Ashish Sinha

Keratocystic odontogenic tumour (KCOT) misdiagnosed as a dentigerous cyst.

Keratocystic odontogenic tumours are known for their peculiar behaviour, varied origin, debated development, unique tendency to recur and disputed treatment modalities. Thus, it has been the subject of much research over the last 40 years. It was formerly known as odontogenic keratocyst (OKC). OKC received its new title as keratocystic odontogenic tumour (KCOT) by the WHO (2005) in order to suggest its aggressive and recurrent nature. KCOT is a benign intraosseous neoplasm of the jaw. Involvement of the maxillary sinus is an unusual presentation. We present the case of an 11-year-old child with extensive KCOT and an impacted canine in the right maxillary sinus. The cyst was initially misdiagnosed to be a dentigerous cyst based on the clinical and radiographic features though a differential diagnosis of KCOT and adenomatoid odontogenic tumour was made. The histological examination of the specimen finally confirmed it to be a KCOT. The clinical, radiological and histological features of this tumour along with its surgical management have been discussed.

Hormonal effect on gingiva: pubertal gingivitis

A 13-year-old female patient reported to the department with pain in the gums and bleeding from the gums during brushing. On examination, there was a solitary firm gingival enlargement between 11 and 12. Marginal gingiva of lower anterior teeth was severely inflamed and bleeding on probing was present (figure 1). Generalised gingivitis was present (figure …

Giant cystic lymphangioma in childhood: a rare differential for the acute abdomen

Cystic lymphangiomata are rare benign tumours of childhood resulting from an abnormal development of the lymphatic system, most commonly arising in the head and axillary region. We report a case of haemorrhagic intra-abdominal cystic lymphangiomata presenting as an acute abdomen. A 5-year-old girl was admitted with low-grade fever, generalised abdominal pain and elevated inflammatory markers, and a clinical diagnosis of acute appendicitis was made. At operation, two large fluid-filled haemorrhagic cystic lesions were found to occupy most of the abdominal cavity. The lesions were completely excised and histological examination identified them as cystic lymphangiomata. This case report and literature review highlights aspects of the presentation which might have resulted in a preoperative diagnosis, which is seldom achieved.

Evaluation of Different Root Canal Obturation Methods in Primary Teeth Using Cone Beam Computerized Tomography

OBJECTIVE To evaluate the efficiency of 3 different obturation techniques; motor driven lentulospiral, hand held lentulospiral and reamer in primary anterior teeth and presence of voids by analyzing with CBCT. STUDY DESIGN 60 single rooted extracted primary teeth were prepared and obturated with ZOE paste. Obturation methods were divided into three groups. GROUP I- motor driven lentulo spiral, II- hand held lentulo spiral and III- reamer. Obturated samples were scanned in CBCT machine and images were analysed for the evaluation of their quality of fill comprising presence, location and size of voids. RESULTS At all the locations, Group II had maximum number of sites with voids when compared to other two groups. However, statistically significant intergroup differences were observed only at coronal third location (p=0.001) and overall assessment (p=0.003). Number of affected sites revealed the difference between Groups I and II be significant statistically (p=0.002) while the difference between Groups I and III and between Groups II and III was not significant statistically (p>0.05). At all the locations as well as for combined assessment, Group I had minimum mean size of the void. CONCLUSION Motor driven lentulo spiral technique demonstrated more number of optimal fills with fewer voids when compared to hand held lentulo spiral technique and reamer.

Oral melanotic neuroectodermal tumor of infancy

Melanotic neuroectodermal tumor of infancy (MNTI) is an extremely rare, benign neoplasm of neural crest origin composed of relatively primitive pigment-producing cells. It usually affects new born or infants of <1 year of age, generally involving the face or cranium. This case report describes a 4-month-old child with MNTI involving the anterior region of maxilla. A partial maxillectomy was performed on the left side of maxilla and the patient is now under follow-up.

Co-relation of body mass index, dental caries and periodontal status with fluorosis in different high fluoridated areas of Haryana state, India.

BACKGROUND AND AIM The aim of the present study is to compare the effect of corticotomy versus prostaglandin E1 injection in human subjects on rate of tooth movement, anchorage loss and their effect on crest bone height and root length. SETTINGS AND DESIGN Clinical interventional study. Split mouth design was used. MATERIALS AND METHODS Study was done on 32 regular orthodontic patients. A volume of 100 mcg of prostaglandin E1 was injected on the right side once in 2 weeks and on the left side corticotomy was performed, and canine retraction was started on both sides simultaneously. The rate of space closure and anchorage loss was assessed with casts. The root length and crestal bone height changes were assed with IOPAs. The comparison of rate of tooth movement, anchorage loss, crestal bone height and root length changes between the sides were statistically analyzed using paired t-test. RESULTS The average rate of space closure on right side was 0.36 mm/week with a standard deviation of 0.05 mm/week and on the left side average rate of space closure was 0.40 mm/week with a standard deviation of 0.04 mm/week. The difference between the rate of closure between the right side and left where found to be statistically significant (P=0.003). The anchorage loss, the crestal bone height changes and root length changes were not statistically significant. CONCLUSION The rate of tooth movement was significantly more with corticotomies when compared with given dose of prostaglandin injection.

Laparoscopic management of chylous ascites following laparoscopic donor nephrectomy

Laparoscopic donor nephrectomy (LDN) is an established operation for organ procurement in living donor transplantation. Living donor renal transplantation is being performed more frequently and is associated with better graft function and survival. The minimal access approach for organ procurement from healthy individuals ensures early convalescence and improved patient participation. Here we describe a rare complication of LDN. Postoperative chylous ascites frequently occurs secondary to aortic surgery. Though previously described after LDN, its treatment remains contentious. Conventional strategies have adopted an expectant approach with medical management. These include parenteral feeding, bowel rest and somatostatin analogue usage. We report laparoscopic suture ligation as the principal management of postoperative chyle leak. We advocate surgical exploration in acute onset, high output chylous ascites. Pre-existing port site incisions were used for undertaking successful laparoscopic repair. This surgical approach enabled faster convalescence and reduced hospital stay—important considerations for our healthy living donor.

Comparative evaluation and applicability of three different regression equation-based mixed dentition analysis in Northern Uttar Pradesh population

Aims: This study aims to examine the accuracy and comparative correlation of three regression equation-based mixed dentition analysis in children of Moradabad city, North Uttar Pradesh. Settings and Design: Tanaka–Johnston, Bernabe–Flores-Mir, and Ling–Wong regression equations were developed from a sample of North European, Peru, and Southern Chinese children population, respectively. Hence, it becomes questionable when applied to children of Moradabad city situated in North Uttar Pradesh, India. Subjects and Methods: The study was conducted on a sample of 100 school going children, age range is 11–14 years with complete permanent teeth except third molars. The mesiodistal crown dimensions of all erupted incisors, canines, premolars, and molars were measured with digital calipers with a calibration accuracy of 0.01 mm. The actual tooth measurements were then compared with predicted values using Tanaka–Johnston, Bernabe–Flores-Mir, and Ling–Wong regression equations, respectively using paired t-test. Results: The mean difference between the actual and estimated values of canines and premolars using Tanaka–Johnston, Bernabe–Flores-Mir, and Ling–Wong were clinically and statistically significant (P< 0.001). Conclusions: Mesiodistal dimensions of male samples are larger than female samples. All the three regression equations are not accurately applicable to this population.

Evaluation of Three Different Regression Equations Based Mixed Dentition Analysis in Children of Moradabad City, India

Objective: To assess the accuracy and applicability of three regression equations based mixed dentition analysis in children of Moradabad city, India. Material and Methods: Actual mesiodistal width of maxillary and madibular incisors, canines and premolars of 100 children (50 male and 50 female) aged 11-14 years were measured on dental cast with electronic digital vernier caliper. The analysis of Tanaka- Johnston, Ling-Wong and Jaroontham-Godfrey regression equations were tested on the dental casts. All analyses were performed on SPSS software. Data were summarized as Mean ± standard deviation (SD) paired observations were compared by paired t-test (two-tailed test) while independent groups were compared by independent Student’s t-test. The level of significance was at P < 0.001. Results: The analysis of Tanaka-Johnston, Ling-Wong, Jaroontham-Godfrey regression equations tended to overestimate the mesiodistal width of the canines and premolars with the actual measured values. Conclusion: All the three regression equations based mixed dentition overestimated the mesiodistal width of canines and premolars in Moradabad population.

Effect of Qmix and Other Irrigants on Dentin Adhesives in Pulp Chambers of Primary Teeth: SEM Study

OBJECTIVE To compare the effect of different endodontic irrigants on microleakage of adhesives used within pulp chamber of primary molars. STUDY DESIGN 72 Primary molars were divided into 6 groups, according to 3 irrigants and 2 adhesives used. After de-roofing the pulp chamber, pulp was extirpated. In 36 samples, pulp chambers were bonded with Xeno V+ after irrigation with either QMix (Group1); 17%EDTA+5%NaOCl (Group2) or normal saline (Group3) and in other half samples, pulp chambers were bonded with SinglebondUniversal after irrigation with either QMix (Group 4); 17%EDTA+5% NaOCl (Group5) or normal saline (Group 6). All the samples were restored with Filtek Z350. Ten teeth from each group were assessed for dye penetration. Two samples in each group were viewed under scanning electron microscope. Data was statistically analyzed using Mann-Whitney and Kruskal Wallis tests at a significance level of P < 0.05. RESULTS Mean microleakage scores were: Group 1-1.5±0.70, Group 2-1.6±.51, Group 3-2.4±0.96, Group 4-1.2±0.42, Group 5-1.2±0.42, Group 6-1.1±0.32. CONCLUSIONS Irrigation with QMix significantly reduced the microleakage of XenoV+ but had no significant effect on microleakage of SinglebondUniversal. Irrigation with EDTA/NaOCl or QMix had no detrimental effect on the sealing ability of either of the adhesive tested.