A Comparative Evaluation of Salivary Changes and Oral Indices in Pediatric Patients Having Chronic Kidney Disease and Juvenile Diabetes with Healthy Controls

Background and Aim: Chronic Kidney disease is a common condition seen in Juvenile diabetes with 90% of renal impairment patients displaying a wide spectrum of oral manifestations in the hard and soft tissues including changes of the salivary composition and flow rate. There is an increase in the serum cystatin-C, urea and creatinine levels in these patients, which is reflected in the saliva. This study was conducted to assess the changes in salivary levels of cystatin-C, urea, and creatinine as well as oral – Decayed, Missing and Filled Teeth Index (DMFT) and gingival indices in pediatric patients suffering from chronic renal disease and juvenile diabetes and compare them with healthy individuals.Methods: Fifteen patients with juvenile diabetes suffering from chronic renal disease and 15 healthy controls aged 2-18 years were included in the study. Their saliva was analyzed for creatinine, cystatin-C and urea levels using an auto-analyzer and correlated with their existing serum levels. DMFT, gingival index, gingival bleeding and gingival enlargement indices were also assessed. Results: Increased levels of salivary cystatin C, urea (p value <0.001) and creatinine (p value =0.001) were seen in the cases. The deft value was significantly lower (p value <0.001) while the gingival index, gingival bleeding index, and gingival enlargement index were significantly higher in the subjects with renal impairment.  Conclusion: Chronic Kidney disease results in many metabolic changes in the body, necessitating frequent biochemical blood analysis. Saliva, being a non-invasive, simple and rapid adjunctive tool, can be used for diagnosing and staging the disease and to check the progression of the condition.Keywords: Chronic Kidney Disease; Renal Dysfunction; Saliva; Cystatin-C; Diagnosis

Dentigerous cyst enucleation: A conervative approach

Dentigerous cyst is a type of odontogenic cysts and generally occurs in the ages of twenties or thirties. Dentigerous cyst always includes a tooth which cannot complete the eruption process and occurs around the crown by the fluid accumulation between the layers of enamel organ. In rare cases, dentigerous cyst occurs in the first decade of life and develops in an immature permanent tooth as a result of a chronic inflammation of overlying nonvital primary tooth. In this report, a case of dentigerous cyst in primary dentition in a 9-year-old child patient and its treatment were presented. The standardized treatment for a dentigerous cyst is enucleation and extraction of the involved tooth. In cases of larger cysts, an initial marsupialization to diminish the size of the osseous defect, followed by enucleation and tooth extraction, has been advocated. However, if the patient is a child and the cyst is small, removal of cystic lining followed by extraction of deciduous tooth usually results in disappearance of the cyst and preservation of the permanent tooth. When dealing with larger lesions, enucleation and tooth extraction have been favored. This can lead to functional, cosmetic, and psychologic consequences for the child

Assessment of dental anxiety by using graphological scale among 8-13-aged children: An observational study

Background: Dental anxiety is an important component of distress to patients in the dental operatory. If the dentist is aware of the level of anxiety of his patient, he is not only forewarned about the patient’s behavior but can also take measures to help reduce the anxiety during the operative procedure. Patients who are highly anxious about dental treatment may react differently than do those who are less anxious. We have many anxiety scales to detect in dental operatory but none of them have objectivity about reveling anxiety. Patients’ perceptions may change from time to time and so does their response. So we need an objective type of scale that will help to diagnose anxiety. Methodology: participants were divided into two groups 20 in each group. The children of both groups were given ACDAS scale to solve. (by patient and parent as this scale has an opinion of parents too) For detecting anxiety through graphology, Navrang Anxiety Scale (NAS), require unruled paper, writing matter, and pen was given to participants to write the essay and obtain the handwriting sample from the patient. Result: The significant association was seen between the graphological scale and the ACDAS scale.&nbsp

A Case of Full Mouth Rehabilitation of a 5-year-old Child with Severe Early Childhood Caries

An important health problem worldwide that adversely impacts infants and children’s oral health is early childhood caries. Early loss of primary teeth due to trauma or caries can result in decreased masticatory function, reduced esthetics, incorrect pronunciation of sounds, and the development of aberrant oral habits. Every child has a fundamental right to live happily and healthily; therefore, it should be addressed and managed to prevent further complications. This case report gives insight into the dental rehabilitation of the patient with mutilated primary dentition