Addisonian Hyperpigmentation as Oral Manifestation in Primary Adrenal Insufficiency – A Case Report

Primary adrenal insufficiency is an endocrine disorder which is characterized by aldosterone and cortisol deficiency due to destruction of the adrenal cortex. The purpose of this case report is to present a rare case of 10-year-old child patient who reported with a chief complaint of pain in the upper left back tooth region of the jaw since a week and was diagnosed as Addison disease with hyperpigmentation of dorsal surface of the tongue, perioral structures and skin folds, nails and overall skin of the body. Oral manifestations along with endocrine issues play a crucial role in diagnosis & treatment planning of this disease. Dental infection can be a cause of adrenal crisis in patients with long term adrenal insufficiency, so paediatric dentists should be aware and a multidisciplinary approach is mandatory to ensure adequate medical and dental treatment in children. Limited number of case reports in literature suggest that adrenal crisis is a rare emergency condition in dentistry, and diagnosis is mandatory to rule out any condition before a dental surgical procedur

Evaluation of skeletal maturation in Indian adolescents using calcification stages of permanent mandibular second molar

Aim: The aim of this study was to investigate the relationships between the stages of calcification of teeth (permanent mandibular second molar) and cervical vertebrae maturation (CVM). Materials and Methods: This study was conducted on 200 Indian children (98 boys and 102 girls), whose panoramic radiographs (orthopantomogram) for mandibular second molar tooth calcification stages and visual appraisals of the lateral cephalograms for CVM stages, were recorded using Demirjian Index (DI) and CVM indicator (CVMI). Results: Each stage appeared earlier in female participants than males. A highly significant association was found between DI and CVMI. Stage F and G of DI, which corresponds to Stage 3 of CVMI indicated the start of the peak in mandibular growth, which would be appropriate time to plan for growth modification appliance placement. Stage G of DI also corresponds to Stage 4 of CVMI, i.e., deceleration of adolescent growth spurt. Stage H of DI corresponding to CVMI Stages 5 and 6 indicates that the peak of mandibular growth has already occurred and is not appropriate for functional appliances. Conclusion: Mandibular second molar calcification stages are reliable skeletal maturity indicators for the evaluation of growth phases in children

P-Cincher: A modified band contouring plier

This article presents modification of band contouring plier into arch wire cinching plier (P-Cincher), which is easy to modify and user-friendly. The conventional method for arch wire bending is by heating and bending of distal ends of the arch wire with the help of light wire plier or Weingart plier, this method of arch wire bending is time-consuming, and it may loosen bands or debonding of bondable buccal tube while cinching. This plier is designed to overcome disadvantages of conventional method, and it will definitely help in faster and effective cinching of arch wire

Effectiveness of Audiovisual Distraction in Reducing Children’s Anxiety for Pain During Medical and Dental Treatments: A Systematic Review and Meta-analysis

Background: Audiovisual distraction is a potentially good technique to reduce medical treatment procedure-related fear and anxiety among children. However, few studies have assessed its effectiveness. Objective: To conduct a systematic review and meta-analysis for evaluating the effectiveness of audiovisual distraction in reducing pain anxiety in pediatrics. Methods: Randomized control trials and experimental studies that reported the use of audiovisual distraction during medical/dental treatments among children aged 3–8 years, used the Face, Legs, Activity, Cry, Consolability (FLACC) scale to assess pain, and were published between 2005–2021 and in English were retrieved from PubMed, Scopus, and Web of Science. A random-effects model was used for evidence analysis. Results: A total of four studies were included in the systematic review and meta-analysis: two were from South Asia and one each were from Africa and North America. Three of these studies were randomized control trials. The variability among the studies was high. Three of the four studies found that AV techniques were significantly effective in reducing pain during procedures compared with the control group (P < 0.00001), while one study found no difference; the cumulative evidence in the forest plot was similar. Conclusion: Cumulative evidence suggests that the use of audiovisual distraction is an effective strategy in reducing medical/dental procedures-related pain anxiety among children aged 3–8 years. However, evidence on this is currently limited, and thus further studies are required using various AD techniques and on different populations to substantiate these findings. Funding: None. Registration: PROSPERO (Ref no.: CRD42021245874)

Probiotics for life – Part I general health perspectives

Scientific evidence is expanding continuously during the past few decades, pointing to the beneficial effects of probiotic bacteria on human health. Food industry has been very active in studying and promoting various probiotic products. The WHO has advocated the reduced use of antibiotics and microbial interference therapy (use of nonpathogens to eliminate pathogens), observing the increasing development of antimicrobial resistance. Initially, probiotics were traditional used for the treatment of gastrointestinal disorders and allergies; later, there has been an expansion in therapeutic uses of these agents in urogenital infections, carcinomas, etc. Due to the increasing mountain of literature on this topic, brief user-friendly information is provided in lucid language for busy clinicians. This Part I article gives an overview of the history and properties of probiotics, mechanisms of action, and uses to promote general health. The Part II article, coming in next issue of this journal, highlights on oral health. To understand oral effects of probiotics, their medical background knowledge is essential

Autologous reattachment of complicated crown fractures using intra canal anchorage: Report of two cases

Crown fractures are most common form of dental trauma sustained by children and adolescents. Major portion of these crown fractures are uncomplicated. Complicated crown fractures though infrequent and account only 4-16%, is an enigma to any clinician. Autologus reattachment of the tooth fragment is a simple and conservative procedure in managing such crown fractures. The present article intends to report the successful clinical management of Autologus tooth fragment reattachment in two complicated crown fractures

Diagnosis and management of periodontal disease in children and adolescents: A brief review

Periodontal disease when occurring in children leads to premature tooth loss, affecting the quality of life. Thus, screening pediatric and adolescent patients early, for periodontal disease is deemed imperative to its early management for improved prognosis. Chronic periodontitis (CP) has slow rate of progression, whereas aggressive periodontitis (AP) affecting children and young adults has rapid rate of progression. The management of AP in particular is affected by bacterial virulence of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis in plaque leading to rapid attachment and bone loss around the affected teeth. Nonsurgical treatment, use of appropriate antimicrobial therapy, and surgical correction of defects is required to mitigate disease followed by a comprehensive supportive periodontal therapy. This review visits the current understanding of periodontal disease, its management in pediatric and adolescent patients

Spectrum of choices to restore the smile of a child: An update on current pediatric anterior crowns

Esthetic treatment of severely damaged primary teeth is one of the greatest challenges to pediatric dentists. A wide variety of full coverage esthetic crowns for primary teeth are commercially available in the market. A practitioner should choose convenient, durable, and reliable solution which is fulfilled with complete knowledge of different crown forms. This article on esthetic crowns for children gives an outline of various anterior crowns in a tabular form, reviews their composition, advantages, disadvantages, and selection criteria