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   Table of Contents - Current issue
Coverpage
January-March 2020
Volume 38 | Issue 1
Page Nos. 1-96

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EDITORIAL  

Smart pediatric dentistry: We have come a long way! p. 1
Sudhindra M Baliga
DOI:10.4103/JISPPD.JISPPD_122_20  PMID:32174621
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REVIEW ARTICLE Top

Retentive strength of luting cements for stainless steel crowns: A systematic review p. 2
Shruti Virupaxi, Ramya Pai, Praveen Mandroli
DOI:10.4103/JISPPD.JISPPD_313_19  PMID:32174622
Background: Stainless steel crowns (SSCs) are unique coronal restorative materials used commonly in the management of primary teeth with extensive caries. Aim: The aim of this study was to perform a systematic review to evaluate the retentive strength of luting cements for SSCs. Materials and Methods: Two reviewers performed a database search of the studies published from 2004 till date. The inclusion criteria were papers published in the English language andin vitro studies on retentive strength of SSC on primary molars. All potentially relevant studies were identified by the title and the abstract. After the full-text analysis, the selected studies were included in the systematic review. Results: Sixteen nonduplicated studies were found. However, after reviewing the articles, only seven were included. Risk bias was assessed. Out of seven studies included in the systematic review, five studies presented medium risk of bias and two studies showed high risk of bias. Conclusion: Within the limitations of this study, thein vitro literature seems to suggest that the use of self-adhesive resin cements shows higher retentive strength, followed by resin-modified glass-ionomer cement (RM-GIC) and conventional GIC. However, RM-GIC can be a preferred luting agent due to its clinical advantages over resin cements. Thus, it can be concluded that choice of cement will depend on individual patient needs and clinical situation.
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ORIGINAL ARTICLES - EPIDEMIOLOGY Top

Single-nucleotide polymorphism in Vitamin D receptor gene and its association with dental caries in children p. 8
Victoria Guru Aribam, Nalini Aswath, Arvind Ramanathan
DOI:10.4103/JISPPD.JISPPD_222_19  PMID:32174623
Background: Though factors such as diet, oral hygiene, salivary flow and surface characteristics of the tooth enamel play a role in the causation of dental caries, genetic factors also contribute significantly in influencing the susceptibility or resistanance to the occurrence of caries. Aims and Objectives: To analyse the relationship between a single nucleotide polymorphism in the vitamin D receptor gene TaqI locus and associate its presence with dental caries in children. Materials and Methods: A case control study was conducted among 120 children in the age group of 6-12 years. 60 cases with a DMFT of >3 and 60 controls with a DMFT of 0 were selected. Genomic DNA was extracted from salivary samples collected from the patients and presence of polymorphism was analyzed by PCR-RFLP. Results: Pearson chi square test and Fisher exact tests were used for comparison of differences in genotypes or allele frequencies between groups. No significant difference between the cases and control was observed among the different genotypes and the alleles. However, there was an inclination in the incidence of caries with the genotype 'tt' and 'Tt' when compared with the genotype'TT'. Conclusion: In this study done to analyse the SNP in vitamin D receptor gene and its association with dental caries in children indicates a higher caries risk for a patient with't' allele and 'tt' genotype.
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The prevalence of molar incisor hypomineralization of school children in and around Muvattupuzha, Kerala p. 14
Tharian B Emmatty, Aluckal Eby, Methippara John Joseph, Jose Bijimole, Kumar Kavita, Ismail Asif
DOI:10.4103/JISPPD.JISPPD_152_18  PMID:32174624
Background: Molar incisor hypomineralization (MIH) is a developmental dental defect and has a significant impact on the quality of life of affected individuals. Most of the prevalence studies of MIH have been carried out in the European countries; very little data are available from India. Aim: The aim and objective of this study was to determine the prevalence of MIH in 8–15-year-old Malayalee school children in and around Muvattupuzha, Kerala. Settings and Design: A cross-sectional epidemiological study was conducted in 5318 healthy Malayalee school children aged between 8 and 15 years in and around Muvattupuzha. Materials and Methods: The first permanent molars (FPMs) and all permanent incisors were examined for MIH using the European Academy of Paediatric Dentistry 2003 diagnostic criteria. The severity of hypomineralization was recorded according to the Wetzel and Reckel scale. Statistical Analysis: The data were analyzed using the Statistical Package for the Social Sciences software version 20.0, and a comparison between groups was carried out using the Chi-square test. P ≤ 0.05 was considered for statistical significance. Results: A total of 216 children were diagnosed with MIH. The maximum MIH-affected tooth was found to be mandibular right FPM (186), followed by mandibular left FPM (172), maxillary left FPM (160), and maxillary right FPM (156). Conclusion: The prevalence of MIH in permanent dentition of Malayalee school children in and around Muvattupuzha was 4.1%. Among the MIH-affected children, very few have undertaken dental treatment for the same. Hence, proper awareness and planned preventive and restorative programs are required to minimize the problem.
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Comparison of impact of oral hygiene instructions given via sign language and validated customized oral health education skit video on oral hygiene status of children with hearing impairment p. 20
Sudhindra Baliga M, Meghana Ajay Deshpande, Nilima Thosar, Nilesh Rathi, Sphurti Bane, Pranjali Deulkar
DOI:10.4103/JISPPD.JISPPD_37_20  PMID:32174625
Introduction: Children with special health-care needs have limitations in oral hygiene performance due to their potential motor, sensory, and intellectual disabilities and so are more prone to have compromised oral health. Aim: This study aimed to compare the impact of oral hygiene instructions given via sign language and a validated customized oral health education skit video on oral hygiene status of children with hearing impairment (CHI). Settings and Design: Ethical clearance was obtained from the institutional ethical committee for research activities. The study was carried out across CHI schools of Wardha district, Maharashtra, India. Methodology: Sixty-eight CHI, within the age group of 6–13 years, were divided into two educational intervention groups: customized oral health educational video (Group A) and sign language (Group B). A structured questionnaire was designed to gather information about the routine oral hygiene practices via the Indian Sign Language. Baseline Gingival Index (GI)-S and Plaque Index-S indices were recorded. Based on the group assigned, oral hygiene instructions were given on a daily basis. Reassessment was done after 4 weeks. Statistical Analysis: Unpaired t-tests were performed (P < 0.05) to determine if significant differences exist between the two groups. Results: Postintervention plaque scores between Group A and Group B were 0.12 ± 0.22 and 0.07 ± 0.22, respectively, and the difference between the two was statistically insignificant (P = 0.330). For GI, scores in Group A and Group B were 0.03 ± 0.12 and 0.04 ± 0.12, respectively, and the difference was statistically insignificant (P = 0.669). Conclusion: Both sign language and the validated customized video modeling have been proved to be positively influencing the oral hygiene status of CHI equivalently.
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Prevalence and pattern of caries in primary anterior teeth of preschool children: An observational study p. 26
Vinay Kumar Srivastava
DOI:10.4103/JISPPD.JISPPD_62_20  PMID:32174626
Introduction: Primary teeth are prone to caries. Consequences of caries may hamper eruption and function of the succedaneous teeth. The aim of the study is to find the prevalence and patterns of dental caries in maxillary and mandibular primary anterior teeth of preschool children. The study design adopted was an analytical observational study. Methodology: Caries examination was done using the WHO caries detection criteria. Anterior carious tooth surfaces were examined under optimal light source by a single qualified examiner to minimize visual error. The age of children was measured in years. Obtained data were subjected to statistical analysis using SPSS 16 software. A test for significance was done with the help of the Chi-square test. Results: Right maxillary and mandibular canines had more caries prevalence and patterns as compared to their left counterpart of the same arch. Maxillary canines had more prevalence of caries as compared to mandibular canines. Mandibular lateral incisors had about eight times less chance to develop caries as compared to maxillary lateral incisors. Maxillary and mandibular right central incisors had equal caries prevalence and patterns of their counterparts of the same arch, but maxillary central incisors had four times more caries prevalence as compared to mandibular central incisors. Conclusions: Right maxillary and mandibular anterior teeth had more prevalence of caries as compared to their left counterparts. Maxillary anterior teeth had more prevalence of caries as compared to mandibular anterior teeth.
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YouTube™ video content analysis on space maintainers p. 34
Hakan Yilmaz, Merve Nur Aydin
DOI:10.4103/JISPPD.JISPPD_215_19  PMID:32174627
Aim: Since it is difficult to understand by patients or parents, YouTube™ videos can be used to describe space maintainers. However, the reliability and quality of the information in the YouTube™ videos about space maintainers have not been investigated. Therefore, the purpose of this study was to examine the quality of information provided on YouTube™ about space maintainers. Materials and Methods: Videos were searched on YouTube™ using the key words of “space maintainers” in the Google Trends application. From the first 120 results, after discarding the ones immediately deemed insufficient, 46 videos were selected for analysis. To classify the video content as high or low, a scoring system formed of seven parameters was used. For a global evaluation of the video quality, the video information and quality index were applied. Data obtained were analyzed statistically using the independent t-test, the Mann–Whitney U-test, and the Chi-square test, and the Pearson correlation coefficient was calculated. Results: The quality of the content of videos was found to be mean 2.89 from a maximum of seven points, with 15 (32.6%) videos determined to be of high quality and 31 (67.4%) of low quality. The “likes” index was higher in the high-quality videos (P < 0.05). No statistically significant difference was determined between the groups responsible for uploading videos to YouTube™ in respect of the quality content (P > 0.05). Conclusion: The content quality of videos on YouTube™ about space maintainers is usually low. High-quality content expected from videos uploaded by specialists/dental practitioners was not provided compared to other groups.
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Assessing the behavior management problems during the first dental visit of preschool children using a doll placement test p. 41
Akhil Suresh, YM Karuna, Srikant Natarajan, TM Maimoona, Savitha Shenoy, Anupama P Nayak, Ashwin P Rao, Suprabha B Shrikrishna
DOI:10.4103/JISPPD.JISPPD_206_19  PMID:32174628
Context: Assessing dental anxiety as a predictor of the likely behavior of the child in the dental operatory is of paramount importance for a clinician to render quality care. Aim: This study aims to correlate the dental anxiety of preschool children as shown during the doll placement test with that of their behavioral patterns during the first dental visit. Settings and Design: This cross-sectional study was conducted between the ages of 3–7 years. Materials and Methods: During their first dental visit, the background variables were elicited from parent/guardian at the reception desk. Later at the play area, the child was given a set of dolls representing dentist, child, and mother to place them in a model dental office having a dental chair. The child was then taken for the initial oral examination, during which the behavior of the child was rated using Frankl's Behavior Rating Scale. The data collected were analyzed using Chi-square test and binary regression analysis. Results: The observed association between the doll placement pattern and the behavior of the patient during dental treatment was statistically significant (P < 0.001). The binary regression analysis showed that the child's unpleasant previous medical and parent's unpleasant dental experiences had higher odds favoring uncooperative behavior (46.63 and 41.93, respectively). Conclusions: The child's behavior on the dental chair is associated with the doll placement pattern, which is also influenced by experiences of the child during his/her encounter with the medical doctor and previous dental experiences of their parents.
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ORIGINAL ARTICLES - LABORATORY RESEARCH Top

Residual root dentin thickness for three different rotary systems: A comparative cone beam computed tomography in vitro study p. 48
Matam Glore Suneetha, Ahmed Abdul Moiz, Hateem Sharief, Kalyani Yedla, Mubashir Mirza Baig, Mohammed Ali Salem Abu Al Qomsan
DOI:10.4103/JISPPD.JISPPD_190_19  PMID:32174629
Background: Residual root dentin thickness (RDT) in endodontically treated teeth is a major factor that is responsible for longevity of treated tooth. Aims and Objectives: To evaluate and compare the amount of RDT during endodontic treatment using manual K-files and rotary Mtwo, ProTaper Next, and Hero shaper instruments. Settings and Design: Anin vitro study was carried out on a sample of 100 freshly extracted human single straight rooted mandibular first premolar teeth. Methodology: The teeth were divided into five groups of twenty each and mounted on wax rims for a preoperative cone beam computed tomography scan to calculate the dentin thickness 3 and 6 mm from the apex. All the teeth were treated according to their groups. Statistical Analysis: The observations were then statistically analyzed using one-way ANOVA to evaluate the difference among four groups followed by post hoc test for pairwise comparison. Results: Maximum preservation of dentin was seen in Group V (cleaning and shaping done with rotary Hero shaper files) at 3 and 6 mm from the apex, whereas minimum preservation of dentin was seen in Group IV at 3 mm (cleaning and shaping done with rotary ProTaper Next files) and Group II at 6 mm (cleaning and shaping done with hand K-stainless steel files) from the apex. Overall there was a statistically significant difference in RDT values between Group V and Groups I, II, III, IV both at 3 and 6 mm from the apex. Conclusion: Cleaning and shaping with rotary Hero shaper files preserved more amount of dentin when compared to hand K-files, rotary Mtwo, ProTaper Next.
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Comparison of shear bond strength of light cure mineral trioxide aggregate and light cure calcium hydroxide with nanofilled composite: A stereomicroscopic and scanning electron microscope analysis p. 56
Anu Boby, Deepika Pai, Kishore Ginjupalli, Sumit Gaur
DOI:10.4103/JISPPD.JISPPD_178_19  PMID:32174630
Objective: The quest for ideal pulp capping materials has given rise to the development of newer materials such as light cure mineral trioxide aggregate (MTA). The bond strength of the pulp capping materials with overlying restoration is one among the several factors that are critical for the success of vital pulp therapy. Hence, we conducted this study to evaluate and compare the shear bond strength (SBS) of light cure MTA and light cure calcium hydroxide with nanofilled composite. Materials and Methods: Thirty acrylic blocks each with a central hole were prepared to uniform dimensions and randomly distributed into two equal groups. In Group I, light cure MTA, and in Group II, light cure calcium hydroxide was used as pulp capping materials. After the application of adhesive system, nanofilled composites were applied onto the pulp capping material using a cylindrical plastic matrix. The SBS was tested on a universal testing machine (Instrom 3366, UK) at a crosshead speed of 0.5 mm/min. The samples were examined under stereomicroscope and scanning electron microscope to analyze different modes of failure. Results: The results were statistically analyzed using independent sample t-test. Light cure MTA attained the mean SBS of 6.54 MPa and light cure calcium hydroxide attained the mean SBS of 6.56 MPa. There was no significant difference statistically in SBS of both the materials (P < 0.05). The modes of failure were predominantly mixed failure followed by cohesive failure within the restorative material in both Group I and II. Conclusion: The results of the study suggest that the SBS of light cure MTA and light cure calcium hydroxide is comparable. The modes of failure analyzed in both light cure MTA and light cure calcium hydroxide are not significantly different statistically. Hence, both materials can be successfully used as pulp capping material with nanofilled composite.
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A comparative evaluation of the efficacy of erbium: yttrium–aluminum–garnet and diode lasers in smear layer removal and dentin permeability of root canal after biomechanical preparation – A scanning electron microscopy study p. 64
Sapna Dhawan, Purshottam Jasuja, Heena Khurana, Ekta Gakhar, Harveen Singh
DOI:10.4103/JISPPD.JISPPD_174_19  PMID:32174631
Introduction: The chemomechanical preparation of root canal dentin with hand or rotary instruments creates debris and a smear layer. Root canal preparation (RCP) along with irrigants is not effective in cleaning apical portions, and hence, different laser activation systems were used for better cleaning in the apical third. Aim: The aim of this study is to compare the efficacy of erbium: yttrium–aluminum–garnet (Er:YAG) and diode laser irradiation in smear layer removal and dentin permeability after biomechanical preparation using scanning electron microscopic investigation. Material and Methods: Thirty sound single-rooted human teeth were distributed randomly and equally into three groups (n = 10 each) based upon the type of laser irradiation after RCP: Group I (control group) – RCP with ProTaper rotary system using the standard irrigating protocol; Group II – RCP with ProTaper rotary system using the standard irrigating protocol followed by diode laser irradiation; and Group III – RCP with ProTaper rotary system using the standard irrigating protocol followed by Er:YAG laser irradiation. After root sectioning, specimens were dehydrated, then gold plated and observed using a scanning electron microscopy. Then, the smear layer scores were recorded and performed using the statistical analysis. Results: Smear layer removal efficacy of Er:YAG laser was more at coronal, middle, and apical third when compared to Group I and Group II. Debris removal score of Group III (Er:YAG) was better than Group I (17% ethylenediaminetetraacetic acid) and Group II (diode). Conclusion: Er:YAG laser-activated RCP was comparatively efficient in cleaning the smear layer and dentinal tubules opening.
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ORIGINAL ARTICLES - CLINICAL RESEARCH Top

Comparison of the effectiveness of Bach flower therapy and music therapy on dental anxiety in pediatric patients: A randomized controlled study p. 71
Uma B Dixit, Rishita R Jasani
DOI:10.4103/JISPPD.JISPPD_229_19  PMID:32174632
Background: Dental anxiety is a primary cause of missed dental appointments, delayed treatment, and untreated dental caries in children. Alternative techniques such as music therapy (MT) and Bach flower therapy (BFT) have potential to reduce anxiety. Lack of randomized controlled studies evaluating effectiveness of these methods in reducing dental anxiety led us to this study. Aim: To compare the effectiveness of BFT and MT on reduction of dental anxiety in pediatric patients. Materials and Methods: A total of 120 children (aged 4–6 years) were selected and randomly allocated to three groups: BFT, MT, and control. All children received oral prophylaxis and fluoride treatment. Dental anxiety was evaluated using North Carolina Behavior Rating Scale, Facial Image Scale (FIS), and physiological parameters. Results: Significantly better behavior was seen in children from the BFT group as compared to the control group (P = 0.014). FIS scores measured postoperatively did not show significant differences among the groups. Children from the BFT and MT groups showed a significant decrease in the pulse rates intraoperatively from the preoperative period. Intraoperative systolic blood pressure in children from the MT group was significantly lower than both the BFT and the control groups. Diastolic blood pressure significantly increased in the control group intraoperatively, whereas other groups showed a decrease. Conclusion: The results of this study demonstrate significant effects of both single dose of BFT and exposure to MT, on reduction of dental anxiety in children aged between 4 and 6 years.
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Incidence of postoperative flare-ups after single-visit and multiple-visit endodontic therapy in permanent teeth p. 79
Anju Singh, Konark , Abhas Kumar, Jazib Nazeer, Rohit Singh, Supriya Singh
DOI:10.4103/JISPPD.JISPPD_354_19  PMID:32174633
Aim: Single- and multiple-visit root canal treatment has been the subject of long-standing debate in the endodontic community, so the purpose of this study was to determine the incidence of postoperative flare-up after single- and multiple-visit endodontic therapy in permanent teeth. Materials and Methods: A total of 65 children aged >10 years who underwent root canal treatment were randomly categorized equally into two treatment groups: the first group underwent single-visit treatment, and the other group underwent multiple-visit therapy. The visual analog scale was employed to evaluate pain preoperatively and postoperatively after obturation. Recall visits were carried out after 1 week, 1 and 3, 6 and 9 months. The Statistical Package for the Social Sciences version 15.0 was employed for statistical analysis. Results: Except at the baseline, at all the other time intervals, the mean pain score in the multiple-visit group was higher as compared to that of the single-visit group; statistically no significant difference was found. Conclusion: The mean pain score in the single-visit group was lower as compared to that of the multiple-visit group; however, the difference between the two groups was statistically significant (P > 0.05).
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CASE REPORTS Top

Periostitis ossificans in a 10-year-old child p. 84
Camilla Marcelino, Maria Dalla Costa, Alexandre Roberto Heck, Mary Aparecida Pereira Heck, Fabian Calixto Fraiz
DOI:10.4103/JISPPD.JISPPD_117_18  PMID:32174634
Periostitis ossificans (PO) is a type of osteomyelitis stemming from an odontogenic infection, generally found in children and adolescents, and often leads to the loss of the involved tooth. This case presents a less invasive alternative for the treatment of PO. A 10-year-old patient presented with an asymmetrical increase in the left side of the mandible. Tooth 36 exhibited pulp necrosis and incomplete root formation. Radiographically, the bone in the region had the appearance of the layers of an onion. Computed tomography indicated periosteal bone proliferation in the region of the ramus and angle of the mandible adjacent to the vestibular cortical bone. Therapy involved root canal preparation and intracanal medication with calcium hydroxide in tooth 36. Complete remission of the condition occurred within 14 months. In conclusion, endodontic intervention is a less invasive alternative and should be considered to minimize the negative impact of tooth loss in children.
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A simplified de novo approach for vector control in facemask therapy p. 88
Harpreet Singh, Raj Kumar Maurya, Chandresh Shukla, Tanmay Mittal, Pranav Kapoor, Poonam Sharma, Babita Niranjan, Devashri Awasthi
DOI:10.4103/JISPPD.JISPPD_70_18  PMID:32174635
One of the most common clinical challenges encountered with facemask therapy for early correction of skeletal Class III malocclusions is the delivery of appropriate direction of force for effecting the pure translation of maxilla. This technical note describes a novel method involving the use of Begg's auxiliary for achieving efficient and predictable delivery of protraction forces. With this modified assembly, effective vector control for facemask can be achieved without the need to remove the bonded Hyrax assembly. This chairside modification is an effective and invaluable method for predictable force delivery in facemask therapy.
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A case report of squamous papilloma of the hard palate in a pediatric patient p. 91
Jaya A R, Nagarathna C, N Aishwarya
DOI:10.4103/JISPPD.JISPPD_71_18  PMID:32174636
Oral squamous papillomas are benign proliferating lesions induced by human papillomavirus. These lesions are painless and slowly-growing masses. As an oral lesion, it raises concern because of its clinical appearance. These lesions commonly occur between age 30 and 50 years, and sometimes can occur before the age of 10 years. Oral squamous papilloma accounts for 8% of all oral tumors in children. Common site predilection for the lesion is the tongue and palate and may occur on any other surface of the oral cavity such as the uvula and vermilion of the lip. Here, we are presenting a case of squamous papilloma on the palate in a 9-year-old child.
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A rare case of Dandy–Walker syndrome in the 12-year-old girl p. 94
Deepak Khandelwal, Dhiraj Kumar, Namita Kalra, Rishi Tyagi, Amit Khatri, Sunil Kumar
DOI:10.4103/JISPPD.JISPPD_343_18  PMID:32174637
Dandy–Walker syndrome (DWS) is a rare congenital cystic malformation of the posterior cranial fossa. Patients show signs and symptoms of complex clinical manifestations, ranging from cranial nerve and cerebellar dysfunctions to extracranial abnormalities, which may pose challenges in dental management. This article represents a rare case of a 12-year-old girl with DWS along with the involvement of the oral cavity.
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