Kalpana Bansal

Cerebral Palsy: A Dental Update

ABSTRACT Special and medically compromised patients present a unique population that challenges the dentist’s skill and knowledge. Providing oral care to people with cerebral palsy (CP) requires adaptation of the skills we use everyday. In fact, most people with mild or moderate forms of CP can be treated successfully in the general practice setting. This article is to review various dental considerations and management of a CP patient. How to cite this article: Sehrawat N, Marwaha M, Bansal K, Chopra R. Cerebral Palsy: A Dental Update. Int J Clin Pediatr Dent 2014;7(2):109-118.

Hypodontia and Delayed Dentition as the Primary Manifestation of Cleidocranial Dysplasia Presenting with a Diagnostic Dilemma

Cleidocranial dysplasia is a rare autosomal disorder which manifests as partial or complete absence of clavicles, multiple supernumerary teeth, and delayed closure of fontanelle. Classical cases of cleidocranial dysplasia are easily diagnosed very early in the life. However, cases with partial manifestation of the syndrome and noncontributory family history are difficult to diagnose. Here, we report a case of 8.5-year-old girl child who presented with delayed tooth development (without any supernumerary teeth), anterior open fontanelle, and normal clavicles, thus resulting in a diagnostic dilemma.

Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study

Introduction Formocresol has been a popular pulpotomy medicament for many years. It is considered the “gold standard“ in pediatric dentistry. However, concerns have been raised over its use in children. It has been reported that formocresol has toxic and mutagenic effects in cell culture, dental crypts, and precancerous epithelial cells. Therefore, additional biocompatible treatment alternatives are required to replace formocresol pulpotomy. Aims This study compared the clinical and radiographic success rates of ferric sulfate (FS) and bioactive tricalcium silicate cement (Biodentine, Septodont) as pulpotomy agents in primary molar teeth over a period of 9 months. Materials and methods Fifty primary molar teeth, symptom free, requiring pulpotomy in children aged 4 to 8 years were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 25 teeth) and Biodentine (for 25 teeth) were used as pulpotomy agents. Permanent restorations were stainless steel crowns in most cases, in both groups. Patients were recalled for follow-up at 1, 3, 6, and 9 months intervals. The data were statistically analysed using chi-square test. Results At 9 months, 96% clinical success rate was observed in the FS and 100% in the Biodentine group. Radiographic success rate in the FS group was 84%, whereas 92% in the Biodentine group at 9 months. No statistically significant difference was found between the two groups. Conclusion Biodentine can be used as a pulpotomy agent but further long-term studies are required. How to cite this article Sirohi K, Marwaha M, Gupta A, Bansal K, Srivastava A. Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study. Int J Clin Pediatr Dent 2017;10(2):147-151.

Association of severe early childhood caries with iron deficiency anemia

Background: Severe tooth decay is known to affect the health and well-being of young children. However, there has been minimal research showing the association of severe early childhood caries (S-ECC) and iron deficiency anemia (IDA). Aims: The primary aim of this study was to investigate an association between S-ECC with IDA. The secondary objective was to find an association between severe caries and body weight of the child. The oral health-related quality of life of children with S-ECC was also assessed. Materials and Methods: Following the ethical approval, 60 children aged 2-6 years (30 with S-ECC and 30 controls with caries status <2) were recruited for this cross-sectional association study. Each child received a clinical examination for dental caries status using deft index and a blood investigation to determine various parameters; hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration, and packed cell volume (PCV). Children underwent venipuncture after due parental consent, and 2.5 mL blood was collected from each child to evaluate the above parameters. Following this, the parents filled up a 10 point questionnaire to determine the child′s quality of life. Data were then analyzed by t-test and Fischer′s exact t-test. Result: On comparison of percentage of children with IDA in S-ECC and control group, it was found that children with S-ECC were more likely to have IDA odds ratio (95% confidence interval): 10.77 (2.0, 104.9), (P = 0.001). In addition to this, S-ECC children were significantly more likely to have low Hb, MCV, and PCV levels (P < 0.001) which imply that S-ECC may be a risk marker for the development of anemia. More children (93%) with severe caries were found to have less body weight than ICMR standard weight for age as compared to children with low caries (P < 0.05%). Conclusion: S-ECC is strongly associated with the anemia due to iron deficiency, and efforts should be made toward the preventive and curative aspects of ECC, which may improve the general well-being and quality of life of a child.

Evaluation of Buccal Infiltration with Articaine and Inferior Alveolar Nerve Block with Lignocaine for Pulp Therapy in Mandibular Primary Molars

OBJECTIVE Failure of inferior alveolar nerve block in achieving profound anesthesia of the pulp due to various reasons has led to the introduction of more potent local anesthetic agents like articaine. This study was conducted to compare the efficacy of buccal infiltration with articaine in achieving pulpal anesthesia of primary molars as compared to inferior alveolar nerve block with lignocaine. STUDY DESIGN 30 patients (4-8 years) with indication of pulp therapy in at least two mandibular primary molars were selected. Patients were randomly assigned to receive nerve block with lignocaine or infiltration with articaine on first appointment and the other solution on second appointment. All the pulpotomies and pulpectomies were performed by a pediatric dentist. Two researchers standing at a distance of 1.5 m recorded the Pain Scores and Sound, Eye, Motor (SEM) scores. After the completion of procedure, the patient was asked to record the Facial Image score and Heft-Parker Visual Analogue Score (HP-VAS). RESULTS Pain Score recorded at the time of injection showed significantly more movements with block as compared to infiltration (p<0.001). SEM scores at time of pulp extirpation were also higher for block than infiltration (p<0.001). CONCLUSION Articaine infiltration has the potential to replace inferior alveolar nerve block for primary mandibular molars.

Comparison of dermatoglyphic traits and dental anomalies associated with cleft lip or cleft lip and palate patients with normal healthy children.

BACKGROUND Dermatoglyphics are considered as a window of congenital abnormalities and is known to be one of the best available diagnostic tools in genetic disorders. OBJECTIVE The present study was conducted to observe and compare the differences in the dermatoglyphic patterns between cleft lip/palate (CL/P) and normal healthy children and evaluate their associated dental findings. SETTING This is a cross-sectional prevalence study in which dermatoglyphic patterns and dental anomalies of 90 (CL/P) and normal healthy children aged 0-15 years were recorded under standard conditions of seating and lighting. MATERIALS AND METHODS Dermatoglyphic traits were recorded using ink stamp pad method. Dental findings were recorded through clinical and radiographic examination. RESULTS The most frequently seen dermatoglyphic trait in the study and control group was loops followed by whorls and arches. A highly significant (P < 0.001) difference between loops in the study and control group and statistically significant difference in the whorls (P = 0.001) were found using Students t-test. The comparison of dental anomalies was accomplished using Chi-square test and hypodontia (50%) was seen maximum in cleft patients. CONCLUSION Any deviation in dermatoglyphics features indicates a genetic etiology.

Lesch-Nyhan syndrome: The saga of metabolic abnormalities and self-injurious behavior

Lesch-Nyhan syndrome (LNS) is an X-linked recessive disorder of purine metabolism caused by a mutation in Xq26.2-q26.3 (OMIM 308000.0004). The presence of the diagnostic triad, i.e. signs of self-injurious behavior (SIB) and results of pedigree analysis and novel molecular biology & genetic testing, confirms the diagnosis of LNS. With a level of hypoxanthine guanine phosphoribosyl-transferase 1 (HPRT1) enzyme activity < 2%, patients develop neurological, neurocognitive, and neuromotor symptoms along with SIB. Described here is a case of 4-year-old boy who was diagnosed with LNS. The boy displayed SIB, i.e. biting of the lips and fingers, and he had cerebral venous sinus thrombosis caused by LNS.

Dental Awareness among Parents and Oral Health of Paediatric Cancer Patients Receiving Chemotherapy.

INTRODUCTION Dental care is often overlooked by the parents of children receiving treatment for cancer including chemotherapy who are in a phase of severe immunosuppression. AIM (i) To study dental attitudes of parents of children receiving chemotherapy towards importance of dental care. (ii) To evaluate oral hygiene status and compare it with healthy controls. MATERIALS AND METHODS A questionnaire assessing the awareness towards dental care was given to the parents of 47 paediatric patients suffering from cancer receiving chemotherapy and to parents of 47 paediatric patients reporting to outpatient Department of Pedodontics at SGT Dental College. Oral examination was also carried out for both the groups and DMFT/dmft, plaque and gingival index were noted. RESULTS Parents had a varying opinion regarding dental health of their child. The caries status of children in the control group was greater than children in the study group. The mean plaque index of children in the control group (1.40) was greater than children in the study group (1.34) which was statistically significant according to Mann-Whitney U test. The gingival health of children in the study group was better than children in the control group which was also not statistically significant. CONCLUSION This study highlights need for a periodic referral of the child cancer patients to the paediatric dental clinic in hospitals for the timely dental care.

Effect of Comprehensive Dental Rehabilitation on Growth Parameters in Pediatric Patients with Severe Early Childhood Caries.

ABSTRACT Background: Children who have severe early childhood caries (S-ECC) weigh significantly less than caries-free children. The association between S-ECC and weight suggests that its timely treatment at early stages may preserve general health, in addition to preventing pain and infection. Objective: This study was conducted to evaluate whether children with untreated S-ECC had lower weight and height as compared with children with low caries and to evaluate whether full mouth rehabilitation of children with S-ECC resulted in the phenomenon of catch-up growth. Materials and methods: The weight and height of children with noncontributory medical histories and S-ECC (3-6 years) were compared with caries-free children, before and 6 months after full mouth dental rehabilitation. Results: Prior to dental rehabilitation, children with S-ECC had significantly less weight and height than their comparison counterparts (p < 0.001). Following therapeutic intervention, the test group children exhibited catch-up growth in relation to weight, as there was no significant difference in the body weight of the test and control groups (p = 0.171). Conclusion: Comprehensive full mouth rehabilitation of children with S-ECC results in catch-up growth, thus improving the overall health of the child. How to cite this article: Sachdev J, Bansal K, Chopra R. Effect of Comprehensive Dental Rehabilitation on Growth Parameters in Pediatric Patients with Severe Early Childhood Caries. Int J Clin Pediatr Dent 2016;9(1):15-20.

Effect of Diet Modification on Salivary Parameters and Oratest in High-caries-risk individuals

Aim This study was aimed to assess the salivary parameters and caries activity test (Oratest) in high-caries-risk individuals and effect of diet modification and parental education on salivary parameters and Oratest. Materials and methods Forty-five children aged between 5 and 8 years and decayed, extracted due to caries, filled teeth (deft)/decayed, missing, filled teeth (DMFT) scores >5 were selected and evaluated for salivary parameters, such as hydration status of oral mucosa, resting pH, unstimulated salivary flow rate (USFR) and stimulated salivary flow rate (SSFR), buffering capacity of stimulated saliva (BCSS) before and after diet counseling using GC India Saliva Check Kit. Oratest was performed to assess the caries activity. Children’s parents were asked to record 5 to 7 days diet chart. Diet charts were collected and based on the evaluation of specific diet charts, diet counseling was provided. After 6 weeks, salivary parameters and Oratest were reevaluated. Baseline and postdiet counseling salivary parameters were subjected to statistical analysis using Student’s t-test (paired) and Wilcoxon signed rank test. Results From baseline to 6 weeks, USFR and SSFR were increased which were statistically significant. Buffering capacity and resting pH increased slightly but was not statistically significant. The reading of Oratest increased significantly, indicating a decreased caries activity in individuals. Conclusion It can be concluded that diet counseling, parental education, and regular motivation can positively alter salivary parameters, such as USFR and SSFR. How to cite this article: Jain S, Bansal K, Marwaha M, Sehrawat N, Singla S. Effect of Diet Modification on Salivary Parameters and Oratest in High-caries-risk Individuals. Int J Clin Pediatr Dent 2018;11(1):34-39.