Ramesh Krishnan

Enzymatic antioxidants and its role in oral diseases

Antioxidants are substances that when present at very low concentration inhibits the oxidation of a molecule. It has the capacity to nullify the ill effects of oxidation caused by free radicals in the living organisms. The unpaired electrons of these free radicals are highly reactive and neutralize the harmful reactions of human metabolism. Protection of the body against free radicals is provided by some enzymes which come under a distinctive group, concerned solely with the detoxification of these radicals. Superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase are the key enzymatic antioxidants of this defense system by which the free radicals that are produced during metabolic reactions are removed. This review highlights the mechanism of action of enzymatic antioxidants SOD, GPX and catalase and its role in oral disease.

The relationship between dental age, bone age and chronological age in underweight children

Background and Objective: The knowledge of bone age and dental age is of great importance for pediatrician and pediatric dentist. It is essential for a pediatric dentist to formulate treatment plan and it is a source of complementary information for pediatrician. There are few studies, which showed the relationship between dental age, bone age and chronological age in underweight children. Therefore, objective of this study was to determine and compare dental age, bone age and chronological age in underweight children. Materials and Methods: 100 underweight children between the age group of 18-14 years were selected. Chronological age was assessed by recording date of birth. Dental age assessment was done using orthopantamogram following the method described by Demirjian. Bone age assessment was carried out using hand wrist radiograph following Bjork, Grave and Brown′s method. Results: Dental age and Bone age was delayed compared to chronological age in both sexes. The correlation between chronological age, dental age and bone age were all positive in males. Interpretation and Conclusion: The data supports the concept that dental age and bone age delay is a significant feature in underweight children. It is important to consider dental age and bone age as variables for diagnosing underweight children. To support our findings further a well-designed, controlled as well as longitudinal studies with a larger sample size is required.

Prevalence of early childhood caries and its risk factors in 18–72 month old children in Salem, Tamil Nadu

Background: Early childhood caries (ECC) is one of the most common dental diseases among the preschoolers, leading to suboptimal health. A study was planned to evaluate the prevalence of ECC in preschool children in the age group between 18 and 72 months and its relationship with parent′s education and socioeconomic status of the family. Materials and Methods: This cross-sectional study was conducted among 2771 children selected randomly, in the age group 18-72 months and attending playschools and primary schools in urban, semi-urban, and rural areas of Salem, Tamil Nadu. A modified Winter et al. questionnaire and a proforma were used for collecting information on each child. The completed questionnaire and proformas were statistically analyzed and evaluated. The statistical analysis was done using Student′s t-test and analysis of variance (ANOVA) to obtain mean values. Results: The prevalence of ECC in Salem was 16% with a mean dfs of 5.23 ± 1. Prevalence was high among the children of low socioeconomic status group and the children of working mothers, with a mean dfs of 10.47. Conclusion: The prevalence of ECC was 16% in Salem, Tamil Nadu. ECC was seen more in children of working mothers, lower parental education, and lower socioeconomic groups.

Knowledge, attitude, and perception of mothers towards emergency management of dental trauma in Salem district, Tamil Nadu: a questionnaire study.

BACKGROUNDnDental trauma is one of the main oral health problems in childhood, and can cause pain and distress. It is important to provide emergency care to combat the aftermaths of trauma.nnnAIMnThe aim of the study is to assess the knowledge and attitude of mothers regarding dental trauma and its management.nnnMATERIALS AND METHODSnA questionnaire consisting of 33 closed-ended questions were used to interview 150 mothers who participated in the study. The questions assessed the knowledge and attitude of mothers towards their childs dental visit, dental trauma, and its management. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 17.0.nnnRESULTSnMothers previous experience of dental trauma when associated with the preservation of avulsed tooth of the child, those mothers who had the experience of dental trauma reported that they would discard the tooth which was found to be statistically significant (P < 0.05) when compared to the mothers with no experience of trauma. The education status of the study population when associated with the knowledge variables of avulsion, it was found that most of the variables had statistically significant association with P < 0.05.nnnCONCLUSIONnThis study reveals that there is a lack of awareness among the mothers regarding the emergency management of dental trauma. This warrants the need of an effective communication between dental professionals and mothers for better handling of dental emergencies.

Goltz-Gorlin syndrome: Case report and literature review

Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities.

Surgical management of a large cleft palate in a Pierre Robin sequence: A case report and review of literature

Pierre Robin syndrome or Pierre Robin sequence (PRS) is a congenital etiologically heterogeneous condition presenting with various malformations. Here we are reporting the surgical management of an 18-month-old female baby who was referred from Department of Pediatrics with a complaint of a large cleft palate. She was taken up for palatoplasty with consent for elective tracheostomy. After genetic evaluation, the authors conclude that the presented case was a PRS in isolation with mild cardiac anomalies and an inferiorly placed hypoplastic epiglottis. Patient should be followed up and growth modifications of the jaws should be done.

A rare occurrence of supplementary maxillary lateral incisors and a detailed review on supernumerary teeth

This article highlights a rare occurrence of nonsyndromic supplemental maxillary lateral incisors in a 11-year-old boy. It also includes a detailed literature review of supernumerary teeth.

Knowledge and attitude about early childhood caries among pregnant mothers from low socioeconomic status: A questionnaire study

Background: For health and well-being, oral health is an integral component. Unfortunately, many children are afflicted with dental caries at an early age, even those as young as 12 months. By imparting knowledge, awareness among parents about this disease can bring about reduction of early childhood caries (ECC) at an early stage. Aim: The aim of this study was to evaluate knowledge and attitude of expectant mothers about ECC and to reassess the level of knowledge after giving anticipatory guidance. Materials and Methods: The questionnaire consisted of 10 questions which were distributed to 100 participants after which anticipatory guidance was given to them. After 15 days, the same questionnaire was distributed among the participants with order of the questions interchanged. Chi-square test was used for statistical analysis. Results: There was a significant improvement in the knowledge and attitude about the disease after giving the anticipatory guidance among the participants. P < 0.01 and the result were statistically significant. Conclusion: Knowledge and attitude of mothers were found to increase on provision of anticipatory guidance, which was retained even after 15 days.

A comparative evaluation of bifidobacteria levels in early childhood caries and severe early childhood caries

Background: Bifidobacteria levels in saliva were found to be significantly correlated in adults with dental caries but less information available in the literature regarding its role in children. Aim: The aim is to compare the salivary levels of Bifidobacteria in children who are caries free with that of early childhood caries (ECC) and severe ECC (S-ECC). Materials and Methods: Saliva was collected using the tongue-loop method from a total of 60 children between the age group of 3–5 years and they were further divided into 3 groups. In addition, the age and gender of the children, sugar amount in diet, sugar frequency in diet, were recorded. Results: Bifidobacteria was isolated from all the three groups, but more were from S-ECC, followed by ECC and very few cases of caries-free children and was found to statistically significant (P < 0.001). Salivary levels of Bifidobacteria were significantly correlated with amount of sugar in the diet and frequency of sugar consumption. Conclusions: Salivary levels of Bifidobacteria were significantly associated with S-ECC and ECC, followed by caries free group. In future, it can be used as a salivary marker for caries risk assesment.

The effect of fluorosis on human teeth under light microscopy: A cross-sectional study

Background: Fluoride is needed for the normal development of bone and teeth; in high levels, it affects developing teeth and bone. Dental fluorosis (DF) is caused by ingestion of excess fluoride mainly through drinking water. Aim: The present study aims to observe and understand the histological changes of fluorosed teeth under light microscope (LM). Materials and Methods: Teeth which were indicated for extractions for orthodontic or periodontal problems were selected. Thirty extracted teeth were selected with varying degrees of DF based on modified Deans fluorosis index. Ground sections of these teeth were prepared and the sections were studied under binocular LM. Photomicrographs were taken under high power objective using 15 megapixels Nikon camera. Results and Conclusion: Qualitative histologic changes in different grades of fluorosed teeth were evaluated in enamel, dentin, cementum and between their junctions. Fluoride interacts with enamel in both mineral phases and organic macromolecules by strong ionic and hydrogen bonds resulting in incomplete crystal growth at prism peripheries. This presents as hypomineralization of enamel and dentin, increased interglobular dentin, increased secondary curvatures and changes in cementum such as diffuse cementodentinal junction and increased thickness of Tomes’ granular layer. Changes in the structure of the teeth with Deans index below 2 and teeth with Deans index of 2 and above were compared using Chi-square test. P value was found to be highly significant being 0.00047. Many of the features of dental fluorosis seen in the present study under light microscope are comparable to those results studied under specialized microscopes.