Comparative assessment of cleaning efficacy of two exclusive paediatric rotary files in root canals of primary teeth: An in vitro study.

BACKGROUND: Paediatric rotary file systems have recently been developed for primary teeth use. AIM: To study the cleaning efficacies of two paediatric rotary endodontic files, the Prime PedoTM, and the Kedo-SG BlueTM against the standard H files. DESIGN: This in vitro study included 54 freshly extracted primary molars, which were randomised into three groups (n = 18 each) and were prepared using either Kedo-SG BlueTM, Prime PedoTM or hand H files after injecting methylene blue dye into the canals. Pre- and post-operative cone beam computerised tomography (CBCT) was performed to assess change in root canal volumes. Methylene blue dye removal from canals was assessed using stereomicroscopy, and canal cleanliness was examined by scanning electron microscopy (SEM). RESULTS: Both Prime PedoTM and Kedo-SG BlueTM files reduced significantly less dentine when compared with conventional hand filing with Prime PedoTM removing the least amount of dentine. No significant difference was found in median SEM scores among the groups in the cervical, middle and apical thirds of the roots. Stereomicroscopic assessment of root canal cleanliness using dye removal technique shows a statistically significant difference existing between Kedo-SG BlueTM and hand H files groups. CONCLUSION: Prime PedoTM removed the least amount of dentine. Kedo-SG BlueTM performed significantly better than conventional hand filing with H files when the root canal cleanliness was assessed.

Comparative evaluation of intranasal midazolam-ketamine, dexmedetomidine-ketamine, midazolam-fentanyl, and dexmedetomidine-fentanyl combinations for procedural sedation and analgesia in pediatric dental patients: a randomized controlled trial.

Background: In order to assess the effectiveness of various analgesio-sedative combinations for pain relief and sedation in pediatric dental patients, a thorough evaluation of clinical studies and patient outcomes is necessary. Methods: A total of 128 healthy, uncooperative pediatric dental patients were randomly allocated to receive one of the four combinations of drugs via the intranasal (IN) route: Group I received midazolam-ketamine (MK), Group II received dexmedetomidine-ketamine (DK), Group III received midazolam-fentanyl (MF), and Group IV received dexmedetomidine-fentanyl (DF) in a parallel-arm study design. The efficacy and safety of the combinations were evaluated using different parameters. Results: The onset of sedation was significantly faster in the DF group than in the DK, MF, and MK groups (P < 0.001). The depth of sedation was significantly higher in the DK and DF groups than in the MK and MF groups (P < 0.01). DK and DF produced significant intra- and postoperative analgesia when compared with combinations of MK and MF. No significant adverse events were observed for any of the combinations. Conclusions: The DK and DF groups showed potential as analgesio-sedatives in view of their anxiolytic and analgesic effects.

Non-surgical management of a large periapical lesion with internal resorption using PRF, hydroxyapatite and MTA.

Periapical lesions of endodontic origin are caused by microbial infection of pulp. According to various studies, it is known that necrosis of pulp provides a favourable habitat for microbes to replicate and release various toxins into the periapical tissue leading to inflammation and formation of a periapical lesion. A variety of non-invasive methods to manage such lesions include conservative root canal treatment, aspiration-irrigation technique, decompression technique, calcium hydroxide therapy, lesion sterilisation and tissue repair therapy, and the apexum procedure. We present a case report describing non-surgical management of a large periapical lesion associated with a permanent central incisor displaying internal inflammatory resorption using platelet rich fibrin (PRF), bone graft and mineral trioxide aggregate (MTA).

Validation of a New Graphic Facial Nerve Grading System: FAME Scale.

Background and Objective: Most of the existing qualitative facial nerve grading systems are very subjective while the quantitative grading systems are more complex, require longer data input time and specific software. There is a need for having a scoring system with graphic criteria to improve the subjectivity, reliability and convenience. We aimed to develop and validate such a reliable graphic scale for use in Bell's palsy. Methods: Face videos of patients with unilateral facial paralysis were recorded using smartphones and analyzed for six items including five voluntary facial movements apart from complications of facial palsy (synkinesis, hyperkinesis, and contracture). 15 videos were used for pilot study, 75 for the development of scale and 110 for its validation. Each video was rated on two separate occasions by 3 independent raters, a score of 0-4 was assigned to each item using the graphic scoring criteria, and a composite score was obtained (range 0-24). Five disease severity categories: normal (score 0), mild (score 1-6), moderate (score 7-12), severe (score: 13-18) and profound facial weakness (score: 19-24). Results: The proposed scale and its component items had high inter-rater and intra-rater reliability (Kappa >0.7). Good correlation (Pearson co-efficient >0.7) was seen among the voluntary movements. The proposed scale is a valid tool to score motor deficits and complications of facial palsy. Conclusions: The proposed scale is a valid and reliable graphic scale to describe facial motor dysfunction and its secondary defects.

Proximal Dominant Hereditary Motor and Sensory Neuropathy with TFG Mutation: First Case Report from India.

Hereditary motor and sensory neuropathy with proximal predominance (HMSN-P) is a rare degenerative disorder inherited in an autosomal dominant fashion. This disease was described first in Japanese descendants from Okinawa and Shiga prefectures in mainland Honshu in 1997. The disease is characterized by adult onset of proximal weakness and atrophy, muscle cramps, fasciculations, areflexia, high incidence of elevated creatine kinase, hyperlipidemia, and diabetes mellitus, resembling Kennedy disease, though the mode of inheritance is autosomal dominant, rather than X linked. We examined a 56-year-old male patient with clinical features suggestive of HMSN-P and positive family history in an autosomal dominant fashion. Clinical, electrophysiological, and genetic factors were also reviewed. The appearance of HMSN-P in India and elsewhere calls for clinicians in nonendemic regions to be familiar with this rare disorder, which has typically been geographically confined.

Spatial and seasonal variability in the water chemistry of Kabar Tal wetland (Ramsar site), Bihar, India: multivariate statistical techniques and GIS approach.

This study was performed to evaluate the spatial and temporal distribution of major ions in water samples of a newly designated Ramsar site, namely Kabar Tal (KT) wetland of Bihar. Samples were collected during summer, monsoon, and winter seasons. The analytical and GIS results show that concentration of electrical conductivity, chloride, and nitrate are higher in summer than monsoon and winter. However, the concentration of major cations such as sodium, potassium, calcium, and magnesium are higher in winter than monsoon and summer. In addition, major anions like sulphate and phosphate concentration is higher during monsoon than summer and winter. Multivariate statistical tool (discriminant analysis) results suggest that temperature, pH, electrical conductivity, sulphate, and potassium are the major parameters distinguishing the water quality in different seasons. The study confirms that seasonal variations are playing a major role in the hydrochemistry of KT wetland. Overall, this work outlines the approach towards proper conservation and utilization of wetlands and to assess the quality of surface water for determining its suitability for agricultural purposes. Overall, this work highlights the approach towards estimating the seasonal dynamics of chemical species in KT wetland and its suitability for irrigation purposes.

Morphological variations of lingula and prevalence of accessory mandibular foramina in mandibles: A study.

INTRODUCTION: The lingula is used for identifying the site for injection of local anesthetics and for excision of nerve in facial neuralgia. The relationship between lingula and lingual nerves may aid in risk associated with an impacted third molar. Due to its connection to nerve and vascular structures, the study of the lingula provides important information related to oral and maxillofacial surgical procedures, such as the sagittal split ramus osteotomy and the intraoral vertico-sagittal ramus osteotomy carried out to correct dento facial deformities. Intra-operative complications such as hemorrhage, fracture, and nerve injury may occur if lingula is not correctly identified. MATERIALS AND METHODS: This study was conducted in the Department of Oral Medicine and Radiology, Career Post Graduate Institute of Dental Sciences and Hospital, Lucknow, U. P (India) on fifty (100 sides) dry adult human mandibles to determine the different shapes of lingula. The shapes of the lingula were classified as triangular, truncated, nodular, and assimilated types. RESULTS: The most common shape found in the study was the triangular (61.6%) while the least common shape was the assimilated (11.6%). All types of lingule were more prevalent unilaterally. The prevalence of accessory mandibular foramina (AMF) was 12% on the right side and 4% on the left side of the mandible. CONCLUSION: The present study provides information regarding different shapes of lingule and incidence of AMF in the populations of Lucknow and its surrounding areas (Uttar Pradesh) North India. The findings of the present study are very helpful to oro-dental surgeons, anthropologists, and forensic practice experts.

Comparative evaluation of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in permanent teeth with incomplete root development: a randomized controlled trial.

INTRODUCTION: The purpose of this study was to evaluate and compare, clinically and radiographically, the effects of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as pulpotomy agents in permanent teeth with incomplete root development. METHODS: A total number of 70 children requiring pulpotomy in 70 permanent molars with incomplete root development were screened. Sixty-two patients met the inclusion criteria and were enrolled in the study. The patients were randomly allocated equally in 2 treatment groups. MTA pulpotomy was performed in group A (the control group), and PRF pulpotomy was performed in group B (the experimental group). The treated teeth were restored with amalgam followed by stainless steel crowns. Clinical and radiographic evaluations were performed after 6, 12, and 24 months. Thus, the data obtained were blindly analyzed using the chi-square test. RESULTS: There was no significant difference between the 2 groups in terms of clinical and radiologic success. Radiographically, all available cases (53 teeth) showed evidence of root growth and canal narrowing. Complete apical closure was observed in 88.8% in the PRF group (experimental group) and 80.07% of roots in the MTA group (control group), respectively, at 24 months. CONCLUSIONS: PRF could be used as a suitable biological and economic alternative to MTA in pulpotomy procedures of permanent teeth with incomplete root development.

Enamel microabrasion for aesthetic management of dental fluorosis.

Fluorosis has increased in recent times due to fluoridation of drinking water and addition of fluoride to various edible items, which leads to unaesthetic appearance of teeth visible at close quarters. The enamel microabrasion technique is a conservative method that improves the appearance of the teeth by restoring bright and superficial smoothness, without causing significant structural loss. The aim of this article is to describe an easy technique for managing mild to moderate dental fluorosis using Opalustre (Ultradent Products) microabrasion slurry. This conservative approach may be considered an interesting alternative to more invasive prosthetic techniques like composite resin restorations, ceramic veneers or crown fabrications.

Intramucosal nevus of buccal mucosa in a male child.

Nevus (mole or birthmark) is a benign tumour of skin and mucosa characterised by the presence of melanin-producing, neuroectodermally derived cells, which can be light to dark brown, reddish brown, blue or flesh coloured. It varies in shape from oval to round. Oral melanotic nevi are uncommon oral lesions causing focal pigmentation. They were found only in 0.1% of population in a large survey. Nevi can be acquired over time or congenital. Acquired nevi are considered benign neoplasms whereas congenital nevi are hamartomas. They are located usually on the palate but less commonly on buccal mucosa, gingiva and lips. This article presents a case report of an intramucosal nevus of buccal mucosa in a 5-year-old boy with its surgical removal.

Non-syndromic multiple supernumerary teeth: report of a case with 13 supplemental teeth.

The presence of supernumerary teeth (STs) may give rise to a variety of clinical problems. These include failure of a tooth to erupt, delayed eruption, ectopic eruption, diastema, rotation of adjacent teeth, displacement of teeth and crowding. This case describes a 14-year-old male patient who presented with the complaint of pain in the left mandibular posterior region. Intraoral examination revealed the presence of carious retained deciduous second molar in this region. An orthopantomogram was advised which 'initially' revealed 11 STs, positioned in all four quadrants in posterior regions. Two more STs were detected in the following investigations totalling 13. Dental literature rarely reports presence of STs in such a large number. The objective of this case is to report detection of STs, radiographic examination, extraction of the retained deciduous molars and STs in the mandible to facilitate eruption of mandibular premolars.

Familial aggregation of maxillary lateral incisor agenesis (MLIA).

Agenesis of maxillary lateral incisors and mandibular second premolars is the most frequent form of hypodontia. Its prevalence varies across population from 0.8% to 4.5%. Genetic aberrations and environmental factors may cause agenesis of one or more teeth. The management of child having such a problem is very important since diastema in teeth especially in upper anteriors not only affects child's physical appearance but also its psychological development as the child wants to look like other children. In this article is presented a case of non-syndromic agenesis of maxillary lateral incisors (MLIA) and mandibular central incisors in a 10-year-old boy (patient) in permanent dentition with its management along with the radiographic investigations and photographic presentations of the other members of his family affected with this condition.