SESSION 24 CODE:FDT 722 TITLE: Amelogenesis Imperfecta- A Case Report NAME: : Dr. Arti Chaudhary BACKGROUND:Amelogenesis imperfecta (AI) represents a group of developmental conditions, genomic in origin, which affect the structure and clinical app earance of enamel of all or nearl y all the teeth in a more or less equal manner, and which may be associated with morphologic or biochemical changes elsewhere in the body. AI exists in isolation or associated with other abnormalities in syndromes. It may show autosomal dominant, autosomal recessive, sex -linked and sporadic inheritance patterns. In families with an X -linked form it has been shown that the disorder may result from mutations in the amelogenin gene, AMELX. Autosomal recessive AI has been report ed in families with known consanguinit y. Diagnosis is based on the famil y history, pedigree plotting and meticulous clinical observation. CASE REPORT: This paper presents a case report of a 9 year old boy whose chief complaint was discolored te eth since childhood. History revealed that his deciduous teeth were also discolored. The history did not reveal any eruption disturbances and patient was caries free. Investigations included orthopantomogram and Karyot yping. MANAGEMENT: A thorou gh oral prophylaxis was done. Permanent first molars were restored with Stainless steel crowns. Esthetic crowns were given on maxillary anterior teeth. Mandibular anterior were restored with composite veneering. LIMITATIONS As the knowledge regarding genetic mutations associated with the various t ypes of AI increases, our ability to make an accurate diagnosis of AI will be remarkabl y improved. The similarit y in the clinical features of the different AI t ypes makes the differentiation among them difficu lt at the clinical level. Correlation of the genetic mutations with the clinical phenot ypes will be extremel y valuable for managing patients with AI. Moreover, this knowledge allows us to make better predictions of the AI t ypes that are associated with problems such as calculus formation and skeletal open bites, and to select the most optimal treatment approaches for each case. SESSION 24 CODE:FDT 723 TITLE: GAUCHER’S –A PEDODONTIST’S PERSPECTIVE OF TREATING THIS SPECIAL CHILD NAME: Dr Pallavi Urs Gaucher disease, the lysosomal storage disorder, is a result of the genetic defect in production of the enzyme β-glucocerebrosidase, and the consequent accumulation of glucocerebroside, in the cells of the monocyte-macrophage system .The clinical heterogeneity, affecting 1in 100,000 people, is autosomal recessive and attributable to more than 200 mutations within the glucocerebrosidase gene. Classically, three clinical forms have been delineated, based on the absence (type I) or presence (types II and III) of neurological signs, splenomegaly, growth retardation may be seen. Anemia and thrombocytopenia, causing easy fatigability and a tendency towards spontaneous gingival bleeding, enamel and dentin hypoplasia, are the most prominent features of Gaucher disease. CASE REPORT :A 5 year old child diagnosed with Gauchers type III (Juvenille neuronopathic form) at the age of 2 years reported to the Department Of Pedodontics And Preventive Dentistry At A.E.C.S Maaruti dental college and research center Bangalore .He was the first child of a consanguinous married couple. The history revealed mental retardation, slurring speech, discolored teeth, spontaneous gingival hemorrhage and oculomotor apraxia .The child has been receiving the enzyme replenisnment: Cerezyme from the age of three. Dental treatment was delayed as the parents were apprehensive as most of the general practioners had suggested the treatment under general anesthesia. TREATMENT The mental retardation in the child was the most challenging aspect to provide treatment under local anesthesia, but was done successfully with various behavior management techniques such as tell show do, modeling and positive reinforcers .The entire treatment was scheduled during the week of enzyme replacement as the hemoglobin and platelet counts would reach normal levels. Oral prophylaxis, restorations, pulp therapy in relation to the upper anteriors followed by composite build up with posts was done under antibiotic prophylaxis. LIMITATIONS: None. SESSION 24 CODE:FDT 724 TITLE: RAPP HODGKIN’S SYNDROME – A CASE REPORT NAME: DR.S.KARTHIKEYANI BACK GROUND REPORT: Rapp-Hodgkin syndrome, an extremely rare inherited multisystem disorder that is apparent at birth (congenital) or during infancy, belongs to a group of diseases known as ectodermal dysplasias.Less than 50 cases have been reported in medical literature.Rapp-Hodgkin syndrome, like Ectodermal dysplasias typically affects the skin, teeth, hair, and/or nails. An incomplete closure of the roof of the mouth (cleft palate) and/or an abnormal groove in the upper lip (cleft lip)is always seen.In most cases, Rapp-Hodgkin syndrome is inherited as an autosomal dominant trait. CASE REPORT: A patient named Mst.Mubeen aged 8yrs reported to the Department of Pediatric dentistry, Sri Ramakrishna dental college and hospital with numerous missing teeth & surgically corrected cleft lip & palate. He had facial dysmorphism, sparse hair & reduced sweating. History revealed that he was a normal, full term baby with birth weight appropriate for his gestational age. Parents were healthy & had consanguinous marriage. A positive family history was noted with maternal grand mother & 2 siblings showing abnormalities of hair, skin & teeth MANAGEMENT PROTOCOL : The treatment of Rapp-Hodgkin syndrome is directed towards the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists. Pediatricians, surgeons, physicians who specialize in the diagnosis and treatment of disorders of the skin (dermatologists), specialists who assess and treat hearing problems (audiologists); dental specialists, eye specialists (ophthalmologists), and/or other health care professionals may need to systematically and comprehensively plan an affected child's treatment. LIMITATIONS: The psychological impact of the disease on the patient and the family is devastating. Long term treatment and multidisciplinary treatment affects the patient compliance SESSION 24 CODE:FDT 725 TITLE: Dental Trauma – Sequel of delayed management NAME: Dr. Anjana. G Background of report Dental trauma in children is the most common, devastating, and most mismanaged. Traumatic dental injuries are unanticipated events and if not managed immediately and appropriately, can have serious consequences. Many a times delay in management due to the parent’s ignorance regarding the importance of immediate care or lack of expertise on the clinician’s part, jeopardize the vitality and existence of involved teeth. The number of mismanaged cases of dental trauma being reported prompted this case reports and criteria for prioritization of traumatic dental injuries. Case report Two cases of delayed trauma management, outcome and further management is reported. The first case reports the delayed management of loss of vitality of a tooth with enamel dentin fracture leading to formation of a radicular cyst and further management. The second case reports the outcome of delayed replantation and further management. Management protocol The aim of correct management of dental injuries, following the guidelines for evaluation and management is to ensure that pre teenage children do not experience the loss of traumatized teeth, due to inaccurate diagnosis and poor treatment. Management of traumatic injuries should be based on whether the trauma needs acute, subacute or delayed management. The management of both cases were done as attempts to prevent loss of anterior teeth, though with compromised prognosis, due to improper management earlier. Limitations Management cases with questionable prognosis, where the pathologic sequel of improper management is already present is hoping against hope for success. SESSION 24 CODE:FDT 726 TITLE: UNICYSTIC AMELOBLASTOMA IN A YOUNG CHILD : A CASE REPORT NAME: : DEEPA SINGAL Background of the report: Ameloblastoma is a common odontogenic epithelial tumour of the jaws with characteristic locally aggressive behavior and high recurrence rate. It has three variants: conventional (solid), unicystic and peripheral ameloblastomas. In comparison to the solid variant, unicystic Ameloblastoma (UA) is usually found in younger population and is less aggressive in nature with lower recurrence rate. The term UA is used for those cystic lesions which resemble grossly, clinically and radio graphically to a jaw cyst but shows typical features of Ameloblastoma histologically. The aim of this article is to report a case of UA at very young age (i.e. in a 11 years old female child) and its management. Case report: 11 years old girl reported to the department of pedodontics with swelling on right side of mandible of two months duration. On clinical and Radiographical examination, it resembled dentigerous cyst involving 47 & 48 teeth. On histopathological examination, it was diagnosed as Unicystic Ameloblastoma (luminal & mural variants). Management Protocol: Surgical resection or enucleation, with wide surgical margins which are clear of diseased tissue, is the mainstay of treatment. Radiation therapy is recommended when there is malignancy, inability to completely remove the Ameloblastoma, recurrence, unacceptable loss of function, and unacceptable cosmetic damage. In this case, enucleation with wide surgical margins was done. Limitations: Persistent follow-up examination is essential for managing Ameloblastoma. Follow up should occur at regular intervals for at least 10 years. Follow up is important, because 50% of all recurrences occur within 5 years postoperatively. Limitation of our report is that follow up is of very short duration. Limitations: Persistent follow-up examination is essential for managing Ameloblastoma. Follow up should occur at regular intervals for at least 10 years. Follow up is important, because 50% of all recurrences occur within 5 years postoperatively. Limitation of our report is that follow up is of very short duration. SESSION 24 CODE:FDT 727 TITLE: “MULTIDISCIPLINARY MANAGEMENT OF AN UNUSUAL CASE OF MULTIPLE DEVELOPMENTAL DEFECTS IN LATERAL INCISOR FOLLOWED BY INTRUSIVE INJURY TO PRIMARY INCISORS” NAME: : Dr Arpana V Bansal Background of report: Dental traumatic injuries occur frequently in children. The close relationship between the apices of primary teeth and germ of the permanent successors can lead to developmental disturbances in the permanent dentition. Developmental disorder can occur in any tooth. One of the most common teeth affected is lateral incisor. These developmental anomalies can cause various clinical problems. Clinical and radiographic characteristics of these anomalies may sometime present confusing picture. Therefore recognition of this condition, early diagnosis and treatment are important to avoid complications. Case report & Management: A 14 year old girl reported with discoloration and pain in right upper lateral incisor. Past dental history revealed trauma to primary central incisors and right lateral incisor 10 years back. Clinical and radiographic examination reveals multiple developmental defects in the affected tooth. Concomitant presence of these anomalies along with impacted permanent right maxillary canine was a challenging job for clinician. Multidisciplinary treatment planning had lead to biomechanical, structural, and esthetic integrity in our case. SESSION 24 CODE:FDT 729 TITLE: Reconstruction of Traumatized Anterior Teeth Using Polyethylene Fibres And Composite Resin - A Case Report NAME: : Dr. Lata Kiran Mehta Background of report: Traumatic injuries in children and adolescents are a common problem and several studies have reported that the prevalence of these injuries has increased during the past few decades. There is perhaps no single disturbance that has greater psychological impact on both the parents and children than the loss or fracture of a child’s anterior teeth. This is especially so if the injury affects the permanent dentition and involves the loss of extensive tooth structure. The ability to predictably restore endodontically treated teeth to its original strength and fracture resistance without placement of full-coverage restoration could provide potential periodontal and economic benefit to the patients. Recent advancements in adhesive dentistry have generated more conservative and non- invasive approach for the management of such teeth. Case report: The present case report describes management of Ellis class III fracture using Leno Weave Ultra High Modulus Polyethylene Fibers (RIBBOND) and composite and restoring the functionality and aesthetic of the tooth, with a follow up of 12 months. Management protocol: In the restoration of traumatized anterior teeth, both aesthetic and mechanical considerations should be taken into account. Fiber reinforced composite restorations showed a strengthening effect on the tooth structure, with fracture resistance similar to that of unaltered tooth. Various studies concluded that it possess adequate modulus of elasticity and strength to function successfully in the mouth. Limitation: For fractured anterior teeth, there are several treatment alternatives such as composite resin restorations and prosthetic repair. However, combining a polyethylene fiber and composite restorations, which have lower chair time and minimal tissue removal, could be an admirable alternative. If patient shows positive response and co-operation towards the treatment. SESSION 24 CODE:FDT 730 TITLE: Oral & Dental Management of Epileptic Mentally Challenged Adolescent- A Case Report. NAME: Dr. Saurabh Ramesh Joshi Background- Epilepsy and seizure disorders affects about 8000 children in India. The disease is caused by a number of genetic, physiologic, and infectious disorders as well as trauma. Treatment is primarily pharmaceutical but can also be surgical. The disease itself and the pharmaceutical management often have an impact on the oral cavity. The aim of this Case report is to educate dentists on the diagnosis and dental management of epilepsy and seizure disorders. Case Report- A 15 year old male epileptic mentally challenged patient on antiepileptic medication, reported to dental clinic with pain in maxillary anterior region and with multiple decayed teeth. Few of the teeth were endodontically treated by a previous dentist where the treatment was a failure. Few permanent molar extractions were also carried out by previous dentist. The occlusion of patient was deranged. The patient required a complete oral rehabilitation. Management Protocol – A comprehensive medical and dental management protocol was followed. This included Pain management, Control of Seizures with Anti- Epileptic Drugs(AEDs), Caries Control, Endodontic treatment, Surgical Management (for failed endodontic treatment), Prosthetic management, orthodontic management as well as the Dietary changes of the patient. A non-pharmacological behavior management was given a prime importance in this case. Limitations- Since the patient was mentally challenged, all the dental procedures took a longer time to complete . Also proper scheduling of appointments is essential in such cases, where it was given a minimal importance. SESSION 24 CODE:FDT 808 TITLE: HEARING COLOURS OR TASTING SOUNDS?? “ SYNESTHESIA” THE WORLD OF CROSS WIRED SENSES! NAME: Dr.Sankriti.A.Murthy INTRODUCTION: SYNESTHESIA (Joined sensations) is a rare capacity to hear colour, taste shapes or experience other equally startling sensory blending. Synesthesia is “INVOLUNTARY” and “AUTOMATIC”. Although known to medicine since 300 years, its importance has re emerged recently. SIGNIFICANCE OF REVIEW: Human beings have 5 senses so there can be 10 possible synesthetic pairings. This synesthetic response can be “strong” or ‘weak” and can affect day to day activities from a minimum to a maximum. Dental setup is distinctive in the fact that, all the 5 senses are aroused during a dental procedure. Example: sound from the airotor, taste and smell of various materials, the tactile perception and the visual stimuli. What experience a synesthete will have in a dental set up is of importance. This review is all about understanding the various types of synesthesia, the clinical features, probable mechanism & causes and also the implication this peculiar and unique neurological cross wiring has on pedodontics. RECENT UPDATE: Synesthesis is also said to occur in conjunction with other conditions like autism, migraine and epilepsy. SESSION 24 CODE:FDT 809 TITLE: POSSIBILITIES OF DENTAL IMPLANTS IN PEDIATRIC PATIENTS NAME: : Dr. Gyanendra Kumar INTRODUCTION: Traumatic tooth loss or congenital partial anodontia, mainly in patients with ectodermal dysplasia, is frequently encountered in children. In those cases, oral rehabilitation is required before skeletal and dental maturation, and removable prosthesis is often the treatment of choice. However, it may lead to increased caries rates, increased residual alveolar résorption, and other periodontal complications. SIGNIFICANCE: Use of implants in children had been discussed lately. From a physiologic standpoint, the conservation of bone may be the most important reason for the use of dental implants in growing patients, and it even may be beneficial in some cases to stimulate alveolar bone development. Other factors that favor implant placement in children are their excellent local blood supply, positive immunobiologic resistance, and uncomplicated osseous healing. RECENT UPDATES : Recent studies coborates with the results with due acknowledgement to the fact that, the dental and skeletal growth is a major confounding variable when implants are used in children. Few other studies are also suggestive of the preference of placing implants after growth is completed, upon sexual maturity, the appropriate age for installation of implants. It is recommended to wait for the completion of skeletal and dental growth before planning to place an implant; however, many physiologic and psychological factors create pressure to commence earlier treatment. SESSION 24 CODE:FDT 810 TITLE: ROBOTICS IN PEDIATRIC DENTISTRY - A FUTURISTIC APPROACH NAME: DR. A.ANANTHARAJ INTRODUCTION Robots have captured the imagination of inventors and storytellers for centuries. While the birth of automation technology can be traced to the Greeks, the first individual robots were not produced until the 1970’s. Today’s cutting edge humanoid robots are the result of years of trial and error. Robots have been widely used in medical field successfully where extreme precision and delicacy is necessary, and the margin for error is slim. Dentistry is undergoing yet another change, in helping mankind enter a new era-The Era of Robotics. SIGNIFICANCE OF REVIEW CAD CAM based robot programming has been devised as robots can help in precise and reliable cutting. Their use can range from diagnosis, clinical work on patients to laboratory work. Dentists can use joysticks and virtual glasses to operate handpieces to prepare cavity for restoration, perform endodontic therapy and prepare tooth surfaces for bridges. They can also be employed for teaching purpose. Robot can be useful in imparting dental treatment in remote areas. RECENT UPDATE In the 79th General session by IADR, researchers have announced that a dental robot has been created that can perform dental procedures. The use of robotics can make the work much more smooth and comfortable. This presentation focuses on the current development of robotics in dentistry and also on the future applications. SESSION 24 CODE:FDT 811 TITLE: Between Meal Eating Episodes – A Review of the Indian Scenario and Pedodontic Implications NAME: : Dr. P.Praveen Introduction: Between Meal Eating Episodes (Snack) is defined as any intake of food or energy- containing beverage outside of the usual meal times. Urbanization and economic development as well as market globalization has resulted in rapid changes in the Indian diet and lifestyles. This dietary excess is leading to chronic diseases such as obesity, diabetes, cardiovascular diseases, cancer, osteoporosis and oral diseases. WHO has identified these changes and identified the role of diet in oral health as a priority area. Significance of review This paper seeks to review the current trends in Between Meal Eating Episodes in India and its impact on oral health of children. Review of the relevant literature reveals disturbing trends in dietary patterns that are contributing to deterioration in health in general and oral health in particular. This is evidenced by the rising dental caries experience worldwide and in the Indian subcontinent. On the contrary healthy snacks can overall health of the individual. This review will help formulate specific guidelines for the Pedodontic community and the care-givers. Recent update: Several studies The paper critically reviews all the relevant literature published over the last 5 years in order to identify the trends and changes in Between Meal Eating Episodes among Indian children, impact on oral health and its significance to the practice of Pedodontics. SESSION 24 CODE:FDT 812 TITLE: Salivary Anti-oxidants and pediatric dentistry: a review NAME: Dr Ananth Kamath P Introduction: Saliva, a heterogeneous fluid comprising of proteins, glycoprotein, electrolytes, small organic molecules and compounds transported from the blood, constantly bathes the teeth and oral mucosa. Apart from the routine functions of the saliva, its been found that there are some substances called anti oxidants which will act against the free radical produced due to lipid peroxidation etc. Free Radiacals (FR) and Reactive Oxygen Species(ROS) are associated with various diseases . In the pediatric age group oxidative damage has been implicated in the pathogenesis of numerous diseases and entities. In the newborn period these include broncho- pulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, perinatal brain damage and neonatal hemochromatosis. Apart from this, dental diseases like gingival and periodontal diseases and dental caries are associated with FR and ROS. Significance: This review focuses on data indicating that the types and functions of the salivary antioxidants and determining the various methods of Salivary total antioxidant. Recent clinical trials have found that antioxidant supplementation can significantly improve certain immune responses locally as well as systemically. Anti oxidants can be added in very low volumes in dental materials like dental cements which are commonly used for restorative purposes. Also antioxidant supplements can be tried in mouthwashes and topical fluorides. SESSION 24 CODE:FDT 813 TITLE: ROLE OF GENETICS AND VARIOUS SYNDROMES ON CLEFT LIP & PALATE FORMATION NAME: : Prof. Subrata Sarkar Introduction Genes are ultramicroscopic structure of DNA which is present in the chromosome. Total number of human genes are 30,000 of these some are functional gene and some are non-functional genes. Gene transmits hereditary character, behavior and features from generation to generation. Genes transmits chemical structure at molecular level, enzymes and various metabolic products, control development, reverse genetic mechanisms, cause various hereditary diseases Maupertius (1689-1759) was the first person who observed that certain diseases are inherited in character. Project (2001) suggested various oral, dental and craniofacial manifestations are heritable in nature. Cleft lip and Cleft Palate, is one of the common orofacial abnormalities inhuman beings. Anatomists suggested that improper fusion of sutural growth may cause cleft. Significance Genetic diseases may cause gross abnormality in physical, mental and structural abnormality. .
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