Chiranjit Ghosh

Low-dose acitretin in Papillon-Lefèvre syndrome: treatment and 1-year follow-up.

The Papillon–Lefèvre syndrome (PLS) is a rare, autosomal recessive disease that manifests with palmoplantar keratoderma and destructive periodontitis resulting in early onset periodontal breakdown in deciduous and permanent dentition. Management of this condition is difficult. Here we report one 11‐year‐old consanguineous Muslim boy suffering from PLS. After failing to get any benefit from methotrexate, three cycles of acitretin, each for 2 months, were given 1 month apart. In each cycle, acitretin (25 mg) was given every other day. At the end of the third cycle, treatment was stopped for 4 months to observe the extent of relapse. Thereafter, acitretin (25 mg) was given twice weekly for 4 months and then the patient was followed up for 1 year. Treatment with acitretin resulted in excellent improvement of periodontitis, increase in the alveolar bone height, and periodontal attachment. Improvement remained stable at the end of 1‐year follow‐up. There was excellent (>75%) improvement in keratoderma at the end of active therapy. Mild worsening of palmoplantar keratoderma was noticed whenever the drug was stopped. It improved when the drug was restarted. Other areas remained stable. At the end of 1‐year follow‐up, good improvement (50%) in palmoplantar keratoderma was achieved.

Assessment of oral health status of Santal (tribal) children of West Bengal.

Context: Santal is the third largest tribal community of India leading a very poor standard of education and life style. There are, however, few population-based studies evaluating the oral health status among Santal children in West Bengal. Aims: The aim of the study was to evaluate the oral health status of Santal children of West Bengal by assessing prevalence of dental caries and inflammatory condition of gingival. Settings and Design: Santal children aged between 2-14 years (N = 1205) were randomly selected from different Santal communities of West Bengal for this study. The children were divided into three different groups according to dentition. Materials and Methods: Caries for permanent dentition Decayed Missing Filled Tooth (DMFT), for deciduous dentition decayed extracted filled (def index was used. For mixed dentition DMF and def was measured respectively and then added together. Inflammatory condition of gingival was assessed by papillary marginal attachment (PMA) index. Statistical Analysis Used: the data was analyzed statistically by SPSS software version 11. Results: The study showed there was no significant difference (P > 0.05) between the average decayed extracted filled teeth (deft)/DMFT for boys and girls in deciduous and permanent dentition. But in mixed dentition this value for the boys was significantly higher (P < 0.001) than girls. ′Z′ values were found to be non significant when compared mild, moderate and severe gingivitis between boys and girls in each dentition group, but mild gingivitis significantly increases from deciduous dentition to mixed to permanent dentition (P <0.001).

Bilateral Molariform Mandibular Second Premolars

Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots.

Esthetic anterior fixed functional space maintainer

Traumatic dental injury is one of the main causes of premature loss of maxillary anterior teeth in schoolgoing children, causing psychological trauma both to patient as well as parents. In that situation, choice of treatment is maintaining the space by space maintainer which may be fixed/removable or functional/nonfunctional. This article describes rehabilitation of a 4½-year-old child after avulsion of the maxillary central incisor, using fixed functional anterior esthetic space maintainer.

Primary double teeth in siblings: A report

Double teeth are developmental malformations affecting both primary and permanent dentition. This article describes primary double teeth in both the siblings of a family. A 5-year-old boy had a bilateral distribution of anomaly involving lower lateral incisor and canine. Radiographic analysis revealed that his right mandibular permanent lateral incisor was missing. His sister, a 3½-year-old girl, also had double teeth affecting mandibular left lateral incisor and canine. She displayed no other dental anomaly. The boy presented shovel-shaped maxillary permanent central incisors. Family involvement of double teeth is very rare. Double teeth in siblings and simultaneous occurrence of multiple dental anomalies probably show a hereditary etiology.

Salivary IgA versus HIV and Dental Caries

INTRODUCTION The inter-relationship of Human Immunodeficiency Virus (HIV) infection and dental caries as well as Salivary Immunoglobulin-A (S-IgA) level appear to remain under explored while a manual and electronic search of the literature was made. Hence, the present study was undertaken to assess the relationship of S-IgA and dental caries status in HIV positive children. AIM The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV positive and negative children and determine the dental caries status in HIV positive and HIV negative children, which may help in treatment planning and prevention of the same. MATERIALS AND METHODS A total of 28 HIV positive children aged between 6-14 years and 28 age matched HIV negative children were included in this study and both samples were randomly selected from the same Non-Governmental Organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. Only 2cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to WHO criteria (1997) using a flat mouth mirror and CPI probe. RESULTS In HIV +ve group mean S-IgA level was calculated as 81.61 ± 6.20 μg/ml, mean DMFT was 3.86 ± 3.37, mean deft was 4.75 ± 2.86. In HIV -ve group mean S-IgA level was calculated as 145.57 ± 17.83μg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong-ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, p < 0.001) and negative but Not Significant (N.S.) correlation (r = -0.19, t = 0.99, p > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, p < 0.001), S-IgA and deft (r = -0.942, t =14.32, p=<0.001) was found in HIV-ve group. CONCLUSION This study suggests that the individuals who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

A comparative evaluation of dental caries status among hearing-impaired and normal children of Malda, West Bengal, evaluated with the Caries Assessment Spectrum and Treatment

Context: Dental caries is one of the major modern-day diseases of dental hard tissue. It may affect both normal and hearing-impaired children. Aims: This study is aimed to evaluate and compare the prevalence of dental caries in hearing-impaired and normal children of Malda, West Bengal, utilizing the Caries Assessment Spectrum and Treatment (CAST). Settings and Design: In a cross-sectional, case-control study of dental caries status of 6-12-year-old children was assessed. Subjects and Methods: Statistically significant difference was found in studied (hearing-impaired) and control group (normal children). In the present study, caries affected hearing-impaired children found to be about 30.51% compared to 15.81% in normal children, and the result was statistically significant. Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group, and the result is significant at P < 0.05. Statistical Analysis Used: Statistical analysis was carried out utilizing Z-test. Results: Statistically significant difference was found in studied (hearing-impaired) and control group (normal children). In the present study, caries effected hearing-impaired children found about 30.51% instead of 15.81% in normal children, and the result was statistically significant (P < 0.05). Regarding individual caries assessment criteria, nearly all subgroups reflect statistically significant difference except sealed tooth structure group, internal caries-related discoloration in dentin, and distinct cavitation into dentine group. Conclusions: Dental health of hearing-impaired children was found unsatisfactory than normal children when studied in relation to dental caries status evaluated with CAST.

A comparative evaluation of ideal apical sealing material for open apex single rooted permanent tooth: An in vitro study

Introduction: Traumatic injury and dental caries in developing tooth can cause irreversible damage to the pulpal tissue, which hinders the normal physiologic root development. Aims and Objectives: The aim was to find out the sealing efficacy of mineral trioxide aggregate (MTA) as an ideal apexification material of a permanent tooth with an open apex by comparative evaluation of grey and white MTA of different thickness and time interval in vitro. Materials and Methods: A total of 144 teeth were randomly distributed into 6 equal test groups containing 24 teeth each and then filled with white and gray MTA to thickness of 1, 2, and 4 mm. Microleakage of these samples was studied by bacterial leakage model at definite intervals (After 24 h,7 th day,15 th day, and 30 th day). Results: After 24 h, for 1 mm thickness, grey MTA showed less leakage than white MTA, but the difference is not statistically significant at 5% level (Z = 0.32, P = 0.75). After 7 days, in 1 and 2 mm thickness, White MTA showed 64.71% and 16.67% leakage, while Grey MTA revealed 50% and 8.33% leakage in the same category. No leakage was found among the samples of 4 mm in both MTA. After 15 days in 1 mm, 100% leakage was recorded in both MTA. In 2 mm, presence of leakage is 15% for White and 13.64% leakage were present in Grey MTA. However, this difference is not significant (Z = 0.126, P = 0.9). In 4 mm MTA, only 1 leakage was found in White and none for Grey. This difference is not significant (Z = 1.02, P = 0.31). After 30 days, in 2 mm, 9% more leakage was observed in White MTA samples (23.53%) than that of Grey MTA (14.29%). In the category of 4 mm, 0.37% more leakage was observed in White MTA samples (8.70%) than that of Grey MTA (8.33%). However, this difference was not statistically significant. Conclusion: The present study showed that apical barrier of 4 mm demonstrated less leakage than 1 and 2 mm barrier in both White and grey MTA after 30 days of study and grey MTA demonstrated significantly less leakage than white MTA.

Prevalence and distribution of hypodontia in a group of Bengali pediatric population

Background: Hypodontia or congenitally missing teeth are one of the most common dental anomalies. Its prevalence and distribution vary among populations. Aim: The aim of this study is to investigate the prevalence and distribution of hypodontia in the permanent dentition of a group of Bengali pediatric patients. Materials and Methods: In this cross-sectional study, 716 pediatric patients (373 boys and 343 girls) aged 10 to 14 years were investigated radiographically for hypodontia. The data were analyzed using the Fisher exact test and the Chi square test. Results: The prevalence of hypodontia was 4.7% (n = 34). The girls showed a higher prevalence of congenitally missing teeth than boys (5.2 vs. 4.2%), although this difference was not statistically significant. The number of missing teeth ranged from one to five, and 47% had one missing tooth. Conclusion: Prevalence of hypodontia in the Bengali pediatric population was 4.7%. Incisor and premolar hypodontia was observed in this study. The most frequently missing teeth shown in the present study was not in accordance with most of the Caucasian and Asian studies.

Dens evaginatus in association with supernumerary teeth: Report of a case

Dens evaginatus is an uncommon developmental anomaly that appears as a tubercle or an accessory cusp projecting from the occlusal surface of the affected tooth. The anomaly most commonly affects the premolars, and the mandibular premolars are five times more frequently affected than the maxillary premolars. Dens evaginatus occurs almost exclusively in people of mongoloid origin. Isolated cases of dens evaginatus have also been documented in the Caucasian population. This article describes a case of dens evaginatus on the maxillary left first premolar affecting a Bengali boy. The child also exhibited two mesiodens and shovel-shaped maxillary incisors. Both dens evaginatus and supernumerary teeth are clinically significant anomalies. Early diagnosis of dental anomalies helps in selecting the correct treatment plan and minimizes further complications.