Compound odontoma associated with impacted maxillary central incisor dictates a need to be vigilant to canine eruption pattern: A 2-year follow-up

Canine deviation from its path of eruption is usually followed by either delayed or impaction of canine. One of the important and not so noticed reasons for canine displacement is formerly impacted central incisor. The difference in age of eruption of these two teeth is 4 years; however, the absence of maxillary incisor should be perceived with utmost conviction about impending canine displacement leading to its impaction as well. This case presents similar picture where composite, compound odontoma with respect to maxillary central incisor led to its impaction resulted in deviated path of eruption for erupting canine. This canine displacement to worsen prognosis ended up getting impacted if not dealt with cautiously in the later stages of occlusal development

Griscelli syndrome type 2: a novel mutation in gene with different clinical features in 2 siblings: a diagnostic conundrum

Griscelli syndrome type 2 (GS2) is a rare autosomal recessive disease caused by mutations in the RAB27A gene. It is characterized by cutaneous hypopigmentation, immunodeficiency, and hemophagocytic lymphohistiocytosis. We describe 2 brothers who had GS2 with clinically diverse manifestations. The elder brother presented with a purely neurological picture, whereas the younger one presented with fever, pancytopenia, hepatosplenomegaly, and erythema nodosum. Considering that cutaneous hypopigmentation was a common feature between the brothers, genetic analysis for Griscelli syndrome was performed. As the elder sibling had died, mutation analysis was only performed on the younger sibling, which revealed a novel homozygous mutation in the RAB27A gene on chromosome 15 showing a single-base substitution (c.136T>A p.F46I). Both parents were heterozygous for the same mutation. This confirmed the diagnosis of GS2 in the accelerated phase in both siblings. The atypical features of GS2 in these cases are a novel mutation, isolated neurological involvement in one sibling, association with erythema nodosum, and 2 distinct clinical presentations in siblings with the same genetic mutation

Evaluation of treatment related fear using a newly developed fear scale for children: "Fear assessment picture scale" and its association with physiological response

Introduction: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. Aims: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. Settings and Design: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. Statistical Analysis Used: Shapiro-Wilk test, McNemar′s test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. Results: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure. Conclusions: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time

A comparative microleakage evaluation of three different base materials in Class I cavity in deciduous molars in sandwich technique using dye penetration and dentin surface interface by scanning electron microscope

Introduction: A major objective in restorative dentistry is the control of marginal leakage, which may occur because of dimensional changes or lack of adaptation of restorative material to the cavity preparation. Numerous techniques have been advocated to overcome polymerization shrinkage in composite restorations. Aim and Objectives: This study investigated microleakage of three different bases under composite resin in sandwich technique using dye penetration and dentin surface interface using scanning electron microscope (SEM). Materials and Methods: Sixty extracted deciduous molars were stored in distilled water and Class I cavities with a width of about one-fourth of intercuspal distance and a depth of 0.5-1 mm below the dentino-enamel junction was prepared without bevels. In Group 1 - glass ionomer cement (GIC); Group 2 - mineral trioxide aggregate (MTA); Group 3 - Biodentine™ was placed as a base under composite. Teeth were longitudinally sectioned in two halves, through the centers of the restoration, immersed in 2% methylene blue and microleakage was evaluated under stereomicroscope and surface interface between base and dentin was evaluated under SEM. Results:Under the condition of in vitro study, less microleakage and less internal gaps were seen in Biodentine™ (0.00 ± 0.00 and 4.00 ± 1.59) group than MTA (0.00 ± 0.00 and 6.08 ± 1.82) and GIC (25.25 ± 6.57 and 14.73 ± 3.72, respectively) and showed very strong positive correlation between microleakage and internal gaps. Conclusion: Biodentine™ exhibits superior marginal sealing ability as well as marginal adaptation under composite resin as compared to MTA and GIC

Evaluation and comparison of the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism

Background: Autism is a neurobiological disorder characterized by impaired social interaction, communication difficulties, and lacking manual dexterity. These limitations make the oral hygiene maintenance very difficult. Aim: The aim of this present study is to evaluate and compare the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism. Setting and Design: Sample comprised 22 children with autism who daily visited a day care and education center named ARUSHI - a center for children with special health care needs in Bhopal. Methods: Children were divided into two groups (Group A and B) according to toothbrush used and further divided into subgroups (A1 and B1 [low fluoridated − Pediflor toothpaste] and A2 and B2 [calcium sucrose phosphate − Enafix toothpaste]). Oral hygiene instructions and brushing technique demonstration were given every day for a period of 1-month. Oral health status was evaluated before and after the study using simplified oral hygiene index (OHI-S) and its Miglani's modification for primary dentition, plaque index (PI), gingival index (GI), and decayed, missing, and filled teeth (DMFT)/deft index. The perception of parents regarding oral hygiene practices for their kids was also evaluated by an awareness and attitude questionnaire. Statistical Analysis: OHI-S, GI, PI, and DMFT/deft were statistically evaluated using Mann–Whitney U- test. Results and Conclusion: Mean value of OHI-S decreased significantly with powered toothbrush (0.035 [P < 0.05]) in both groups. However, PI decreased significantly for Enafix when used with powered toothbrush (0.042 [P < 0.05]). Perception of parents was seen to improve significantly after 1-month study (0.000 [P < 0.05])