Solitary Median Maxillary Central Incisor Syndrome: A Case Report of a Unique Dental Anomaly.

Solitary median maxillary central incisor (SMMCI) syndrome is complex and usually develops 35-38 days postconception during the intrauterine period. A noteworthy discovery is that just one central incisor in the maxillary alveolus, found exactly on the centerline, is present in both deciduous and permanent dentitions with other congenital anomalies. Around one in every 50,000 live babies exhibits this abnormality. This report describes the case of a 13-year-old female patient with SMMCI syndrome with a complaint about an unsightly appearance due to a single large upper front tooth. We underline the importance of increasing clinician awareness of SMMCI syndrome and the need for a multidisciplinary approach to its care.

Intentional Replantation as a Viable Option for Crown-Root Fracture in Maxillary Central Incisor: A Case Report.

Crown-root fractures are often challenging to treat and have a poor prognosis. The present case explains the successful management of a vertically fractured tooth treated by intentional replantation in a 12-year-old child. The patient underwent a successful 12-month follow-up, which included a mobility test and measurement of the gingival sulcus depth. Additionally, a radiological assessment was performed to evaluate the root resorption, the integrity of the alveolar cortex, and the periodontal space. We suggest that intentional replantation may be an effective therapeutic approach for the treatment of cases of vertical crown-root fractures.

Teledentistry: A Comprehensive Review and Its Application in Pediatric Dental Care.

In recent years, dental technology has experienced remarkable advancements, mirroring the evolution of communication and information technologies. The advent of information technology has paved the way for a new frontier in healthcare known as teledentistry. This innovative approach has revolutionized the delivery of dental care across geographical distances, enhancing accessibility and communication in the realm of oral health. This article aims to highlight the various methodologies of teledentistry, discuss its benefits for both patients and dentists, and emphasize its potential to overcome geographical barriers, enhance access to dental care, and promote oral health equity, especially among children. There are three primary teledentistry methods: real-time consultation, the store-and-forward method, and the remote monitoring method. Real-time consultation facilitates immediate interaction between dentists and patients through video conferencing, enabling the sharing of data and medical history. The store-and-forward method involves the collection and transmission of essential diagnostic materials, enhancing diagnostic accuracy. Remote monitoring allows continuous patient evaluation from a distance, improving healthcare delivery and patient safety. Teledentistry's impact on pediatric and preventive dentistry is substantial. It offers remote counseling, diagnosis, and monitoring for children, especially in areas with limited access to dental care. Additionally, mobile gaming apps play a role in behavioral management and reducing dental anxiety among children. Both patients and dentists benefit from teledentistry. Patients gain access to timely consultations, reducing the need for immediate in-person visits. Dentists can efficiently evaluate and monitor patients, collaborate with specialists, and provide expert advice, leading to improved healthcare delivery. Teledentistry is transforming dental care by overcoming geographical barriers, improving access, and enhancing communication. While facing challenges, its potential to revolutionize healthcare delivery and promote oral health equity is undeniable. With ongoing advancements and strategic measures, teledentistry is poised for a promising future in healthcare.

Role of Betel Nut in Liver Toxicity in Oral Submucous Fibrosis and Oral Cancer Patients: A Case-Control Study.

BACKGROUND: In 2004, the International Agency for Research on Cancer (IARC) revised its conclusion that betel quid, both with and without tobacco, as well as areca nut alone, was carcinogenic to humans. Areca nut may enhance chemical hepatocarcinogenesis. Researchers have studied the role of areca nut components in the etiology of oral submucous fibrosis (OSF) for the past two decades. OBJECTIVES: In this, we will study the role of betel nut chewing on the liver and its correlation with the occurrence of OSF and oral cancer. METHODOLOGY: It is a type of case-control study for a duration of three months. A total of 60 subjects were selected based on the selected groups and exclusion criteria. A detailed case history was taken, and after that blood samples were collected for conducting liver function tests. After the collection of reports from the labs, the results were assessed, analyzed, and correlated with the case history of each subject. RESULTS: This research aids in the identification of a link between the occurrence of OSF, oral squamous cell carcinoma (OSCC) liver damage, and the practice of eating betel nuts. Chewing betel quid on a regular basis appears to be a separate risk factor for liver damage, OSCC, and OSF. CONCLUSION: This assessment of liver function with case history in each subject aids in providing an improvised and prioritized method for the early diagnosis of liver misfunctioning in the patient with OSF or Oral Cancer due to a common etiological factor, that is betel nut.

Chemical Composition of Areca Nut and Its Adverse Effects on Human Health.

Areca nut (AN) is one of the addictive substances consumed widely in the world. The composition of AN is very complex, and each component has variable properties. This study aims to review the composition of AN and its adverse effects on humans. For this review, the literature search was performed by an electronic search of the Pubmed/Medline, Scopus, and Google Scholar databases using proper MESH headings and retrieved the articles published from 1997 to 2022. The eligibility criteria included human studies, a form of AN, the composition of AN, harmful effects of AN, the effect of AN on the oral cavity, the effect of AN on vital organs, and articles published in English. Data were extracted regarding the composition of AN, forms of AN, and harmful effects of AN on the oral cavity and on other systems. A total of 449 articles were identified from various databases, and 36 studies were selected that met the inclusion criteria. The active components of AN, which produce harmful effects, are primarily alkaloids, polyphenols, tannins, and certain trace elements. AN is consumed in different forms, and based on the form, its composition also varies. AN is known to cause deleterious effects on the oral cavity as well as various body organs. The most dangerous and widely reported impacts of AN on the oral cavity are the development of oral submucous fibrosis, a premalignant condition, and oral malignancy. However, during the chewing process, excretory products of AN are released and circulate in the body of "chronic habitual" and affect the other body parts. Thus, AN consumption may contribute to cardiac, liver, endocrinal, metabolic, respiratory, and reproductive system disorders also. AN composition is complex, and its consumption is harmful to human health. In regard to controlling the issue of the harmful effects of this habit, preventive measures should be established.

Regenerative Endodontics-Reviving the Pulp the Natural Way: A Case Report.

Regenerative endodontic therapy (RET) offers a novel treatment option for developing teeth with pulp necrosis. In the current instance, RET was used to treat an immature mandibular permanent first molar that had been identified with irreversible pulpitis. The root canals were treated with triple antibiotic paste (TAP) and 1.5% sodium hypochlorite (NaOCl) irrigation. TAP was removed, and 17% ethylenediaminetetraacetic acid (EDTA) was used to treat the root canals during the second visit. As a scaffold, Platelet-rich fibrin (PRF) was applied. Mineral trioxide aggregate (MTA) was applied over PRF, and composite resin was used to repair the teeth. Radiographs taken from the posterior were utilized to assess the healing. The teeth displayed no signs of pain and healing after the six-month follow-up periods, and pulp sensibility tests using a cold and electric pulp tester produced no results. Conservative treatment options should be considered to save immature permanent teeth and assist in the regeneration of the root apex.

Management of Laterally Luxated Primary Teeth: A Case Report.

Lateral luxation can be defined as the traumatic displacement of a tooth in a direction other than axial. The current case report describes the use of composite resin splinting to treat laterally luxated primary maxillary central incisors which resulted in an anterior cross bit. A 5-year-old boy reported to the clinic complaining of pain and mobile front teeth that is his primary right and left central incisors were laterally luxated. After a complete clinical examination and radiographic evaluation, the teeth were repositioned and stabilized for 4 weeks by splinting the laterally luxated tooth to the adjacent teeth. Follow-up examinations revealed that the tissues had healed well and that the corresponding central permanent incisor was healthy and unaffected. This case study highlights the significance of prompt diagnosis, effective treatment, and routine follow-up of traumatized teeth because they may have an adverse effect on both dentitions and "Oral Health-Related Quality of Life". When feasible, conservative treatment should be considered because it may be more suitable in some circumstances.

An Unusual Case of Bilateral Radix Entomolaris Treated With Lesion Sterilization and Tissue Repair in Primary First Molars.

Morphological dental anomalies such as supernumerary roots are rare in primary teeth. Their location, frequency, and associated peculiar root canal morphology should be known to a pediatric dentist. It is crucial to carefully examine intraoral radiographs to ensure that such variations do not go undetected. Such variances must be identified to ensure complete cleaning and filling of all root canals. Negligence in treating all canals can result in recurrent infection or treatment failure. Understanding the anatomical variation of the tooth like radix entomolaris (RE), is important for successful dental treatment. This report presents a rare case of bilateral RE of primary mandibular first molars in middle childhood treated with lesion sterilization and tissue repair.

Management of Ankyloglossia in a Six-Year-Old Child After Cleft Lip and Palate Surgery: A Case Report.

Ankyloglossia or tongue-tie is caused by an excessively short, thick lingual frenum that restricts the normal movements and functions of the tongue. It has a higher prevalence in infants than in children and adults. In the present case, a six-year-old male came with his parents with a chief complaint of difficulty in speech. His medical history revealed that he had a congenital cleft lip and cleft palate, for which he had undergone surgery soon after his birth. He was categorized by Kotlow classification as Class II (moderate ankyloglossia). Under local anaesthesia, diode laser surgery was planned to treat the tongue-tie. The patient showed excellent healing after a one-week follow-up. An increase in tongue movements was seen and the patient was put in consultation with a speech therapist.

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.

Management of Horizontal Root Fracture in Anterior Teeth: A Case Report.

Following traumatic injury, pulpal and periapical pathosis in an immature anterior tooth is common, and treating open apices in these situations is a persistent problem for pedodontists. This is because there is no apical constriction, which would prevent the obturated material from forming an excellent three-dimensional seal or adaption within the canal system. Mineral Trioxide Aggregate (MTA) offers a good choice when employed to create an apical barrier. In this case report, an open apex and periapical lesion involving maxillary right central incisor #21 with the MTA are shown with a six-week follow-up result after being treated for four weeks with triple antibiotic paste as an intra-canal medication. The successful healing of tooth 21 and the diminution of the periapical radiolucency at one-week follow-up were observed.

Triple Antibiotic Paste: A Suitable Medicament for Intracanal Disinfection.

With increasing cases of odontogenic infections, advancements in the treatment modality gain utmost importance. Complexity in the anatomy of the root canal necessitates the selection of the correct medicament and disinfectant. Furthermore, exacerbation of the problem results due to improper cleaning and disinfection of the root canal space. In such cases, manual preparation and irrigation alone will be of no help. The treatment outcome mostly depends upon the correct selection and application of the proper intracanal disinfectant along with the proper choice of medicament. One such intracanal disinfectant is triple antibiotic paste (TAP), a mix of three antibiotics. It's the combined effect of the three drugs mixed in the paste that makes the mix a potent antimicrobial agent effective against microbes. This review aims to evaluate the properties of TAP, its composition, its various application, and its property to help maintain the vitality of the diseased pulp. This review also talks about its drawbacks and its application in primary teeth.

Demystifying Failures Behind Separated Instruments: A Review.

Instrument separation is one of the most routinely encountered mishaps occurring in the arena of endodontics. Separation occurs unknowingly most times and we are left to ponder as to where to head next. It is majorly the lack of knowledge and skill that makes us panic in these times. The objective still remains to effectively clean as well as shape the root canal so that it can best receive the obturating material. Thus sudden breakage of a file during this critical phase leaves the clinician in an absolute dilemma. This review thereby throws light onto the various factors that remain in the hand of the clinician before proceeding for biomechanical preparation of the root canal so as to prevent instrument fracture. The correct application and knowledge of these techniques will prevent procedural mishaps from occurring and further enhance the quality of the treatment.

Applications of Silver Nanoparticles in Pediatric Dentistry: An Overview.

Nanoscience and nanotechnology are emerging fields involved in the synthesis and application of nanoscale materials and structures. Metallic nanoparticles and metallic oxide are being used extensively in dentistry as they interfere with bacterial metabolism and prevent biofilm formation. AgNPs are a class of zero-dimensional materials with distinctive morphologies. The metallic nanoparticles demonstrate the significant antimicrobial activity by ion release, oxidative stress induction, and non-oxidative mechanisms. Metallic silver has been known for its antimicrobial activity since ancient times. Through the years, silver-containing compounds have been used in various forms to treat several medical conditions. Incorporating silver nanoparticles into dental materials may enhance the mechanical features and antibacterial properties of dental materials. Therefore, an increasing number of dental materials with the inclusion of silver nanoparticles are being developed that improve the overall oral health status of patients. This paper aims to review the literature on specific characteristics of silver nanoparticles and their applications in pediatric dentistry.

Enhancing Dental Students' Understanding of Behavior Management in Pediatric Dentistry: A Comparison of Two Teaching Methods.

Aim Communication, behavioral, and attitudinal skills are an integral part of teaching behavior management to dental undergraduate students. Due to the complexity of these skills, clinical teaching through the didactic method imparts minimal capacity for adopting a deep approach to learning. The implications of role play and group discussion could be an opportunity to facilitate such learning outcomes. The objectives of this study were to evaluate and compare the efficacy of role play and group discussion as teaching-learning methods for behavior management in pediatric dentistry. Material and methods The study was carried out with 92 final-year Bachelor of Dental Surgery (BDS) undergraduate students at Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences, Wardha, India. The Tell-Show-Do and non-pharmacological behavior management techniques were taught to the intervention and control groups by the role-play and group discussion methods, respectively. To assess knowledge gain, a pre-test and post-test were conducted. To evaluate the acquisition of communication, behavioral, and attitudinal skills, students were made to perform a clinical procedure, i.e. placement of pit and fissure sealant in primary molars. Each student was evaluated by direct observation using a checklist. Results The results revealed a statistically significant difference between the post-test scores of the role-play and group discussion methods, with average values of 8.57±0.98 and 6.97±0.12, respectively (p= 0.020). The average scores of communication and attitudinal skills among the intervention and control groups were 19.70±0.87 and 13.98±1.51, respectively (p=0.027). Hence, the role-play method was found to be a highly effective method. Conclusion Role-play as a teaching tool was highly effective in instilling behavior management skills among students to deal with young patients in clinical situations as compared to the group discussion method. The difference is depicted in higher scores in the intervention group.

Perception of dental faculty and student regarding class attendance and final performance.

AIM: The aim of this study was to assess the impact of lecture attendance on the academic performance of 3rd BDS students at the DMIMS-U, Sawangi (M), Wardha. This project investigated and correlated the difference between faculty and student perceptions regarding attendance and final performance, including factors thought to influence student attendance. MATERIALS AND METHODS: Participants from a single university were included in the present retrospective observational study. The study was conducted in April 2016; 77 3rd BDS students (2012 Batch) and teaching staff of SPDC willing to voluntarily participate were included and divided into two groups such as Group A and Group B. Student and faculty perceptions were obtained using Likert scale having 15 closed-ended and 3 open-ended questions. Questioner was made related to factors affecting the attendance in class, type of source available for study, awareness about topic, and faculty approach. Comparison between perception of students and faculty regarding attendance and final performance was done using Mann-Whitney U-test. P < 0.05 was considered statistically significant. RESULTS: Quantitative analyses revealed significant differences between faculty and student perceptions on most of the project variables. Qualitative analyses reinforced those findings and suggested that faculty misunderstood what factors actually influence student attendance. The results suggest that there is a substantial disconnect between faculty and student perceptions regarding the importance of class attendance and highlighted areas for faculty to influence student attendance. CONCLUSION: Motivation is the major factor causing students to attend the lectures. Unfortunately, not all students are motivated to study and learn. New styles of teaching may need to be looked into. This needs to be further investigated on large sample size.

Morphological evaluation of temporo-mandibular joint in indian population / Avaliação morfológica da articulação temporo-mandibular em Indianos

The temporomandibular joint (TMJ) is one of the most complex joints in the body and its harmonious functioning is very important to maintain a normal masticatory system. The morphologic alterations and the asymmetrical position of the TMJ structures may lead the various clinicalsigns & symptoms. Morphology of the temporomandibular joint may be influenced by gender of patients, environmental factor and also food habits at various places. Objective: To evaluate the morphology of the temporomandibular joint using computed tomography, in order to determine the condyle shape, joint space and glenoid fossa roof thickness. Material and Methods: One hundred and six healthy patients (212 TMJs) who visited a private hospital (or the University's Hospital) for CT brain scan were included to this crosssectional study sample.The patients were aged between 20­50 years with an average age of 35.46 years. All the images were taken by positioning patients in supine position with 120kvp , 50ma,2.33minute exposure with 0.7mm thick slicesby computed topography machine in all three projection that is Axial, Coronal and Saggital view. Results: For all variables, the mean and standard deviation were calculated, based on gender, and TMJ sides. The Paired t-test was used and P <0.05 will be considered to be significant. Conclusion: Present study showed that thereis positive evidence of temporomandibular joint involvement in elderly patients. Change in morphology and position of condylar head with glenoid fossa and roof thickness are one of the most common cause of degenerative diseases (AU)

Objetivo: A articulação temporomandibular (ATM) é uma das articulações mais complexas do corpo e seu funcionamento harmonioso é muito importante para manter um sistema mastigatório. As alterações morfológicas e a posição assimétrica das estruturas da ATM podem levar os vários sinais e sintomas clínicos. A morfologia da articulação temporomandibular pode ser influenciada pelo gênero dos pacientes, fatores ambientais e também hábitos alimentares diversos. Objetivo: Avaliar a morfologia da articulação temporomandibular usando tomografia computadorizada, a fim de determinar a forma do côndilo, o espaço articular, e a espessura do teto da fossa glenóide. Material e Métodos: Cento e seis pacientes saudáveis (212 ATMs) que foram a um hospital privado (ou Hospital da Universidade) para tomografia computadorizada de cérebro foram incluídos na amostra deste estudo transversal. Os pacientes tinham entre 20 e 50 anos com uma idade média de 35,46 anos. Todas as imagens foram tiradas com os pacientes posicionados em decúbito dorsal com 120kvp, 50mA, 2,33minutos de exposição com espessura de 0.7mm nas três projeções: Axial, Coronal e Saggital. Resultados: Para todas as variáveis, a média e desvio padrão foram calculados, com base no sexo e nos lados da ATM. O teste t pareado foi usado e P <0,05 foi considerado significativo. Conclusão: O presente estudo mostrou que há evidências positivas de envolvimento da articulação temporomandibular nos pacientes mais velhos. Mudança na morfologia e posição da cabeça condilar com a espessura do teto da fossa glenóide é uma das causas mais comuns de doenças degenerativas (AU)

Orthodontic extrusion: diagnosis and treatment with CBCT in a pediatric patient.

Traumatic injury to a primary tooth can affect the underlying permanent tooth germ, and may result in a malformed, hypoplastic crown or root. The degree and nature of malformation depends on the injury. Most trauma cases can be diagnosed using conventional 2-dimensional radiographs, but some cases may benefit from more advanced 3-dimensional imaging such as cone-beam computed tomography (CBCT). This report describes the use of CBCT in the diagnosis and treatment planning of a case in which a 10-year-old girl reported with an impacted, recessed central incisor. The tooth was deformed due to trauma at an early age. Conventional 2-dimensional occlusal and periapical radiographs seemed to indicate that the root had almost completely resorbed. This implied that the optimal treatment plan would be the extraction of the central incisor and, later, the placement of an implant with a crown or bridge. However, a 3-dimensional CBCT radiographic examination showed that the tooth root was long and had enough of a crown-to-root ratio to anchor the tooth. The CBCT examination compelled the treating dentists to maintain the central incisor by orthodontically extruding the tooth and then rebuilding it with a bonded composite restoration.

Radicular cyst of primary tooth associated with maxillary sinus.

Radicular cyst is one of the most common odontogenic cystic lesions found in the jaws. It is inflammatory in nature and found mostly in relation to a non-vital tooth. It usually presents at a later stage in life because the formation of the cyst is the last step in the progression of inflammatory events after a periapical infection. The cyst usually goes unnoticed because of its painless nature and small size. We present the clinical, radiographic and histological characteristics of a radicular cyst along with its management. Cystic sac was removed surgically under general anaesthesia after the elevation of the mucoperiosteal flap. Histopathologically, the cystic sac was consistent with the features of a radicular cyst. Follow-up period of 21 months showed improved radiographical appearance on Coned Beam CT. Vestibular deepening was planned as a future treatment in the same region.