Preterm General Movements in Prediction of Neurodevelopmental Disability and Cerebral Palsy at Two Years: A Prospective Cohort Study

Background: A neurological assessment before discharge from the NICU would enable early targeted intervention to mitigate the risk and severity of cerebral palsy (CP) and neurodevelopmental disability. Objective: To assess the accuracy of general movements (GM) in the preterm and fidgety movement periods in predicting neurodevelopmental disability and cerebral palsy in very preterm infants (?32 weeks gestational age) at 18-24 months corrected gestational age. Study design: Prospective cohort study Participants: One hundred and seventy very preterm infants, mean (SD) gestation 29.8 (1.32) weeks, and birthweight 1215 (226) g. Outcomes: Infants underwent GM assessments in the preterm period (31-36 weeks post-conception age) and fidgety movement period (8-18 weeks post term age). Neurodevelopmental outcomes were assessed in 127 children using the Griffiths Mental Developmental Scales-2. Results: Nine children had neurodevelopmental disability (two infants with cerebral palsy and seven with global developmental delay. The relative risk (95% CI) for neurodevelopmental disability was 1.46 (0.31-6.89) with preterm movements and 6.07 (0.97 – 38.05) with fidgety movements. Sensitivity and specificity values for the prediction of neurodevelopmental disability were 33% and 64% in the preterm period and 25% and 92% in the fidgety movement period, respectively. The sensitivity and specificity values for prediction of CP were 50% and 63% in the preterm period and 100% and 93% in the fidgety movement period, respectively. Conclusion: Preterm movements showed lower sensitivity and specificity than fidgety movements in predicting later CP and neurodevelopmental disability in preterm infants.

Acromegaly: Oral Diagnostician’s Role in Diagnosis: A Case Report.

Acromegaly is an acquired disorder related to overproduction of growth hormone (GH). The condition, though described more than 120 years ago, was only later found to be due to pituitary over secretion and adenomas. It is a rare condition with a tendency toward overgrowth of the mandible, maxillary widening, tooth separation, and skeletal malocclusion which makes its diagnosis important for us dentists. The majority of the cases in the past have been diagnosed by physicians and endocrinologists. Here, we present a case of a 38-year-old male patient who presented with the complaint of increase in the size of lips and forward movement of the jaws since 1 year. Clinical features, radiographic features, and arrival at the diagnosis of Acromegaly with the subsequent referral and treatment are discussed.

Cone Beam Computed Tomography Aided Diagnosis of Double Dens Invaginatus in a Fused Supernumerary Tooth and Maxillary Central Incisor: A Case Report.

Dens invaginatus is a developmental malformation that causes changes in the internal anatomy of the tooth. Fusion and twinning are terms commonly used to describe the clinical presentation of double teeth. The presence of double dens invaginatus is extremely rare. Therefore understanding the complex morphology, type and extension of dens invaginatus are very essential. To establish the diagnostic hypothesis based on a periapical radiograph is a challenge for all different dentistry specialties. With cone-beam computed tomography (CBCT), the diagnostic dilemma is minimized because of the accurate visualization of the anatomy. The visualization of three-dimensional structures is very helpful in the diagnosis of these complex anatomic variations as it favors precise definition of the problem and treatment planning. With this case report, we would like to highlight how CBCT helped in the evaluation and treatment planning of Double dens invaginatus of a fused supernumerary tooth and maxillary central incisor, which could not be done using the intraoral periapical method.