Separation Anxiety-An Unseen Cause for Development of Abnormal Oral and Paraoral Habits and Malocclusion: A Review of Literature and Report of Two Cases

A child's overall well-being depends on its mutual relationship with the caregiver and social environment. Its attachment with the caregiver forms an emotional bond at six months to two years of age. Separation anxiety refers to fear of separation from the attachment figure. In some neglected children in early age of attachment formation, symptoms of separation anxiety persist and they may show debilitating nervous behaviors during growth. It thus becomes an unseen cause of psychological problem and development of abnormal oral habits occlusal dysfunctions and further psychological problems. Oral habits being learnt patterns of muscle contraction are displayed for release of mental tension due to fear and anxiety often associated with anger, hunger, sleep, tooth eruption and fear. Pediatric dentist plays an important role in patient education through anticipatory guidance. Proper diagnosis and early interception of oral habits as a result of separation anxiety disorder can prevent occlusal disturbances in children. The present paper includes review of literature along with the management of two cases of separation anxiety as an unseen cause of development of unique socially unacceptable abnormal oral and paraoral habits and resultant malocclusion. How to cite this article: Dhote VS, Dharmadhikari PM, Bahadure RN, et al. Separation Anxiety-An Unseen Cause for Development of Abnormal Oral and Paraoral Habits and Malocclusion: A Review of Literature and Report of Two Cases. Int J Clin Pediatr Dent 2021;14(S-2):S199-S205.

Management of Dentoalveolar Trauma in a 3-year-old Child with Glanzmann's Thrombasthenia, a Rare Bleeding Disorder: Case Report and Review

Glanzmann's thrombasthenia (GT) is a rare inherited bleeding disorder characterized by disturbed ability of the blood platelets to gather around the site of a broken blood vessel and fail to form a plug to stop bleeding due to deficiency of a glycoprotein IIb/IIIa in the process of blood clotting and results in moderate-to-severe bleeding on slightest injury to blood vessels. It is typically diagnosed in infancy or early childhood due to mucocutaneous bleeding tendencies. Treatment goals in GT are aimed at control of bleeding. Dentoalveolar trauma in patient with bleeding disorder poses a challenge in pediatric dentistry. The present article reports the successful management of subluxation dental injury in a 3-year-old child with “Glanzmann's thrombasthenia associated with sickle cell anemia.” A narrative review of GT is given highlighting the importance of preventive dentistry and anticipatory guidance to reduce potential complications in such patients.

Nonsurgical endodontic treatment of permanent maxillary incisors with immature apex and a large periapical lesion: a case report

Immature teeth with necrotic pulp and large periapical lesions are difficult to treat via conventional endodontic therapy. However, they can be treated with calcium hydroxide and mineral trioxide aggregate (MTA). This article reports the case of a nonvital tooth with a periapical lesion and an open apex that was treated with a single-visit MTA apical plug. A radiographic evaluation taken 6 months post-treatment showed a decrease in the periapical lesion; at 1 year, complete healing was visible.

Antimicrobial efficacy of five essential oils against oral pathogens: An in vitro study

Objectives:

This study was aimed to find out the minimum inhibitory concentration (MIC) of five essential oils against oral pathogens and to find out the minimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) of five essential oils against oral pathogens.

Materials and Methods:

The antimicrobial activities by detecting MIC and MBC/MFC of five essential oils such as tea tree oil, lavender oil, thyme oil, peppermint oil and eugenol oil were evaluated against four common oral pathogens by broth dilution method. The strains used for the study were Staphylococcus aureus ATCC 25923, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 and Candida albicans ATCC 90028.

Results:

Out of five essential oils, eugenol oil, peppermint oil, tea tree oil exhibited significant inhibitory effect with mean MIC of 0.62 ± 0.45, 9.00 ± 15.34, 17.12 ± 31.25 subsequently. Mean MBC/MFC for tea tree oil was 17.12 ± 31.25, for lavender oil 151.00 ± 241.82, for thyme oil 22.00 ± 12.00, for peppermint oil 9.75 ± 14.88 and for eugenol oil 0.62 ± 0.45. E. fecalis exhibited low degree of sensitivity compared with all essential oils.

Conclusion:

Peppermint, tea tree and thyme oil can act as an effective intracanal antiseptic solution against oral pathogens.

Aesthetic Rehabilitation of Discoloured Nonvital Anterior tooth with Carbamide Peroxide Bleaching: Case Series

Discolouration of teeth, especially the anteriores, can result in considerably cosmetic impairment in person. Combine effects of intrinsic and extrinsic colour determines the appearance of teeth. Whitening of teeth with bleaching is a more conservative therapeutic method than full crowns, veneers or composite restorations which is more invasive and expensive. Among bleaching techniques, in office bleaching with carbamide peroxide provide superior aesthetic result in short period of time with no adverse effects. This paper presents case series of tooth discolouration in non-vital tooth which was successfully bleached using 35 % carbamide peroxide. After 1 year follow up the prognosis was good with no reversal of tooth discolouration. This case report allows the better understanding of the concept of nonvital tooth bleaching with carbamide peroxide which gives a non-invasive alternative for aesthetic purpose in preserving the natural tooth structure.

Radicular cyst of primary tooth associated with maxillary sinus

Radicular cyst is one of the most common odontogenic cystic lesions found in the jaws. It is inflammatory in nature and found mostly in relation to a non-vital tooth. It usually presents at a later stage in life because the formation of the cyst is the last step in the progression of inflammatory events after a periapical infection. The cyst usually goes unnoticed because of its painless nature and small size. We present the clinical, radiographic and histological characteristics of a radicular cyst along with its management. Cystic sac was removed surgically under general anaesthesia after the elevation of the mucoperiosteal flap. Histopathologically, the cystic sac was consistent with the features of a radicular cyst. Follow-up period of 21 months showed improved radiographical appearance on Coned Beam CT. Vestibular deepening was planned as a future treatment in the same region.

Orthodontic extrusion: diagnosis and treatment with CBCT in a pediatric patient

Traumatic injury to a primary tooth can affect the underlying permanent tooth germ, and may result in a malformed, hypoplastic crown or root. The degree and nature of malformation depends on the injury. Most trauma cases can be diagnosed using conventional 2-dimensional radiographs, but some cases may benefit from more advanced 3-dimensional imaging such as cone-beam computed tomography (CBCT). This report describes the use of CBCT in the diagnosis and treatment planning of a case in which a 10-year-old girl reported with an impacted, recessed central incisor. The tooth was deformed due to trauma at an early age. Conventional 2-dimensional occlusal and periapical radiographs seemed to indicate that the root had almost completely resorbed. This implied that the optimal treatment plan would be the extraction of the central incisor and, later, the placement of an implant with a crown or bridge. However, a 3-dimensional CBCT radiographic examination showed that the tooth root was long and had enough of a crown-to-root ratio to anchor the tooth. The CBCT examination compelled the treating dentists to maintain the central incisor by orthodontically extruding the tooth and then rebuilding it with a bonded composite restoration.

Occlusal traits of deciduous dentition of preschool children of Indian children

Objectives:

To assess the occlusal relationship, canine relationship, crowding, primate spaces, and anterior spacing in both maxillary and mandibular arches of primary dentition of Indian children of Wardha District and also to study the age-wise differences in occlusal characteristics.

Materials and Methods:

A total of 1053 (609 males and 444 females) children of 3-5 year age group with complete primary dentition were examined for occlusal relationship, canine relationship, crowding, primate spaces, and anterior spacing in both maxillary and mandibular arches.

Results:

The data after evaluation showed significant values for all parameters except mandibular anterior spacing, which was 47.6%. Mild crowding was prevalent at 5 year age group and moderate crowding was common at 3 year-age group.

Conclusion:

Evaluated parameters such as terminal molar relationship and canine relationship were predominantly progressing toward to normal but contacts and crowding status were contributing almost equal to physiologic anterior spacing. Five-year-age group showed higher values with respect to all the parameters.

Unusual Case of Calculus in Floor of Mouth: A Case Report

Calculus consists of mineralized bacterial plaque that forms on the surfaces of natural teeth. It is supragingival or subgingival depending upon its relation with gingival margin. The two most common locations for supragingival calculus are the buccal surfaces of maxillary molars and lingual surfaces of mandibular anterior teeth. It is very important to rule out the predisposing factor for calculus formation. In the present case of an 11-year- old female child, 1.2 × 1.5 cm large indurated mass suggestive of calculus in the left side of floor of mouth was observed. After surgical removal, along with indurated mass, an embedded root fragment was seen. Biochemical analysis of the specimen detected the calcium and phosphate ions approximately equals to the level in calculus. Thus, we diagnosed it as a calculus. Oral hygiene instructions and regular follow-up was advised.

How to cite this article: Bahadure RN, Thosar N, Jain ES. Unusual Case of Calculus in Floor of Mouth: A Case Report. Int J Clin Pediatr Dent 2012;5(3):223-225.

Fibrolipoma of buccal mucosa

The lipoma is a very common benign tumor of adipose tissue, but its presence in the oral and oropharyngeal region is relatively uncommon. Fibrolipoma, a histological variant of lipoma, mostly affect the buccal mucosa and causes functional and cosmetic disabilities. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. This article describes a case of 10 year old girl with fibrolipoma of the buccal mucosa with a relevant review of tumors.

Management of Talons Cusp associated with Primary Central Incisor: A Rare Case Report

The talon cusp is a relatively rare dental developmental anomaly characterized by cusp-like projections, usually observed on the lingual surface of the affected tooth. Normal enamel covers the cusp and fuses with the lingual aspect of the tooth. The cusp may or may not contain an extension of the pulp. The condition can occur in both the primary and permanent dentitions. However, the occurrence of anomalous cusp is rather infrequent in the primary dentition. Little data is available about the treatment of talon cusps in the primary dentition as compared with the permanent dentition. A case of talon cusp in the primary maxillary left central incisor is reported. This dental anomaly was not associated with any other somatic or dental abnormality. The tooth was carious. Pulpal extension into the cusp was detected radiographically. Pulpectomy of the tooth was carried out and restored with composite restoration.

How to cite this article: Bahadure RN, Thosar N, Jain ES. Management of Talons Cusp associated with Primary Central Incisor: A Rare Case Report. Int J Clin Pediatr Dent 2012;5(2): 142-144.

Conventional surgical treatment of oral mucocele: a series of 23 cases

AIM

Mucocele is a common lesion of the oral mucosa that results from alterations of the minor salivary glands due to mucous accumulation, causing swelling. Conventional surgical treatment was planned for these lesions in a group of children and the success rates of the therapy during the transitional period from mixed to permanent dentition were assessed with a series of follow-ups.

MATERIALS AND METHODS

A series of 23 cases of mucocele was observed in children under 10 years of age. Clinically the lesions consisted of a soft, bluish and transparent cystic swelling which normally resolved spontaneously and reappeared after rupture in few days. All cases were treated by conventional surgical procedure with excision of minor salivary glands and underwent a 3-year follow-up.

RESULTS

Out of the 23 cases, 19 (82.6%) were in the lower lip, 2 (8.6%) in the cheek, 1 (4.3%) in the retromolar area and 1 (4.3%) in the upper lip. Those in the lower lip, 15 (79%) were away from the midline and 4 (21%) at midline. One (4.3%) recurrence was seen at the 6-month follow-up. After 3 years, recurrence rate remained the same.

CONCLUSION

Conventional surgical excision with removal of affected minor salivary glands in paediatric patients is a definite treatment for mucocele.

An estimation of fluoride release from various dental restorative materials at different pH: In vitro study

BACKGROUND

In the mid of 1980s, the cariostatic effect of fluoride ions on enamel caries had been demonstrated in many studies. The use of fluoride releasing dental restorative materials has seen increasing from many years for the specific purpose of leaching of fluoride into the surrounding tissues to inhibit secondary dental caries as well as prevention of caries in the newly erupted tooth. In the dental caries, acidic environment causes the demineralization of tooth structure and also affect the restorative margins of dental restoration.

AIM

various restorative materials show different behavior in different pH conditions of oral cavity. Thus, the aim of this study was to evaluate the fluoride release of the various restorative materials at different pH.

DESIGN

In this in vitro study, 30 samples of each dental restorative material were prepared and grouped into five with six samples in each group as per the pH of the solution 4.3, 4.6, 5.0, 5.5, and 6.2. All the samples were subjected to alternate cycling of the demineralizing solution (6 h) and remineralizing solution (18 h) for 15 days.

RESULTS

the fluoride release was measured by using fluoride ion specific electrode and digital ion analyzer. The result showed that the fluoride release rate was significantly higher in first day and reduced after third day to nearly constant level. At pH 4.3, the fluoride release was highest and lowest at pH 6.2.

CONCLUSION

the Amalgomer CR showed the highest fluoride release among all the experimental dental restorative materials.

Dental aspect of distal tubular renal acidosis with genu valgum secondary to rickets: a case report

Distal renal tubular acidosis is a disease that occurs when the kidneys do not remove acid properly into the urine, leaving the blood too acidic (called acidosis). Distal renal tubular acidosis (type I RTA) is caused by a defect in the kidney tubes that causes acid to build up in the bloodstream. It ultimately results rickets which include chronic skeletal pain, in skeletal deformities, skeletal fractures. Rickets is among the most frequent childhood diseases in many developing countries. Dental problems in rickets include delayed eruption of permanent teeth, premature fall of deciduous teeth, defects in structure of teeth, enamel defects in permanent teeth (hypoplastic), pulp defects, intraglobular dentine, and caries tooth. Herewith, reported a case of distal tubular renal acidosis with genu valgum secondary to rickets, with pain and extraoral swelling associated with right and left mandibular 1st permanent molars. Teeth were infected with pulp without being involved with caries. Radiographically cracks in enamel and dentin were observed. Pulp revascularization with 46 and root canal treatment was done for 36 with followup of 1 year.