Dental and anesthetic management of a child with epidermolysis bullosa

Epidermolysis bullosa (EB) is a wide spectrum of rare genetic disorders characterized by marked fragility of the skin and mucous membranes in which vesculobullous lesions occur in response to trauma, heat, or no apparent cause. This case report deals with the dental and anesthetic management of a 10-year-old girl with dystrophic EB.

Children's behavior pattern and behavior management techniques used in a structured postgraduate dental program

BACKGROUND

Anxiety and fear remain the primary emotion of a child entering a dental office. Successful pediatric dentistry depends not only on the dentist's technical skills, but also on his ability to acquire and maintain a child's cooperation.

METHODS

A retrospective study was done using the case records of 247 children, to evaluate their behavior patterns, based on the Wright's modification of Frankl's behavior rating scale. Various behavior management techniques like the tell-show-do, reinforcements, voice control, and hand over mouth exercise used in the postgraduate section of the Department of Pediatric Dentistry, Meenakshi Ammal Dental College, Chennai, India, were also evaluated in this study.

RESULTS

Behavior of the children improved on the subsequent visits. Tell-show-do was the most common behavior management technique used and more aversive management techniques were rarely used in managing children in the dental office.

CONCLUSION

Proper assessment of children's behavior helps the dentist to plan appointments and render effective and efficient dental treatment. Appropriate use of management techniques can improve the child's behavior in subsequent dental visits.

Quantitative assessment of IgA levels in the unstimulated whole saliva of caries-free and caries-active children

Saliva is commonly referred to as the blood stream of the oral cavity. It has many functions, one of the major functions being protection of teeth against dental caries. There are many components in saliva, each one having a specific role in the prevention of dental caries. The composition of saliva varies from individual to individual and in the same individual it varies between the glands. The composition of whole saliva, especially when unstimulated, has gained much interest, because it is this which constantly bathes the teeth. The aim of this study was to determine the IgA levels in the unstimulated whole saliva of caries-free and caries-active children aged 3-6 years and to correlate its role in protection of the tooth against dental caries.

Effect of fluoride varnish on Streptococcus mutans counts in plaque of caries-free children using Dentocult SM strip mutans test: a randomized controlled triple blind study

Dental caries is one of the most prevalent infectious diseases and although of multifactorial origin, Streptococcus mutans is considered the chief pathogen in its development. Fluoride is one of the most effective agents used for the reduction of dental caries apart from oral hygiene maintenance.

AIMS

The aim of this study was to estimate the counts of Streptococcus mutans and to evaluate the effect of Fluor Protector fluoride varnish on these counts in the plaque of caries-free children using Dentocult SM Strip Mutans.

MATERIALS AND METHODS

Thirty caries-free subjects were selected for the study based on the information obtained from a questionnaire and were randomly assigned to the control group consisting of ten subjects and the study group consisting of twenty subjects. Plaque samples were collected on the strips from the Dentocult SM kit and after incubation, the presence of Streptococcus mutans was evaluated using the manufacturer's chart. The study group was subjected to a Fluor Protector fluoride varnish application following which the samples were collected again after 24 hours.

RESULTS

The average Streptococcus mutans counts in the primary dentition of caries-free children before and after the application of Fluor Protector fluoride varnish were 10(4)-10(5) colony forming units (CFU)/ml and <10(4) CFU/ml respectively.

CONCLUSION

The results showed that the study group had a statistically significant reduction in the plaque Streptococcus mutans counts than the control group.

Rapid onset intratubular calcification following renal transplantation requiring urgent parathyroidectomy

BACKGROUND

Secondary hyperparathyroidism is a common complication of end-stage renal disease often requiring parathyroidectomy. Renal transplant with the restoration of normal renal function often allows resolution of hyperparathyroidism, avoiding the need for parathyroid surgery. However, a proportion of patients with hyperparathyroidism become overtly hypercalcemic after renal transplantation which poses management dilemmas between medical and surgical treatment.

CASE

We present the case of a 48-yearold man with end-stage renal failure known to have secondary hyperparathyroidism who received a living related renal transplant. Postoperatively he developed prompt hypercalcemia, polyuria, polydipsia and rapid onset intratubular calcification, leading to acute tubular necrosis diagnosed on renal biopsy on Day 7 post transplantation. He underwent surgical parathyroidectomy with resolution of his hypercalcemia and improved renal transplant function.

DISCUSSION

This case emphasizes the need for good management of secondary hyperparathyroidism together with close surveillance of PTH in patients awaiting renal transplantation. With good renal transplant function hyperparathyroidism usually resolves. Posttransplant surgical parathyroidectomy should be reserved for severe progressive end organ damage.

Noonan syndrome: a case report

Noonan syndrome is a developmental disorder characterized by facial dysmorphia, short stature, cardiac defects and skeletal malformations. It may be sporadic or inherited as an autosomal dominant or recessive trait and occurs, one in 1,000-2,500 children. This is a case report of a 13 year-old girl who was referred by a general dental practitioner to a pediatric dentist for management. Full mouth dental rehabilitation was done and the child was brought to a dental institution for correction of orofacial and occlusal defects. Multidisciplinary treatment is the key to success in managing children with Noonan syndrome and the pediatric dentists play an important position to lead the health team.

Visual p3 in female alcoholics

BACKGROUND

The P300 (P3) component of the event related potential has been established as a sensitive risk marker of vulnerability to alcoholism. Most alcoholism studies have focused on men; recent studies indicate that women are equally vulnerable to developing alcoholism.

METHODS

Visual P3 recorded from 31 electrode positions was evaluated in 44 alcoholic and 60 control women, 24-50 years of age. P3 amplitudes and latencies of the two groups were statistically compared using Analysis of Variance; source localization of surface amplitude values from each group were plotted using a low-resolution brain electromagnetic tomography.

RESULTS

The results indicated that alcoholic women had significantly smaller P3 amplitudes in the frontal and central regions compared with controls. Source localization showed lowered activation in alcoholic women in right dorso-lateral prefrontal cortex and the ventro-medial fronto-central regions.

CONCLUSIONS

The results suggest that P3 is an equally sensitive endophenotypic marker of vulnerability to alcoholism in women. The findings are discussed in terms of functional and physiologic significance of the P3 amplitude in alcoholic women and its relationship to drinking behaviors.

A clinical profile to assess the potential risk factors for cleft lip and palate

Cleft lip and palate is one of the most common malformations in man. Although the subject of a great deal of investigation, etiologic factors contributing to these congenital deformities remain largely unknown. Various factors like race, sex, parental age at the time of conception etc. have been listed as the exogenous factors. This article strives to project any significant relationship of these factors to cleft lip and cleft palate.