected. When the Tukey's t-test result was applied it was seen that the mean shear bond strength of all groups of brackets is as follows: Group I (5.31 Megapascals [Mpa]) < Group II (7.37 Mpa) < Group III (8.96 Mpa) < Group IV (5.56 Mpa) < Control group (9.24 Mpa). Alternatively we can say that shear bond strength of following bracket groups can be arranged as Group I < Group IV < Group II < Group III. CONCLUSION: From this study we conclude that Group III, which was recycled with an ultrasonic cleaner with electropolisher and silane coupling agent in place of primer, showed the highest shear bond strength.

Interrelationship of intelligence quotient with caries and gingivitis.

BACKGROUND: Intelligence is the property of mind that encompasses many related abilities, such as the capacities to reason, plan, solve the problem, think, comprehend ideas, use languages and to learn. Intellectual level of a person influence the abilities to learn from experience, adapt to new situations, understand and handle abstract concepts, and use knowledge to manipulate one's environment. This abstract thinking helps the child to maintain his/her oral hygiene in a better way. MATERIALS AND METHODS: The present study was carried out on 252 children of 10-15 years old, reported to the out-patient Department of Pedodontics and Preventive Dentistry; of Teerthanker Mahaveer Dental College and Research Centre; Moradabad, in order to assess the relation between IQ of a child with dental caries and gingival disease. The statistical analysis was performed using Statistical Package for Social Sciences Version 15.0 statistical analysis software. RESULTS: Statistically, there was a significant difference among different intelligence groups and the prevalence of moderate gingivitis (P < 0.001). Prevalence of caries was maximum among those with borderline intelligence (90.9%), and no significant association between level of intelligence and caries prevalence was observed (P = 0.572). CONCLUSION: There was a statistical significant relation between IQ and prevalence of moderate gingivitis and no significant relationship was observed between IQ and dental caries.

Arrested growth: myth or reality.

In Class II, Division I malocclusion is a common problem often associated with mal-relationship of dental bases and mal-alignment of dentition. The approaches to treat Class II, Division I malocclusion include growth modulation, dental camouflage and surgical orthodontics. A 16-year-old female patient with Class II, Division I malocclusion associated with excessive over jet, deep bite, and retrognathic mandible reported to the Department of Orthodontics and Dentofacial Orthopedics, Kothiwal Dental College and Research Center and Hospital, Moradabad. The case was treated with twin block appliance by taking into consideration the over jet which was to the tune of 13 mm and the mandible which was fully locked within the maxilla. The patient was post-pubertal by 3 years and by seeing lateral cephalogram, it falls in CVMI5 stage which mean normally that the growth is only 10% left and theoretically, not appropriate for functional appliance therapy. The patient was treated with twin block appliance to catch up with the arrested growth of mandible followed by fixed mechanotherapy. The result was tremendous and up to the mark.

Modified intracanal post for severely mutilated primary anterior teeth.

Early childhood caries leads to early damage, discolouration and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue thrust and subsequent malocclusion, psychological problems and problem with self-esteem, if aesthetics are compromised. Thus, restoration of severely mutilated primary anterior teeth is often considered as a special challenge, especially in an emotionally immature child. This case documents the restoration of severely mutilated incisors in a patient with early childhood caries.