Assessment of Oral Hygiene Status and Prevalence of Dental Caries and Traumatic Injuries to Anterior Teeth among Visually Impaired Children in Chennai City.

Aim: To assess the oral hygiene status and prevalence of dental caries and trauma to anterior teeth among visually impaired children in Chennai city. Settings and design-a cross-sectional study was conducted in institutionalized blind schoolchildren. Materials and methods: A total of 130 children from two blind schools were selected based on the inclusion and exclusion criteria. Oral hygiene status was assessed using the oral hygiene index-simplified (OHI-S). Dental caries were assessed using decayed-missing-filled teeth (DMFT) and decayed, extracted due to carries, filled teeth (deft) index for permanent and primary dentition, respectively. Trauma to anterior teeth was assessed using Ellis and Davey classification. Statistical analysis used-all the data were analyzed using the Statistical Package for the Social Sciences (SPSS) software 20.0. Results: The assessment of oral hygiene status showed that 54.6% of children had good oral hygiene, 45.4% had fair oral hygiene, and none had poor oral hygiene. The prevalence of dental caries in permanent and primary dentition was found to be 40 and 63.1%, respectively. The prevalence of trauma to anterior teeth was found to be 35.4%. Conclusion: Primary prevention approaches should be taught to parents and school teachers for early intervention of oral health problems. How to cite this article: Kannappan J, Srinivasan D, Chiriyankandath JL, et al. Assessment of Oral Hygiene Status and Prevalence of Dental Caries and Traumatic Injuries to Anterior Teeth among Visually Impaired Children in Chennai City. Int J Clin Pediatr Dent 2023;16(1):93-96.

Clinical Profile, Neuroimaging Characteristics, and Surgical Outcomes of Patients With Acute Acquired Non-accommodative Comitant Esotropia.

PURPOSE: To report the clinical presentations, neuroimaging findings, and surgical outcomes in patients with acute acquired non-accommodative comitant esotropia (AACE). METHODS: A retrospective review of records of all patients diagnosed as having AACE between January 2011 and December 2019 across three tertiary eye care centers was done. Cases with AACE onset after age 1 year were included. Patients were divided into two groups based on age of onset of esotropia: childhood (16 years or younger) and adult (older than 16 years). Surgical success was defined as postoperative horizontal deviation of 8 prism diopters (PD) or less at the last follow-up visit. RESULTS: A total of 338 patients (220 males and 119 females; mean age at presentation: 12.60 ± 9.8 years) met the study criteria. The mean age at onset of esotropia in the childhood and adult onset groups was 3.61 ± 1.1 and 26.6 ± 8.7 years, respectively. There were significantly more individuals with myopia (30%) in the adult onset group compared to the childhood onset group (6%) (P = .004). Thirty-seven (16%) had positive neuroimaging findings (16.4% adult onset vs 9.4% childhood onset). A total of 148 (44%) patients underwent surgery for esotropia, and the overall success rate was 73%. Mean preoperative esotropia was comparable in either group (P = .20), but surgical success was better in the adult onset group (75.6% vs 66.3% in the childhood onset group). Mean duration of follow-up postoperatively was 13.6 ± 12 months. CONCLUSIONS: Two-thirds of the patients had childhood onset of AACE. Intracranial pathology was found in 1 of 6 patients. Surgical success was better in the adult onset group, which was not influenced by preoperative esotropia, neuroimaging findings, or refractive status, but was dependent on age at onset of esotropia and duration between onset and intervention. [J Pediatr Ophthalmol Strabismus. 2023;60(3):218-225.].

Silver Modified Atraumatic Restorative Technique: A Way towards "SMART" Pediatric Dentistry during the COVID-19 Pandemic.

As the coronavirus disease-2019 pandemic outbreak continues to be a global public health concern, dentists should seek means to provide oral health care with minimal risk. To meet the recommendations of the Center for Disease Control, alternative non-aerosol generating techniques have been proposed to minimize the risk of disease transmission to patients and dental healthcare personnel. Among recent materials, silver diammine fluoride (SDF) has been shown to be effective in preventing and arresting caries. This along with an atraumatic restorative treatment with glass ionomer cements (GICs) makes it a potentially attractive adjunctive therapy for caries management in pediatric patients. In this technique, SDF is applied over carious tissue and the lesion is restored with auto-polymerizing GIC. This review article aims to provide a practical background and clinical guide for the application of silver-modified atraumatic restorative technique (SMART) as a safe way to provide dental services to children during the pandemic.

Systemic Lupus Erythematosus and Third Nerve Palsy: Unusual Presentation and Review of the Literature.

We report the case of a young female with pyrexia of unknown origin, cutaneous macules and an incomplete third cranial nerve palsy, that led to the diagnosis of systemic lupus erythematosus (SLE) with neurological manifestations. Her visual acuity was normal. Fundus examination showed cotton wool spots in both eyes. Neuroimaging was also normal. Systemic work up revealed pancytopaenia, hypocomplementaemia, and the presence of multiple autoantibodies including anti-double stranded deoxyribonucleic acid and lupus anticoagulant. She was effectively treated with intravenous pulsed corticosteroid therapy, cyclophosphamide, and oral hydroxychloroquine. This case highlights the uncommon involvement of cranial nerve mononeuropathy in SLE, the importance of systemic examination and autoimmune workup in young patients with such a presentation.

Effectiveness of Parental Participation in a Dental Health Program on the Oral Health Status of 8-10-year-old School Children.

Aim: Prevention-focused school dental health program (SDHP) is a cost-effective intervention that countries can use to lessen the problem of dental diseases by educating on oral health. The current study aims to assess the effectiveness of parental participation in an SDHP held at periodic intervals on the oral health status (OHS) of children aged 8-10 years attending a local school in Southern India. Materials and methods: The longitudinal study was scheduled between September 2018 and June 2019 (36 weeks) in 120 participants who were healthy school children aged 8-10 years at a private school in Kelambakkam. This 36-week duration study assessed the effectiveness of school dental health education program with and without parents at every 12 weeks interval. The OHS of subjects was assessed using the standard indices [i.e., Decayed, Missing and Filled permanent teeth (DMFT), decayed, extracted, and filled primary teeth (deft), and Simplified Oral Hygiene Index (OHI-S)]. Friedman's test and Mann-Whitney U test were used for analyzing the data as indicated. Results: In postintervention visits, children with parental participation had significantly lower caries increments than children without parental participation. While the oral hygiene index scores have improved significantly in both groups over time, the improvement in the parental participation group was greater. Conclusion: It can be concluded that the SDHP is an educational driver that showed a constructive impression on the oral health of children. The participation of the child's parents in SDHP has significantly improved the OHS of children. How to cite this article: Sowmiya Sree RA, Joe Louis C, Senthil Eagappan AR, et al. Effectiveness of Parental Participation in a Dental Health Program on the Oral Health Status of 8-10-year-old School Children. Int J Clin Pediatr Dent 2022;15(4):417-421.

Isolated Focal Infantile Hemangioma of the Alveolar Ridge with Glucose Transporter-1 Reactivity: An Aberrant Presentation.

AIM AND OBJECTIVE: To give dental practitioners an insight into the unusual presentation of focal infantile hemangioma on the alveolar ridge showing immunoreactivity to glucose transporter-1 (GLT1). We also recommend the importance of using standardized terminologies to describe the type of hemangioma. BACKGROUND: One of the most commonly seen and misdiagnosed vascular tumors of the skin and soft tissues of the head and neck region in children are infantile hemangiomas. Infantile hemangiomas developing at extracutaneous locations such as the oral cavity are rare, especially without cutaneous involvement. CASE DESCRIPTION: A 9-month-old infant girl presented to the Pediatric Dental Department with a swelling over the maxillary alveolar ridge. The solitary exophytic mass appeared after birth and gradually enlarged in size with episodes of bleeding during feeding. Clinical examination revealed a reddish-pink pedunculated mass that bled profusely on palpation. The lesion was excised by electrocautery and was found to be express glucose transporter-1 confirming the diagnosis of infantile hemangioma. The patient was followed up for 1 year and showed no recurrence. CONCLUSION: Hemangiomas are usually misinterpreted to be pyogenic granulomas, vascular malformation, reactive granulation tissue, or congenital granular cell tumor. This report highlights the use of glucose transporter-1 when there is suspicion of hemangioma for immunohistochemical distinction from other histologically similar vascular lesions of the oral cavity. CLINICAL SIGNIFICANCE: Dental surgeons treating vascular lesions of the oral cavity should advocate for surgical management techniques that also produce hemostasis due to the risk of intraoperative bleeding. HOW TO CITE THIS ARTICLE: Natarajan D, Muthukali S, Nachiappan N, et al. Isolated Focal Infantile Hemangioma of the Alveolar Ridge with Glucose Transporter-1 Reactivity: An Aberrant Presentation. Int J Clin Pediatr Dent 2021;14(2):319-322.

Tribal Odisha Eye Disease Study (TOES). Report # 8. Childhood cataract surgery and determinants of visual outcome in tribal districts.

Purpose: The purpose of this study is to describe the demographic profile, clinical features, visual outcomes, and follow-up patterns after successful cataract surgery in children from the tribal community in Odisha, India. Methods: We retrospectively reviewed records of tribal children aged 4 months-16 years, who underwent public health financed cataract surgery at our institute from January 1, 2015, to December 31, 2019. Collected data included demographic profile, clinical features, outcomes, and follow-up. Univariate and multivariate linear regression identified factors affecting the visual outcome at a 6-week follow-up. Results: During this period, a total of 352 children [536 eyes; mean age: 9.11 ± 4.4 years, 219 boys (62%)] underwent cataract surgery. The most common etiology and presenting complaints were idiopathic congenital cataract and decreased vision, respectively. In 304 children (86%), presenting best-corrected visual acuity (BCVA) was <20/200 (1.0 LogMAR), 113 (32%) had associated strabismus, and 57 (16%) had associated nystagmus. The public health agency did not sponsor postoperative follow-up, and only 195 (56%) and 61 (17.3%) children completed a 6-week and a 3-month follow-up, respectively. Median BCVA at 6-week and 3-month review was 20/125 (0.8, interquartile range [IQR], 0.2-2 LogMAR) and 20/60 (0.5, IQR, 0.25-1.35 LogMAR), respectively. Conclusion: This study showed that children from the tribal community presented late with poor presenting VA and had suboptimal visual outcomes with inconsistent follow-ups. Greater advocacy, delivery of care closer to the place of residence, and financial support for follow-up care could improve early detection, regular evaluation, and outcomes.

Pituitary adenoma presenting as acute onset isolated complete third cranial nerve palsy without vision changes.

We report a case of isolated unilateral complete pupil involving third cranial nerve palsy due to pituitary adenoma with parasellar extension into the right cavernous sinus. The patient was referred to us from neurosurgery with sudden onset binocular vertical diplopia with complete ptosis, and mild right-sided headache of 5-day duration. Ocular examination revealed pupil involving third cranial nerve palsy in right eye while rest of the examination including automated perimetry was normal. MRI brain with contrast revealed a mass lesion with heterogenous enhancement in the sella suggestive of a pituitary macroadenoma with possible internal haemorrhage (apoplexy). In addition, the MRI showed lateral spread to the right cavernous sinus which was causing compression of the right third cranial nerve. The patient was systemically stable. This report highlights a unique case as the lesion showed a lateral spread of pituitary adenoma without compression of the optic chiasm or other cranial nerves.

An Evaluation of Occlusal Relationship and Primate Space in Deciduous Dentition in Kancheepuram District, Tamil Nadu, India.

AIM: The objective of the study was to evaluate the occlusal characteristics of primary dentition in 3-5-year-old children in Kancheepuram district. MATERIALS AND METHODS: A cross-sectional survey was carried out on children aged 3-5 year old in the Kancheepuram district. A total of 603 children were examined. Occlusal relationship was assessed separately on both right and left side and was classified as a flush terminal plane, mesial step, or distal step. Similarly, occlusal relationship of primary canine was examined and classified as Class I, II, or III. Primate space was measured in both the arches using digital Vernier caliper. RESULTS: Pearson Chi-square test was used. Statistical significance was noted on both right and left side primary molar occlusion as well as in the canine occlusion across the three age groups. Primate spaces in both arches have been found to be significant across the three age groups. Mann-Whitney test between gender and occlusal relationship was found to be not significant. CONCLUSION: Flush terminal plane is the most common primary molar occlusion found in the present study which is statistically significant. Most of the children had primate space present in upper and lower teeth which is statistically significant.

An experimental phylogeny to benchmark ancestral sequence reconstruction.

Ancestral sequence reconstruction (ASR) is a still-burgeoning method that has revealed many key mechanisms of molecular evolution. One criticism of the approach is an inability to validate its algorithms within a biological context as opposed to a computer simulation. Here we build an experimental phylogeny using the gene of a single red fluorescent protein to address this criticism. The evolved phylogeny consists of 19 operational taxonomic units (leaves) and 17 ancestral bifurcations (nodes) that display a wide variety of fluorescent phenotypes. The 19 leaves then serve as 'modern' sequences that we subject to ASR analyses using various algorithms and to benchmark against the known ancestral genotypes and ancestral phenotypes. We confirm computer simulations that show all algorithms infer ancient sequences with high accuracy, yet we also reveal wide variation in the phenotypes encoded by incorrectly inferred sequences. Specifically, Bayesian methods incorporating rate variation significantly outperform the maximum parsimony criterion in phenotypic accuracy. Subsampling of extant sequences had minor effect on the inference of ancestral sequences.

Sleep loss and the inflammatory response in mice under chronic environmental circadian disruption.

Shift work and trans-time zone travel lead to insufficient sleep and numerous pathologies. Here, we examined sleep/wake dynamics during chronic exposure to environmental circadian disruption (ECD), and if chronic partial sleep loss associated with ECD influences the induction of shift-related inflammatory disorder. Sleep and wakefulness were telemetrically recorded across three months of ECD, in which the dark-phase of a light-dark cycle was advanced weekly by 6 h. A three month regimen of ECD caused a temporary reorganization of sleep (NREM and REM) and wake processes across each week, resulting in an approximately 10% net loss of sleep each week relative to baseline levels. A separate group of mice were subjected to ECD or a regimen of imposed wakefulness (IW) aimed to mimic sleep amounts under ECD for one month. Fos-immunoreactivity (IR) was quantified in sleep-wake regulatory areas: the nucleus accumbens (NAc), basal forebrain (BF), and medial preoptic area (MnPO). To assess the inflammatory response, trunk blood was treated with lipopolysaccharide (LPS) and subsequent release of IL-6 was measured. Fos-IR was greatest in the NAc, BF, and MnPO of mice subjected to IW. The inflammatory response to LPS was elevated in mice subjected to ECD, but not mice subjected to IW. Thus, the net sleep loss that occurs under ECD is not associated with a pathological immune response.