Diagnostic Challenge Involving Diffuse Mandibular Swelling in Mixed Dentition: Use of Cone-beam Radiography.

AIM AND OBJECTIVE: This case report aims to discuss a case of chronic osteomyelitis with proliferative periostitis (COPP) in which cone-beam computed tomography (CBCT) played a key role in the diagnosis and identification of the disease. BACKGROUND: Osteomyelitis is frequently seen in the maxillofacial region, with the mandible being more affected as compared to the maxilla. Chronic osteomyelitis with proliferative periostitis is often seen in children and young adults, which occurs due to the spread of infection from a bacterial focus. CASE DESCRIPTION: A 12-year-old boy presented with a swelling on the right side of the mandible. Extraorally, the swelling appeared diffuse, non-tender, hard on palpation, and was associated with right submandibular lymphadenopathy. Intraorally, a hard bony protrusion was found on the buccal aspect of the edentulous space of the first premolar region obliterating the vestibular depth. It was provisionally diagnosed to be a case of chronic alveolar abscess with respect to deciduous molar, with a suspicion of some underlying bony pathology. Blood investigations showed a raised value of erythrocyte sedimentation rate and alkaline phosphatase. Cone-beam computed tomography examinations showed bony laminations parallel to each other and the underlying cortical bone in the axial and sagittal images and these were present both buccally and lingually. The CBCT descriptions led to the diagnosis of Garre's osteomyelitis in this case which was later confirmed by histopathological examination. CONCLUSION: The detailed imaging as well as the three-dimensional reconstruction of the images has helped to reach out to a differential diagnosis in this case. CLINICAL SIGNIFICANCE: This case report emphasizes the importance of newer techniques such as CBCT in reaching out at a diagnostic conclusion in challenging clinical cases. HOW TO CITE THIS ARTICLE: Passi S, Gupta J, Mehta A, et al. Diagnostic Challenge Involving Diffuse Mandibular Swelling in Mixed Dentition: Use of Cone-beam Radiography. Int J Clin Pediatr Dent 2021;14(3):430-433.

Oral Health Knowledge, Attitude, and Practices among Postgraduate Students of Panjab University, Chandigarh: A Cross-sectional Study.

BACKGROUND: Dental caries and periodontal diseases are the most commonly occurring dental problems. Proper knowledge, attitude, and practices (KAPs) of oral health of young adults will help in prevention of these diseases. AIM: To comparatively evaluate the oral health KAPs related to oral health of postgraduate students of Panjab University, Chandigarh, with respect to gender and different departments. SETTING AND DESIGN: A descriptive cross-sectional survey was conducted using a questionnaire that assessed KAPs of postgraduate students, aged 17-25 years. MATERIALS AND METHODS: This survey was undertaken on 600 postgraduate students of Panjab University, Chandigarh. The sample was divided into 3 groups: group I-arts students (n = 200), group II-science students (n = 200), and group III-commerce students (n = 200). Data were collected and subjected to statistical analysis. STATISTICAL ANALYSIS USED: Chi-squared test was used for comparison between different groups. ANOVA and Kruskal-Wallis compared the data between different departments, and Mann-Whitney U test between males and females. RESULTS: The students of arts had significantly lesser knowledge of oral health compared with other departments. About 65% arts students believed that sweets/soft drinks/chips were causing tooth decay compared with 83% science and 80% commerce students (p value < 0.001). About 52.5% arts students had knowledge that blood on the toothbrush was indicative of gum disease followed by 67% science and 76% commerce students (p value < 0.001). CONCLUSION: In our study, there was no significant difference in gender with respect to KAPs of oral health but a significant difference was observed among different departments with arts students showing significantly lesser knowledge. HOW TO CITE THIS ARTICLE: Verma L, Passi S, Sharma U, et al. Oral Health Knowledge, Attitude, and Practices among Postgraduate Students of Panjab University, Chandigarh: A Cross-sectional Study. Int J Clin Pediatr Dent 2020;13(2):113-118.

Effect of oral health behavior and demographic variables on gingival health in 11-16-year-old school children in Chandigarh, India: A cross-sectional study.

AIMS: The aims of the present study were to assess the prevalence and pattern of gingival bleeding on probing (BOP) and to evaluate the effect of oral health behavior and demographic determinants on gingival health in 11-16-year-old school children in Chandigarh, India. METHODS: A cross-sectional study, using stratified random sampling, was conducted across two age groups, 11-13 years and 14-16 years, and two socioeconomic strata: upper and lower. The World Health Organization (WHO) Oral Health Questionnaire for Children was used to record the data, and the WHO Community Periodontal Index (modified) was used to assess gingival BOP. RESULTS: Among all the 2294 children examined, an estimated 54.2% had gingival BOP. The odds of BOP were also higher in the younger age group (odds ratio [OR]: 1.261, 95% confidence interval [CI]: 1.068-1.487, P = 0.006), higher for boys (OR: 1.200, 95% CI: 1.017-1.416, P = 0.031), and lower in the upper strata (OR: 0.805, 95% CI: 0.682-0.951, P = 0.011). Gingival BOP was 58.5% in the mandibular and 41.5% in the maxillary arch (P < 0.0001); χ2 -test found tooth cleaning frequency to be a significant contributing factor for gingival BOP (P = 0.014). CONCLUSIONS: An inverse co-relation of gingival BOP with age, socioeconomic status, and a higher prevalence in boys was observed, necessitating periodic preventive dental education, particularly focusing on the target group. Additionally, early screening and prompt treatment to intercept the disease is advocated.

Recurrent Kawasaki Disease Presenting to Dentists: "Think Beyond Dentition".

AIM: To create awareness of Kawasaki disease in the dental community as it is a rare disease and some cases might go unnoticed due to lack of knowledge of the treating dentist. Thus proper knowledge helps in the timely diagnosis of the disease and decrease the mortality rate in these patients. Children who show the oral features of this disease should be treated seriously by the dentist. BACKGROUND: Kawasaki disease is a rare acute systemic vasculitis disorder reported in the dental literature. Clinical features include high fever, redness of palms and soles of the feet, conjunctivitis, oropharyngeal mucositis and lymphadenopathy. The cardiac involvement in the form of myocarditis, aneurysms, pericarditis is also seen and is caused by inflammation of vessels of the heart. CASE DESCRIPTION: Here we present a rare case of an 8-year-old girl who presented to the department of Pediatric Dentistry with the chief complaint of recurrent painless swelling of the lower lip. This rare presentation of lower lip swelling has not been cited in the oral manifestation of Kawasaki disease before. CLINICAL SIGNIFICANCE: The disease has high mortality and morbidity rate if not treated early, and hence an early diagnosis and treatment are important in managing this condition. The oral findings are a characteristic feature of this serious disease, hence, many cases might first report to the dental clinician only. Dentists should always remain alert in handling patients having a history of Kawasaki disease because of the possibility of recurrence of the disease. As these patients have valvular heart defects, they might require prophylactic antibiotic treatment before the needed dental procedure. CONCLUSION: Despite this, there seems to be less aware of this disease among the dentist, hence this condition goes unnoticed leading to few citations of this disease in the dental literature. HOW TO CITE THIS ARTICLE: Verma L, Passi S, Kaur G, Gupta J, Joshi M. Recurrent Kawasaki Disease Presenting to Dentists: "Think Beyond Dentition". Int J Clin Pediatr Dent, 2018;11(6):532-535.

Multidisciplinary approach to the rehabilitation in management of child with early childhood caries: a case report.

The aesthetic requirement of severely mutilated primary anterior teeth in case of Early Childhood Caries (ECC) has been a challenge to paediatric dentists. ECC involves the upper anterior teeth early in life and by the time the dentist sees the child, most of the coronal structure is lost. This article presents the clinical sequence of rehabilitation of maxillary anterior primary teeth, and the mandibular posterior teeth.

Goldenhar syndrome.

Goldenhar syndrome is a syndrome of complex structures developing from first and second branchial arches during blastogenesis. The etiology of this rare disease is not fully understood, as it has shown itself variable genetically and of unclear causes. The disorder is characterized by a wide spectrum of symptoms and physical features that may vary greatly in range and severity from case to case. Here we present a unique case of Goldenhar syndrome with absence of left condyle, hypoplasia of the zygomatic bone, no pneumatization of the mastoid process, underdeveloped mandible, bifid tongue and the skin tags in the preauricular area.

Unusual foreign bodies in the orofacial region.

Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, and so forth. The discovery of foreign bodies in the teeth is a special situation, which is often diagnosed accidentally. Detailed case history, clinical and radiographic examinations are necessary to come to a conclusion about the nature, size, location of the foreign body, and the difficulty involved in its retrieval. It is more common to find this situation in children as it is a well-known fact that children often tend to have the habit of placing foreign objects in the mouth. Sometimes the foreign objects get stuck in the root canals of the teeth, which the children do not reveal to their parents due to fear. These foreign objects may act as a potential source of infection and may later lead to a painful condition. This paper discusses the presence of unusual foreign bodies-a tip of the metallic compass, stapler pin, copper strip, and a broken sewing needle impregnated in the gingiva and their management.

Adenomatoid odontogenic tumor: As an unusual mandibular manifestation.

Adenomatoid odontogenic tumor (AOT) is a rare odontogenic tumor which is often misdiagnosed as odontogenic cyst and accounts for about 1% until 9% of all odontogenic tumors. It is predominantly found in young and female patients, located more often in the maxilla in most cases associated with an unerupted permanent tooth. It is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. There are three variants of AOT: follicular, extrafollicular, and peripheral. We report a rare case of follicular-type AOT in the mandible of a 14-year-old male patient who presented with right -sided jaw swelling.

Management of a case of ectodermal dysplasia: a multidisciplinary approach.

Ectodermal dysplasia (ED) is a rare disorder involving 2 or more of the ectodermal structures, which include the skin, hair, nails, teeth, mucus glands, and sweat glands. Each person with ectodermal dysplasia may have a different combination of defects. The most common form of ED is linked to the X chromosome and usually affects men. Another form of the disease affects men and women equally. The patient's special needs are taken into consideration in a treatment plan. The purpose of this case report was to describe the dental management of a 9-year-old boy with ectodermal dysplasia whose maxilla showed the presence of mobile, conical teeth that were unrestorable and a solitary permanent left molar, while his mandible was completely edentulous. These mobile, conical teeth were extracted, and a complete denture was constructed to restore the patient's esthetics, form, and function.

Glass fibre-reinforced composite post and core used in decayed primary anterior teeth: a case report.

Aesthetic requirement of severely mutilated primary anterior teeth in the case of early childhood caries has been a challenge to pediatric dentist. Among restorative treatment options, prefabricated crown and biological and resin composite restoration either by means of direct or indirect technique are mentioned in the literature. This paper presents the clinical sequence of rehabilitation of maxillary anterior primary teeth. Endodontic treatment was followed by the placement of a glass fibre-reinforced composite resin post. The crown reconstruction was done with composite restoration. Resin glass fibre post has best properties in elasticity, translucency, adaptability, tenaciousness, and resistance to traction and to impact. Along with ease of application, fiber can be used as an alternative to traditionally used materials in the management of early childhood caries.

Brachman de Lange syndrome.

Brachman de Lange syndrome or Cornelia de Lange syndrome (CdLS) is a genetic disorder which can lead to severe developmental anomalies. It affects both the physical and intellectual development of a child. It is characterized by skeletal, craniofacial deformities, gastrointestinal and cardiac malformations. This syndrome is of rare occurrence and affects between 1/10,000 and 1/60,000 neonates. Diagnosis is based on the characteristic phenotype, in particular, a striking facial appearance, prenatal and postnatal growth retardation, various skeletal abnormalities, hypertrichosis, and developmental delay. Here, we present the case of a 13-year-old patient, with micrognathia, delayed eruption, multiple carious teeth, missing teeth and periodontal problems together, which had never been reported before. The father was also found to have the same missing teeth as the girl child.

A comparative evaluation of the fracture strength of pulpotomized primary molars restored with various restorative materials.

Sixty extracted primary molars were used in the study. After pulpotomy, these were divided into four groups on the basis of restorative materials to be used. Results showed that the Ormocer had the maximum fracture strength while the posterior Glass Ionomer Cement showed the least fracture strength among the various restorative materials used in the study.