Choice of Surgeons in Retractors used in Cleft Lip and Palate Surgery: An Original Research.

Background: To ensure optimal exposure and enable precise tissue manipulation, cleft lip and palate abnormalities require surgical repair utilizing retractors. Different retractors may affect surgical outcomes; however, this is not yet evident. Examining surgeon preferences for retractors in cleft lip and palate surgery and assessing their impact on patient outcomes were the goals of this study. Materials and Methods: The patients who underwent primary cleft lip and palate repair were retrospectively analyzed. This study evaluated three widely used retractors: the Langenbeck, Gelpi, and Moult Mouth Gag retractors. This study looked at demographic information, surgical results (including scarring, aesthetic outcomes, and wound healing issues), and surgeon preferences for retractors. Results: The study identified differences in surgical outcomes related to various retractor types. Both Group A (Langenbeck retractor) and Group B (Gelpi retractor) demonstrated similar favorable results, such as little wound healing issues, less scarring, and pleasing cosmetic results. The wound healing issues, scarring, and cosmetic outcomes were all worse in Group C (Moult Mouth Gag retractor). Conclusion: Retractors were not always preferred by surgeons doing cleft lip and palate surgery. The type of retractor had an impact on the surgical results; the Moult Mouth Gag retractor performed less well than the Langenbeck and Gelpi retractors. These results highlight the value of using evidence-based criteria to select retractors more effectively and enhance surgical methods for better patient outcomes in cleft lip and palate repair.

Maxillofacial Trauma in Pediatric Patients: A Retrospective Study.

Objective: The study was conducted to analyze the pattern, etiology and management of maxillofacial trauma in children up to 16 years of age. Study Design: Records of the patients who sustained maxillofacial trauma from 2013 to 2018 were retrospectively evaluated for age, gender, etiology, pattern of injuries and their management. Children were divided into three groups-primary (0-5 yrs), mixed (6-11 yrs) and permanent dentition group (12-16 yrs). Maxillofacial trauma was observed as midface fracture, mandible fractures, soft tissue injuries and associated tooth fractures. SPSS software version 19.0 was used for the data analysis. Result: A total record of 99 children were evaluated. Gender-wise distribution was reported twice in male than females. Fall was observed as the major etiological factor (73.7%) with a significant p value of 0.012 using chi-square test. The highest frequency of maxillofacial trauma is noted in mixed dentition group (47.4%). Mandible fracture was most frequently observed followed by associated soft tissue injury. Conservative approach/closed reduction for management was executed for the majority of cases. Conclusion: Knowledge gained from the present study would help in assessing the effectiveness of present preventive modalities and facilitate elaboration of future preventive measures and new research works as well.

Calcium pyrophosphate dihydrate crystal deposition disease and retro-odontoid pseudotumor rupture managed via posterior occipital cervical instrumented fusion: illustrative case.

BACKGROUND: Craniocervical junction and subaxial cervical spinal manifestations of calcium pyrophosphate deposition disease are rarely encountered. The authors presented a severe case of retro-odontoid pseudotumor rupture causing rapid quadriparesis and an acute comatose state with subsequent radiographic and clinical improvement after posterior occipital cervical fusion. OBSERVATIONS: The authors surveyed the literature and outlined multiple described operative management strategies for compressive cervical and craniocervical junction calcium pyrophosphate deposition disease manifestations ranging from neck pain to paresthesia, weakness, myelopathy, quadriparesis, and cranial neuropathies. In this report, radiographic features of cervical and craniocervical junction calcium pyrophosphate deposition disease were explored. Several previously described surgical strategies were compiled, including patient characteristics and outcomes. LESSONS: With this case report, the authors presented for the first time an isolated posterior occipital cervical fusion for treatment of a compressive retro-odontoid pseudotumor with rupture into the brainstem. They demonstrated rapid clinical and radiographic resolution after stabilization of cranial cervical junction only 12 weeks postsurgery.

Pure extraosseous spinal epidural cavernous hemangioma presenting with acute paraplegia: a case report.

INTRODUCTION: Spinal hemangiomas are benign vascular tumors that most commonly originate from the osseous structures of the spinal column. Epidural spinal hemangiomas without osseous involvement are uncommon and are classified as pure epidural spinal hemangiomas. Extraosseous spinal epidural cavernous hemangiomas are rarely described and among available reports; most patients present with slowly progressive neurological symptoms. Herein, we present a novel case of acute neurological dysfunction from a pure spinal epidural hemangioma that was managed through surgical resection with good neurological recovery at follow-up. CASE PRESENTATION: A 45-year-old previously healthy man presented to the emergency room with sudden inability to ambulate and was found to have bilateral lower extremity weakness. Magnetic resonance imaging of the spine demonstrated an epidural mass extending out of the right T5/6 neural foramen. The mass enhanced heterogeneously, and the preoperative diagnosis favored an atypical schwannoma. The lesion was surgically removed en-bloc through a midline posterior decompression with instrumentation. Histopathologic examination confirmed cavernous hemangioma pathology. Within 6 weeks of the surgical intervention, the patient had regained full sensorimotor function and these effects were durable through long term follow-up. DISCUSSION: Pure spinal epidural hemangiomas are rare and generally have an insidious clinical course. This case report highlights that these uncommon lesions may present with substantial and acute neurological dysfunction requiring urgent neurosurgical intervention. This should prompt clinicians to consider cavernous hemangioma in the differential diagnosis of patients presenting with acute neurological deterioration and an epidural spinal tumor.

Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis.

AIM: This retrospective study aimed to analyze dental traumatic injuries and their management in children up to 16 years of age. MATERIALS AND METHODS: Records of the patients who sustained dental trauma from 2013 to 2018 were evaluated for age, gender, etiology, type of injuries, and their management. Children were divided into three groups-primary (0-5 years), mixed (6-11 years), and permanent dentition group (12-16 years). Dental trauma was assessed by Ellis and Davey's classification of tooth fracture along with other associated injuries. RESULTS: Total records of 466 children with 750 injured teeth (665 permanent and 85 primary) were evaluated. Males were reported twice as females. Fall was noted as the major etiological factor (93.1%). The highest frequency of dental trauma was observed in the permanent dentition group (54.7%). Ellis class IV fracture was the most common dental injury and maxillary central incisor was the most frequently injured tooth. Soft tissue injury was noted as the most commonly associated injury. Most of the dental traumatic injuries in permanent teeth were treated by root canal treatment while the majority of primary dentitions were managed by observation and wound care. CONCLUSION: Ellis class IV fracture was noted as the most frequent type of dental injury and fall was a major etiological factor. The permanent dentition group of children was more affected and a male predominance was observed. CLINICAL SIGNIFICANCE: The information gained from the present study would help in providing various preventive modalities to parents, caregivers, and teachers regarding these injuries in the future and also facilitate several new researches in this field. HOW TO CITE THIS ARTICLE: Patidar D, Sogi S, Patidar DC, et al. Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis. Int J Clin Pediatr Dent 2021;14(4):506-511.

Comparative evaluation of bone regeneration with platelet-rich fibrin in mandibular third molar extraction socket: A randomized split-mouth study.

PURPOSE: Platelet-rich fibrin (PRF) is a new platelet concentrate concept consisting of an autologous fibrin gel having accumulation of platelets and the released cytokines in a fibrin clot. The study aims to evaluate the efficacy of autologous PRF in accelerating bone regeneration and repair in fresh third molar extraction sockets. The investigators hypothesized the cicatricial properties and accumulation of growth factors in a single clot which will improve bone density and quality. MATERIALS AND METHODS: PRF results from a natural and progressive polymerization occurring during centrifugation. Two groups were made with bilaterally impacted third molar patients. PRF was obtained and surgical extraction was carried out under aseptic conditions. Quantitative data are presented as mean. Statistical significance was inferred at P < 0.05. RESULTS: Results obtained were evaluated statistically and found a significant difference between the groups in improvement in alveolar bone density of regenerate measured radiographically. The study demonstrates a faster bone formation in the extracted sockets with PRF as compared to control. CONCLUSION: PRF proved to be an autologous biomaterial with useful features that allowed efficient postextraction bone defect filling and faster bone regeneration.

Effect of Distinctive Moisture Conditions on Push-out Bond Strength of Three Root Canal Sealers-An In-Vitro Study.

OBJECTIVE: Endodontic sealer should adhere to both dentin and the core filling material but the moisture conditions of the canals affect the adhesive properties of the sealer. An ideal sealer with perfect moisture conditions will lead to greater strength of the restored tooth, which may provide greater resistance to tooth fracture and clinical longevity of an endodontically treated tooth. The aim of this study was to evaluate the effect of moisture conditions on the push-out bond strength of three root canal sealers: AH Plus® (Dentsply-Tulsa Dental, Tulsa, OK), Epiphany (Pentron Clinical Technologies, Wallingford, CT), and GuttaFlow (Coltene/Whaledent, Altstatten, Switzerland). MATERIALS AND METHODS: A total of 120 single-rooted, non-carious teeth were collected for the study and were stored in normal saline. The root canals were prepared using step-back technique. Teeth were divided into four groups based on type of drying procedure used and further subdivided into three subgroups based on the type of sealer used. The samples were cut horizontally to produce slices and then tested for push-out bond strength using Universal Testing Machine (Servo Series 50 kN; P S I Sales Private Limited, New Delhi, India). The specimens were examined for mode of fracture under magnification and the results were analyzed statistically. RESULTS: Distinctive moisture conditions for all sealers were observed and the highest strength of AH Plus® was evaluated under moist condition, Epiphany under dry condition, and GuttaFlow under normal condition, respectively. CONCLUSION: Distinctive moisture conditions affect the push-out bond strength of the sealers.

Proximity of maxillary posterior teeth roots to maxillary sinus and adjacent structures using Denta scan®.

AIM: The study aimed to investigate the proximity of maxillary posterior teeth roots to maxillary sinus and measure the distance of maxillary posterior teeth roots and the sinus floor as well as the thickness of bone between the roots and alveolar cortical bone using Denta scan®. MATERIALS AND METHODS: The study samples include Denta scan® images of fifty patients with normally erupted bilateral maxillary first premolar to maxillary second molar. The vertical relationship of each tooth root with maxillary sinus is classified into four types of Denta scan® images (based on the classification by Jung in 2009). The distance between the sinus floor and root, and the bone thickness between the root and alveolar cortical plate will be measured and analyzed. CONCLUSION: The buccal root of the maxillary molars was more commonly protruded into the maxillary sinus. Among the roots of maxillary posterior teeth, mesiobuccal root of first molar and palatal root of second premolar were found in close proximity to the floor of maxillary sinus. The bone thickness on the buccal aspect to the root was significantly thinner in the maxillary first premolar and maxillary first molar as compared to other maxillary posterior teeth roots. CLINICAL SIGNIFICANCE: Knowledge of anatomical relationship between the maxillary posterior teeth and maxillary sinus guides us not only in proper preoperative treatment planning but also avoids the possible complications encounter while performing the minor oral surgical procedures involving maxillary posterior teeth, which are close to the maxillary sinus.

Situs inversus in a patient with nevoid basal cell carcinoma syndrome: a histogenetic relationship?

Nevoid basal cell carcinoma syndrome (NBCCS) is an uncommon autosomal dominant inherited disorder with high penetrance and variable expressivity. It affects multiple organ systems, including the stomatological, skeletal, skin, eye, reproductive, and central nervous systems. It is caused by mutations in the patched tumor suppressor gene, PTCHI, located in the 9q22.3-q31 chromosome. To our knowledge, this is the first report of a patient with unusual radiological features, i. e. dextrocardia and situs inversus totalis, in conjunction with common features including multiple keratocystic odontogenic tumors, bifid ribs, palmar and plantar pits, bridging of the sella turcica and calcification of the falx cerebri. We examined whether these genetic conditions were associated, as both involve ciliary dysfunction.