Case Report: Holistic dental care for a child with Hunter syndrome: Addressing dental ramifications, overcoming challenges, and enhancing quality of life.

Hunter syndrome (MPS II), an X-linked recessive lysosomal storage disorder, is a result of deficiency of the iduronate 2-sulfatase enzyme (IDS), leading to cognitive impairment, systemic organ involvement, and increased dental problems. This case report describes the management of a child with Hunter syndrome who was referred to the Department of Paediatric and Preventive Dentistry for pain in the upper front teeth. Intraoral examination revealed severe early childhood caries, prompting planning for full-mouth rehabilitation under general anaesthesia due to the child's uncooperative behaviour. In response to recommendations from the Department of Otolaryngology and the Department of Paediatric Surgery, a comprehensive treatment plan consolidated full-mouth rehabilitation in addition to adenoidectomy and inguinal and umbilical herniotomy procedures during a single session of general anaesthesia. Successful interventions were reflected in the uneventful one-month follow-up of the patient, highlighting the efficacy of the interdisciplinary approach. The key takeaway underscores the importance of collaborative interventions, emphasising singular intubation for patients requiring recurrent hospitalisations, providing both monetary relief and reducing post operative healing time. Designed to address global developmental delay in the child, a personalised home care plan was also implemented. Evaluation of plaque and gingival indices before and after the home care regimen demonstrated a notable improvement, indicating an enhanced oral quality of life.

Pyoderma Gangrenosum: An Ulcer With Unorthodox Treatment.

Pyoderma gangrenosum (PG) is a rare, reactive, non-infectious inflammatory dermatosis. It typically presents with extensive cutaneous ulcerations. A 20-year-old lady presented with a painful, progressive, non-healing ulcer with purulent discharge on the right upper thigh. Debridement of the ulcer was done, and pus was sent for culture and sensitivity. Despite regular wound care, the ulcer was progressing in size with persistent pain. The ulcer exhibited the phenomenon of pathergy. The pus was sterile on examination, and the histopathology showed extensive neutrophilic infiltration. A history of similar non-healing ulcers in a family member pointed toward the diagnosis of this rare condition. Treatment of pyoderma gangrenosum started in conjunction with the dermatology department. After appropriate wound care with systemic steroids and immunomodulators, the ulcer healed by secondary intention. PG is a diagnosis of exclusion. A high level of suspicion of an uncommonly presenting ulcer would lead to early diagnosis and appropriate treatment. Early diagnosis and treatment with corticosteroids and immunosuppressants can heal the lesion early by minimizing pathergy.

Accuracy of clinical methods of age estimation based on permanent teeth present as erupted: A study on the coastal population of India.

INTRODUCTION: The role of age estimation in paediatric dentistry has been well documented with an onus being placed for the development of methods independent of radiographic analysis. The study was done to evaluate the accuracy of previously established clinical methods of age estimation in Indian children and to derive new methods for use in an Indian subpopulation. MATERIALS AND METHODS: Foti's clinical method of age estimation based on the eruption status of permanent teeth was tested for accuracy in a sample comprising 1000 children within the age group of 6-14 years encompassing five different southern states of India. A comparative evaluation of Foti's methods and new regressive models developed for an Indian subpopulation was conducted in a sample size comprising 100 children reporting to the department of pedodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore. RESULTS: Statistical analysis revealed greater correlation between chronological and estimated dental age using the newer formulae as compared to the original formulae. CONCLUSION: Hence it is derived that the new population specific methods can help ascertain an individual's age with relative accuracy, even in the absence of radiographs, and hence can be of considerable importance in a rural setup.

Skeletal open-bite treatment with zygomatic anchorage for a child with mental retardation: A new modality.

Anterior open bite (AOB) is one of the most difficult malocclusions to treat and maintain in orthodontics. Malocclusion occurs more frequently in children with disabilities than in healthy children. Surgical correction of severe AOB often requires maxillary impaction to reduce the anterior facial height. The zygomatic buttress area could be a valuable anchorage site to achieve intrusion of maxillary posterior teeth. A 16-year-old boy with mental retardation showing signs of persistence of infantile behavior, decreased cognitive functioning, and psychomotor skill deficits (no identified syndrome) with an AOB was treated by intrusion of maxillary posterior teeth using I-shaped multipurpose titanium miniplate (SK Surgicals, India). A 7 mm AOB was corrected after 6 months of intrusion. The benefits of this treatment as an alternative to conventional orthodontic appliances are significant in subjects who lack the understanding or with manual dexterity to use an orthopedic appliance.

Helicobacter pylori IgG antibodies in aqueous humor and serum of subjects with primary open angle and pseudo-exfoliation glaucoma in a South Indian population.

PURPOSE: A prospective, nonrandomized, comparative study was carried out to investigate levels of anti-Helicobacter pylori-specific IgG antibodies in the aqueous humor and serum of patients with primary open angle glaucoma (POAG), exfoliation syndrome [pseudo-exfoliation glaucoma (PXFG)], and with normotensive cataract patients, who served as controls. METHODS: Aqueous humor was aspirated at the beginning of glaucoma surgery from 50 eyes of 50 patients with POAG, with PXFG and at the beginning of phacoemulsification cataract surgery from controls. Serum samples were obtained. Anti-H. pylori IgG concentration in the aqueous humor and serum was measured by means of enzyme linked immunosorbent assay. RESULTS: Serum analysis of anti-H. pylori IgG antibodies revealed statistically significant difference between POAG and PXFG (52.26+/-52.51 vs. 25.22+/-35.27, P=0.01). Also, the difference between POAG and controls was statistically significant (54.05+/-55.04 vs. 33.83+/-41.73, P=0.04). However, on comparing PXFG with the control group, the difference was statistically insignificant (P=0.12). The mean concentration of anti-H. pylori IgG antibodies in aqueous humor of patients in POAG and controls were not statistically different (3.93+/-5.14 vs. 2.65+/-2.87, respectively, P=0.73). The mean concentration of anti-H. pylori IgG antibodies in aqueous humor of patients in PXFG and controls were not statistically different (8.87+/-30.25 vs. 2.65+/-2.87, respectively, P=0.83). There was also no statistical difference of IgG levels between POAG and PXFG (3.93+/-5.14 vs. 8.87+/-30.25, respectively, P=0.87). CONCLUSIONS: The levels of anti-H. pylori IgG titers in sera of individuals with POAG were significantly higher compared with PXFG and control groups. We support the hypothesis of the role of anti-H. pylori antibodies in causative mechanism for POAG. We could not find a significant link between the anti-H. pylori IgG antibodies and the PXFG.