Dental management of a child with Wiskott Aldrich syndrome prior to bone marrow transplant: A case report.

AIM: Orodental manifestations are commonly presented in Wiskott Aldrich Syndrome (WAS). The purpose of this paper is to report a case of dental management of a 5-year-old male child with WAS before Hematopoietic Stem Cell Transplantation (HSCT). Such patients are more prone to infection due to pretransplantation chemotherapy and posttransplantation immunosuppression; thus, it becomes imperative to eliminate all potential sources of infection before transplantation. MATERIALS AND METHODS: Fluctuating blood parameters before the dental procedure was an important challenge in rendering dental treatment. Dental procedures were carried out under general anesthesia by maintaining the hematological parameters with blood and platelet transfusion. The conventional dental treatment may not be applicable in such patients as failure of dental treatment can cause the failure of HSCT, and it has to be modified based on the clinical acumen and recommendations. CONCLUSIONS: This case report focuses on the measures to be taken before, during, and after the dental procedure to ensure the success of the dental therapy and prevent failure of HSCT due to residual dental foci of infection. A multidisciplinary approach involving a pedodontist, a pediatrician, and a hematologist can improve the quality of life of such patients.

Tamponade effect of resorbable biological barrier in quality of obturation in primary molar.

AIM: Physical properties of obturating materials have a direct effect on the quality of obturation; less viscous material will tend to extrude beyond the apex. We hypothesize that the use of absorbable gelatin sponge (AGS) can prevent the extrusion of these materials. This study aimed to evaluate the quality of obturation in root canals filled with iodoform-calcium hydroxide (Metapex) premixed paste and Metapex with AGS (MAGS) in primary molars. METHODS: This in vivo study comprised 60 primary mandibular molars which after instrumentation were divided into 2 groups according to the obturation material used, Metapex and MAGS, followed by radiographic evaluation to assess the quality of the obturation. The χ2 -test was applied for statistical analysis. RESULTS: There was a statistically significant difference between Metapex and MAGS groups in achieving optimum obturation (P < .001). Metapex and MAGS exhibited 86.65% and 38.88% optimum obturation respectively. The overfilling of root canals effectively reduced from 38.88% to 4.44%. CONCLUSION: The addition of AGS to Metapex causes a "tamponade effect", which reduces the tendency of Metapex to extrude beyond the root apex. Root canal obturation using a modified filling paste like MAGS is effective in obtaining optimum obturation in primary teeth.