Peripheral Giant Cell Granuloma of Posterior Maxilla in a 9-Year Child.

Peripheral giant cell granuloma is a relatively uncommon benign reactive gingival lesion of the oral cavity. A 9-year boy presented with a painless, slow-growing, reddish-blue, soft tissue lesion on attached gingiva adjacent to maxillary right first and second premolars, which was interfering with eating. A periapical radiograph demonstrated focal alveolar bone loss and slight teeth displacement adjacent to the lesion. Diagnosis of peripheral giant cell granuloma was made through clinical and radiographic evaluation, by its typical presentation and correlation with histopathologic findings. Complete excision was carried out down to the underlying bone. A follow-up visit was scheduled after 7 days and deep scaling was performed. There was no recurrence three months post-excision. Timely detection and excision of this lesion is important to avoid future dentoalveolar problems. Key Words: Giant cell granuloma, Benign, Peripheral, Child.

Congenital Isolated Bilateral Soft Tissue Syngnathia In A 4-Day Old Baby Boy.

Congenital maxillomandibular syngnathia is characterized by fusion of jaws. Depending on the severity, it has a wide range of clinical presentations. It can be complete /incomplete and may be unilateral or bilateral. Primary concern in such patients is maintenance of airway and feeding difficulties. Therefore, early recognition and management is important to reduce nutritional, feeding, airway difficulties and growth-related problems in such new-borns. This case report presents a case of syngnathia in a 4-day infant with bilateral fusion of maxilla and mandible, leaving a small anterior portion. Early intervention was planned and the fusion was released to facilitate feeding. Good mouth opening was seen on 1week follow-up.

Compound odontoma in a nine-years-old boy associated with impacted permanent central and lateral incisor - a case report.

Odontomas are one of the most common tumours of odontogenic origin. They are usually asymptomatic but may be associated with retained primary teeth or missing permanent teeth. Though the exact aetiology is unknown, the postulated causes include trauma, infection, inheritance and genetic mutation. Early diagnosis and management will result in fewer complications. Conservative surgical excision is the treatment of choice. This case report presents a treated case of compound odontoma associated with delayed eruption of the permanent central incisor in a nine-yearsold boy.

Comparison Of Two Intracanal Medicaments In Resolution Of Apical Radiolucency.

BACKGROUND: As a gold standard, calcium hydroxide has always been used as a root canal medicament against root canal pathogens but its combination with chlorhexidine is not being employed in routine despite its documented efficacy and results. The objective of the study is to compare calcium hydroxide and combination of calcium hydroxide with 2% CHX on the basis of radiographic evidence of resolution of periapical radiolucency when they are used as an interappointment dressing /intracanal medicament for 14 days.. METHODS: A total of 60 patients of either gender was included in the study. The age range was 15-60 years with the radiographic evidence of radiolucency of 2-4 mm in size. Both maxillary and mandibular teeth till first molar were selected. Teeth with previous endodontic treatment mentally handicapped and terminally ill patients were excluded. Selected patients were placed randomly into Group 1 (calcium hydroxide alone) and in Group 2 (calcium hydroxide in combination with 2% chlorhexidine gel). Obturation and permanent filling was done at 14th day. The patient was recalled after 90 days of obturation and a radiograph was taken. Final outcome was measured at the end of 90thday of obturation. RESULTS: The mean of percentage reduction in size of apical radiolucency at 3 months was 91.03% for group 1 and 97.26% for group 2 with p-value 0.13 (not significant). The results suggested equivalent results after medication with 2%chlorhexidine with calcium hydroxide but 2% chlorhexidine still showed better results than the group without CHX in terms of healing. CONCLUSIONS: This study concluded that calcium hydroxide in combination with 2% chlorhexidene as intracanal medicament results in better resolution of periapical radiolucency in terms of percentage resolution of periapical radiolucency.

Comparison of frequency of pain in root canal treatment using sodium hypochlorite and chlorhexidine as root canal irrigants.

OBJECTIVE: To compare the frequency of pain in root canal treatment using sodium hypochlorite and chlorhexidine as root canal irrigants. METHODS: The cross-sectional study was carried out from January to June 2016 at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan, and comprised patients aged 18-40 years with irreversible pulpitis involving a posterior tooth. The patients were divided into two equal groups, with Group-I receiving 2% chlorhexidine, and Group-II receiving 5.25% sodium hypochlorite. Following the use of the irrigants, the selected teeth were evaluated for pain at 72 hours using Visual Analogue Scale. RESULTS: There were 60 patients divided into groups of 30(50%) each. The overall mean age was 27.97±5.9 years. There were 32 (53.3%) females and 28 (46.6%) males. The mean post-operative pain score was 1.70±1.9 in Group-I and 1.90 ± 2.3 in Group-II (p=0.5). In Group-I, 25(83.3%) patients had no pain while in Group-II, 20(66.7%) had no pain (p=0.1). CONCLUSIONS: There was no difference in post-operative pain at 72 hours between 2% chlorhexidine and 5.25% sodium hypochlorite when used as irrigants.

Comparison of frequency of post-obturation pain of single versus multiple visit root canal treatment of necrotic teeth with infected root canals. A Randomized Controlled Trial.

OBJECTIVE: To determine the pain of single versus multiple visit endodontic treatment after obturation in teeth with necrotic pulps and infected canals. METHODS: The randomized controlled study was conducted from January to June 2016 at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Dental patients aged 18-60 years of either gender were selected who were subjected to computer-generated randomisation. Both maxillary and mandibular single rooted teeth till second premolar were included. Single visit endodontic treatment to Group-I subjects was carried out by gaining access to canals, cleaning, shaping and obturation at same visit whereas in Group-II patients, who underwent multiple visits, cleaning and shaping was followed by placement of intra-canal medicament, while obturation was done 5 days later. Patients were recalled within 48 hours after obturation to record the pain score using visual analogue scale.. RESULTS: Of the 60 patients, 30(50%) were in each of the two groups. There was no significant difference in post-operative pain in the two groups (p=0.8). The frequency of post-operative pain was not significant either (p>0.05). The post-operative mean pain score was 2.23±1.736 in Group-I and 2.38±1.94 in Group-II (p=0.8).. CONCLUSIONS: Treatment carried out in single visit or multiple visits showed no difference in pain frequency.

Comparison Of Frequency Of Post Operative Sensitivity In Amalgam Restorations Using Copal Varnish And Dentin Adhesive Liner.

BACKGROUND: Micro leakage around the margins of a restoration is believed to be one of the main causes of postoperative sensitivity. Dental amalgam is a non-insulating material and has the potential to transfer heat and cold causing irritation of the pulp. Different dentin tubule sealers are used under amalgam restoration to compensate for this post-operative sensitivity. This study was conducted to compare the frequency of sensitivity in amalgam restorations using copal varnish and dentin adhesive liner (dentin bonding agent). METHODS: A total of 60 patients of either gender, aged 18-40 years having class 1 carries in posterior teeth were included. Teeth with restorations, dentinal sensitivity and patients taking analgesic drugs for chronic pain conditions were excluded. The selected patients were placed randomly into Group A (copal varnish) & Group B (dentin adhesive liner), by using computer generated table of random numbers. Restored teeth were evaluated 1-month post operatively for sensitivity. RESULTS: Mean age was 25.63±5.42 years. Out of 60 patients, 68.0% were females and 32.0% were males with a female to male ratio of 2:1. The mean post-operative pain score was 2.83±2.79 in Group A and in Group B, it was 1.43±2.14 with a p-value of 0.03. There was no pain on application of a cold stimulus in 14 (46.7%) patients in Group A (copal varnish) while in Group B (Dentin adhesive), no pain was seen in 23 (76.7%) patients with p-value of 0.02. CONCLUSIONS: This study concluded that dentin adhesive liner (dentin bonding agent) is better than copal varnish in reducing postoperative sensitivity in amalgam restorations.

Comparison of periodontal health status of smokers versus non-smokers.

BACKGROUND: This study aims to compare the periodontal health status of current smokers versus nonsmokers. The study was carried out in the Dental department, Pakistan Institute of Medical Sciences (PIMS) between May 2009 and June 2010. A total of 280 male subjects, married, over the age of 18 were selected to take part in the study and their periodontal health was assessed by presence of calculus, bleeding on probing and pocket depth greater than four millimetres. METHODS: Patients including smokers and non smokers were selected on the basis of the inclusion and exclusion criteria. Subjects were clinically evaluated by using a specially designed CPITN probe which was used to measure pocket depths in the mouth. The mouth was divided into six sextants. The other variables examined included bleeding on probing and presence of calculus. The data was subsequently analyzed using the SPSS statistical software programme. The statistical significance level was set at 5%. RESULTS: There was decreased incidence of bleeding on probing (31.7%) in smokers than non-smokers (53.5%) however, there was an increased incidence of calculus formation among smokers (89.4%) compared to the subjects who did not smoke (69.6%). There was a significant difference between the overall mean pocket depth in smokers (3.7 +/- 1.4) and non-smokers (3.0 +/- 1.1). All of the above differences were found to be statistically significant. CONCLUSION: There was a marked association between cigarette smoking and periodontal disease.

Traumatic injuries of the permanent maxillory incisors at Dental Department, Pakistan Institute of Medical Sciences Islamabad: a retrospective study.

BACKGROUND: The study aims to ascertain the prevalence of traumatic dental injures of the maxillary permanent incisors at Dental Department, Pakistan Institute of Medical Sciences Islamabad during the years 2003-2005. Information concerning age, sex, cause, type of tooth, number of injured teeth and patterns of tooth injury were recorded retrospectively from 336 patients aged between 8-40 years, comprising 498 traumatized teeth. METHODS: The dental records of all the patients presenting with dental trauma were examined for collection of data relating to age, sex, cause, number of injured teeth, type of tooth and type of tooth trauma. Type of tooth trauma was recorded according to the Andreason classification. The data was subsequently processed and analyzed using the SPSS statistical software programme. The statistical significance level was set at 5%. RESULTS: Of the 336 patients, 227 were males (67.6%) and 109 were females (32.4%). The gender difference was statistically significant (p < 0.0001). The patients had a total of 498 traumatized teeth. A large number of dental trauma occurred in patients aged between 9-11 years. Most injuries involved one tooth in 227 patients (67.6%). However two teeth in 90 patients (26.7%), three teeth in 11 patients (3.2%) and only in 8 patients (2.3%) four teeth were involved. Fractures in enamel only occurred in 74 teeth (14.6%). Uncomplicated crown fractures in 208 teeth (41.9%) were the most commonly encountered dental trauma. 137 teeth (27.6%) suffered complicated crown fractures, 44 teeth (8.9%) uncomplicated crown-root fractures, 19 teeth (3.8%) complicated crown-root fractures and avulsion in 16 teeth (3.2%) only. The main causes were falls in 225 patients (66.9%), collision with objects in 40 patients (11.9%), road traffic accident in31 patients (9.2%) violence in 21 patients (6.2%), and sports in 19 patients (5.6%). The maxillary central incisor was traumatized in 384 teeth showing a high percentage of 77%. CONCLUSION: Raising public dental awareness regarding the serious outcome of traumatic dental injuries is mandatory to improve the prognosis of dental trauma and to avoid complications.