Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment.

Objective: To evaluate the reliability of the digital radiograph of the middle phalanx of the third finger (MP3) in skeletal maturity assessment Study Design: Fifty children (24 girls and 26 boys) belonging to the circumpubertal age-group were selected for the study. Two radiographs - lateral cephalogram and digital radiograph of the MP3 region - were taken in each child. Age assessment was based on the changes in shape of the cervical vertebrae and the epiphysis of the middle phalanx of the third finger of the left hand. The radiographs were assessed by three examiners. The inter- and intraexaminer variability were determined by the Wilcoxon rank sign test and the Kruskal-Wallis test and were found to be nonsignificant. Examiner 3 showed the best intraexaminer agreement and was selected to evaluate the radiographs for the entire study. Results: The correlation determined between the MP3 stages and cervical vertebrae maturity index (CVMI) stages, the peak-wise distribution of the MP3 stages, and the correlation between the MP3 stages and the chronological age were found to be highly significant. Conclusions: Digital radiograph of the MP3 region is definitely a simple, reliable, cost-effective, and time-saving technique for the assessment of skeletal maturity.

Computerised tomographic study of tuberculous meningitis in children.

Twenty-one patients with clinical and laboratory diagnosis of tuberculous meningitis were studied at the paediatric department and neuroradiology unit of Bangur Institute of Neurology, both attached to IPGME & R, Kolkata, during the period from 1st February, 1996 to 31 st July, 1996. The age group of the patients were between 1 and 8 years. It clearly appears that CT is an extremely powerful investigative modality for the diagnosis, management and follow-up assessment of development of any complications like hydrocephalus, cerebral infarction, etc. CT examination also can predict the prognosis of the patients.

A comparative evaluation of three fluoride varnishes: an in-vitro study.

This study was conducted to compare the caries preventive efficacy of Fluoritop - SR; the first fluoride varnish manufactured in India with Fluor Protector and Bifluorid 12, the two commercially available fluoride varnishes which have to be imported from other countries and are cost prohibitive. The demineralization inhibitory effects and the antibacterial effects on Streptococcus mutans were studied (in vitro). Calcium and Phosphorus dissolutions were estimated as a measure of the demineralization inhibitory effect. Antibiotic sensitivity tests using the serial tube dilution method and disk diffusion method were used to evaluate the antibacterial effects of the fluoride varnishes. Of the three varnishes, Fluor Protector was seen to exhibit the highest demineralization inhibitory effect, while Fluoritop-SR was found to be comparable to Bifluorid 12 in its caries protective effects.

Caries prevalence amongst handicapped children of South Canara district, Karnataka.

This epidemiological investigation was carried out among 524 handicapped children in the age group of 3-30 years, attending 8 different non-residential special schools in South Canara district, Karnataka. The examination procedure and criteria were those recommended by W.H.O. in 1997. The total caries prevalence was found to be 71.56%. The mean deft in the primary dentition was found to be 3.06 +/- 3.14. The mean deft and DMFT in the mixed dentition were 3.32 +/- 2.82 and 1.14 +/- 1.08 respectively. The mean DMFT in the permanent dentition was 4.51 +/- 3.17. The prevalence of dental caries was higher in the mentally subnormal and handicapped children. The decayed component constituted the majority of the dental caries index. Lack of conservative approach to the treatment had been confirmed in the study.

Midline space closure in the mixed dentition: a case report.

Supernumerary teeth which occur both in the primary and the permanent dentition are seen more frequently in the permanent dentition causing a variety of pathological disturbances. Presented herewith is a case report of a patient with a mesiodens which had caused flaring of the maxillary central incisors and impeded normal eruption of the maxillary lateral incisors. Extraction of the mesiodens was carried out; subsequently followed by the space closure utilizing simple fixed orthodontic therapy.

Relationship between the existing caries status, plaque S. mutans and Cariostat caries activity test in children.

An attempt was made in this study to find out the sensitivity and specificity of a caries activity test, CARIOSTAT and its relationship to the existing caries status and the plaque S. mutans level. The test proved to be highly sensitive and specific with significant relationship to the S.mutans count in the dental plaque. There also was a significant relationship between both the cultured microorganisms on MSB agar and the plaque in the Cariostat medium.

Fusion of primary incisors--a report of six cases.

Six cases of asymptomatic dental twinning anomalies in the primary dentition are reported in 4205 school children. A clinical and radiographic presentation of the cases of fusion of primary incisor teeth is illustrated. This clinical entity has been found to appear with varied clinical and radiographic appearances. An association of fusion of primary incisors with the number of succedaneous teeth was seen.

Leopard syndrome--report of a variant case.

This case report presents a patient with Leopard syndrome, with multiple lentigines all over the body and face, ocular hypertelorism, delayed secondary sexual characteristics, mild cardiac abnormalities and supernumerary teeth. Clinical relevance of this syndrome lies in its early recognition and precautions to be taken during any invasive dental procedure, which if not performed under antibiotic prophylaxis and premedication, could lead to infective endocarditis. Additionally, a multidisciplinary approach with pediatric and medical consultants is mandatory during the management of such cases.

Mesiodens in the primary dentition--a case report.

Supernumerary teeth are among the most significant dental anomalies affecting the primary and the permanent dentitions. Mesiodens is a supernumerary tooth with a cone shaped crown and a short root. Though it occurs frequently in the permanent dentition, it is extremely rare in the primary dentition. The exact etiology is still obscure and not well understood. Supernumerary teeth occur as isolated dental findings or as part of a syndrome. The frequency with which supernumerary teeth occur and the effects they have on development of normal occlusion justify the radiographic examination of preschool children. Early removal of such teeth is recommended if they impede the eruption of adjacent permanent teeth, appear inverted or rudimentary, associated with certain pathologic conditions or are symptomatic.

Oral habits in children--a prevalence study.

This epidemiological study was conducted upon 4,590 school children to find the prevalence of oral habits in Mangalore in relation to their age and sex and to find the correlation, if any, between the habits and the malocclusion status. We noted that 29.7% of the population had habits of which 3. 1% had digit sucking, 4.6% mouth breathing, 3.02% tongue thrusting, 6.2% bruxism, 6% lip/cheek biting, 12.7% nail biting, 9.8% pencil biting and 0. 09% masochistic habits respectively. Digit sucking, pencil biting and tongue thrust were highly prevalent among Group 1 (3-6 years) children. Mouth breathing and bruxism were significant in Group 2 (7-12 years) cases whereas lip/cheek biting and nail biting were more common in Group 3 (13-16 years) cases. Digit sucking, tongue thrust, mouth breathing and bruxism were more prevalent among the boys whereas lip/cheek biting, nail biting and pencil biting were more prevalent among the girls. 28.95% of the children in Group 2 and 3 with habits had malocclusion. There was a significant correlation between class I type 2, class II div 1 and tongue thrust and mouth breathing whereas children with digit sucking showed a high correlation with class I type 2 malocclusion.

Traumatic injuries to the anterior teeth among South Kanara school children--a prevalence study.

The present study was carried out to assess the prevalence and distribution of the traumatic injuries to anterior teeth among 4500 school children in the age group of 3 to 16 years from South Kanara District of Karnataka. Information concerning sex, age, cause of trauma, number of injured teeth, type of the teeth, lip competence, terminal plane relationship and the molar relationship were recorded. A total of 238 cases (5.29%) had incisor and canine fractures, which was more prevalent among the boys (72.27%) than the girls (27.73%). The leading cause of injury was undefined falls and the maxillary central incisors were commonly affected in both the primary and the permanent dentition. Enamel fracture was the most common form of injury noted. Class 1 Type 2 and Class 2 division 1 molar relationship cases exhibited significantly very high number of fractured teeth. Only 1.68% of the cases with traumatized teeth had undergone treatment.

Reattachment of a fractured maxillary incisor crown--case report.

Management of traumatic injuries to the teeth is a challenge to the practising dentist. It has no prescriptive method for occurring, possesses no significant predictable pattern of intensity or extensiveness and occurring at times when dentists are least prepared for it. It may not only leave physical scars but also a psychological impact on its victim. Yet, more than half of all children traumatize either their primary or permanent teeth before leaving the school, coupled with the dynamic panorama of sporting activity worldwide and the significant increase in violence among the populations. Tooth trauma and its management loom as a major challenge to the dental practitioner. A case of a 11 year old boy with Ellis Class 3 traumatic injury to the maxillary left central incisor is reported. A pulpectomy was performed followed by reinforcement and reattachment of the crown fragment and restoration with composite resin.

Bilaterally fused primary mandibular incisors--a case report.

Fusion of teeth results from abnormal events in the embryologic development of teeth. In most cases the clinical and radiological findings allow only a presumptive diagnosis to be established since the specific terminology described refers to the etiology of the process, which often cannot be established. An unusual case of bilateral fusion in primary mandibular incisor region in a four-year-old boy is reported.

Dentigerous cyst with inflammatory etiology from a deciduous predecessor--report of a case.

Dentigerous cysts arising from overlying infected predecessor teeth are very rare. This report describes one such case where extraction of the infected deciduous tooth with marsupialization led to the eruption of the premolar. Periodic radiographic evaluation is required to note and prevent recurrence and other serious complications arising from these cysts.

Prognostic factors in intracerebral haemorrhage.

In a prospective study, the prognostic value of clinical characteristics and CT scan findings in 50 patients of intracerebral haemorrhage (ICH) has been examined. Follow up has been done over 6 months period. Each patient has been individually followed up for 8 weeks. At the end of the follow up period 34% of the patients died, 36% were dependent on outside help for daily living while 30% were capable of independent existence. Age of more than 60 yrs, Glasgow Coma Scale (GCS) Score of 6 or less (in a modified Scale of 10) at the time of admission, ICH volume greater than 30 ml., midline shift in CT scan of more than 3 mm and presence of intraventricular haemorrhage (IVH) and hydrocephalus had an adverse impact on outcome. Young age, GCS score of more than 8, ICH volume of less than 20 ml, presence of lobar haemorrhage and absence of IVH/hydrocephalus were associated with relatively favourable outcome.