A Rare Case of Calcified Radicular Cyst in Deciduous Tooth.

Radicular cysts (RCs) are one of the most common odontogenic cystic lesions of inflammatory origin. It originates mostly from epithelial residues in periodontal ligaments secondary to inflammation. The pathogenesis involves the activation of epithelial cell rests of Malaseez after physical, chemical, or bacterial injury. Radiographically, it is seen as a well-defined unilocular lesion of size >1.5 cm. RCs are considered rare in the primary dentition, comprising only 0.5-3.3% of the total number of RCs in both primary and permanent dentitions. This is the first case to be reported of a radicular cyst in primary teeth, with dystrophic calcification. How to cite this article: Sunny R, Rag B, Punathil S, et al. A Rare Case of Calcified Radicular Cyst in Deciduous Tooth. Int J Clin Pediatr Dent 2024;17(1):86-88.

Bacterial infection-related glomerulonephritis in patients with diabetes.

AIM: Diabetic patients are prone to infections, thus making them a unique cohort at risk of developing bacterial infection-related glomerulonephritis (IRGN). METHODS: In total, 1693 adult diabetic patients underwent kidney biopsy between 2005 and 2021 at our tertiary care hospital in South India. Of these, 121 consecutive cases which met criteria of bacterial IRGN were included in this study. RESULTS: The mean age of the cohort was 53.1 ± 10.1 years and 83/121 (68.5%) were males. Majority (98.3%) had type 2 diabetes for a median duration of 6 (IQR, 2-12) years. The most common sites of infection were skin (47/121, 38.8%) and urinary tract (15/121, 12.4%). Fifty percent (58/121) of patients had underlying advanced diabetic kidney disease (DKD). Isolated C3 deposits (without immunoglobulin) occurred in 66/121 (54.5%) patients predominantly in advanced DKD patients. IgA-dominant glomerulonephritis occurred in only 9/121 (7.4%) patients. Short-course oral steroid was given to 86/121 (71.1%) patients. Steroid related dysglycemia and immunosuppression related infections occurred in 9/61 (14.8%) and 16/61 (26.2%) patients respectively. Of the 90 patients with follow up details >3 months, 46 (51.1%) progressed to kidney failure over a median period of 0.5 (IQR, 0-7.2) months. Patients diagnosed in the latter half of our study period (2013-2021) were older, less commonly presented with fever, had more pronounced hypocomplementemia and severe renal histology predominantly with a 'starry sky' immunofluorescence pattern. CONCLUSION: Superimposed bacterial IRGN on underlying DKD is associated with poor renal outcomes. Use of short course steroid was associated with significant toxicity.

Efficacy of Periarticular Cocktail Injection in Rheumatoid Patients Undergoing Total Knee Replacement.

BACKGROUND: Pain control after total knee replacement (TKR) is of primary importance to joint replacement surgeons to achieve good functional outcome post-surgery. This becomes even more challenging when these major procedures are done in immunocompromised patients like rheumatoid arthritis. Good peri-operative analgesia facilitates early rehabilitation, improves patient satisfaction, and reduces the hospital stay. The adverse effects caused by epidural analgesia or parenteral opioids can be avoided by replacing it with an analgesic cocktail locally. Our prospective study was to evaluate the benefits of a periarticular cocktail injection which was given in rheumatoid patients undergoing bilateral TKR in single sitting with respect to pain and knee motion recovery. METHODS: Sixty-four rheumatoid arthritis patients undergoing simultaneous primary total knee replacement were included in the study. A total of 128 knees were randomized either to receive a periarticular intra-operative injection containing ropivacaine, fentanyl, clonidine, cefuroxime and epinephrine (Group A) on one knee and to receive plain ropivacaine (Group B) on the opposite knee. The perioperative and post-operative analgesic regimens were standardized. All patients received the same standard analgesia protocol. Visual analog scores for pain, knee range of motion and quadriceps function were recorded on the day of surgery, first post-operative day, second post-operative day, day of discharge, and 2 weeks and 6 weeks during follow-up. The need for rescue analgesic requirement and adverse effects to the cocktail injection were also noted during the study period. RESULTS: The patients who received the periarticular cocktail fared better in terms of pain scores and functional recovery. Additional rescue agents used were significantly less at 6 h, at 12 h, and over the first 24 h after the surgery in group A when compared with group B. No cardiac or central nervous system toxicity was observed. CONCLUSIONS: Periarticular cocktail injection significantly reduces the requirements for post-operative analgesia and also improves patient satisfaction, with no apparent risks, following total knee arthroplasty in rheumatoid arthritis.

Reliability of Cone Beam Computed Tomography in Comparison with Panoramic Radiography to Predict the Anatomical Relationship of Inferior Alveolar Nerve with Mandibular Third Molar: A Radiological and Clinical Study.

OBJECTIVES: The purpose of the study was to assess the precision of cone beam computed tomography (CBCT) in comparison with panoramic radiography in determining the anatomical relationship of inferior alveolar nerve (IAN) with the impacted mandibular third molar. MATERIALS AND METHODS: Twenty patients diagnosed with the following panoramic radiographic markers: darkening of the root, interruption of white line of mandibular canal, diversion of mandibular canal, and narrowing of the roots suggesting a close relationship of roots with the mandibular canal were selected and underwent an additional CBCT to assess the proximity of IAN to mandibular third molar roots. All patients were assessed for loss of sensation or neurosensory deficit in the chin and lower lip during postoperative period by objective and subjective methods. RESULTS: Twenty patients with an average age of 25.4 years (21-39 years) with 21 impacted mandibular third molars were included in this sample. It was found that after the removal of impacted third molars, IAN was not visible in any of the cases and postoperative objective and subjective neurosensory tests showed no signs of neurosensory disturbances. CONCLUSION: The study found that CBCT had limited usefulness in neurovascular bundle exposure prediction, prior to surgical removal of impacted mandibular third molars. The accuracy of radiographic markers in conventional panoramic radiography to predict neurovascular exposure was also limited.

Reconstruction of Craniofacial Bone Defects with Autologous Human Bone Marrow Stem Cells and Autogenous Bone Grafts: A Case Report with Review of Literature.

Reconstruction of craniofacial bony defects has always been a challenging task for the surgeons over the years. The science of reconstructing such defects is of at most importance to craniofacial and plastic surgeons due to its relevance in facial aesthetics function as well as prerequisite procedure for continuing other surgical procedures. The main goal of the reconstruction of the craniofacial defects is to reduce the morbidity by restoring the facial form and aesthetics, as well as a good function of the facial structures by achieving a reasonable occlusion and articulation. Although significant improvements have occurred during the last few decades, challenges still exist as to what type of reconstruction to be carried out with regard to techniques and the type and quality of materials of choice to be used. As decades progressed, the advancement in surgical techniques and the variety of reconstruction methods have definitely improved the quality of life. This article reviews the method of bony reconstruction of craniofacial defects using autologous human bone marrow stem cells and autologous bone grafts and its modification, which includes much recent tissue engineering techniques and regenerative medicine, thereby replacing older techniques by biological substitutes, which can restore improve and maintain orofacial function and aesthetics.

Correction to: Efficacy of Periarticular Cocktail Injection in Rheumatoid Patients Undergoing Total Knee Replacement.

[This corrects the article DOI: 10.1007/s43465-020-00230-3.].

Comparison of Efficacy of Lycopene and Lycopene-Hyaluronidase Combination in the Treatment of Oral Submucous Fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic progressively scarring disease of the oral cavity. Lycopene is a powerful antioxidant obtained from tomatoes and has the highest singlet oxygen quenching capacity and a high capacity of quenching other free radicals in vitro among dietary carotenoids. Hyaluronidase is a substance prepared from the testes and semen of mammals that modifies the permeability of connective tissue through the hydrolysis of hyaluronic acid. OBJECTIVE: To evaluate the efficacy of lycopene and lycopene-hyaluronidase combination, and to compare the efficacy of lycopene and lycopene-hyaluronidase combination in the treatment of OSMF. STUDY DESIGN: The study consisted of 45 patients with OSMF divided into three equal groups. Patients in Group A were given Lycored 16 mg daily in two equally divided doses for 3 months. Patients in Group B were given LycoRed along with hyaluronidase intralesional injection of 1500 IU twice weekly for 3 months. Patients in Group C were given placebo capsules. Patients were evaluated after 3 months. The following parameters were recorded: mouth opening, visual inspection, palpatory findings, and burning sensation. RESULTS: There was statistically significant change in mouth opening and burning sensation for lycopene and lycopene-hyaluronidase combination than in the placebo group in the treatment of OSMF, but the lycopene-hyaluronidase combination did not show any statistically significant change when compared with lycopene alone. CONCLUSION: Lycopene appears to be a very promising antioxidant in the management of oral submucous fibrosis, both in clinical and symptomatic improvement.

Estimation of Serum Cortisol Levels in Oral Lichen Planus Patients with Electrochemiluminescence.

OBJECTIVES: The objectives of this study were to compare the serum cortisol level in oral lichen planus (OLP) patients with normal healthy individuals and to compare the serum cortisol level in patients with erosive and nonerosive forms of OLP. MATERIALS AND METHODS: A case-control study involving 60 patients within the age group of 20-50 years was carried out. Group A included 15 subjects with nonerosive lichen planus, without skin involvement; Group B included 15 subjects with erosive lichen planus, without skin; and Group C included 30 subjects with no apparent lesions of the oral mucosa and the skin. From the cases and controls, 7mL venous blood was taken from median cubital vein two times (between 8 and 10 AM, and 4 and 6 PM) by using a 10 mL syringe from which 5 mL was taken for estimation of serum cortisol. RESULTS: The serum cortisol levels of the erosive OLP patients were significantly higher than those of nonerosive OLP patients and controls. There was no significant difference in the serum cortisol levels between nonerosive OLP in comparison with controls.