Namita Kalra

A retrospective analysis of maxillofacial injuries in patients reporting to a tertiary care hospital in East Delhi

Background and Aim: Maxillofacial trauma is frequently encountered in the Accident and Emergency department of hospitals either as an isolated injury or as a part of multiple injuries to the head, neck, chest, and abdomen. This study aimed to assess retrospectively the profile of maxillofacial injuries in patients reporting to a tertiary care hospital in East Delhi. Materials and Methods: The study was conducted in the Department of Dentistry, UCMS and GTB Hospital, Delhi. Dental case record sheets of 1000 medicolegal cases reporting to the hospital emergency were scrutinized and various demographic and epidemiologic factors, including the patients age and gender, time and day of reporting, and the etiology and nature of injury were recorded. Results: The peak incidence of maxillofacial injury was observed in the age group of 21–30 years, with males outnumbering females in all age groups. Maximum number of trauma cases reported in late evening hours, especially on weekends. Interpersonal assault was the primary etiological factor followed by road traffic accidents. Soft tissue injuries were very common and maxillofacial fractures, when present, were most frequently observed in the mandible followed by the midface. Conclusion: The changing trend of the etiology of maxillofacial injuries in East Delhi necessitates strict legislation against violence and education in alcohol abuse. Periodic review of driving skills and stricter implementation of traffic rules in this area is a must to minimize the physical, psychological, and emotional distress associated with maxillofacial trauma.

Non-syndrome multiple supplemental supernumerary teeth.

Multiple supernumerary teeth without any associated systemic conditions or syndromes are not common. We document a case of non-syndrome multiple supplemental supernumerary teeth in mandibular premolar region of an adolescent male patient, an incidental findings during routine radiographic examination. Periodic examination is recommended to monitor the clinical behavior.

A Comparison of Two Pain Scales in the Assessment of Dental Pain in East Delhi Children

Pain is the most common symptom of oral diseases. Pain perception in children is highly variable and unreliable due to poor communication. Therefore we designed a study to compare pain measurement techniques, that is, visual analogue scale (VAS) and Wong-Baker faces pain rating scale (WBFPS) among Delhi children aged 3 to 14 years undergoing dental extraction. Method. A cross-sectional study was conducted on 180 patients aged 3 to 14 years who had undergone dental extraction. Children were assessed for their pain sensitivity using visual analogue scale (VAS) and Wong-Baker faces pain rating scale (WBFPS ). Result and Conclusion. Pain threshold tends to decline, and the self-management of pain becomes more effective with increasing age. Genderwise result shows that communication ability of boys and girls is similar in all age groups.

Papillon- Lefèvre Syndrome: Report of a case and its management

Papillon-Lefèvre Syndrome (PLS) is a rare autosomal recessive disorder first described by two French physicians, Papillon and Lefèvre in 1924. The disorder is characterized by diffuse palmoplantar keratoderma and precocious aggressively progressing periodontitis, leading to the premature loss of deciduous and permanent teeth at a very young age. The cutaneous lesions are usually manifested simultaneously with the intra-oral presentations and include keratotic plaques on the palms and soles varying from mild psoriasiform scaly skin to overt hyperkeratosis. The etiopathogenesis of the syndrome is relatively obscure and immunologic, genetic or possible bacterial etiologies have been proposed. Due to the vast degree of periodontal breakdown involved at such an early age, the dental surgeon is often the first to diagnose the syndrome. This paper presents a clinical presentation a 15 year old male diagnosed with Papillon- Lefèvre Syndrome. Key words:Papillon-Lefèvre Syndrome, palmoplantar keratoderma, rapidly progressing periodontitis.

A conservative approach to pediatric mandibular fracture management: Outcome and advantages

Pediatric mandibular fractures are rare and their treatment remains controversial. Management is extremely complicated in mixed dentition as it is inherently dynamic and unstable. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. This case report describes and evaluates the conservative technique of acrylic splint in the treatment of pediatric mandible fracture in a 12-year-old female child. The patient with isolated mandibular fracture was treated with acrylic splint and interdental wiring followed by evaluation of clinical and radiographic healing as well as the somatosensory status. Patient demonstrated clinical union to her pre-injury occlusion by three to four weeks. Panoramic finding supported the finding of clinical examination throughout the study. High osteogenic potential of the pediatric mandible allowed conservative management to be successful in this case.

Biological aspects of tooth fragment reattachment in immature incisors.

Tooth fragment reattachment is a relatively new technique and there are many aspects which still need to be explored. Reported here is a case of enamel and dentin fracture of 11 and 21. There was a very thin layer of dentin clinically over the pulp chamber and the root apices were immature. The reattachment procedure was modified slightly. The initial joint was made with protective calcium hydroxide and glass ionomer cement on the approximating surfaces. The further reattachment was accomplished using composites and acid etch technique. This was done for pulpal protection. After six months, reattachment was intact and successful with no staining, sensitivity or pain. The radiographs revealed root completion of the immature incisors. The reattachment procedure proved to be biologically superior in addition to its esthetic value and psychological advantage.

Clinical and radiographic comparison of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in primary molars

Aim: This study aimed to evaluate and compare the Platelet-rich fibrin (PRF) and Mineral trioxide aggregate (MTA) as a pulpotomy agent in primary molars. Material and Methods: In this study, 50 primary molars from 50 healthy children aged 5–9 years requiring pulpotomy were randomly allocated into two groups. In PRF group, after coronal pulp removal and hemostasis, remaining pulp tissue was covered with PRF preparation. In the MTA group, the pulp stumps were covered with MTA (Pro Root MTA-Root Canal Repair Material, Dentsply International Inc.) paste obtained by mixing MTA powder with sterile water at a 3:1 powder to water ratio. All teeth were restored with reinforced zinc oxide eugenol base and glass – ionomer cement. Stainless steel crowns were given in both groups 24 h after treatment. Clinical evaluation was undertaken at 1, 3, and 6 months intervals whereas radiographic evaluation of the treated teeth was carried out at the interval of 6 months. Results: By the end of 6 months, the overall success rate was 90% in PRF group and 92% in MTA Group. A statistically significant difference was observed between the groups at 6 months of follow-up (P < 0.05). The results were statistically nonsignificant between the groups (P > 0.05). Conclusion: Radiographic and clinical outcome in PRF group could suggest it as an acceptable alternative in pulpotomy of primary teeth. PRF holds a promising future in the area of primary tooth vital pulp therapy.

An appraisal of the prevalence and attributes of traumatic dental injuries in the permanent anterior teeth among 7–14-Year-Old school children of North East Delhi

Aims: The aim of this study was to assess the prevalence, associated risk factors, characteristics, and pattern of traumatic dental injuries (TDIs) in the permanent anterior teeth among school children of North East Delhi area. Settings and Design: A cross-sectional study was done in 3000 school-going children aged 7–14 years. Materials and Methods: A detailed case history and clinical examination were performed on the entire sample population. TDIs were recorded according to Andreasens epidemiological classification of TDIs including World Health Organization codes. Statistical Analysis Used: For finding the independent association of the significant variables with outcome, multivariable logistic regression analysis was used. Results: A prevalence of 10.7% was observed in the sample being studied. Dental trauma was significantly (P < 0.05) associated with male gender, and high statistical significance (P < 0.001) was noted with age, participation in sports, lip seal, and overjet. Fall of the child while playing by himself/herself was the most common cause; afternoon and schools were the most common time and place of occurrence of TDIs, respectively. Single tooth enamel fractures in the left maxillary central incisors were most commonly seen. Adhesive restorations were the most frequent form of treatment required. Conclusions: Organizing studies addressing the prevention and treatment needs of TDIs and educational programs aimed toward parents and school teachers are of paramount importance. Furthermore, recognizing the tremendous treatment negligence is extremely critical to adequately analyze indifference of the people toward dental trauma and its consequences.

Riga–Fede Disease associated with Natal Tooth

Eruption of tooth at about 6 months of age is a significant milestone in a child’s life and is an emotional event for parents. However, a tooth present in the oral cavity at the time of birth can lead to a lot of delusions. Natal and neonatal teeth are conditions of fundamental importance not only for a dental surgeon, but also for a pediatrician since their presence may lead to numerous complications. Early detection and treatment of these teeth are important as they may induce tongue deformity, dehydration, inadequate nutrients, and growth retardation. Riga–Fede disease (RFD) is a reactive mucosal disease due to repetitive trauma of tongue by anterior primary teeth during forward and backward movements. This article reports a case wherein a natal tooth has led to the development of ulcer on ventral surface of tongue in a 4-week-old infant.

Peripheral giant cell granuloma: An unusual presentation in pediatric patient: A report of two cases

The peripheral giant cell granuloma (PGCG) is a relatively common tumor-like growth of the oral cavity. It is also known as giant cell epulis. PGCG is an oral, nonneoplastic, tumor-like growth that occurs exclusively on the gingiva and the alveolar mucosa. It affects both sexes, with a slight predilection for females, especially after puberty. It is not a true neoplasm but rather benign hyperplasic lesion. It is probably caused by local irritation or trauma which resulted in gingival or mucosal hemorrhage.