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BACKGROUND: Pomegranate, Grape seed and Guava extracts have much been reviewed in Ayurveda and has been proven to have antibacterial action Aim: The objective of the study is to investigate and compare the mouthwash prepared from pomegranate, grape seed and guava extracts on salivary streptococci levels at the end of 48 hr and 7 days, of twice a day usage. STUDY DESIGN: 40 school going children aged 8-10 yrs, randomly allocated into 4 groups (n=10 for experimental group) were asked to rinse with a) Mouthwash prepared from Pomegranate extract, 15 ml twice a day b) Mouthwash prepared from Grape seed extract, 15 ml twice a day, c) Mouthwash prepared from guava extract, 15 ml twice a day, d) Control- Distil water, twice a day. The oral streptococci colony forming units/ml (CFU/ml) was assessed by inoculating the salivary samples on blood agar media at the end of 48 hrs, and 7 days. RESULTS AND CONCLUSION: the aqueous extracts of the chosen herbal plants showed an acceptable antibacterial efficacy against oral streptococci.
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Extrato de Sementes de Uva/farmacologia , Lythraceae , Antissépticos Bucais/farmacologia , Extratos Vegetais/farmacologia , Psidium , Streptococcus/efeitos dos fármacos , Criança , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Boca/microbiologia , Streptococcus/isolamento & purificaçãoRESUMO
Aim and objective: This case report aims to describe the management of a case of rare gingival lesion in a young pediatric patient. Background: An increase in the size of the gingival tissue is known as gingival hyperplasia. This can cause esthetic as well as functional problems, and interfere with normal functions like mastication and speech. A histological form of fibroma, fibroepithelial hyperplasia is a proliferative fibrous lesion of the gingival tissue. These lesions can be caused by trauma or persistent irritation, or they can develop from the periodontal, periodontal ligament, or periosteum cells. Case description: This paper discusses a situation in which the parents of a 4-year-old girl presented to the department with a major complaint of swelling in the upper front tooth region, who was diagnosed with fibroepithelial hyperplasia with the help of a biopsy and histologic evaluation. Conclusion: In this case surgical excision was performed under local anesthesia with no postoperative complications, and a 2-year follow-up was made with a positive outcome. Clinical significance: When these type of gingival lesions are present, they should be investigated and diagnosed properly. They should be managed as soon as possible without causing any further complications to permanent dentition. How to cite this article: Niranjan B, Shashikiran ND, Dubey A, et al. A Rare Gingival Lesion in Children: Fibroepithelial Hyperplasia. Int J Clin Pediatr Dent 2022;15(4):468-471.
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Mercury toxicity from amalgam dental fillings and their potential for creating problems in the environment and for human health have prompted the development of new restorative materials. The leading alternatives among these are glass ionomer cements. According to current understanding, restorative materials that slowly release fluoride exert a local cariostatic effect. For this purpose, glass ionomer cements have desirable properties in that they help prevent recurrence of caries by releasing fluoride over a long period. Thus, they function in accord with the major cariostatic mechanism of fluoride, which is believed to be its action to promote remineralization and to influence the morphology of teeth by reducing enamel solubility and by suppressing oral cariogenic bacteria. Although the minimum local concentration of fluoride release required to inhibit demineralization has not been determined, it is reported that the cariostatic ability of fluoride releasing restorative materials is significant. Zirconomer defines a new class of restorative that promises the strength and durability of amalgam with the protective benefits of glass ionomer while completely eliminating the hazards of mercury. The inclusion of specially micronized zirconia fillers in the glass component of zirconomer reinforces the structural integrity of the restoration and imparts superior mechanical properties for the restoration of load-bearing permanent teeth. Combination of outstanding strength, durability, and sustained fluoride protection deems it ideal for multiple applications. The aim of the present study was to determine the fluoride release from glass ionomer cements and compare it with new material zirconomer. Materials and methods: Sample preparation: Tablets of glass-ionomer cements and zirconomer were prepared. A dental floss was incorporated into the tablets during fabrication to allow suspension into the test medium. Each disk specimen was immersed in airtight polyethylene bottle containing 20 mL of deionized water and incubated at 37°C and stored for 24 hours. Determination of fluoride ion release: Fluoride ion measurement was performed after 6 hours, 24 hours, 48 hours, 7 days, and 14 days under normal atmospheric conditions by fluoride ion selective electrode connected to an ion selective electrode meter. Result and conclusion: Both the material tested in the study had the ability to release fluoride but higher fluoride release was observed by zirconomer as compared to GIC at all time intervals. Clinical significance: From a clinical point of view, both the restorative materials release fluoride at all time intervals; however, addition of zirconia particles in zirconomer increases its strength and provides superior mechanical properties. Therefore, due to the combination of both good structural integrity and fluoride releasing properties, zirconomer can be used for restoration of load bearing teeth. How to cite this article: Kukreja R, Singla S, Bhadoria N, et al. An In Vitro Study to Compare the Release of Fluoride from Glass Ionomer Cement (Fuji IX) and Zirconomer. Int J Clin Pediatr Dent 2022;15(1):35-37.
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AIM: Investigation and evaluation of remineralization potential of functionalized tricalcium phosphate paste (fTCP) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACPF) paste on artificially created white spot lesion on human primary and permanent enamel through scanning electron microscopy and microhardness assessment. MATERIALS AND METHODS: Sixty freshly extracted primary and permanent teeth were selected and artificial white spot lesion were created by using standardized demineralizing solution. Remineralization was carried out using the test pastes. The assessment of demineralization and remineralization was done through a scanning electron microscope and microhardness assessment. RESULTS: Among the three groups, fTCP shows significantly higher increase in mean microhardness (p < 0.001) through ANOVA and the LSD post hoc test when compared to CPP-ACPF and control group. Also, the unpaired t-test showed that mean change in microhardness in permanent teeth was significantly higher than primary teeth in different time intervals for both experimental groups. Surface morphology was assessed through a scanning electron microscope. CONCLUSION: Based on the results of the current study, f-TCP showed comparatively more remineralization potential than CPP-ACP with fluoride. HOW TO CITE THIS ARTICLE: Bhadoria N, Gunwal MK, Kukreja R, et al. An In Vitro Evaluation of Remineralization Potential of Functionalized Tricalcium Phosphate Paste and CPP-ACPF on Artificial White Spot Lesion in Primary and Permanent Enamel. Int J Clin Pediatr Dent 2020;13(6):579-584.
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AIM AND OBJECTIVES: The aim and objectives of this study are to evaluate and compare the effectiveness of Myristica fragrans - Nutmeg, Terminalia chebula - Myrobolan, Ocimum sanctum-tulsi, and 2.5% sodium hypochlorite (NaOCl) on the removal of the smear layer by the scanning electron microscope (SEM). SETTINGS AND DESIGN: Endodontic treatment aims at disinfection and then obturation of root canal system in to prevent re-infection. Root canal irrigants play a pivotal role in the disinfection process. One of the important properties of an irrigant is the removal of complete smear layer and debris. Smear layer has the potential to protect bacteria within the dentinal tubules; therefore removal may be prudent. Smear layer removal increases the bond strength of resin sealers which results in better apical seal. MATERIALS AND METHODS: Forty extracted single-rooted, primary teeth were allocated randomly into four groups of ten each: Group 1 - NaOCl, Group 2 - Nutmeg, Group 3 - Myrobolan, and Group 4 - Tulsi. Samples were stored in sterile saline (0.9% NaCl) and then decoronated at the level of the cementoenamel junction. Working length was determined followed by appropriate irrigation. The roots were split into two halves with a chisel and were stored in 2.5% glutaraldehyde solution for 24 h. After fixation, the samples were dehydrated in ethanol series (70, 90, and 95 and twice at 100%). Each specimen was mounted on Al stub and sputter coated with a 20 nm layer of gold. Samples were then examined using a SEM quantum 60 at magnification of ×2000. RESULTS: Tulsi demonstrated the most statistically significant results followed by myrobolan and nutmeg extract. All herbal extracts were found to be significantly effective than 2.5% NaOCl. CONCLUSION: Tulsi, nutmeg and myrobolan can be effectively used as an irrigant in primary teeth.
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Camada de Esfregaço , Cavidade Pulpar , Dentina , Ácido Edético , Humanos , Microscopia Eletrônica de Varredura , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Hipoclorito de Sódio , Dente DecíduoRESUMO
BACKGROUND/INTRODUCTION: Cavity disinfection before restoration aids in reducing the number of residual bacteria, thus, decreasing the rate of secondary caries. Propolis, at low concentrations, inhibits the growth of cariogenic bacteria. Liquorice roots are known to have antimicrobial, anti-inflammatory, and antioxidant properties. AIM AND OBJECTIVES: Evaluation and comparison of antimicrobial efficacy of liquorice and propolis extract gels used as cavity cleaning agents against Streptococcus mutans in deciduous molars by confocal laser scanning microscopy (in vitro study). MATERIALS AND METHODS: Liquorice and propolis extracts were converted into gels after recording the minimum inhibition concentration. Class I cavity was prepared on 135 extracted deciduous molars and subjected to inoculation with S. mutans. Teeth were randomly divided into groups I, II, and III which were treated with gels of liquorice, propolis, and distilled water, respectively, for 60, 120, and 180 seconds each. Specimens were sectioned and stained with fluorescent dyes and observed under a confocal laser scanning microscopy (CLSM). The data obtained were statistically evaluated. RESULTS: The mean nonviable/viable bacterial count and the depth of penetration were found to be maximum in group I and minimum in group III. A statistically significant difference was found to be between groups I and II and groups I and III, while with groups II and III, it was nonsignificant at all 60, 120, and 180 seconds. The bacterial depth penetration between groups I and II at 180 seconds was nonsignificant. CONCLUSION AND CLINICAL SIGNIFICANCE: Though liquorice showed better antimicrobial potential as compared to propolis extract, both can be used efficiently as cavity disinfectants. HOW TO CITE THIS ARTICLE: Godbole E, Tyagi S, et al. Efficacy of Liquorice and Propolis Extract Used as Cavity Cleaning Agents against Streptococcus mutans in Deciduous Molars Using Confocal Microscopy: An In Vitro Study. Int J Clin Pediatr Dent 2019;12(3):194-200.
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BACKGROUND: Pulpotomy is the treatment for cariously exposed vital primary molars. UsingfFormocresol as a pulpotomy agent is been in controversy, which has triggered the search for better alternatives. The product like 'Myristica fragrans (MF)-Nutmeg gel, Terminalia chebula (TC)-Myrobolan gel is gaining popularity as herbal pulpotomy agents. AIM: To evaluate and compare clinical and radiographical success of herbal gels Myristica fragrans (MF)-Nutmeg, and Terminalia chebula (TC)-Myrobolan as pulpotomy medicaments in primary teeth. MATERIALS AND METHODS: Twenty participants (n = 20), each with at least two primary molars requiring pulpotomy, were selected and divided into two test groups. In 10 children Terminalia chebula gel was placed in one side and Formocresol on another side. Rest 10 children were treated with Myristica fragrans gel on one side and another side with formocresol. The treated teeth selected for clinical and radiographic evaluation were monitored periodically for 3, 6 and 12 months. RESULTS: With the follow-up of 12 months there was no significant difference in efficacy of all three pulpotomy medicaments, i.e. Nutmeg, Myrobolan, and Formocresol, respectively was found. CONCLUSION: Herbal gels have a promising role in dentistry having the proper knowledge, and their effects on teeth would prove them as a successful dental therapeutic agent. HOW TO CITE THIS ARTICLE: Mali S, Singla S, Sharma A, Gautam A, Niranjan B, Jain S. Efficacy of Myristica fragrans and Terminalia chebula as Pulpotomy Agents in Primary Teeth: A Clinical Study. Int J Clin Pediatr Dent, 2018;11(6):505-509.
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PURPOSE: This study was conducted to evaluate the efficacy of various techniques to fill root canals of primary teeth by volumetric analysis using cone beam computed tomography (CBCT) to assess percentage of obturated volume (POV), percentage volume of voids (PVV), and depth-of-fill. METHODOLOGY: Root canals in 40 extracted deciduous maxillary incisors were instrumented with H-files to size 35 and volume of the canal measured using CBCT under "On Demand 3D AppTM Software" (Cybermed Inc. Medical 3D imaging software). The teeth were divided into four groups of 10 samples each and root filled by Lentulo spiral mounted on slow-speed hand-piece, NaviTip System, Bi-directional spiral and Combination method i.e. Lentulo spiral mounted on slow speed hand-piece followed by NaviTip syringe respectively, after that depth-of-fill for each group was checked. Then, the filled canal volume was measured using CBCT under "On Demand 3D AppTM Software". Further, the (POV), (PVV) was calculated. STATISTICAL ANALYSIS: The data were statistically analysed using one-way ANOVA, Turkey post Hoc test and Pearson's Chi-square test. CLINICAL SIGNIFICANCE: Adequate adaptation of root canal filling material decreases the chance of microorganism regrowth, reinfection due to voids creation and minimizes the potential drawback of overfilling like foreign body reaction or deflection of the unerupted permanent tooth. RESULTS: The four groups were comparable in canal volume. The overall percentage of obturated volume was 53%, 59.7%, 40.3% and 75.1%; the overall percentage volume of voids was 48%, 40.3%, 58.6%, 29.5%; optimally filled canals for each group was 80%, 60%, 30% and 90% respectively (p < 0.05). CONCLUSION: The greatest percentage of obturated volume and maximum number of optimally filled canals was obtained in method combining both Lentulo spiral in slow speed hand piece along with NaviTip system. Whereas, voids were the constant finding with all root fillings.How to cite this article: Sijeria P, Bhartia R, Swamy KVN, Kulkarni S, Singla S. Evaluation of Root Canal Filling in Primary Teeth by Volumetric Analysis: In Vitro Study. Int J Clin Pediatr Dent, 2018;11(5):386-392.
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BACKGROUND: Evaluation of bond strength and microleakage caused by polymerization shrinkage provides a screening mechanism and an indication of the potential for the clinical success of composite restorations. AIM: The aim of this study was to determine the effect on shear bond strength and microleakage of standard and expired composites. MATERIALS AND METHODS: Selected specimens were etched using 37% phosphoric acid for 15 seconds and were randomly divided into four groups. Group I: Standard composite and bonding agent; group II: Expired composite and bonding agents; group III: Standard composite and expired bonding agent; and group IV: Expired composite and standard bonding agent. Specimens were further subdivided into two subgroups. In subgroup A, specimens were sheared with a universal testing machine, and the results were calculated in MPa; in subgroup B, specimens was sectioned longitudinally and analyzed for leakage (dye penetration) using a stereomicroscope. RESULTS: The results of the present study showed that acceptable values for bond strength and microleakage were obtained even if one of the components of the dental resin composite is expired. CONCLUSION: In Indian scenario, the expired composite material may provide some assistance in compromised clinical situations. It can be used as an interim restoration and compensate for the high material cost. HOW TO CITE THIS ARTICLE: Talreja N, Singla S, Shashikiran ND. Comparative Evaluation of Bond Strength and Microleakage of Standard and Expired Composite at Resin-Dentin Interface: An in vitro Study. Int J Clin Pediatr Dent 2017;10(1):1-4.
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AIM: The aim of the present in vitro study is to evaluate and compare antimicrobial efficacy of commercially available child's dental formulas in reduced concentrations containing different forms of fluoride against Streptococcus mutans activity. MATERIALS AND METHODS: The selected dentifrices were prepared in dilutions of 1:1, 1:2, 1:4, 1:8, and 1:16 using sterile pyrogen-free distilled water. Various dilutions of the selected toothpaste slurries were incubated in the agar plate containing pure strains of S. mutans, and antimicrobial activity of each was assessed by measuring the diameter of zones of inhibition (in mm). Agar well plate diffusion method and minimum inhibitory concentration (MIC) determination were the methods used in this study. The inhibitory circle of each dentifrice was measured and MIC was achieved by considering the value of diameter of the circle. RESULTS: The results of the study showed that even at a lower concentration of fluoride, inhibition halos were obtained for all the formulations at different dilutions. CONCLUSION: The kid's formulations having lower fluoride concentration show antimicrobial activity even after dilutions. Thus, commercially, the fluoride concentrations can be further lowered down in the dentifrices, thereby reducing the risk associated with fluoride. HOW TO CITE THIS ARTICLE: Malhotra R, Singla S, Shashikiran ND. Comparison ofAntimicrobial Activity of Child Formula Dentifrices at different Concentrations: An in vitro Study. Int J Clin Pediatr Dent 2017;10(2):131-135.
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Canine deviation from its path of eruption is usually followed by either delayed or impaction of canine. One of the important and not so noticed reasons for canine displacement is formerly impacted central incisor. The difference in age of eruption of these two teeth is 4 years; however, the absence of maxillary incisor should be perceived with utmost conviction about impending canine displacement leading to its impaction as well. This case presents similar picture where composite, compound odontoma with respect to maxillary central incisor led to its impaction resulted in deviated path of eruption for erupting canine. This canine displacement to worsen prognosis ended up getting impacted if not dealt with cautiously in the later stages of occlusal development.
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OBJECTIVE: To study the prevalence of Celiac disease (CD) in first-degree relatives (FDR) of CD children. METHODS: This observational study was performed in FDR (parents and siblings) of consecutive newly diagnosed cases of CD enrolled from January 2011 through March 2012. Screening for CD in FDR was done using IgA tissue transglutaminase (tTG) levels in serum and the seropositive subset underwent upper gastrointestinal (UGI) endoscopy and biopsy to confirm the disease. In addition, HLA analysis for CD was performed in most of the index cases and FDR. RESULTS: Of 202 FDR of the 64 index cases with CD, 17.3 % (35/202) were seropositive for IgA tTG while confirmed biopsy proven CD was diagnosed in 10.2 % (8/78) of children and 8.1 % (10/124) of adults. HLA DQ2/DQ8 was positive in 96.7 % of the index cases and all FDR with confirmed CD. CONCLUSIONS: The prevalence of CD among FDR is 9 fold higher than the general population. High prevalence of CD in presence of anemia and short stature in seropositive FDR in index study indicates need of targeted screening of this subgroup for the presence of CD.CD is unlikely in the absence of HLADQ2/DQ8.
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Doença Celíaca/imunologia , Imunoglobulina A/análise , Autoanticorpos , Humanos , Índia , Prevalência , Centros de Atenção Terciária , TransglutaminasesRESUMO
INTRODUCTION: A major objective in restorative dentistry is the control of marginal leakage, which may occur because of dimensional changes or lack of adaptation of restorative material to the cavity preparation. Numerous techniques have been advocated to overcome polymerization shrinkage in composite restorations. AIM AND OBJECTIVES: This study investigated microleakage of three different bases under composite resin in sandwich technique using dye penetration and dentin surface interface using scanning electron microscope (SEM). MATERIALS AND METHODS: Sixty extracted deciduous molars were stored in distilled water and Class I cavities with a width of about one-fourth of intercuspal distance and a depth of 0.5-1 mm below the dentino-enamel junction was prepared without bevels. In Group 1 - glass ionomer cement (GIC); Group 2 - mineral trioxide aggregate (MTA); Group 3 - Biodentine™ was placed as a base under composite. Teeth were longitudinally sectioned in two halves, through the centers of the restoration, immersed in 2% methylene blue and microleakage was evaluated under stereomicroscope and surface interface between base and dentin was evaluated under SEM. RESULTS: Under the condition of in vitro study, less microleakage and less internal gaps were seen in Biodentine™ (0.00 ± 0.00 and 4.00 ± 1.59) group than MTA (0.00 ± 0.00 and 6.08 ± 1.82) and GIC (25.25 ± 6.57 and 14.73 ± 3.72, respectively) and showed very strong positive correlation between microleakage and internal gaps. CONCLUSION: Biodentine™ exhibits superior marginal sealing ability as well as marginal adaptation under composite resin as compared to MTA and GIC.
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Preparo da Cavidade Dentária/métodos , Cimentos Dentários/química , Infiltração Dentária/diagnóstico por imagem , Restauração Dentária Permanente/métodos , Microscopia Eletrônica de Varredura/métodos , Dente Molar/diagnóstico por imagem , Dente Decíduo/diagnóstico por imagem , Compostos de Alumínio/química , Compostos de Cálcio/química , Resinas Compostas/química , Preparo da Cavidade Dentária/classificação , Esmalte Dentário/patologia , Adaptação Marginal Dentária , Restauração Dentária Permanente/classificação , Dentina/diagnóstico por imagem , Combinação de Medicamentos , Cimentos de Ionômeros de Vidro/química , Humanos , Teste de Materiais , Óxidos/química , Silicatos/química , Propriedades de SuperfícieRESUMO
BACKGROUND: Autism is a neurobiological disorder characterized by impaired social interaction, communication difficulties, and lacking manual dexterity. These limitations make the oral hygiene maintenance very difficult. AIM: The aim of this present study is to evaluate and compare the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism. SETTING AND DESIGN: Sample comprised 22 children with autism who daily visited a day care and education center named ARUSHI - a center for children with special health care needs in Bhopal. METHODS: Children were divided into two groups (Group A and B) according to toothbrush used and further divided into subgroups (A1 and B1 [low fluoridated - Pediflor toothpaste] and A2 and B2 [calcium sucrose phosphate - Enafix toothpaste]). Oral hygiene instructions and brushing technique demonstration were given every day for a period of 1-month. Oral health status was evaluated before and after the study using simplified oral hygiene index (OHI-S) and its Miglani's modification for primary dentition, plaque index (PI), gingival index (GI), and decayed, missing, and filled teeth (DMFT)/deft index. The perception of parents regarding oral hygiene practices for their kids was also evaluated by an awareness and attitude questionnaire. STATISTICAL ANALYSIS: OHI-S, GI, PI, and DMFT/deft were statistically evaluated using Mann-Whitney U- test. RESULTS AND CONCLUSION: Mean value of OHI-S decreased significantly with powered toothbrush (0.035 [P < 0.05]) in both groups. However, PI decreased significantly for Enafix when used with powered toothbrush (0.042 [P < 0.05]). Perception of parents was seen to improve significantly after 1-month study (0.000 [P < 0.05]).
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INTRODUCTION: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. AIMS: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. SETTINGS AND DESIGN: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. STATISTICAL ANALYSIS USED: Shapiro-Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. RESULTS: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure. CONCLUSIONS: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.
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A 7-month-old male presented with developmental delay and multiple congenital anomalies. He was found to have partial trisomy for the distal segment of chromosome 15 (q22-qter). Chromosome analysis of the mother showed a reciprocal balanced translocation between long arms of chromosome 6 and 15, t (6;15)(q26;q22).
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Cherubism is a self-limiting non-neoplastic autosomal dominant fibro-osseous disorder of the jaw usually found in children between 2-5 years of age. It occurs predominantly in boys and is characterized clinically by bilateral swelling of cheeks due to bony enlargement of the jaw that gives the patient a typical cherubic look. Cherubism may occur as solitary cases or in many members of family, often in multiple lesions. Radiographically the lesions appear as multilocular bilateral radiolucent areas. The present case report describes a 13-year-old female cherubic child with progressive swelling of cheeks.
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Griscelli syndrome type 2 (GS2) is a rare autosomal recessive disease caused by mutations in the RAB27A gene. It is characterized by cutaneous hypopigmentation, immunodeficiency, and hemophagocytic lymphohistiocytosis. We describe 2 brothers who had GS2 with clinically diverse manifestations. The elder brother presented with a purely neurological picture, whereas the younger one presented with fever, pancytopenia, hepatosplenomegaly, and erythema nodosum. Considering that cutaneous hypopigmentation was a common feature between the brothers, genetic analysis for Griscelli syndrome was performed. As the elder sibling had died, mutation analysis was only performed on the younger sibling, which revealed a novel homozygous mutation in the RAB27A gene on chromosome 15 showing a single-base substitution (c.136T>A p.F46I). Both parents were heterozygous for the same mutation. This confirmed the diagnosis of GS2 in the accelerated phase in both siblings. The atypical features of GS2 in these cases are a novel mutation, isolated neurological involvement in one sibling, association with erythema nodosum, and 2 distinct clinical presentations in siblings with the same genetic mutation.
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CONTEXT: Demineralization of tooth by erosion is caused by frequent contact between the tooth surface and acids present in soft drinks. AIM: The present study objective was to evaluate the remineralization potential of casein-phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, 1.23% acidulated phosphate fluoride (APF) gel and iron supplement on dental erosion by soft drinks in human primary and permanent enamel using atomic force microscopy (AFM). MATERIALS AND METHODS: Specimens were made from extracted 15 primary and 15 permanent teeth which were randomly divided into three treatment groups: CPP-ACP paste, APF gel and iron supplement. AFM was used for baseline readings followed by demineralization and remineralization cycle. RESULTS AND STATISTICS: Almost all group of samples showed remineralization that is a reduction in surface roughness which was higher with CPP-ACP paste. Statistical analysis was performed using by one-way ANOVA and Mann-Whitney U-test with P < 0.05. CONCLUSIONS: It can be concluded that the application of CPP-ACP paste is effective on preventing dental erosion from soft drinks.
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Congenital rickets is a very rare entity in the spectrum of metabolic bone disease in children. The authors report an as yet unreported case of congenital rickets presenting with respiratory distress at birth. The radiographs of long bones and wrist showed generalized osteopenia with cupping and fraying of epiphyseal ends in the second week of life. The patient was managed with very high doses of vitamin D which led to clinico-radiological and biochemical improvement. More than being interesting for its extreme rarity, this report assumes importance as it brings forth the possibility of congenital rickets being a differential diagnosis for a newborn with respiratory distress.