Prosthetic Management of an Eviscerated Eye of a 13-month-old Patient: A Case Report.

Background: On account of loss of eye following Rubella infection, a 13-month-old baby girl patient required a maxillofacial prosthesis to restore her facial esthetics and social health as she grows. Case presentation: The process of prosthesis fabrication began at the time of enucleation where a conformer was given. Post healing the procedure was completed in a span of 2 days taking adequate trials and cross references for the like-like appearance of the prosthesis. Conclusion: A heat-cure acrylic resin based prosthetic eye was delivered with adequate instructions on the insertion and removal and hygiene maintenance given to the care providers. How to cite this article: Shetty NHG, Shetty MS, Saha S, et al. Prosthetic Management of an Eviscerated Eye of a 13-month-old Patient: A Case Report. Int J Clin Pediatr Dent 2024;17(1):89-91.

An Assessment of the Accuracy of Recurring Esthetic Dental Proportion: An In Vivo Comparative Analysis of Maxillary Anterior Teeth Proportion With Chu's Gauge and Custom-Made Calipers.

Smile designing, in harmony with nature, has always been a challenge in dentistry. Several theories have been proposed in the past with a view to replicate an esthetic smile. One such method proposed by Dr. Chu involves using the recurring esthetic dental (RED) proportion. He designed a scale for calculating the average values for the height and width of upper anterior teeth for a specified population. However, whether this average is valid for other populations has not been verified. Hence, this study was conducted to evaluate if Chu's gauge value agrees with the dimension of anterior teeth in the South Indian population. The study involved 362 subjects whose anterior teeth dimension was assessed using Chu's gauge and a custom-made caliper. The proportion of the population whose dimension aligns with the average values on Chu's gauge was evaluated. The results showed that in the cohort, 39% had their central incisor dimension coinciding with the red band of Chu's esthetic scale, 10% had their lateral incisor coinciding with the blue band of Chu's esthetic scale, and 6.4% of the subjects had their canine dimension coinciding with the yellow band of Chu's esthetic scale.

An Evaluation of the Relation Between Variation in Arch Forms and Relative Parallelism of the Occlusal Plane to the Line Joining the Inferior Border of Ala of the Nose With Different Tragal Levels of the Ear in Dentulous Subjects: An In Vivo Study.

Introduction The purpose of this study was to evaluate which of the three positions on the tragus (superior, middle, and inferior), when connected to the inferior border of the ala of the nose, was the most parallel to the natural occlusal plane in dentate patients, to correlate the level of the naturally existing occlusal plane with the ala-tragal line when the tragus was divided into three portions (superior, middle, and inferior), and to determine which position in the tragus occlusal plane is the most parallel. The study also evaluated the correlation between the variation of arch forms and the relative parallelism of the occlusal plane to the ala-tragal line at different tragal levels. Methods This study included 1405 subjects between the ages of 18 and 35 years. A custom-made occlusal plane analyzer was used to check the relative parallelism between the existing occlusal plane and the ala-tragal line when the tragus was divided into the superior, middle, and inferior portions. The Fox plane of the occlusal plane analyzer was placed on the occlusal plane and the paralleling rod was adjusted till parallelism was obtained. The point on the tragus (superior, middle, or inferior) at which parallelism existed was recorded. The study also measured the inter-canine and intermolar distance to find the type of arch form and related it to the position (superior, middle, or inferior) at which the ala tragal line was parallel to the occlusal plane. The assessment was done on both the right and left sides of the subjects. Results Out of the 2810 tragi, the most common location at which parallelism was established was the inferior part of the tragus, which accounted for 47% of the total. Seventy-one percent (71%) of the subjects showed ovoid arch form. When the variation of arch forms was compared to the level of occlusal plane, 46.8% of the subjects with tapered arch form, 54.5% of subjects with square arch form, and 46.0% of subjects with ovoid arch form had the level of the occlusal plane at the inferior portion of the tragus. Conclusion The result of the study indicated that in the majority of the tragi studied, 47% of the subjects had the occlusal plane parallel to a line joining the inferior border of the ala of the nose to the inferior part of the tragus. Irrespective of the arch form, the occlusal plane was found parallel to a line joining the inferior border of the ala of the nose and the inferior part of the tragus. Thus the tragal position did not show any correlation to the variation of arch forms.

Excision Versus Fixation of the Radial Head: A Comparative Study of the Functional Outcomes of the Two Techniques.

INTRODUCTION: The management of displaced and comminuted radial head fractures has been a matter of debate amongst surgeons for many years. Radial head excision formed the mainstay of surgical management of these injuries. Over the years, there have been improvements in the surgical techniques and availability of better implants and instrumentation techniques, hence, open reduction and internal fixation of these fractures is gaining popularity. AIM: To compare the outcome of elbow function between radial head excision and open reduction and internal fixation of the radial head with mini screws of Mason Type II and Type III radial head fractures and to assess the complications that occur in both techniques. MATERIALS AND METHODS: A prospective study was conducted in the Department of Orthopaedic Surgery of Justice K.S.Hegde Charitable hospital. A total of 40 patients between the age group of 30-50 years with Mason Type II and Type III fresh closed radial head fractures were included in the study. Group I consisted of 20 patients who underwent radial head excision and Group II consisted of 20 patients who underwent open reduction and internal fixation with mini screws. Patients were reviewed at postoperative week 3, 6 and 24. Radiographs were taken and functional outcome assessment of the elbow was done during all the follow ups. Elbow physiotherapy was started on postoperative week three. Scoring of elbow function was done as per the Disabilities of the Arm, Shoulder and Hand (DASH) scoring system. Results were tabulated, compared and analysed statistically using the 'chi-square test'. RESULTS: At the end of six months, the patients of the open reduction and internal fixation group had lower DASH scores (4.82±2.73 points) than the radial head excision group (14.23±5.60 points). This inferred that patients who underwent open reduction and internal fixation had better functional outcomes than the excision group. Complications of proximal radial migration was noted in three patients, elbow osteoarthritis was noted in two and periarticular ossification was noted in six patients who underwent radial head excision. CONCLUSION: Open reduction and internal fixation of Mason Type II and Type III radial head fractures is a better management technique as compared to radial head excision for management of Mason Type II and III radial head fractures.

To Operate or not to Operate the Mid-Shaft Fractures of the Clavicle: A Comparative Study of Functional Outcomes of the Two Methods of Management.

INTRODUCTION: Fractures of the clavicle are some of the most common fractures which are seen in the adult population. Mid-shaft fractures of the clavicle are considered the most common form of clavicle fractures and about half of them are displaced fractures. They have been managed non-operatively over the years. However, severe displacement and comminution of these fractures have warranted the requirement of operative intervention, due to increased incidence of mal-union, worsening of shoulder functions etc., after conservative management. The introduction of locking compression plates, have increased the incidence of operative intervention in the management of these injuries. AIM: To study and compare the functional outcome of the shoulder after open reduction and internal fixation versus non-operative management of mid-shaft clavicle fractures. MATERIALS AND METHODS: A prospective study was conducted from June 2013-October 2015 in the Department of Orthopaedic Surgery, K.S. Hegde Medical Academy, Mangalore. A total of 30 skeletally mature patients between the age groups of 20-50 years with diagnosed fresh mid-shaft clavicle fractures, AO type A and B mild to moderate displacement, were enrolled into the study with. They were divided into two groups randomly. Group 1 consisted 16 patients who underwent open reduction and locking compression plate fixation and Group 2 consisted of 14 patients who were managed with application of a clavicle brace and arm pouch for three weeks. Reviews were done at three, six and 24 weeks postoperatively. The patients were assessed clinically and radiographs were taken during all the reviews. Scoring of shoulder function was done using the Disabilities of the Arm, Shoulder and Hand (DASH) score during all the reviews. The results were tabulated compared and analyzed statistically using the 'Independent t-test' and Chi-square test. RESULTS: The DASH scores at the end of 24 weeks were noted to be 8.57±6.073 points for the 14 patients in the conservative management group and 7.74±16.422 points for the 16 patients in the open reduction and internal fixation group. This indicated that there was no significant difference noted in terms of shoulder function between the two groups. Six of the 14 patients in the conservative management group were noted to have mal-union of the fracture. No non-unions were noted in the conservative or operative groups. No mal-union was noted in the open reduction and internal fixation group. CONCLUSION: Though open reduction and internal fixation of mid-shaft clavicle fractures reduced the incidence of mal-union, no significant difference was noted in the functional outcome of shoulder function as compared to when the fracture was managed conservatively.

Management of congenital pseudarthrosis of the tibia in children under 3 years of age: effect of early surgery on union of the pseudarthrosis and growth of the limb.

The study was undertaken to determine whether the results of treatment of pseudarthrosis of the tibia in children under age 3 are so poor as to recommend that surgery be deferred until after 3 years of age. Radiographs and case records of 26 consecutive patients with Crawford type IV congenital pseudarthrosis of the tibia who were treated operatively were reviewed. Growth abnormalities of the tibia, fibula, and femur of the affected limb at presentation were identified. The outcome of treatment, in terms of union of the pseudarthrosis, refracture rate, and limb length, in 13 children treated operatively before age 3 years was compared with those operated on later. Union of the pseudarthrosis occurred in 12 of 13 children (92%) who were treated before 3 years of age by excision of the pseudarthrosis, intramedullary rodding, and dual-onlay cortical bone grafting. Union occurred in only five of seven children who underwent the same procedure between the ages of 3 and 12 years. The extent of shortening of the limb at the time of surgery was least in children younger than 3 years. The limb length discrepancy remained virtually static in 11 children who had transarticular Rush rodding before age 3. Growth abnormalities of the fibula, tibia, and femur were less pronounced in children operated on early. The study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years.