Comparative Evaluation of Fresh Aloe barbadensis Plant Extract and Mineral Trioxide Aggregate as Pulpotomy Agents in Primary Molars: A 12-month Follow-up Study.

BACKGROUND: The purpose of this study was to compare the clinical and radiographic outcomes of fresh Aloe vera barbadensis plant extract and mineral trioxide aggregate (MTA) as pulpotomy agents in primary molar teeth. MATERIALS AND METHODS: Pulpotomy procedure was performed in sixty primary molar teeth which were randomly allocated to two groups, i.e., Aloe vera pulpotomy (Group A) and MTA pulpotomy (Group B). All the pulpotomized teeth were evaluated clinically and radiographically at 1, 3, 6, 9, and 12 months of time interval using predetermined criteria. RESULTS: The success rates between Groups A and B at the end of the 1st month were 24.1% and 96.4%, at the end of 3rd month were 57.1% and 100%, at the end of 6th month were 75% and 100%, at the end of 9th month were 66.6% and 100%, and at the end of 12 months were 100% and 100% respectively. The overall success rates at the end of 12-month follow-up period were 6.9% and 71.4%, respectively, after taking dropout patients into consideration, and the difference was statistically significant (P < 0.001). CONCLUSIONS: MTA pulpotomy was found to be superior when compared to fresh A. barbadensis plant extract pulpotomy in primary molars.

A Case of Lacrimo-Auriculo-Dento-Digital Syndrome with Multiple Congenitally Missing Teeth.

Lacrimo-auriculo-dento-digital (LADD) syndrome is an extremely rare disorder which may occur sporadically or inheritably as an autosomal dominant condition. It is characterized by defects in the lacrimal apparatus, ear problems, and dental and digital abnormalities. However, specific symptoms vary greatly among the cases with a high degree of overlap with other similar genetic disorders. Here, we describe a 7-year-old boy with LADD syndrome, clinical and radiological findings, dental treatment undertaken, and its differential diagnosis.

A Comparative Evaluation of the Effectiveness of Three Different Irrigating Solution on Microorganisms in the Root Canal: An Invivo Study.

INTRODUCTION: An infected root canal system either due to caries exposure or trauma cannot be eliminated by the host defense mechanisms alone or in combination with systemic antibiotic therapy. It can be treated through professional endodontic intervention using both chemical and mechanical procedures. AIM: To suggest triple antibiotic solution containing tetracycline, ornidazole and ciprofloxacin as a new endodontic irrigant that may possess superior antibacterial activity in comparison with chlorhexidine solution. MATERIALS AND METHODS: This study was carried out on 60 teeth from 40 children with anterior tooth fracture, asymptomatic, non-vital and necrotic in nature. Patients were randomly divided into three groups of 20 teeth each depending upon the type of irrigant. After access opening microbial samples were obtained: a) Pre- irrigation i.e. sample after pulp extirpation and before irrigation, b) Post-irrigation i.e. sample after irrigation, stored in sterile containers and immediately transferred to microbiological laboratory. After incubation of samples aerobically at 37(0)C for 24 hours, the samples were streaked on blood agar culture media and incubated for 48 hours. After 48 hours, the colony forming units were counted using a colony counter. Statistical analysis was carried out using Kruskal-Wallis test, Wilcoxson signed rank test and Mann-Whitney test. RESULTS: On intra group comparison, highly significant differences in the colony forming units were found between pre-irrigation and post-irrigation sample for all the three groups. On inter group comparison, statistical difference was found between saline and chlorhexidine (p ≤ 0.001), saline and triple antibiotic paste (p< 0.001). The greatest percentage decrease was obtained in samples treated with Chlorhexidine solution (Group 2) i.e.73.91. The triple antibiotic irrigating solution group showed percentage decrease of 66.22 followed by Group 1 (Saline) 15.04. The difference found amongst the groups was statistically insignificant. CONCLUSION: It was concluded that triple antibiotic irrigating solution can be used as an irrigating solution. The antibacterial action of triple antibiotic irrigating solution is comparable with chlorhexidine. Although saline may not be effective in the antimicrobial action but its flushing action may be able to decrease some microbial load.

Comparative evaluation of retention ability of amorphous calcium phosphate containing and illuminating pit & fissure sealants in 6-9 year old age group.

AIMS: The primary aim of this study is to evaluate and to compare the retention of two different pit and fissure sealants on permanent mandibular 1 st molar teeth. MATERIALS AND METHODS: A total of 110 children aged between 6-9 years were selected. In each child, Aegis with amorphous calcium phosphate sealant was applied on the permanent mandibular 1 st molar of the right side while Delton the illuminating sealant was applied on the permanent mandibular 1 st molar of the left side, keeping the permanent maxillary 1 st molars as control. The treated teeth were evaluated for retention of sealants at 3, 6 and 12 months interval. STATISTICAL ANALYSIS USED: The statistical analysis was performed using the Mann-Whitney U-test and Chi-square tests and Statistical Package for the Social Science version 15.0 statistical analysis software. RESULT: The results were showed that retention and loss of sealant from the occlusal surfaces of the sealed teeth in both groups was maximum between 3 and 6 months. CONCLUSION: Though statistically no significant difference was observed between the two groups, sealant with ACP showed better retention than the illuminating sealant.

Bilateral dens evaginatus (talon cusp) in permanent maxillary lateral incisors: a rare developmental dental anomaly with great clinical significance.

Talon cusp is an accessory cusp-like structure which projects from the cingulum area or cementoenamel junction. It is important for dentists to be aware of the potential complications that may occur with talon cusp. Early diagnosis and treatment is important, especially to prevent pulpal complications in permanent teeth which may be in developing stage in paediatric patients. The purpose of this paper is to report a case of bilateral talon cusp in permanent maxillary lateral incisors. Associated dental anomalies and clinical problems are discussed along with successful management of the case with conservative therapy.

Surgical management of iatrogenic perforation in maxillary central incisor using mineral trioxide aggregate.

Root perforations are undesired complications of endodontic treatment. The repair of root perforation can be accomplished using different materials and techniques. Mineral trioxide aggregate (MTA) is widely used to seal perforations because of its biocompatibility and sealability. This article describes a case report where an iatrogenic root perforation was repaired successfully with MTA in maxillary right central incisor of a 13-year-old boy.

Temporomandibular joint involvement in ankylosing spondylitis.

Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints. Clinician should be suspicious of AS when a patient reports with painful restricted movements of joint, neck or back and with no trauma history. Conventional radiographic methods have allowed the demonstration of TMJ abnormalities in patients with AS, but CT is necessary to establish joint space relations and bony morphology. We describe a case of severe AS with TMJ involvement in a 40-year-old female patient and demonstrated TMJ changes on CT. A CT was able to demonstrate articular cartilage changes, disc- and joint abnormalities. Thus, if conventional radiographs in a symptomatic patient with rheumatic diseases are unable to demonstrate changes, CT can provide valuable additional information of the changes in the TMJ.

Peripheral ossifying fibroma.

Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and occurring frequently in the anterior maxilla. It represents upto 2% of all lesions that are biopsied. Other terms used to describe this lesion include peripheral ossifying fibroma, peripheral cementifying fibroma and calcified or ossified fibrous epulis. Paediatric patients with such a lesion have special management considerations as it requires early recognition and treatment. It requires proper treatment protocol with close postoperative follow-up. This case report presents a 12-year-old boy with an unusually large lesion in relation to the palatal aspect of the maxillary anterior teeth and its management.

Surgical management of multiple supernumerary teeth and an impacted maxillary permanent central incisor.

Hyperdontia is the condition of having supernumerary teeth, or teeth which appear in addition to the regular number of teeth. It is a developmental anomaly and has been argued to arise from multiple aetiologies. The most common site is the maxillary incisor region; but the prevalence of more than three teeth supernumerary tooth is less than 1%. A case of 13 year male patient is reported with a multiple impacted supernumerary tooth in maxillary anterior region hindering the eruption of right permanent central incisor. The supernumerary tooth was treated via surgical approach followed by an interim prosthesis for permanent central incisor which later on erupted in due course of time. Background Supernumerary teeth may be defined as any teeth or tooth substance in excess of the usual configuration of 20 deciduous and 32 permanent teeth. The presence of supernumerary teeth in the premaxillary region often poses unique diagnostic and managerial concerns for the practitioner. Rarely is the surplus number compensated by an absence or deficiency of other teeth. Therefore, the dysfunctional nature of supernumerary teeth and their ability to create a variety of pathological disturbances in the normal eruption and position of adjacent teeth warrants their early detection and prudent management. Approximately 76-86% of cases represent single-tooth hyperdontia, with two supernumerary teeth noted in 12-23% and three or more extra teeth noted in less than 1% of cases. Multiple supernumerary teeth are also associated with many syndromes like cleidocranial dysplasia and Gardner's syndrome etc. However, it is rare to find multiple supernumeraries in individuals with no other associated disease or syndrome. In such cases, the maxillary anterior region is the common site of occurrence. The exact aetiology is not clearly understood. The supernumerary teeth result from any disturbance in the initiation and proliferation stages of odontogenesis. There are several theories regarding the development of a supernumerary tooth-phylogenetic reversion (atavism) theory, dichotomy of tooth germ theory and hyperactivity of the dental lamina. The latter being the most accepted theory, states that the remnants of dental lamina or palatal offshoots of active dental lamina are induced to develop into an extra tooth bud, which results in the formation of a supernumerary tooth. Genetics is also considered to contribute to the development of supernumerary teeth, as these have been diagnosed in twins, siblings and sequential generations of a family. Classification of supernumerary teeth may be on the basis of position or form. Positional variations include mesiodens, paramolars, distomolars and parapremolars. Variations in form consist of conical types, tuberculate types, supplemental teeth and odontomes. Supernumerary teeth may, therefore, vary from a simple odontome, through a conical or tuberculate tooth to a supplemental tooth which closely resembles a normal tooth. Also, the site and number of supernumeraries can vary greatly. This report presents a case of a non-syndromic male patient with multiple supernumerary teeth and a permanent impacted tooth in the maxillary anterior region.

Modified intracanal post for severely mutilated primary anterior teeth.

Early childhood caries leads to early damage, discolouration and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue thrust and subsequent malocclusion, psychological problems and problem with self-esteem, if aesthetics are compromised. Thus, restoration of severely mutilated primary anterior teeth is often considered as a special challenge, especially in an emotionally immature child. This case documents the restoration of severely mutilated incisors in a patient with early childhood caries.

Nasolabial cyst mimicking inflammatory cyst.

The nasolabial cyst is an uncommon non-odontogenic soft tissue cyst. It arises as an ectodermal developmental swelling and is classified as a fissural cyst, found outside the bone, in the region corresponding to the nasolabial furrow and alar nose. A case of nasolabial cyst with classic clinical and histopathological features, along with few features mimicking those of an inflammatory cyst in a 32-year-old woman is reported.