A Rare Bilateral Presentation of Multiple Dens Invaginatus, Shovel-Shaped Incisor and Talon Cusp With Mesiodens.

The aim of this paper is to describe a unique and unusual case of concomitant appearance of morphological dental anomalies in the maxillary anterior region, along with its management in a patient with no systemic abnormality. This case report describes the clinical and radiographic features of talon cusp, dens invaginatus, shovel-shaped incisors and a supernumerary tooth occurring in a single patient, which is a rare presentation. All 4 permanent maxillary incisors had dens invaginatus, the permanent maxillary canines showed the presence of talon cusps, the permanent maxillary central incisors were shovel-shaped and an erupted mesiodens was also observed. Treatment included restorative, surgical and orthodontic approaches.

Factors influencing lingual nerve paraesthesia following third molar surgery: a prospective clinical study.

BACKGROUND AND OBJECTIVES: The purpose of this prospective study was to evaluate the incidence and various risk factors influencing the sensory deficit in case of lingual nerve injury (LNI) in individuals whose impacted mandibular third molars are surgically removed under local anesthesia. MATERIALS AND METHODS: The study was based on the data collected prospectively from a random group of 100 patients who underwent surgical removal of bony impacted lower third molar in a dental hospital. Details of the patient, reason for extraction, type of impaction, method of surgery and signs and symptoms of nerve injury are recorded. Neurosensory testing was done to evaluate the LNI at 1 week, 1 months, 3 months and 6 months interval. Comparison was carried out using Chi square test. For all tests a P < 0.05 was considered significant. RESULTS: The incidence of LNI was 4 % and of temporary in nature which recovered well within 6 months postoperatively. The age of the patient above 26 years, lingual flap retraction, depth of impaction (red line ≥10 mm) and duration of surgery above 30 min were the significant factors for causing LNI. CONCLUSIONS: The age of the patient, depth of impaction, lingual flap retraction and longer duration of surgery are significant risk factors for LNI during mandibular third molar surgery. Greater care should be taken to avoid the morbidity and patients should be informed well ahead about the probable complications.

Indigenous tooth powders = covert lead poisoning?

AIM: The present study aimed to measure the concentration of lead in various indigenous preparations of tooth powders available and used locally in and around Udaipur, Rajasthan, India. MATERIALS AND METHODS: Seven different brands of tooth powders manufactured and/or marketed locally were obtained from stores all over Udaipur city. Some home-made powders commonly used for cleaning teeth were also collected. The tooth powders were analyzed for lead content by atomic absorption spectrophotometry. RESULTS: All tooth powders tested were found to contain high levels of lead ranging from 21 ppm to 82 ppm, above the maximum permissible level of 20 ppm prescribed by the Bureau of Indian Standards. CONCLUSION: Indigenous tooth powders contain high levels of lead and thus may be a source of lead poisoning that is often overlooked.

Extensive idiopathic external apical root resorption on a 13 year old child.

External root resorption in permanent teeth can occur as a result of a multitude of local and systemic factors. Root resorption that is idiopathic or occurring without any identifiable underlying cause is an unusual phenomenon, especially in children. This article describes a rare case of extensive external apical root resorption affecting multiple teeth and occurring concomitantly with localized periodontitis in a 13 year-old child. No significant systemic, local or familial findings could be identified as a plausible cause for the root resorption.

An in vitro evaluation of antimicrobial efficacy of primary root canal filling materials.

OBJECTIVE: The present study aimed to evaluate and compare six different materials commonly used for filling the root canals of primary teeth for antimicrobial efficacy against some of the microorganisms commonly found in infected root canals. STUDY DESIGN: In this experimental in vitro study six root canal filling materials were tested for antimicrobial efficacy against eight microbial strains using the agar diffusion method. RESULTS: Zinc oxide eugenol paste exhibited the strongest antimicrobial potential followed by Endoflas, zinc oxide-calcium hydroxide-sodium fluoride mixture, zinc oxide-calcium hydroxide mixture and calcium hydroxide paste (Apexcal). The addition of sodium fluoride to the zinc oxide-calcium hydroxide mixture enhanced the antimicrobial efficacy. Metapex demonstrated minimal inhibition and Vaseline was non-inhibitory. CONCLUSIONS: All the test filling materials demonstrated varying antimicrobial activity against the microorganisms tested. Zinc oxide eugenol paste and materials containing zinc oxide were found to be more effective against the microorganisms compared to materials without zinc oxide.

Sealing ability and thermal diffusivity of cavity lining materials: an in vitro study.

AIMS: The purpose of this study was to evaluate and compare the sealing ability and the thermal insulating capability of four different cavity lining materials. MATERIALS AND METHODS: Forty noncarious human mandibular second premolars that were extracted for orthodontic treatment were collected, cleaned, and stored in distilled water. These premolars were randomly divided into four groups of ten teeth each for treatment with the different cavity lining materials. Group I teeth were treated with cavity varnish, group II teeth with amorphous calcium phosphate (ACP), group III teeth with dentin bonding agent, and group IV teeth with resin-modified glass ionomer cement (RMGIC). Electrical resistance and the difference in the time-temperature curve of the external surface and the pulp side [A D -A P ] of each tooth following heat and cold application for 120 s were measured before and after cavity lining placement to determine the sealing ability and thermal insulating property, respectively. Data collected were subjected to statistical analysis. For paired data, paired t-test and Wilcoxon's signed rank test were used. One-way ANOVA was used for comparisons between multiple groups and the Mann-Whitney U test for comparisons between pairs. RESULTS: The mean difference in electrical resistance (in K ohm) of different cavity lining materials were as follows: group I = +3.53, group II = -1.00, group III = +20.43, and group IV = +11.44. The mean differences in the area (A D -A P ) under the time-temperature curve following heat application were as follows: group I = 6.6 mm 2 , group II = 15.3 mm 2 , group III = 130.5 mm 2 , and group IV = 412.0 mm 2 . The mean differences in the area (A D -A P ) under the time-temperature curve following cold application were as follows: group I = 24.5 mm 2 , group II = 3.2 mm 2 , group III = 314.9 mm 2 , and group IV = 480.5 mm 2 . CONCLUSION: Dentin bonding agent and RMGIC provided effective sealing of the dentinal tubules and significant thermal insulation when compared to the other tested cavity lining materials.

Dental crowding in primary dentition and its relationship to arch and crown dimensions among preschool children of Davangere.

The purpose of the present study was to evaluate dental crowding in the deciduous dentition and its relationship to the crown and the arch dimensions among preschool children of Davangere. Stratified randomized selection of one hundred, 3-4 year old healthy children with all primary teeth erupted was done and divided into two groups. One group had children with anterior crowding in both the arches while the other had spacing. Alginate impressions of the upper and lower arches were made and the study casts were obtained. The tooth and arch dimensions were determined. Mesiodistal dimensions of all the teeth were significantly larger in the crowded arch group. However, the buccolingual dimensions of the maxillary right central incisor, mandibular lateral incisors and the maxillary molars and the crown shape ratio of maxillary lateral incisors, mandibular canines and mandibular right second molar was statistically different. No significant correlation was found between the arch width and the presence of crowding of deciduous dentition. The arch depth of the spaced dentition was greater when compared to the crowded ones. The arch perimeter of the crowded arches was significantly less than the spaced arches.

Management of an unusual maxillary dentoalveolar fracture: a case report.

The purpose of this case report was to describe the management of a trauma-induced maxillary dentoalveolar fracture of the right maxilla in an 8-year-old boy. The child presented with swelling of the right maxillary region, difficulty in chewing and closing the mouth, and a sutured laceration on the cheek. Complete palatal displacement of the fractured fragment involving the deciduous canine and molars was observed clinically and confirmed by radiological examination. The fracture was reduced and stabilized using a custom-fabricated, open-cap acrylic splint with modified interdental wiring under general anesthesia.