Rahul Kaul

Tricho-dento-osseous syndrome and precocious eruption

Tricho-dento-osseous syndrome (TDO), an uncommon form of ectodermal dysplasia is an autosomal dominant genetic disorder which is characterized by inherited defects in tissues arising from epithelial-mesenchymal interaction. Genetic studies have revealed that it is caused by mutation in the DLX3 gene. TDO presents with a great phenotypic heterogeneity and studies have suggested that this heterogeneity is the result of environmental factors or other genetic modifiers. In this article, we report a case of TDO in which the child had typical clinical features of hair, teeth and bone defects, as seen in TDO. Parents of the child were unaffected. Genetic analysis of the child revealed mutation in DLX3 gene. The child also showed precocious eruption of the permanent molars, a clinical feature which has been rarely reported. We suggest that the precocious eruption seen in TDO is probably due to a markedly increased osteoblastic activity. Key words:Tricho-dento-osseous syndrome, DLX3 gene, precocious eruption.

Clinical Measurement of Maximum Mouth Opening in Children of Kolkata and Its Relation with Different Facial Types.

INTRODUCTION Maximal opening of mouth is described as the greatest distance between incisal edge of maxillary central incisor to the incisal edge of mandibular central incisor, when the mouth is opened as wide as possible painlessly or as the inter incisal distance plus the overbite. Clinical measurement of normal range of Maximum Mouth Opening (MMO) in children is an important diagnostic criterion for evaluation of stomatognathic system, especially for those with temporomandibular and neurogenic dysfunctions. AIM To determine the correlation of maximal mouth opening with age, sex, height, body weight and different facial types. MATERIALS AND METHODS The study was a cross-sectional study which was conducted on 434 children, who were randomly divided into three groups based on their age: Group I- children of age 6 to 8 years, Group II- children of age 8.1 to 10 years, Group III- children of age 10.1 to 12 years. For each child, the examiner took three readings of MMO in millimeters (mm) and the mean of the three readings was considered. Age, sex, standing height, body weight and facial type of each child were also recorded simultaneously. Pearson correlation was used to determine the relationship between the different parameters. p-value <0.05 was the bench mark for statistical significance in the analysis. Descriptive and inferential analysis was done for the data using SPSS version 20.0. (SPSS 20, inc.; Chicago). RESULTS The estimated average MMO measured for girls and boys in the age range of 6-8 years, with a total sample size of 139, was 41.14 ± 4.29 mm and 42.16 ± 3.98mm respectively in euryprosopic face type. In leptoproscopic face type, it was 42.12 ± 4.54mm and 43.76 ± 3.80 mm in girls and boys respectively. In mesoproscopic face type, MMO measured was 41.77 ± 4.09mm and 42.51 ± 3.95 mm in girls and boys respectively. The estimated average MMO measured for girls and boys in the age range of 8.1-10 years, with a total sample size of 143, was 44.42+4.69mm and 43.30 ± 4.11 mm in euryprosopic face type. In leptoproscopic face type, it was 43.02 ± 3.92mm and 46.29 ±3.09mm in girls and boys respectively. In mesoproscopic face type, MMO measured was 42.50 ±4.32 and 42.80 ± 5.16 mm in girls and boys respectively. The estimated average MMO measured for girls and boys in the age range of 10.1-12 years, with a total sample size of 152, was 44.63 ± 5.28 mm and 45.80 ± 5.18 mm respectively in euryprosopic face type. In leptoproscopic face type, it was 45.76 ± 4.98 mm and 46.28 ± 4.68 mm in girls and boys respectively. In mesoproscopic face type, MMO measured was 45.32 ± 5.80 mm and 46.03 ± 5.86 mm in girls and boys respectively. CONCLUSION There was a significant difference in MMO between males and females; with males having higher values in all age groups. MMO is seen to increase with age in a statistically significant manner. Significantly increased value of MMO was observed in leptoproscopic face type in comparison to euryproscopic and mesoproscopic face type for each age group.

A Survey on the Use of Antibiotics among the Dentists of Kolkata

Introduction Dental infections are multimicrobial in origin with their etiological factors involving a combination of Gram-positive, Gram-negative, facultative anaerobes, and obligate anaerobic bacteria. Thus, antibiotics and analgesics account for a great majority of medicines prescribed by the dental surgeons. Inappropriate prescription of antibiotics by health care professionals has become a worldwide issue nowadays. Aim The purpose of the present study was to: • Determine the pattern of antibiotic prescription among dentists of Kolkata. • Assess the attitude of dentists toward antibiotic resistance. Materials and methods An electronic version of the questionnaire of cross-sectional survey regarding antibiotic use and attitude toward growing antibiotic resistance was constructed using Qualtrics (Qualtrics Pvt. Limited Provo, Utah), an internet online survey tool that was e-mailed to dental surgeons of Kolkata registered with Indian Dental Association (IDA), West Bengal. A reminder e-mail was given after 1 month to recollect the responses from them. Results The survey was e-mailed to 300 dental surgeons, out of which 115 dental surgeons completed the survey, thereby achieving a response rate of 38.33%. Majority of the respondents (60%) chose amoxicillin in nonallergic patients. Average minimum duration of antibiotic therapy was 5 days. The drug of first choice for patients with an allergy to penicillin was erythromycin. The prime determinant of antibiotic use was facial swelling (68%). The prime determinant to select a particular brand of antibiotics was affordability of that brand (61%). Almost all (99%) dental surgeons were aware of antibiotic resistance being a growing concern. As per their views, there was overprescription of antibiotics. How to cite this article: Kaul R, Angrish P, Jain P, Saha S, Sengupta AV, Mukherjee S. A Survey on the Use of Antibiotics among the Dentists of Kolkata, West Bengal, India. Int J Clin Pediatr Dent 2018;11(2):122-127.

Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India

Introduction Childhood obesity, dental caries, and periodontal disease are major public health problems due to their adverse impact on the growth and development of children. Obesity and oral health are associated as both share some common risk factors. Aim The specific aim of the study was to determine the correlation, if there is any, between obesity and oral health in children. Materials and methods A cross-sectional survey was conducted in five districts of West Bengal, India. A total of 1,227 school-going children of 6 to 12 years were examined from the districts of Howrah, Hooghly, West Midnapore, South 24-parganas, and North 24-parganas. Following indices were analyzed: Decayed-missing-filled teeth (DMFT), decayed, extracted, filled teeth (deft), simplified oral hygiene index (OHI-S). Depending on their nutritional status, subjects were categorized as being normal weight, overweight, and obese. Logistic regression analysis were applied to the study to find out the association between the above-mentioned dental indices and independent variables: Gender and nutritional status. Result A positive association was found between obesity and oral health status in children. Conclusion Considering the results of this study, it was concluded that obesity is related to oral hygiene status of children. In order to improve oral hygiene status in children, dietary modifications need to be done. How to cite this article: Halder S, Kaul R, Angrish P, Saha S, Bhattacharya B, Mitra M. Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India. Int J Clin Pediatr Dent 2018;11(3):233-237.

Smart materials-making pediatric dentistry bio-smart

As of now, there has been no single material in dentistry that fulfills all the requirements of an ideal material. While the search for an “ideal material” continues, a newer generation of materials has been introduced. The adjective “smart” implies that these materials are able to sense changes in their environments and then respond to these changes in predetermined manners – traits that are also found in living organisms. These materials may be altered in a controlled fashion by stimulus such as stress, temperature, moisture, pH, and electric or magnetic field. Some of these are “bio-mimetic” in nature while others are “bio-responsive.” These materials would potentially allow new and groundbreaking dental therapies with a significantly enhanced clinical outcome of the treatment procedures. This paper attempts to highlight some of the currently available “smart materials” in pediatric dentistry which may over the course of years help us move toward a new era of bio-smart dentistry.

Distance M-Me: A novel parameter having significant potential as a predictor of mandibular growth

Objectives: The purpose of the present study was to investigate the relationship of the measured distance between two mandibular points (distance M-Me) to chronological age and to find out whether the absolute values of distance M-Me could be classified age-wise into a unique range, which could be directly read for predicting the stage of mandibular growth. Methods and Materials: The study sample consists of lateral cephalometric records of 65 patients (34 females and 31 males; age range: 6–21 years). Chronological age was calculated in decimal years. Lateral cephalograms were assessed by two independent examiners. Points M and Me were located on the lateral cephalograms, and linear distance between them was measured. Results: Pearson product-moment correlation coefficients showed a high correlation between chronological age and distance M-Me (0.746 for females and 0.869 for males, p < 0.01). When the values of distance M-Me were compared with chronological age, it was possible to make four age groups (for females and males separately), where each group showed a unique range of value for distance M-Me. The values increased with increasing age. Conclusions: Increase in value of distance M-Me with age, showing reduced individual variation, depicts a well-conserved linear dimension. Values of distance M-Me can be directly read for predicting the stage of mandibular growth and can be used as a valuable adjunct or substitute to chronological age.

Evaluation of knowledge, awareness, and attitude toward emergency dental trauma management among the school teachers of Kolkata

Introduction: Traumatic dental injuries (TDIs) are very common in childhood. Majority of TDI occur at home followed by schools. The prognosis of TDIs to a great extent is dependent on prompt emergency measures taken at the site of accident. Hence, it is of paramount importance to assess the knowledge of people present at the site of accident that generally includes parents, teachers, and sports coaches. Aim of Study: The aim of the study was to assess the knowledge, attitude, and awareness of school teachers of Kolkata regarding management of TDIs. Materials and Methods: A cross-sectional survey was conducted on 400 school teachers of Kolkata over a period of 2 months using a pretested close-ended questionnaire. The questionnaire had three parts: Part 1 contained questions on personal information, Part 2 contained questions based on two imaginary cases of trauma, and Part 3 related to their attitude toward dental trauma education. Chi-square test was done to describe the strength of the associations. Results: : The overall knowledge of school teachers regarding management of TDIs was not found to be satisfactory. It was observed that most of the teachers were in favor of taking immediate professional consultation for the emergency management, but most of them were unaware of the steps to be taken on their part to minimize complications and improve prognosis. Conclusion: Despite the lack of knowledge and awareness regarding management of dental trauma, school teachers of Kolkata had a good attitude toward management of dental trauma and its education.

Rare molariform supernumerary teeth: Why are they bilateral?

Anterior supernumerary teeth in the permanent dentition may be supplemental or rudimentary. Rudimentary types are further classified as conical, tuberculate, and molariform. The molariform type has been only rarely reported. We report a rare variety of anterior supernumerary teeth - the molariform type, occurring bilaterally and in association with a midline supernumerary tooth. We also suggest a hypothesis for the bilateral occurrence of supernumerary teeth.

Dental complications of head and neck radiotherapy and their management: A review

In addition to anti-tumor effects, ionizing radiation causes damage to normal tissues located in the radiation portals. The complications of radiation treatment include mucositis, hyposalivation, loss of taste, osteoradionecrosis, radiation caries, and trismus. These sequelae may be dose-limiting and have a tremendous effect on patients quality of life. In this review, radiation-induced changes in healthy oral tissues and the resulting clinical consequences and their management is discussed.