Effect of premature loss of primary teeth on prevalence of malocclusion in permanent dentition: A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to assess the effect of premature loss of primary teeth in children of mixed dentition age on the prevalence of malocclusion in permanent dentition. MATERIAL AND METHODS: A search was conducted in Medline through PubMed, Cochrane databases, Google Scholar, and Directory of Open Access Journals (DOAJ) through March 2023. All observational studies that evaluated the association between premature loss of primary teeth and malocclusion in permanent dentition were included for analysis. Quality of studies was evaluated using the Newcastle-Ottawa tool. Meta-analysis was conducted using Cochrane Review Manager (RevMan) Version 5.3. The association between different categories of malocclusion and premature loss of primary teeth was assessed using a random-effects model. Heterogeneity was explored through sensitivity analysis. Certainty of evidence was evaluated using GRADE analysis. RESULTS: This meta-analysis showed that the premature loss of primary teeth significantly increases the prevalence of overall malocclusion in permanent dentition (OR=2.54, P=0.003; I2: 83%). Subgroup analysis showed an insignificant relationship of premature loss of primary teeth with Class I malocclusion (OR=1.14, P=0.45; I2: 63%) and Class II malocclusion (OR=1.63, P=0.18; I2: 87%) but statistically significant relationship with Class III malocclusion (OR=3.73, P=0.006; I2: 71%). Sensitivity analysis reflected a significant reduction in I2 values. CONCLUSION: This meta-analysis provides substantial evidence supporting the relationship between premature loss of primary teeth and malocclusion in permanent dentition. Notably, Class III malocclusions exhibited a significant association with premature loss of primary teeth.

Management of Adenomatoid Odontogenic Tumor in a Pediatric Patient with Preservation of an Associated Impacted Tooth: A Combined Surgical and Orthodontic Approach.

The adenomatoid odontogenic tumor (AOT) is a rare benign neoplasm that is typically treated through surgical enucleation and curettage. Any impacted tooth associated with the tumor are also extracted during the procedure. We present a case of AOT encompassing an impacted left maxillary central incisor in a 13-year-old male. The patient underwent routine treatment, but the tooth was orthodontically extruded using traction. Within two years, the incisor successfully attained its functional position in the arch, without any signs of recurrence. Preserving an impacted tooth associated with AOT is not common, and only a few cases have been reported in the literature. It is important to manage AOT conservatively and to save the associated tooth for both functional and aesthetic purposes. Long-term follow-up is crucial to monitor any potential recurrence. In summary, our case highlights the successful orthodontic management and preservation of an impacted tooth in a teenager with AOT.

Stylalgia and Styloidectomy: A Review.

Stylalgia also referred to as Eagle's or stylohyoid syndrome (first described by Watt Eagle) is a constellation of signs secondary to an elongated styloid process or due to mineralization of the stylohyoid or stylomandibular ligament or the posterior belly of the digastric muscle (Malik et al. in Iran J Otorhinolaryngol 30(6): 101, 2018). The Eagle's syndrome includes symptoms ranging from stylalgia (i.e., pain in the tonsillar fossa, pharyngeal or hyoid region) to foreign-body sensation in the throat, cervicofacial pain, otalgia or even increased salivation or giddiness. Diagnosis is primarily based on symptomatology, physical examination and radiographic investigations and should not be missed. However, palpation of tonsillar fossa with radiological demonstration of the elongated styloid process confirms the diagnosis. Surgical treatment by tonsillo-styloidectomy produces satisfactory results in stylalgia. (Malik et al. in Iran J Otorhinolaryngol 30(6):101, 2018).

Systematic review and meta-analysis comparing the efficacy of dexmedetomidine to midazolam as premedication and a sedative agent in pediatric patients undergoing dental procedures.

INTRODUCTION: Pediatric dental surgeries are associated with the emotions of fear, anxiety, and other behavioral disturbances of children that need to be managed. Sedation using drugs like dexmedetomidine (DEX) and midazolam (MID) is a common pharmacological behavior managing technique. We conducted this meta-analysis to evaluate the efficacy of both these drugs in current literature. METHODOLOGY: A thorough literature search was conducted on PubMed, MEDLINE, Google Scholar, and Cochrane's database for randomized studies that compared sedative efficacy of dexmedetomidine with midazolam in children of 0-15 years of age undergoing dental surgeries. Sedation in children during dental procedure, when used as a premedication, at the time of separation from parents and at the time of mask induction, onset time, duration of anesthesia, and surgery were evaluated. The mean differences (MDs), odds ratio (OR), and their 95% confidence intervals (CIs) were calculated both for continuous and dichotomous outcome data using random-effects model. RESULTS: Seven studies met out inclusion criteria and were analyzed. Results of premedication with DEX was associated with more anxiolysis (OR=0.29, 95% CI: 0.17-0.52, p=0.0001; I2=0%) and at the time of separation from parents (OR=0.36, 95% CI: 0.19-0.69, p=0.002; I2=52%) in comparison to MID. No significant differences in results were seen at mask induction (OR=0.63, 95% CI: 0.34-1.18, p=0.15; I2=47%) and for sedation in children during dental procedures (OR=0.52, 95% CI: 0.07-3.70, p=0.51; I2=72%). Also, there were no significant differences in onset time, duration of anesthesia, and surgery between the two agents. CONCLUSION: DEX proved to be a better premedicant than MID for pediatric patients. No significant difference in efficacy of both sedative agents was observed in children undergoing dental treatment. More clinical trials need to be conducted to see its efficacy in dental surgeries in children of standardized ages and with standard doses.

Post-COVID fungal infections of maxillofacial region: a systematic review.

With the advent of coronavirus disease (COVID-19) pandemic, a wide range of life-threatening maxillofacial fungal coinfections have also been observed in patients. We conducted this systematic review to collate and evaluate the data to enable clinicians to understand the disease pattern and types of mycosis and provide meticulous management of these infections in COVID-19 patients. The review was carried out in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A systematic electronic literature search was conducted on major databases using keywords in combination with Boolean Operators. Manuscripts discussing cases of maxillofacial fungal infections in COVID-19 patients were included. A total of 11 studies were systematically reviewed to assess the fungal coinfections in COVID-19 patients. Twenty-one cases of mucormycosis, 58 of candidiasis, and 1 each of aspergillosis and mixed infection were observed in the region of head and neck. Significant increase in invasive fungal infection is evident in patients suffering from COVID-19 which could be due to immunosuppression and other pre-existing comorbidities. Early diagnosis and intervention like systemic antifungals or surgical debridement is mandatory to reduce morbidity and mortality.

Oral myiasis affecting paediatric patients: a systematic review.

INTRODUCTION: Oral myiasis is a rare condition caused by Dipteran larvae that feed on living or dead tissues, ingested food or body fluids. It affects immunocompromised individuals with low socioeconomic status or those unable to maintain proper hygiene. Cases of oral myiasis are scarce but debilitating in children. We conducted a systematic review to understand the nature of disease, its causative factors, treatment and ways to prevent the occurrence of this condition among children. METHODOLOGY: The review was carried out in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A systematic electronic literature search was conducted on major databases using keywords in combination with Boolean Operators. Manuscripts discussing cases of oral myiasis in paediatric patients were included in the review. RESULTS: The exhaustive literature search and evaluation of full texts revealed 32 studies that fulfilled the inclusion criteria. A total of 68 cases of oral myiasis were reported from 2 to 16 years of children, majorly involving gingiva of maxillary anterior region and palate. CONCLUSION: The dreadful condition of myiasis can be prevented by decreasing the number of flies, maintenance of good hygiene and by educating the susceptible population. Affected children must be managed by following proper treatment regimens.

Anesthetic Effectiveness of Articaine and Lidocaine in Pediatric Patients During Dental Procedures: A Systematic Review and Meta-Analysis.

Purpose: Pain on needle insertion and deposition of local anesthetic agents are a cause of anxiety in pediatric patients. Articaine is a potential anesthetic agent whose superior properties reduce the need for multiple insertions, yet it is not commonly used. The purpose of this study was to compare the effectiveness of articaine with lidocaine in pediatric dental anesthesia. Methods: An exhaustive search of the literature was conducted using the electronic databases (Medline, Google Scholar, and Cochrane). Randomized controlled clinical trials evaluating anesthetic effectiveness of articaine and lidocaine in children up to 14 years old by Facial Pain Scale (FPS) and Visual Analog Scale (VAS) were included in the review. Qualitative analysis and risk of bias assessment were done. Values obtained using FPS and VAS were analyzed using a random-effects model. Results: Out of the 25,447 studies obtained from various databases, 11 were considered eligible for inclusion. Assessment of effectiveness using both scales revealed articaine to be significantly better (mean difference [MD] equals -0.46; 95 percent confidence interval [95% CI] equals -0.81 to -0.12; P=0.008; I 2 equals 58 percent; VAS - mean difference equals -0.20, 95% CI equals -0.29 to-0.10, P=0.0001, I 2 equals zero percent). Conclusion: Effectiveness of articaine as a local anesthetic in pediatric dentistry was better than the gold standard lidocaine but the rating difference was small based on the FPS.

Primary mandibular molars with supernumerary roots: a report of 2 cases.

A supernumerary root is a developmental condition occurring due to disturbances in the Hertwig epithelial root sheath. Supernumerary roots are rare in primary mandibular molars, and the etiology is uncertain. However, it is crucial for dental practitioners to be aware that extra roots may be present in primary teeth and provide accurate diagnosis when they occur. An extra root or canal that is not identified during endodontic treatment can lead to treatment failure. The present report describes 2 cases of primary mandibular second molars with supernumerary roots showing carious involvement. In one of the patients, the molar had 2 supernumerary roots and was treated successfully by pulpectomy. In the other patient, the molar had 1 supernumerary root. The tooth was extracted, and a space maintainer was placed.

Efficacy of preoperative antibiotics in prevention of dental implant failure: a Meta-analysis of randomized controlled trials.

BACKGROUND: Dental implants are commonly used for replacement of missing teeth. Despite the published data highlighting the high success rate of dental implants, failures do occur. Some of these failures are believed to be a result of bacterial contamination at the site of implant insertion. Various antibiotic regimens have already been suggested to prevent failure due to infection. OBJECTIVE: This meta-analysis aims to examine the efficacy of preoperative antibiotics in prevention of dental implant failure secondary to infections. METHODOLOGY: An exhaustive search was conducted on electronic database including PubMed Medline, Google Scholar, Scopus, and Cochrane on July 15, 2019. All the randomized controlled trials (RCT) comparing preoperative antibiotics with no antibiotics/placebo in dental implants were included in the study. The primary outcome for assessment was implant failure. A random effect meta-analysis was conducted for risk ratios of dichotomous data. RESULTS: A total 8544 abstracts were screened following which 16 full text articles were reviewed and 5 RCTs were included in the analysis. Meta-analysis results indicated that the preoperative antibiotics resulted in statistically significantly lower number of implant failures. CONCLUSION: Preoperative antibiotics effectively reduce the implant failure rate. However, it is recommended to conduct large-scale RCT to determine the efficacy of preoperative antibiotics in dental implants.

Retention of flowable composite resins in comparison to pit and fissure sealants: a systematic review and meta-analysis.

Despite the worldwide decline in dental caries, pit and fissure caries remains a cause of concern, and application of pit and fissure sealants is an important preventive measure. Due to the high wear rate of conventional unfilled sealants, various other materials have been tested for fissure sealing. The present meta-analysis was conducted to compare the effectiveness of flowable composite resins as a fissure sealant to that of conventional pit and fissure sealants. A literature search was performed in MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar. Clinical trials comparing the efficacy of flowable composite resins as fissure sealants to that of conventional pit and fissure sealants on permanent teeth with a follow-up of 12 or 24 months were included in this meta-analysis. The retention rates of the 2 groups were evaluated with a random-effects model using Cochrane Reviews software (Cochrane RevMan, version 5.3). Seven studies were included in the final review. Flowable composite resins proved to be a significantly better fissure-sealing material after 1 year of follow-up (odds ratio = 0.47; 95% CI = 0.22-1.01; P = 0.05; degree of inconsistency [I2] = 59%). The retention rates of flowable composite resins at the end of 2 years were similar to those of conventional pit and fissure sealants (odds ratio = 0.71; 95% CI = 0.13-3.95; P = 0.70; I2 = 85%). Flowable composite resins proved to be a superior alternative to conventional sealants after 1 year of follow-up; however, no such difference between the 2 groups was observed after 2 years of follow-up. Further longitudinal studies should be conducted to evaluate the long-term retention and efficacy of flowable composite resins in fissure sealing.

Loneliness and disability as predictors of oral diseases among 2 groups of older adults in central India.

BACKGROUND: In this study, the authors aimed to assess the association of loneliness and disability with oral health in 2 groups older adults (≥ 60 years) in central India. METHODS: A total of 421 older adults participated in the study; 316 (75.1%) attended outpatient services at the Department of Dentistry, All India Institute of Medical Sciences, Bhopal, India, and 105 (24.9%) were from old age homes. The authors used the Patients Reported Outcomes Measurement Information System's social isolation 8a short form to assess loneliness. Disability was assessed using the 12-item version of the self-administered World Health Organization Disability Assessment Scale. The authors conducted regression analyses to establish the association of loneliness and disability with the decayed, missing, and filled tooth index; periodontal disease; and edentulousness. RESULTS: Poor oral health findings were noted in both groups. Eighty-eight (20.9%) participants had never visited a dentist, and 201 (88.5%) had unmet dental prosthetic needs. Loneliness and disability were associated with decayed, missing, and filled tooth index scores; periodontal disease; and edentulousness, with odds ratios of 1.86, 1.29, 2.37 and 4.63, 3.85, 3.63 respectively (P < .001). Age, sex, socioeconomic status, type of residence, tobacco use, and use of oral health care were also independent variables associated with oral health (P < .001). CONCLUSIONS: Loneliness and disability were found to be significantly associated with oral health. The study results found poor oral health, low use of oral health care, and high unmet need for dental prosthetics in the 2 groups of older adults. PRACTICAL IMPLICATIONS: Practicing dentists need to understand the significance of loneliness and social isolation on oral health. Interventions to reduce isolation and disability can be beneficial in improving the oral health of older adults.

Bilateral presentation of different supernumerary teeth in nonsyndromic patients: case reports.

Supernumerary teeth--teeth in excess of the normal dental complement--are usually asymptomatic, and their presence is detected incidentally on radiographs. Mesiodentes are the most common type of supernumerary teeth, followed by maxillary distomolars, maxillary lateral incisors, mandibular fourth molars, and maxillary premolars. Bilateral occurrence of supernumerary teeth is rare. When supernumerary teeth do occur bilaterally, they are most often associated with a syndrome such as Gardner syndrome or cleidocranial dysostosis. This article presents case reports of 4 nonsyndromic patients with different forms of bilateral supernumerary teeth: bilateral mesiodentes, bilateral paramolars, bilateral distomolars, and bilateral parapremolars. The supernumerary teeth were managed by extraction or clinical and radiographic monitoring.

Oral Submucous Fibrosis in Pediatric Patients: A Systematic Review and Protocol for Management.

AIM: To conduct a systematic review evaluating the cases of oral submucous fibrosis in pediatric patients. MATERIAL AND METHOD: Systematic review was conducted using PRISMA guidelines. The article focused on oral submucous fibrosis in pediatric patients were included. A total of five manuscripts were included in our systematic review. The prevalence of OSMF in pediatric patients, gender distribution, causes, and clinical presentation were reviewed. RESULTS: On systematically reviewing, a total of 10 cases of OSMF in pediatric patients were found. The youngest patient reported to be diagnosed with OSMF was of 2.5 years of age. Female preponderance was noticed. All the patients had the habit of areca nut chewing which subsequently led to fibrosis. CONCLUSION: Such a rapid increase in the rate of OSMF among pediatric population is a potential danger to the society. The habit of areca nut chewing is the major cause for this dreadful condition. Lack of health consciousness and low level of education are the major factors for initiation of this habit among children. Therefore it is imperative for the parents and school as well as government authorities to take serious actions.