Abhishek Dhindsa

A study of sports related occurrence of traumatic orodental injuries and associated risk factors in high school students in north India.

Background: Oral and dental injuries contribute to a major part of sports related injuries in children. Trauma occurring in developing years disrupts normal social functioning and brings about a major impact on quality of life due to their cumulative effect. Objectives: To assess the prevalence and causes of various sports related traumatic orodental injuries among 8 to 16 year school students along with identifying the associated risk factors in North India. Patients and Methods: A cross sectional study consisting of high school students of different organized sports teams aged 8-16 years was carried out in geographical area of north India. The students were selected by multistage cluster sampling methodology. 1105 students from 19 school teams (sports teams) and sports academies participated in study through structured interview and clinical examination in different sports situations. Results: 30.3% (n = 335) of students suffered from orodental injuries. A higher number of girls had injury (32%) than boys (29%), though the difference was not significant. Most of the students suffered from soft tissue injuries (48%) followed by tooth fractures (43%). Maximum numbers of injuries were reported in high velocity (44.1%) and medium intensity sports (46.6%) (P < 0.001) Maximum injuries occurred in basketball (50%) and lowest in the field of badminton (6.1%) (P < 0.05). Amateurs (52%) suffered the most from injuries as per level of coaching. Only 6% of boys and 2% of girls used mouthguards. Conclusions: The result of the present study confirmed that students participating in different organized sports at high school level are at a very high risk of getting orodental injury. Hence knowledge and education regarding prevention of traumatic injuries is of paramount importance.

Comparative evaluation of the effectiveness of electronic dental anesthesia with 2% lignocaine in various minor pediatric dental procedures: A clinical study

One of the most distressing aspects of dentistry for pediatric patients is the fear and anxiety caused by the dental environment, particularly the dental injection. The application and induction of local anesthetics has always been a difficult task, and this demands an alternative method that is convenient and effective. Electronic dental anesthesia, based on the principal of transcutaneous electric nerve stimulation (TENS), promises to be a viable mode of pain control during various pediatric clinical procedures. Therefore, the aim of the present study was to evaluate the effectiveness of TENS and to compare its efficacy with 2% lignocaine during various minor pediatric dental procedures. Pain, comfort and effectiveness of both the anesthetics were evaluated using various scales and no significant difference was observed between 2% lignocaine and TENS in the various pain scales, while TENS was perceived to be significantly effective in comfort and efficacy as judged by the operator and quite comfortable as judged by the patient himself/herself.

Esthetic management of developmental enamel opacities in young permanent maxillary incisors with two microabrasion techniques--a split mouth study.

PURPOSE This study evaluated the effectiveness of two microabrasion materials for the removal of developmental enamel opacities in young permanent maxillary incisors. MATERIALS AND METHODS Using a split-mouth study design, 37% phosphoric acid and 18% hydrochloric acid were used for removal of visually unesthetic developmental enamel opacities of young permanent maxillary anterior teeth from 25 subjects (11-13 years old) by two microabrasion techniques for 10 and 5 seconds respectively. This procedure was repeated four to six times during each clinical appointment. The subjects were evaluated about their satisfaction with the treatment. Two blinded evaluators appraised both sides of the mouth using visual analog scale. The records were analyzed using Wilcoxon test. RESULTS The majority of the subjects (approximately 97%) reported satisfaction at the end of the treatment (p = 0.001**). Statistical significant reduction in enamel opacities was observed by evaluators immediately after microabrasion technique in group 1 (81.75%) and in group 2 (81.4%) (p < 0.002). Reduction was increased to 97.2% in group 1 and 96.7% in group 2 after 1 month. CONCLUSIONS Both microabrasion techniques showed comparative highly significant successful results in esthetic management of enamel opacities clinically and in terms of subjects satisfaction. CLINICAL SIGNIFICANCE Developmental enamel defects like diffuse opacities due to high-fluoride content in water and demarcated opacities associated with positive dental history and are commonly seen in young permanent maxillary incisors of both boys and girls in their developing years. They are aware of unesthetic appearance of these newly erupted permanent anterior teeth and become highly motivated when informed about minimally invasive, patient friendly, cost-effective, and safe treatment like microabrasion for esthetic improvement. Both noninvasive microabrasion techniques using 37% phosphoric acid (group 1) and 18% hydrochloric acid (group 2) show comparatively high success results in treating enamel defects successfully to the subjects satisfaction along with their parents.

Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible.Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Transmission of mutans streptococci in mother-child pairs

Background & objectives: Dental caries is an infectious, transmissible disease. Maternal transfer of mutans streptococci (MS) has been a subject of research. The aim of this study was to evaluate the transmission of MS from mother to children through genetic analysis. Methods: Thirty mother–child pairs were included and divided into three groups according to the age of the children. Saliva samples were collected and MS colonies from each mother-child pair were isolated. After inoculation and incubation, MS colonies were submitted to amplification technique by polymerase chain reaction (PCR) for identification and arbitrarily primed PCRs (AP-PCRs) to determine various MS genotypes. Results: From birth to six months of age, 30 per cent of children exhibited MS colonization, and by the age of 30 months, 100 per cent harboured the bacteria (P < 0.001). Factors associated with MS colonization were eruption of teeth (P < 0.001), feeding habits with mean colony count being significantly lower in breast-fed as compared to bottle-fed children (P < 0.001) and a significant association between mean MS count of child and mothers practice of sharing spoon with child (P < 0.001). The AP-PCR fingerprinting profile analysis showed 17 MS groups (clusters) containing identical or highly related isolates in mother-child pairs with a high level of similarity (77.27 %). Interpretation & conclusions: The presence of matching MS genotypes suggested vertical transmission from mothers to children. Feeding habits, gum cleaning and number of erupted teeth in children had significant effect on MS colonization. There is a need to develop strategies to present MS colonization in children.

Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study

Background: To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)2) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. Materials and Methods: The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). Results: In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)2 group. Conclusion: MTA and Ca(OH)2, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.

Assessment of White Spot Lesions and In-Vivo Evaluation of the Effect of CPP-ACP on White Spot Lesions in Permanent Molars of Children.

INTRODUCTION As hindrance of remineralisation process occurs during orthodontic therapy resulting in decalcification of enamel because number of plaque retention sites increases due to banding and bonding of appliances to teeth. AIM The present analytic study was undertaken to assess the occurrence of white spot lesions in permanent molars of children with and without orthodontic therapy and to evaluate the effect of Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions in post-orthodontic patients in a given period of time. MATERIALS AND METHODS The study comprised of examination of 679 first permanent molars which were examined to assess the occurrence of smooth surface white spot lesions in children of 8 to 16 years age group. Group I comprised subjects without any orthodontic treatment and Group II comprised of subjects who had undergone orthodontic therapy. The sample size was calculated using the epi-info6 computer package. Treatment group included 20 post-orthodontic patients examined with at least one white spot lesion within the enamel who received remineralizing cream (GC Tooth Mousse, Recaldent, GC Corporation.) i.e., CPP-ACP cream two times a day for 12 consecutive weeks. Computerized image analysis method was taken to evaluate white spot lesions. These frequency and percentages were compared with chi-square test. For comparison of numeric data, paired t-test was used. RESULTS Of the total 278 (49.6%) first permanent molars showed occurrence of smooth surface white spot lesions out of 560 in Group I and 107 (89.9%) first permanent molars showed presence of white spot lesions out of 119 debanded first permanent molars of children examined in Group II. CPP-ACP therapy group showed reduction in severity of codes which was found to be highly significant after 12 weeks and eight weeks on gingival-third, p-value (<0.001) and significant after eight weeks and four weeks on middle-third according to ICDAS II criteria and computerized image analysis. CONCLUSION CPP-ACP therapy minimum for 12 weeks is highly recommended as post-orthodontic treatment need in management of smooth surface white spot lesions on teeth undergoing fixed orthodontic therapy according to the present study.

Oral drug-induced lichenoid reaction in pediatric age group

Mucocutaneous diseases in the pediatric population are extremely rare and, hence, can have both psychological and behavioral bearing. Mucosal conditions in children include herpetic stomatitis, vesiculobullous lesions, aphthous and traumatic ulcerations, candidiasis, lichen planus, and drug-related mucosal lesions. This case report deals with a rare presentation of a 4-year-old child reporting with an extensive involvement of oral cavity with erythematous, ulcerative, and pigmented areas associated with drug intake.

Oral subcutaneous midline leiomyomatous hamartoma presenting as congenital incisive papilla overgrowth in a toddler

Congenital soft-tissue tumors of oral cavity are mostly hyperplastic and benign in nature. This article presents an unusual case of congenital subcutaneous hamartoma of incisive papilla in a 2-year-old female child causing feeding and breathing difficulty. Total excisional biopsy was done under local anesthesia. Histopathology of tissue in reticulin-stained slide showed the presence of immature muscle fibers whereas Massons trichrome stain revealed collagen fibers and smooth muscles confirming the diagnosis of oral midline subcutaneous smooth muscle (leiomyomatous) hamartoma of incisive papilla. It is important for dental professionals to be aware of this oral lesion present from birth mimicking overgrowth of incisive papilla, by its presentation, differential diagnosis, histopathology, and management.

Correlation between dental caries experience and mutans streptococci counts by microbial and molecular (polymerase chain reaction) assay using saliva as microbial risk indicator

Background: The aim of this study was to assess the relationships of quantitative salivary levels of mutans streptococci (MS) in children, aged 3–6 years and 12–15 years, exhibiting variable patterns of caries activity, and to compare the association of MS in saliva using microbial and molecular (polymerase chain reaction [PCR]) assay. Materials and Methods: In this cross-sectional observational study, eighty children were included, forty children each in Group I (3–6 years) and Group II (12–15 years). Children were further divided into two subgroups (Group IC, INC and Group IIC, IINC) based on their dental caries status. Saliva samples were collected and plated onto Mitis Salivarius-Bacitracin agar plates. After detection of MS, DNA was isolated and purified, and MS were evaluated using the PCR and AP-PCR. Results: Of the selected 80 children, 42 were male and 38 were female. In Group IC, the mean colony count was 2.27 ± 0.54 × 105 CFU/ml, and in Group INC, the mean colony was found to be 1.61 ± 0.54 × 105 CFU/ml. In Group II, where mean colony count of 3.31 ± 0.85 × 105 CFU/ml and 2.44 ± 0.54 × 105 CFU/ml was observed in Group IIC and Group IINC, respectively. Conclusion: The mean colony count increased with increasing age and was also more in children with dental caries. Based on the matrices generated by the PCR analysis using coefficient slipped-strand mispairing, wide range of genetic diversity was seen in cases of children with and without clinically detectable caries.