Dento-skeletal Sequel of Hyrax in Nonsyndromic Cleft Lip and Palate: A Systematic Review and Meta-analysis.

Aim: To critically evaluate and review the dento-skeletal outcomes of hyrax with or without nonsurgical protraction therapy in nonsyndromic cleft lip and palate (CLP) patients. Materials and methods: Electronic databases were searched from PubMed, Cochrane, Scopus, SciELO, Lilacs, and Google Scholar from January 2005 to April 2022 to identify studies reporting on the dento-skeletal effect of hyrax with or without nonsurgical protraction therapy among children aged 7-15 years with CLP before the secondary alveolar bone grafting (SABG) procedure. Abstracts and subsequently eligible full-text articles were screened. The risk of bias in the included randomized and nonrandomized studies was assessed using Cochrane collaboration's risk of bias tool. The random-effects meta-analyses of the mean difference were carried out. Results: A total of 423 studies were identified. After a thorough screening, 19 studies met the inclusion criteria. Of these 19 studies, 13 studies were conducted with only hyrax appliances, six studies had hyrax with nonsurgical protraction therapy. Conclusion: Hyrax had increased intermolar width, anterior nasal cavity width, and posterior maxillary width compared to inverted mini hyrax with p-values = 0.027, 0.004, and 0.03, respectively. Inverted mini hyrax had more canine inclination on noncleft than hyrax. Hyrax and fan-type expanders had an equivalent effect on the dento-skeletal structures indicating that hyrax can be used as an alternative to fan-type expanders. Hyrax with protraction therapy had a remarkable change in ANB angle compared to noncleft patients. How to cite this article: Deepika U, Ray P, Nayak A, et al. Dento-skeletal Sequel of Hyrax in Nonsyndromic Cleft Lip and Palate: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(6):882-896.

Early Orthodontic Intervention in Cleft Lip-Palate and Noncleft Children with Developing Class III Malocclusion: A Clinical Study.

Context: Orthopedic correction of skeletal class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Aims: The aim of the study is to evaluate the dental and skeletal effects of early orthodontic intervention of developing class III malocclusion. Settings and design: A final sample of 38 children in the age-group of 6-14 years having skeletal class III malocclusion was selected. Subjects were divided into two groups; group I-included 18 children (male-10, female-8) with surgically repaired cleft lip and palate and group II-20 children (male-14, female-6) without any cleft lip and palate. Materials and methods: Cemented rapid maxillary expansion (RME) appliances with 11 mm hyrax screws were used in all patients. Elastic traction forces were applied to the reverse-pull headgear worn by the patients. Both pre- and posttreatment records along with lateral cephalograms were taken. Statistical analysis used: The pre- and posttreatment mean and standard deviation measurements of the angular and linear observations were statistically analyzed with Statistical Package for the Social Sciences (SPSS) software (version 13) and were correlated through independent t-test and paired t-test. Results: Following headgear therapy, improvement was greater in the cleft group than noncleft group with greater advancement of maxilla along with clockwise rotation of mandible in clefts. Conclusion: Protraction mechanics with expansion can be employed successfully in repaired cleft lip and palate and noncleft prepubertal children having developing class III malocclusion, showing concave profile, and retrusive maxilla. Key message: Accurate diagnosis and understanding of the individual growth pattern are crucial in the early interception of a class III malocclusion to achieve a more favorable facial profile. How to cite this article: Sahoo SS, Dash JK, Sahoo PK, et al. Early Orthodontic Intervention in Cleft Lip-Palate and Noncleft Children with Developing Class III Malocclusion: A Clinical Study. Int J Clin Pediatr Dent 2023;16(5):716-723.

Clinical evaluation of bioactive resin-modified glass ionomer and giomer in restoring primary molars: A randomized, parallel-group, and split-mouth controlled clinical study.

Aim: This study aims to evaluate and compare the clinical performance of two restorative materials - bioactive resin-modified glass ionomer (ACTIVA BioACTIVE restorative) and giomer hybrid composite (Beautifil Flow Plus) in restoring class I carious primary molars. Materials and Methods: The split-mouth randomized controlled study was conducted on 100 primary molars from 50 children (28 - males, 22 - females) from 50 children in age range of 5-9 years (Mean-7.29±1.34) with at least two occlusal carious lesions on either maxillary or mandibular primary molars. Each child had both the control and the experimental teeth restored with respective restorative materials, Group I (Control, n = 50) → Giomer, Group II (Experimental, n = 50) → Bioactive resin-modified glass ionomer. The restorations were evaluated by two independent investigators using modified United State Public Health Service criteria at immediate postoperative, 6 months, and 12 months. The Chi-square test was used for the statistical analysis after collecting the data. Results: At the 12-month follow-up, 33 children (66 teeth) reported with an attrition rate of 33%. The color match between the groups was not statistically significant at all intervals. The marginal discoloration, marginal integrity, anatomic form, and retention had no significant difference at 6 months. But at 12 months, there was a statistically significant difference between the groups with p value of 0.04,<0.001,<0.02 and <0.001 respectively. respectively. At 12 months, there was no postoperative sensitivity in both groups. Conclusion: Bioactive resin-modified glass ionomer with enhanced properties can be used as an effective restorative material, especially in children with excessive salivation.

Fragile X Syndrome: A Rare Case Report with Unusual Oral Features.

Fragile X syndrome (FXS) is a rare variant of special health-care need demonstrating delayed developmental milestones and associated with intellectual and emotional disabilities ranging from learning problem to mental retardation. The syndrome is usually not diagnosed until 8-9 years of age since the clinical manifestations of the syndrome are greatly attenuated in childhood. The physical characteristics such as facial features, hyperactivity, attention deficit, autistic behavior, and macroorchidism are quite evident in younger age group. The most typical orofacial characteristics associated with children suffering from FXS are mandibular prominence, ogival, and cleft palate. Till date, very few dental literatures have been reported regarding the association of FXS with orodental anomalies. Here, we report a rare case of 14-year-old boy suffering from FXS with typical orofacial characteristics, multiple supernumerary teeth, and dental caries.

Juvenile nasopharyngeal angiofibroma presenting as a palatal swelling.

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, highly vascular and locally aggressive tumor that predominantly occurs in adolescent males. Usually the presenting symptom is a painless nasal obstruction or epistaxis; however, other symptoms may depend on the size and extent of the tumor mass. Owing to the vascularity of the tumor, incisional biopsy is not attempted and the diagnosis is, therefore, dependent on multiplanar imaging modalities such as computed tomography, magnetic resonance imaging and angiography. These also help to assess the tumor mass, pre-operative embolization of the feeder vessel, and treatment planning. Usually, JNA patients are diagnosed by otorhinolaryngologists. The purpose of this paper is to present a rare case of JNA with a tender palatal swelling that was first seen by a dentist.

Foreign body in root canals of two adjacent deciduous molars: a case report.

Children often tend to have the habit of inserting foreign objects in the oral cavity unknowingly for relief of dental pain. Sometimes, children do not reveal to their parents due to fear. These foreign objects may act as a potent source of infection and painful condition. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body and the difficulty involved in its retrieval. Here is a case report, where foreign object was accidentally lodged in the carious deciduous molars by a child. How to cite this article: Dhull KS, Acharya S, Ray P, Dhull RS. Foreign Body in Root Canals of Two Adjacent Deciduous Molars: A Case Report. Int J Clin Pediatr Dent 2013;6(1):38-39.

Gorlin syndrome with bilateral polydactyly: a rare case report.

Gorlin's syndrome is a rare disorder transmitted as an autosomal dominant trait. It is characterized by multiple disorders involving multiple systems. We present a case of 11-year-old male child presenting with multiple odontogenic keratocyst to the dental clinic. Retrograde diagnosis of Gorlin-Goltz syndrome was made after clinical and radiological investigation. How to cite this article: Acharya S, Panda S, Dhull KS, Sahoo SR, Ray P. Gorlin Syndrome with Bilateral Polydactyly: A Rare Case Report. Int J Clin Pediatr Dent 2013;6(3):208-212.

Bilateral maxillary paramolars: a case report.

Supernumerary teeth are a common clinical and radiographic finding and may produce occlusal and dental problems. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. The purpose of this paper was to present a case of supernumerary teeth located in the maxillary molar region bilaterally.

Caries experience and oral hygiene status of children suffering from attention deficit hyperactivity disorder.

OBJECTIVE: The study was conducted to determine the caries experience and oral hygiene status of children suffering from attention deficit hyperactivity disorder (ADHD) and was compared with that of non-ADHD children. STUDY DESIGN: A total of 80 children, including 40 ADHD and 40 non-ADHD children were included in the study. A visual dental examination for dental caries was performed and oral hygiene status of these children was determined. The parent/guardian completed a questionnaire concerning the child's behavior followed by questionnaire to the child regarding oral hygiene practices and food habits. RESULTS: Student-t test and chi-square test showed that children with ADHD had significantly higher defs score, mean plaque score in compared to that of non-ADHD children. Statistical significant differences were also found out in relation with frequency of tooth brushing and consumption of sugary food among the children suffering from ADHD. CONCLUSION: Caries prevalence in the primary dentition is increased in the children suffering from ADHD due to poor oral hygiene and increased consumption of sugary foods.