Congenital cardiac anomalies in non-syndromic cleft lip and cleft palate patients: A systematic review and meta-analysis.

The aim was to establish a specific and definite connection between non-syndromic orofacial cleft patients and associated congenital heart disease (CHD). Following PRISMA guidelines, selective databases were searched for data collection. Studies showing a definite association of CHD with orofacial cleft were included, and studies non-specific of the association of orofacial cleft with CHD were excluded. Data extraction criteria were study design, frequency of CHD in overall non-syndromic orofacial cleft and in specific cleft type, and most prevalent congenital cardiac anomaly. DerSimonian Laird random effects model was used to estimate the pooled proportion of CHD, along with corresponding 95% confidence intervals (CIs) for each measure. Publication bias was assessed using Fail-Safe N analysis and the Rosenthel approach. Of a total of 182 articles searched, only 30 studies were assessed. The overall pooled estimate of the proportion of CHD in total cleft lips/palates was 16% (95% CI: 13-19). The odds of developing CHD in cleft palates was 4.08 times more as compared to cleft lips with 95% CIs of 3.86-4.33, and 1.65 more as compared to cleft lips and palates both with 95% CI of 1.52-1.68. We affirm the upsurging prevalence of CHD in non-syndromic cleft children and vehemently propose that it is of utmost importance to inculcate it in practice and policy-making to screen all non-syndromic orofacial cleft children for congenital cardiac anomaly. This study was registered on PROSPERO (ID no. CRD42023391597) on February 24, 2023.

Bilateral Massive Complex Composite Odontoma of the Mandible: A Rare Case Report.

Rationale: Odontomas result from abnormal growth of differentiated epithelial and mesenchymal cells, which form ameloblasts and odontoblasts along with pulp tissue at times. Patient Concerns: A patient reported with a chief complaint of hard swelling of the lower jaw causing difficulty in mouth opening and facial deformity. Diagnosis: A provisional diagnosis of complex odontome based on clinicoradiological findings was made, which was later confirmed as complex composite odontome histologically. Treatment: Bilateral hard tissue mass was surgically removed from the mandible with utmost precaution to prevent jaw deformity. On fine separation, the specimen yielded nearly 82 small teeth-like structures. Outcomes: Histopathologically, multiple small teeth-like structures with haphazardly arranged central fibrofatty pulpal stroma surrounded by well-formed dentinal tubules and empty areas representing decalcified enamel matrix surrounded by fibrovascular stroma at the periphery were seen. Take-away Lessons: Early diagnosis and treatment ensures minimal surrounding deformities, better prognosis, and less chances of recurrence.

Trends of rhino-orbito-cerebral mucormycosis in COVID-19 patients: An observational study.

Background and Aim: Mucormycosis is a potentially lethal but rare fungal infection that is rapidly progressive. Rhino-orbito-cerebral mucormycosis (ROCM) was the predominant presentation of COVID-19-associated mucormycosis (CAM). Hence, the present study aimed to assess the oral manifestations in CAM patients admitted to the Indira Gandhi Institute of Medical Sciences-A Tertiary Health Care Center. Materials and Methods: This study was conducted on hospitalized patients admitted to our tertiary health care center during the second wave of the COVID-19 pandemic. A total of 54 patients were included in the study and were further evaluated for oral manifestations. Detailed history, clinical examination, and surgical exploration was done for all the subjects. All cases were confirmed by MRI and histopathology. Results: Data collected was subjected to descriptive and inferential statistical analyses. Patients with oral manifestations were mostly in the age range of ≤50 years which was 56.7% (n = 17). Male patients 56.7% were affected more as compared to female patients and most of the patients in our study were from rural areas 56.7%. RBS [Mean ± standard deviation (SD)] was 304.60 ± 100.073. On intra-oral examination 96.7% had a gingival and palatal abscess, 63.3% had tooth mobility, and palatal ulcer/perforation was seen among 56.7% of the patients. Conclusion: The second wave of the COVID-19 pandemic had also created an alarming situation in India and worldwide. Mucormycosis had come as a sudden storm which has created an emergency situation in our hospital and for dental practitioners also. This was also an alarming situation for a dental practitioner for evaluating early signs and symptoms, especially in high-risk patients and decreasing mortality.

A Giant Cutaneous Horn Projecting from Verrucous Carcinoma of Buccal Mucosa: A Rare Case Report.

Cutaneous horn is conical shape of compact keratin that resembles a miniature animal horn. Though morphologically similar to horns in animals they are histologically very different from them. It is a circumscribed, conical, hyperkeratotic dense protrusion with epithelial cornification above the skin surface in response to a wide range of underlying benign and malignant pathological changes. Though benign, a cutaneous horn holds the potential to be premalignant or malignant. In India till now six cases has been reported with cutaneous horn at various unusual sites. We report a unique case of 52-year-old woman with a giant cutaneous horn at left oral commissure with underlying verrucous carcinoma of left buccal mucosa which is a very rare location for such lesion. Considering its malignant potential, adequate therapy requires wide excision with a tumour-free margin of at least 1 cm, particularly in the facial region where the incidence of malignancy is higher.

Dermatoglyphics and Cheiloscopy as Key Tools in Resolving the Genetic Correlation of Inheritance Patterns in Cleft Lip and Palate Patients: An Assessment of 160 Patients.

OBJECTIVE: The objective of this study was to correlate dermatoglyphics and cheiloscopy with genetic inheritance in cleft lip and cleft palate patients. DESIGN AND SETTING: This was a case-control study to look for asymmetry in finger and lip print patterns. All of the participants were divided into two equal groups (40 mothers and 40 fathers in each group). The data were analyzed by three evaluators who were blind to the study to avoid any chances of error. PATIENTS/PARTICIPANTS: A sample of 160 sporadic participants were identified and evaluated. Group A was composed of 80 healthy parents not affected by cleft lip and cleft palate but had at least one child born with nonsyndromic cleft. Group B consisted of 80 healthy parents not affected by cleft lip and cleft palate and had healthy children without cleft lip and cleft palate. MAIN OUTCOME MEASURES: Main outcome measures were marked dermatoglyphic asymmetry and specific lip print pattern in the study group. RESULTS: We found marked asymmetry in various fingerprints and specific type II and type III lip print in the study group when compared with the control group. It was observed that groove count on the lip was significantly more frequent in study group parents. CONCLUSION: Our study determined that there is a significant correlation between increased dermatoglyphic asymmetry and specific type II and type III lip print pattern in parents of children born with cleft. This could act as an important screening marker for the prediction of cleft lip and cleft palate inheritance.

Clinical Evaluation of Proclination of Lower Anterior Teeth during Alignment using a Single Width Bracket-A Pilot Study.

INTRODUCTION: The pre-adjusted brackets are available in various prescriptions and sizes; nevertheless there are still many controversies as to which pre-adjusted edgewise bracket offers the maximum clinical efficiency. AIM: This study was conducted to determine and compare the amount of lower incisor proclination during de-crowding if any of the Mini-Uni Twin Brackets with that of the standard double width brackets. MATERIALS AND METHODS: A total of 20 patients i.e., 10 patients in each group both males and females were randomly selected for the study from subjects seeking treatment, the selected samples were grouped as follows. Group I - Double Width Brackets (3M Unitek Gemini Series) 0.018" slot with Roth prescription. Group II - Mini Uni-Twin Bracket (3M Unitek) 0.018" slot with Roth prescription. RESULTS: The Mini-Uni Twin Brackets had statistically significant (p = 0.01) amount of proclination of the lower anteriors (0.8(o)± 0.3(o)) after de-crowding as compared to the standard Double Width Brackets and since the mean change in the Incisor Mandibular Plane Angle (IMPA) was lesser than 1(o), its clinical significance could be questionable. CONCLUSION: The Mini Uni Twin brackets are comparatively efficient in the lower anterior decrowding but further comparative clinical studies need to be performed on these Mini Uni Twin brackets, with an increase in the sample size and also the number of parameters to prove its total clinical efficiency.

Comparative Evaluation of the Etching Pattern of Er,Cr:YSGG & Acid Etching on Extracted Human Teeth-An ESEM Analysis.

INTRODUCTION: Etching of enamel and dentin surfaces increases the surface area of the substrate for better bonding of the tooth colored restorative materials. Acid etching is the most commonly used method. Recently, hard tissue lasers have been used for this purpose. AIM: The aim of the present study was to evaluate and compare the etching pattern of Er,Cr:YSGG and conventional etching on extracted human enamel and dentin specimens. MATERIALS AND METHODS: Total 40 extracted non-diseased teeth were selected, 20 anterior and 20 posterior teeth each for enamel and dentin specimens respectively. The sectioned samples were polished by 400 grit Silicon Carbide (SiC) paper to a thickness of 1.0 ± 0.5 mm. The enamel and dentin specimens were grouped as: GrE1 & GrD1 as control specimens, GrE2 & GrD2 were acid etched and GrE3 & GrD3 were lased. Acid etching was done using Conditioner 36 (37 % phosphoric acid) according to manufacturer instructions. Laser etching was done using Er,Cr:YSGG (Erbium, Chromium : Ytrium Scandium Gallium Garnet) at power settings of 3W, air 70% and water 20%. After surface treatment with assigned agents the specimens were analyzed under ESEM (Environmental Scanning Electron Microscope) at X1000 and X5000 magnification. RESULTS: Chi Square and Student "t" statistical analysis was used to compare smear layer removal and etching patterns between GrE2-GrE3. GrD2 and GrD3 were compared for smear layer removal and diameter of dentinal tubule opening using the same statistical analysis. Chi-square test for removal of smear layer in any of the treated surfaces i.e., GrE2-E3 and GrD2-D3 did not differ significantly (p>0.05). While GrE2 showed predominantly type I etching pattern (Chi-square=2.78, 0.05

0.10) and GrE3 showed type III etching (Chi-square=4.50, p<0.05). The tubule diameters were measured using GSA (Gesellschaft fur Softwareentwicklung und Analytik, Germany) image analyzer and the 't' value of student 't' test was 18.10 which was a highly significant result (p<.001). GrD2 had a mean dentinal tubule diameter of 2.78µm and GrD3 of 1.09µm. CONCLUSION: The present study revealed type I etching pattern after acid etching, while type III etching pattern in enamel after laser etching. The lased dentin showed preferential removal of intertubular dentin while acid etching had more effect on the peritubular dentin. No significant differences was observed in removal of smear layer between the acid etched and lased groups. Although diameter of the exposed dentinal tubules was lesser after lased treatment in comparison to acid etching, further long term in vivo studies are needed with different parameters to establish the usage of Er,Cr:YSGG as a sole etching agent.