Papillon- Lefèvre Syndrome: report of a case and its management

Papillon-Lefèvre Syndrome (PLS) is a rare autosomal recessive disorder first described by two French physicians, Papillon and Lefèvre in 1924. The disorder is characterized by diffuse palmoplantar keratoderma and precocious aggressively progressing periodontitis, leading to the premature loss of deciduous and permanent teeth at a very young age. The cutaneous lesions are usually manifested simultaneously with the intra-oral presentations and include keratotic plaques on the palms and soles varying from mild psoriasiform scaly skin to overt hyperkeratosis. The etiopathogenesis of the syndrome is relatively obscure and immunologic, genetic or possible bacterial etiologies have been proposed. Due to the vast degree of periodontal breakdown involved at such an early age, the dental surgeon is often the first to diagnose the syndrome. This paper presents a clinical presentation a 15 year old male diagnosed with Papillon- Lefèvre Syndrome

Orthodontic repositioning of traumatically intruded permanent incisors - A report of three cases

Intrusive luxation of permanent teeth is one of the most serious traumatic dental injuries involving damage to the gingival tissue, periodontal ligament, cementum, bone and to the neurovascular supply of the pulp. In addition to disruption of normal tooth development and eruption, it can also lead to pulpal necrosis, root resorption and marginal bone loss. Based on the extent/severity, intrusion maybe classified into mild (<3 mm), moderate (3-6mm) and severe (>6mm). Available techniques for managing intrusive luxation include a wait-and-watch approach to allow for spontaneous re-eruption, orthodontic traction and surgical repositioning. The type of treatment approach employed depends upon the stage of root development, severity of intrusive luxation and the presence or absence of alveolar fractures. It is difficult to predict reliable outcomes with these approaches, since the presence of variables such as the severity of intrusion, associated crown/root fracture, stage of root development and presence of alveolar fractures may alter the prognosis. The present article presents a series of three cases with intrusive luxation of permanent incisors successfully treated using an interdisciplinary approach involving orthodontic traction along with endodontic rehabilitation

Handwashing Action Detection System for an Autonomous Social Robot

Young children are at an increased risk of contracting contagious diseases such as COVID-19 due to improper hand hygiene. An autonomous social agent that observes children while handwashing and encourages good hand washing practices could provide an opportunity for handwashing behavior to become a habit. In this article, we present a human action recognition system, which is part of the vision system of a social robot platform, to assist children in developing a correct handwashing technique. A modified convolution neural network (CNN) architecture with Channel Spatial Attention Bilinear Pooling (CSAB) frame, with a VGG-16 architecture as the backbone is trained and validated on an augmented dataset. The modified architecture generalizes well with an accuracy of 90% for the WHO-prescribed handwashing steps even in an unseen environment. Our findings indicate that the approach can recognize even subtle hand movements in the video and can be used for gesture detection and classification in social robotics

Biometric Assessment of Temporomandibular Disorders in Orthodontics: A Multi-arm Randomized Controlled Trial

Objective:This randomized controlled trial aimed to evaluate the role of fixed orthodontic treatment in the aggravation, precipitation, or alleviation of temporomandibular disorders in young adults.Methods:Sixty patients were randomly assigned to 4 groups of 15 patients each (group I, orthodontic treatment in temporomandibular disorder-free orthodontic patients; group II, orthodontic treatment in patients with mild symptoms of temporomandibular disorders; group III, splint therapy accompanied by orthodontic treatment in patients with moderate symptoms; and group IV, control with no treatment). The biometric equipment used were the T-scan, to analyze the occlusal component; the BioEMG for muscular analysis; BioJVA for temporomandibular joint acoustic analysis; and JT3D for mandibular kinematic analysis. The paired t-test and ANOVA were used for intragroup and intergroup comparisons, respectively. The difference between groups was assessed using post hoc Tukey’s test.Results:Groups I and III showed significant difference in the occlusal, muscular, temporomandibular joint vibration, and kinematic mandibular assessment variables. Group II showed significant improvement in occlusal variables only. Group IV did not show improvement in any of the variables except for certain muscular components.Conclusion:Successful practical utilization of biometric equipment revealed that fixed orthodontic treatment does not aggravate temporomandibular disorders. It was also found that temporomandibular disorders due to malocclusion can be treated successfully with orthodontic treatment, whereas temporomandibular disorders due to multifactorial temporomandibular joint and muscular components might require splint therapy before orthodontic intervention

Detection of oral squamous cell carcinoma metastasis with cathepsin D: An immunohistochemical approach

Background: The lysosomal protease cathepsin D (CD) has been associated with tumor progression in malignant tumors including oral squamous cell carcinoma (OSCC). The purpose of this study was to find out any association between the CD and lymph node metastasis and to study the correlation of CD with various clinicopathological parameters to aid in assessment of its role as a prognostic indicator. Materials and Methods: Immunohistochemical staining was performed on 20 OSCC samples with polyclonal antibody against CD. Positive results indicative of the presence of CD were further analyzed to determine any correlation between the CD and other clinicopathological parameters. Pearson Chi-square analyses, Spearsman correlation coefficient, Mann-Whitney test, Kruskal Wallis test and student t test were used for statistical analysis (P < 0.05). Results: Patients with lymph node metastasis showed statistically significant increase in CD expression (P < 0.01). Increasing tumor size seemed to correlate with increased CD expression (P < 0.05). Conclusion: Based on its association with other clinicopathological variables, CD expression can be used for the assessment of patient survival in cases of OSCC

Statin Hepatotoxicity: Is it a Real Concern?

Statins are the most effective and widely used drugs for treating dyslipidemia, a major risk factor for coronary heart disease. These are one of the safest hypolipidemic drugs but many patients are advised to discontinue statins for the fear of hepatotoxicity. Despite a lack of evidence that statins cause liver diseases, many physicians are reluctant to start statins in patients with an out-of-range liver enzymes value and this reluctance to initiate or interrupt the therapy with statins leads to dyslipidemia and its grave consequences. Further, there are some reports showing an additional benefit of statins in reducing cardiovascular events in patients with abnormal liver function tests

Surgical orthodontic correction of mandibular laterognathism

This case report describes the successful treatment of a patient with mandibular laterognathism and associated facial asymmetry with combined surgical orthodontic approach. After 7 months of presurgical orthodontic treatment, intraoral vertical ramus osteotomy, and straightening genioplasty were performed as two step surgeries to reposition the deviated mandible and chin, respectively. The total active treatment period was 14 months. After surgical orthodontic treatment, significant improvement in occlusion, masticatory function, and facial appearance was discernible. Posttreatment records at 3 years showed stable results with good occlusion

Blue cures blue but be cautious

Methemoglobinemia is a disorder characterized by the presence of >1% methemoglobin (metHb) in the blood. Spontaneous formation of methemoglobin is normally counteracted by protective enzyme systems, for example, nicotinamide adenine dinucleotide phosphate (NADPH) methemoglobin reductase. Methemoglobinemia is treated with supplemental oxygen and methylene blue (1–2 mg/kg) administered slow intravenously, which acts by providing an artificial electron acceptor for NADPH methemoglobin reductase. But known or suspected glucose-6-phosphate dehydrogenase (G6PD) deficiency is a relative contraindication to the use of methylene blue because G6PD is the key enzyme in the formation of NADPH through pentose phosphate pathway and G6PD-deficient individuals generate insufficient NADPH to efficiently reduce methylene blue to leukomethylene blue, which is necessary for the activation of the NADPH-dependent methemoglobin reductase system. So, we should be careful using methylene blue in methemoglobinemia patient before G6PD levels