Chairside endodontic management of a child with fibrodysplasia ossificans progressiva.

Fibrodysplasia ossificans progressiva (FOP) is an exceptionally atypical genetic disorder characterized by heterotopic bone formation within skeletal muscles, ligaments, tendons, and other connective tissues that affects one in 2 million people. A 4-year-old girl with FOP was referred to our practice with complaints of pain and discomfort in both sides of the lower jaw. Clinical examination revealed deep multiple caries and buccal gingival abscess in relation to multiple teeth. Endodontic care and conservative dental procedures were planned and performed chairside after a detailed discussion with FOP medical and dental experts. Very brief dental appointments were conducted with breaks to prevent muscle fatigue. No usage of regional anesthesia or dental dam clamps was done. The patient and her parents were counseled for oral hygiene maintenance, and periodic topical fluoride treatments were performed during successive follow-up appointments. The child is followed for 34 months post-treatment. The dental treatment modifications implemented for the present case were enough to institute good oral health and to prevent the creation of heterotopic ossifications in the maxillofacial region.

An in-vitro evaluation of antibacterial effect of Amalgomer CR and Fuji VII against bacteria causing severe early childhood caries.

OBJECTIVE: To evaluate the antibacterial action of Amalgomer CR and Fuji VII against bacteria causing S-early childhood caries. MATERIALS AND METHODS: Antibacterial activity of Amalgomer CR and Fuji VII was assessed using the agar diffusion test in triplicate. The powder and liquid of each test material was mixed and inserted in the punched wells (6 mm × 2 mm). A composition of 0.2% chlorhexidine digluconate acted as control. The agar plates were incubated at 37°C for 24 h for Streptococcus mutans, S. salivarius, S. parasanguinis and Actinomyces viscosus, whereas Lactobacillus casei was incubated for 48 h. Sizes of the inhibition zones were calculated by subtracting the diameter of the specimen (6 mm) from the average of the three measurements of the halo. For each test material against each bacteria, 9 measurements were made (3 measurements × 3 times). Kruskal-Wallis test was done to compare the zones of inhibition of test materials against individual bacteria. Pair-wise comparison was done by Mann-Whitney U-test. RESULTS: Amalgomer CR had the most antibacterial against S. mutans (31.0 mm), followed by A. viscosus (21.87 mm), S. salivarius (13.87 mm), S. parasanguinis (10.80 mm), and L. casei (9.69 mm). Fuji VII had the most antibacterial action against S. salivarius (10.65 mm), followed by A. viscosus (9.10 mm). However, it did not inhibit the growth of S. mutans (0 mm), S. parasanguinis (0 mm), and L. casei (0 mm). CONCLUSION: Amalgomer CR and Fuji VII showed wide variation in antibacterial action against all test organisms.