Kirti Chaudhry

Context/Background: Children with intellectual and developmental disabilities may have compromised oral health and require oral health rehabilitation under general anaesthesia. Aim: The present study aimed to evaluate the changes observed in the Child Oral Health Impact Profile (COHIP-14) and Family Impact scores (FIS-12) of children with severe behavioural disabilities and medically compromised conditions after oral health rehabilitation (OHR) under general anaesthesia (GA). Materials and Methods: Children with severe behavioural disabilities and medically compromised conditions were recruited, and OHR was done under GA. Teeth with fair prognosis were functionally restored, and teeth with poor prognosis were extracted after parents’/caregivers’ informed consent. Pre-operative and post-operative COHIP-14 and FIS-12 questionnaires were filled out by the parents/caregivers. The pre-operative and post-operative values were compared with those of the Student t -test. Results: All responses for the COHIP-14 and FIS -14 had shown significant ( P ≤ 0.001) change after OHR under GA. Conclusion: The oral and functional health of children with severe behavioural disabilities was improved after OHR under general anaesthesia. The family impact score was also improved in terms of activity and emotions; further financial concerns of the family were also reduced after OHR under GA.

A patient presenting with a history of restricted mouth opening and deflection of the mandible after a prolonged dental procedure raises a suspicion of temporomandibular joint disorder (TMD) due to its estimated high prevalence of 29%. Muscle relaxants and routine active physiotherapy established normal range of movement and pain reduction was achieved through TENS therapy and analgesics. However, the non-subsidence of deflection prompted an initial suspicion of TMD which was overturned by MRI. The MRI evaluation revealed left side medial pterygoid abscess. It is imperative to understand that despite strong history and relevant clinical features, for the definitive diagnosis radiographic evaluation is highly contributory. Misdiagnosing TMD due to its similar presentation can have significant implications for the patient’s well-being and quality of life. The clinical features of medial pterygoid abscess including restricted mouth opening and pain can be similar to that of TMD. These abscesses are most commonly caused by odontogenic infections but can also occur as a result of septic inferior alveolar nerve block techniques. Limited literature reports of pterygoid space abscess have been described, but intramuscular and medial pterygoid abscess is an absolute rarity. Causal relationship to septic inferior alveolar nerve block further makes this case report an interesting read.

The present study aimed to assess the effectiveness of different final irrigation regimens (Cold Atmospheric Pressure Plasma Jet, MTAD, and EDTA) in removing the smear layer from intra-radicular dentin using a Scanning Electron Microscope (SEM). Eighty-four mandibular premolars were prepared with ProTaper Universal hand files and were equally divided into four groups i.e. Normal saline (control), EDTA, MTAD and CAP Plasma Jet. Prepared samples in the control, EDTA and MTAD groups were irrigated with 5 milliliters of the irrigant, and it was retained for 2 min. In the CAP Plasma Jet group, the plasma plume was directed towards the canal lumen for 2 min. The smear layer removal of all the groups was evaluated at the coronal, middle and apical thirds. Statistical analysis was performed using Kruskal-Wallis test followed by Dunn's test. Evaluation by SEM showed that the smear layer removal ability of MTAD and EDTA were significantly better than CAP Plasma Jet (p < 0.05). While CAP Plasma Jet showed results comparable to EDTA in the coronal third. In the middle and apical third of the canal, its effect was comparable to the control group (p > 0.05). MTAD and EDTA aided in better smear layer removal than the CAP Plasma Jet in the coronal, middle, and apical third of the test samples. CAP Plasma jet performed better in the coronal third.

Heterotopic ossifications (HO) are rare, yet, well reported complications after free flap transfer. We present a case of HO that occurred within a month, and has not been previously described in the literature. This serves as a reminder that bony hard swellings proximal to the free flap within a month should raise the suspicion of HO.

Objectives To assess the efficacy of resveratrol in improving functional outcomes following open reduction and internal fixation of maxillofacial fractures. Study Design A single-center, randomized, parallel group, prospective, double-blind clinical trial was conducted on 40 patients between the age 20 and 60 years, requiring open reduction and internal fixation of maxillofacial fractures. The selected patients were randomly divided into two groups, Group 1 (placebo) and Group 2 (resveratrol) where tablets resveratrol 500 mg were given twice daily for 1 month following open reduction and internal fixation of fractured segments. Bite force was calculated pre-operatively and on the 1st, 4th, 8th and 12th week postoperatively. Serum markers osteocalcin and alkaline phosphate were calculated pre-operatively and at 4th and 12th week postoperatively. Results Bite force (690.55 ± 262.00) in the resveratrol group was higher than the placebo group (553.27 ± 300.08) at 12th week postoperatively. However, the difference was non-significant statistically (p = 0.132). Resveratrol group (116.80 ± 55.25) showed better maintenance of serum ALP level as compared to placebo group (107.90 ± 42.99) at 12th week postoperatively, but again it lacked statistical significance (p = 0.573). Resveratrol group after initial reduction at 4th week showed serum osteocalcin levels nearly equal to the preoperative values at 12th week, while the placebo group showed a decline both at 4th and 12th week postoperatively. However, these results were not statistically significant (p = 0.065). Conclusion There was no statistically significant difference in bite force, serum ALP level and serum osteocalcin levels between placebo group and resveratrol group. Though not statistically significant but early increased level of serum osteogenic markers, better restoration of bite force in group 2 (tab. Resveratrol) indicates toward its possible optimistic role in maxillofacial fracture healing. More studies with larger sample sizes are needed in order to confirm the efficacy of this drug in maxillofacial fracture.

Background Oral Submucous fibrosis has a substantial burden on the Indian population; thus there is a substantial need for a validated questionnaire assessing QoL in Hindi. Thus, a prospective cross-sectional study was designed to translate and validate the English version of the OHR QoL-OSF questionnaire into Hindi. Methodology We followed the guidelines suggested by the European Organisation for Research and Treatment of Cancer (EORTC) for the translation procedure and subsequently validated the translated questionnaire with reliability and validity. Results A total of 50 patients were included in this pilot study. Cronbach’s alpha for 17 items was 0.87 signifying high reliability. All questions had an I-CVI of 1.00, demonstrating complete agreement among the content experts regarding the relevance and clarity of items in the questionnaire. Convergent validity was adequately established for all factors except for factor 3 for which it was around 0.43. The intraclass coefficient was 0.803 showing good agreement between the test–retest results. Conclusion The Hindi version of the OHR QoL questionnaire is a reliable instrument having good reliability, good content, good acceptability, and good responsiveness, and thus appears to be a valid instrument. Large studies with large sample sizes can be conducted in the future.

Aim Analyzing quality of Randomized Controlled trials (RCTs) published in the Journal of Maxillofacial and Oral Surgery (MAOS) since inception using Cochrane Risk of Bias tool version 2.0. Methodology Three authors independently screened and evaluated the RCTs according to Cochrane Risk of Bias tool version 2.0 based on the exclusion and inclusion criteria. All six domains of the RoB 2.0 tool were analyzed. The assessment of each judgment can be “Low” or “High” risk of bias, or can express “Some concerns.” Results “Some concerns” were found in the randomization process (57%), and “low ROB” was evaluated in the second domain (57%), third domain (96%) and fourth domain (53%).In fifth domain, maximum of the articles had shown either some concerns in ROB (49%) or low ROB (45%).Analysis of the overall ROB in the included articles, maximum of the articles (50%) of the articles had shown high ROB followed by articles with some concerns in the ROB assessment (36%) and only 14% of the included article shad shown the low ROB in the RCT methodology. Conclusion The methodological and reporting quality in MAOS journal has a significant room for improvement.