Non-Syndromic Supernumerary Premolars with Striking Symmetry –A case report

Aim and objective - Non-syndromic multiple supernumerary teeth are most commonly seen in mandibular premolar region. Dental literature rarely reports symmetrical supernumerary teeth in all four quadrants.  This case reports the unique distribution of supernumerary premolars symmetrically in all the four quadrants .Early diagnosis helps in treatment planning.Case description – This case describes a 17 year old female patient who presented with the complaint of food impaction in the left mandibular premolar region. Intra oral examination revealed the presence of a supplemental premolar tooth in the same region. A panoramic radiograph revealed four supernumerary premolars, each positioned symmetrically in second premolar regions.Conclusion - Supernumerary premolar teeth are usually detected coincidentally on radiographs. This case report stresses the early detection, radiographic examination and frequent evaluation to detect any complications that may be associated with supernumerary premolars

PAPILLON–LEFEVRE SYNDROME: A COMBINED APPROACH FROM THE DERMATOLOGIST AND DENTIST – A CLINICAL PRESENTATION

Papillon–Lefevre syndrome (PLS) is a rare disease characterized by skin lesions, which includes palmar-plantar hyperkeratosis and hyperhidrosis with severe periodontal destruction involving both the primary and the permanent dentitions. It is transmitted as an autosomal-recessive condition, and consanguinity of parents is evident in about one-third of the cases. This paper describes a 13-year-old male patient who presented to the department of pedodontics, with rapidly progressing periodontitis. A general physical examination revealed scaling on the hands and feet, which had been medically diagnosed as PLS. The incidence of this rare entity is increasing in the recent times, which is associated with irreparable periodontal destruction at an early age, with not so prominent skin lesions in some cases. In such instances, the dentist has a more important role in diagnosing, treatment planning and preservation of the periodontal tissues and, at the same time, referring for the treatment of the skin lesions. This paper emphasizes the combined effort of the two specialities in order to maintain skin as well as dental conditions in health by early intervention and a synergistic treatment approach

Hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is an acute viral illness with a distinct clinical presentation of oral and characteristic distal extremity lesions. Knowledge of this is important for the dentists as the oral lesions are the first clinical signs and sometimes may be the only sign because the condition occasionally may regress even before the lesions appear on the extremities. This case describes a 5-year-old boy in whom low-grade fever of 38.7°C and oral lesions were the initial manifestations. Proper diagnosis was established later based on the typical location of the initial intraoral ulcers on the soft palate followed by cutaneous lesions on the hands and feet with vesicle formation surrounded by an erythematous halo. The recognition of HFMD is important for both pediatricians and pedodontists as oral manifestations are the first signs and may mimic many other conditions like acute herpetic gingivostomstomatitis, apthous stomatitis, chickenpox, erythema multiformae and misdiagnosis may involve an inappropriate prescription of medication

Nonsyndromic localized aggressive periodontitis of primary dentition: A rare case report

Periodontitis is an inflammatory disease of the gingiva and tissues of the periodontium. It is characterized by pocket formation and destruction of supporting alveolar bone. Periodontal diseases of aggressive nature are not very common in children. They are usually associated with systemic conditions. The present case report is of a 5-year-old male child who reported with rapid attachment loss and bony defects of the gingiva and supporting structures. His family and medical history gave no contribution for the diagnosis. Blood investigations did not reveal any abnormality. The microbial examination of culture revealed the presence of periodontal pathogen Aggregatibacter actinomycetemcomitans. The treatment objective in the present case was to prevent the further progress of the condition, restore esthetic and function in the child which would psychologically benefit the child

Comparison of shear bond strength and micro-leakage of three commercially available seventh generation bonding agents in primary anterior teeth: An in vitro study

Purpose: The study was conducted with the aim of comparing the shear bond strength (SBS) and microleakage of Tetric N-Bond, G-bond, and Xeno V (seventh generation dentin adhesives) in primary anterior teeth. Materials and Methods: For the shear bond strength, 45 teeth were randomly divided in to three groups namely group A, B, C (n = 15). Samples were mounted horizontally on acrylic block exposing the facial surface and bonded with different adhesives according to manufacturer instructions. A split Teflon mold was used to build the composite resin cylinder and light cured. Shear bond strength was tested using a universal testing machine. The values were statistically analysed. For microleakage, another 45 teeth were similarly grouped. Two class V cavities were prepared on the labial surface and treated with different dentine bonding agents and restored with resin composite (Ivoclar vivadent) A2 shade. The restorations were subsequently thermally stressed for 200 cycles and were subjected to dye penetration test, followed by sectioning through the center of the restoration labiolingually. Each section was examined using stereomicroscope at × 40 magnification to asses dye penetration at the margins of the restoration. Results: The SBS varied between 22.12-23.77 N/mm 2 (P-value = 0.231). The microleakage scores varied between 0.6-1.2 (P-value = 0.03; Post-hoc test A vs B (0.007)).There was a statistically higher degree of microleakage observed in group A when compared to group B. Conclusion: Among the three commercially available bonding agents, there were no statistically significant differences in SBS. G bond had higher microleakage when compared to the others

Prevalence of dental caries in people attending special schools in Hyderabad-Secunderabad, India

Aim: The present cross-sectional study was conducted to determine the decayed, missing, filled primary and permanent teeth (dmft-DMFT) indices and its association with the type of disability in 856 disabled individuals attending special schools in twin cities of Hyderabad and Secunderabad, Andhra Pradesh State, India. Materials and Methods: Participants were grouped according to their disability such as: Mild, moderate, severe mental retardation, hearing and speech defect and others (39) (including Down′s syndrome [20], autism [9], hyperactive [4], microcephaly [2], border line cases [4]). Examination was carried out at their schools, with participants seated in ordinary chairs and examined under natural light with mouth mirror and probe. Subjects were of different age groups ranging from 1 to 55 years. Statistical Analysis Used: Analysis of variance with post-hoc Games-Howell test was used for statistical analysis. Results: Mean dmft; DMFT scores were as follows: 2-6 years: 1.58 ± 1.9; 2.18 ± 2.94, 7-12 years: 1.1 ± 2.4; 1.9 ± 2.13, 13-30 years: 2.38 ± 2.5, 30+ years: 2.13 ± 3.2. Overall only 23% of subjects were caries free. "dmft" was statistically higher among moderate mentally retarded group while DMFT was statistically higher in mild and moderate mentally retarded groups. Conclusions: These findings emphasize the need of educating parents and caregivers of disabled individuals in preventive dental procedures, especially those of the mild and moderate mentally challenged group

Conservative Approach in the Management of Radicular Cyst in a Child: Case Report

Radicular cyst is the most common odontogenic cystic lesion of inflammatory origin. It is also known as periapical cyst, apical periodontal cyst, root end cyst, or dental cyst. It arises from epithelial residues in the periodontal ligament as a result of inflammation. The inflammation usually follows the death of dental pulp. This paper presents a case report of a patient with radicular cyst associated with a primary molar

Non syndromic gingival fibromatosis in a mild mental retardation child

Gingival fibromatosis is a benign oral condition characterized by enlargement of gingival tissues. It usually develops as an isolated disorder but can be one of the features of a syndrome. This case report is of a 5-year-old male with severe gingival hyperplasia and mild mental retardation which was complicated by open bite, abnormal occlusion, open lip posture, and disabilities associated with mastication and speech. Full mouth gingivectomy in single sitting under general anesthesia was done with electrocautery

Type III B dens invaginatus: Diagnostic and clinical considerations using 128-slice computed tomography

Endodontic therapy is successful only when thorough knowledge of root canal morphology is understood. Dens invaginatus is malformation of teeth resulting from invagination of tooth before biological mineralization occurs. It is clinically significant with an early pulpal involvement and chronic periapical lesion, which are often associated with this anomaly. The present case report describes a 13-year-old female patient who reported to our institution with complaint of pain and swelling in the right maxillary region. Intraoral examination revealed Ellis Type II fracture of right maxillary central incisor and normal appearing right maxillary lateral incisor. On radiographic examination right maxillary, lateral incisor roots are morphologically altered with an immature apex and a large periradicular lesion. Conventional radiographs help in the assessment of complex root morphology, but certain limitations pertaining to detail of complexity needs for the use of more advance imaging modalities. Complex anatomic variations can best be diagnosed with the use of computed tomography (CT). A combined endodontic and surgical treatment was performed followed by postobturation CT images which were reviewed as axial slices and in volume rendering multiplanar reconstruction. The scope of using spiral CT in the endodontic diagnosis and treatments is increasing as it provides better resolution than other methods