Rare mandibular condition presenting as trismus: an exploration of IgG4-related disease.

A woman in her 30s presented with a 12-month history of reduced mouth opening and swelling on the right side of her mandible. The swelling was non-tender and firm on palpation. The swelling began to increase in size after the extraction of her carious wisdom tooth. Histopathological and serological examinations confirmed the diagnosis of IgG4-related disease, manifested as a mass in the mandible. The patient was prescribed oral corticosteroids at a tapering dosage over 8 weeks. After 3 months, there was an improvement in the patient's mouth opening and a reduction in the size of the swelling. The patient remains in follow-up care. Including IgG4-related disease in the list of potential diagnoses for oral soft tissue masses is crucial, given their positive response to medical treatment, highlighting the significance of an accurate diagnosis to prevent unnecessary surgery, with oral lesions potentially serving as early indicators before multiorgan complications arise.

Maxillary osteomyelitis in a young female with osteopetrosis: unveiling an uncommon connection.

Osteopetrosis encompasses a spectrum of conditions marked by heightened bone density due to faulty osteoclast-mediated bone resorption, leading to an accumulation of immature bone and thickened cortical structures. This condition gives rise to bone fragility, blood cell irregularities, nerve entrapment and growth challenges, all stemming from disrupted bone remodelling. Craniofacial distinctiveness, encompassing anomalies in the skull and jaw, is a frequent occurrence. Osteopetrosis presents a range of clinical signs, including facial and dental anomalies. The diagnostic process involves thorough clinical and radiological assessments, often obviating the need for genetic testing. Interestingly, few prior reports have delved into the specifics of craniofacial and dental issues in osteopetrosis. The presented case showcases rare occurrence of maxillary osteomyelitis. The diagnosis was established through a combination of history, clinical, radiographic and laboratory findings. The patient declined surgical intervention, leading to the implementation of conservative management involving regular irrigation alongside systemic antibiotic therapy.

Lobular Capillary Hemangioma in a Young Child: Diagnostic Dilemma and Management.

Pyogenic granuloma (lobular capillary hemangioma) is a common reactive tumour-like lesion of the oral cavity arising in response to various stimuli such as chronic local irritation, drug intake, and hormonal changes. The clinical features are similar to other reactive oral lesions such as peripheral giant cell granuloma (PGCG) and therefore the definitive diagnosis depends on histopathologic evaluation. We report a case of a three-year-old Indian boy presenting with a three-month history of a 3.3×1.4×0.8 cm large sessile, lobular, soft-tissue mass of the left mandibular posterior gingival region which was referred to us. An excisional biopsy of the lesion revealed multinucleated giant cells lying in an inflammatory cell infiltrate-rich stroma consisting of plump endothelial cells on histopathologic examination suggestive of lobular capillary hemangioma. The patient was asymptomatic with no new growth on regular follow-up. This is the first reported case of a large pyogenic granuloma in a very young child, which is an uncommon presentation.

The association of psoriasis and psoriatic arthritis with periodontitis: A hospital-based case-control study.

Background Periodontitis can trigger and perpetuate inflammation in several chronic inflammatory diseases. The association of periodontitis with psoriasis has been investigated earlier, but data are incomplete and the influence of confounders has not been fully evaluated. We examined the relationship of dental and periodontal health parameters in patients with psoriasis and/or psoriatic arthritis. Methods This hospital-based cross-sectional analytical study was conducted in patients with chronic plaque psoriasis, psoriatic arthritis or both, and compared with controls. Dental and periodontal health parameters were assessed based on the WHO oral health assessment method. Multivariate logistic regression was done on variables with significant or near-significant values to find the association between periodontitis and psoriasis and/or psoriatic arthritis after adjusting for confounders. Results Psoriasis and/or psoriatic arthritis were independently and significantly associated with periodontal pockets ≥4 mm in depth. Limitations Causality and temporal relationship cannot be established as this was a cross-sectional study. As in all observational studies, the possibility of unmeasured or unknown confounders exists. Psoriatic arthritis was present only in a small subset of patients. Conclusion Patients with psoriasis and/or psoriatic arthritis have significant periodontal inflammation. This needs to be addressed by dental examination and intervention.

The Optimal Hemostasis Duration After Tooth Extraction: A Randomized Controlled Trial.

Background There is a lack of evidence-based practice regarding the duration of pressure pack placement following tooth extraction. This study aimed to compare the incidence of post-extraction bleeding following 60 minutes versus 10 minutes of pressure pack placement. Methodology A randomized controlled trial was conducted at a tertiary care hospital and included patients requiring intra-alveolar tooth extractions. Patients were randomly allocated into the experimental group or control group by a permuted block randomization method. A blinded observer noted the incidence of post-extraction bleeding. Categorical variables were summarized as frequency and percentage. The chi-square test was used for intergroup statistical analysis. P-values <0.05 were considered statistically significant. Results There were 528 participants, 264 of whom were allocated to each group. The incidence of post-extraction bleeding was 8% and 6.8% in the experimental and control groups, respectively. On bivariate analysis, there was no statistically significant difference between the two groups (p = 0.618; relative risk with 95% confidence interval = 1.0). Conclusions In the majority of cases, hemostasis was achieved in 10 minutes. Therefore, removing the pressure pack after 10 minutes may be advised to ensure hemostasis and, ultimately, save chairside time.

Inflammatory Dentigerous Cyst in a 10-year-old Child Treated by Marsupialization: A Case Report.

Aim: To describe the successful eruption of an unerupted premolar associated with a dentigerous cyst without the use of any appliances. Background: Inflammatory dentigerous cyst is a variant of dentigerous cyst occurring in the mixed dentition due to stimulation of the reduced enamel epithelium of a developing permanent tooth by periapical inflammation from its carious, nonvital deciduous precursor. Marsupialization is the preferred treatment to preserve the permanent tooth. Case description: A 10-year-old patient presented to us with a well-defined, tender swelling involving the left mandibular body with buccal cortical expansion. Following imaging, marsupialization was performed involving wide excision of the alveolar mucosa overlying the region along with the cystic lining. At follow-up, spontaneous eruption of permanent teeth into occlusion was noted. Conclusion: This suggests that marsupialization along the crest may allow for successful eruption of the associated permanent teeth with the resolution of the cyst. Clinical significance: Marsupialization along the crest provides a conservative option that allows spontaneous, unassisted eruption of permanent teeth in cases of inflammatory dentigerous cysts. Careful preoperative assessments must be used to make treatment decisions. The successful eruption of permanent teeth and the total resolution of the disease both depend on adequate follow-up. How to cite this article: Jayam C, Yerragudi N, Kumar N, et al. Inflammatory Dentigerous Cyst in a 10-year-old Child Treated by Marsupialization: A Case Report. Int J Clin Pediatr Dent 2023;16(6):871-874.