Ramesh Krishnan

Introduction: Molar Incisor Hypomineralisation (MIH) is a qualitative defect of enamel which is more prone to posteruptive enamel breakdown resulting in the early invasion of dental caries compared to a normal enamel tooth structure. Aim: To assess the differences in the enamel permeability of permanent teeth with and without MIH using Scanning Electron Microscopy. Materials and Methods: Out of the sixteen children, eight children with and eight without MIH were randomly selected. Fully erupted maxillary anterior teeth were subjected for evaluation in this study. Vinyl Polysiloxane impression material was used to make impressions for SEM evaluation. The teeth surfaces were divided, into 9 different morphological areas for assessment. Negative replicas representing enamel droplets were assessed. Odd's ratio was calculated by Logistic Regression Analysis. Results: Presence of enamel droplets was noticed in both the groups, more predominantly in teeth with MIH. On comparing the individual regions, presence of enamel droplets in the hypomineralised areas had significant difference compared to normal enamel, with p-value 0.0012, which was statistically significant, with an odds ratio of 3.4. Conclusion: This study demonstrated a high presence of droplets in MIH teeth compared to teeth without MIH, suggesting a possible high enamel permeability which in turn can be a predisposing factor for dental caries in teeth with MIH.

Mutual trust and relationship between doctors and patients is an important factor of treatment plan. Changing trends in medical field does affect this relationship. This article reviews the basic code of conduct for every medical practitioner.

Introduction: In multiple-appointment root canal treatment, a temporary filling material is used to seal the access cavity between visits. The primary function of this material is to prevent the contamination of the root canal system by fluids, organic debris, and bacteria from the oral cavity. Material and Methods: A total of fifty extracted noncarious unrestored human maxillaryanterior teeth with intact crowns and roots were selected The canals were instrumented using stepback technique and sodium hypochlorite (3%) and hydrogen peroxide (3%) were used as irrigants for each specimen alternatively. The coronal two-thirds of each canal were flared using Gates-Glidden drills up to no. 3 size and obturated with Gutta-percha using zinc oxide-eugenol (ZnOE) as sealer. The teeth were then randomly selected and divided into six groups out of which four were experimental groups and two control groups. The teeth were then immersed in 2% methylene blue dye solution for 3 days. All sealing materials and Gutta-percha were gently removed from the walls of the canal, and the entire circumference of the canal wall examined for dye penetration. Results: The lowest mean leakage was in the Fermit-N group followed by Cavit-W, ZnOE, intermediate restorative materials (IRM), and positive control. Conclusion: Fermit-N showed better sealing ability compared to cavit, ZnOE and IRM.

Introduction: Sialic acids are important terminal sugars of the carbohydrate chains of cell membrane glycoproteins and glycolipids. The progressive rise in total sialic acid (TSA) levels has been significantly associated with tumor progression and metastasis. Materials and Methods: Samples of 2 ml of unstimulated whole saliva were collected from 20 healthy patients, and 20 cases of histopathologically confirmed oral pre-cancer patients and 20 cases of histopathologically confirmed oral squamous cell carcinoma (OSCC) patients, using the method of Navazesh. Estimation of total sialic acid was done by the histochemical method of Yao et al . Results: The study revealed significantly elevated total sialic acid (TSA) levels in the saliva of oral precancer and OSCC patients, yielding a mean value of 59.75 ± 7.29 mg/dl and 204.85 ± 60.38 mg/dl, respectively, against the mean value of 21.65 ± 5.71 mg/dl of the healthy controls. Also, high total sialic acid (TSA) levels in the well-differentiated squamous cell carcinoma cases were appreciable to those of moderately differentiated ones. Discussion and Conclusion: The result suggests the correlation of elevated salivary TSA levels with the progression of OSCC. In conclusion, the study indicates that the glycoprotein metabolism is significantly altered in the saliva of patients, with both oral pre-cancer and OSCC.

Context: There are various regions in India that have high levels of fluoride in drinking water sources. Many people residing in such places suffer from dental fluorosis (DF). Aims: To evaluate the prevalence of DF in children residing in Salem and also to find any correlation between DF and other related factors. Materials and Methods: One school from each block of Salem (total 21 blocks) was selected for the study. A single examiner had evaluated untreated caries, lesions, and DF (for permanent anterior teeth and molars) using the Dean's fluorosis index, in all children. Water fluoride level determination at each school was done using the Tamil Nadu Water Fluoridation and Drainage Board field kit. Other factors that may have contributed to DF were assessed using a questionnaire, which was provided to each student. The data obtained were statistically analyzed using the SPSS software version 11.5. Statistical Analysis: Chi-square test was used for statistical analysis. Results: DF was present in 56.9% of the children examined. It was mostly seen in 9 years old (72%) and male (59%) children. A positive correlation was found between the occurrence of DF and the duration of residence in a place with high water fluoride content, consumption of borewell water (64%), the parts per million of fluoride in drinking water, consumption of black tea (59%). However, no correlation was found between DF, dental caries, consumption of milk, or consumption of foods cooked in aluminum vessels. Conclusion: There was a correlation between DF and factors such as male gender, bore well water consumption, black tea consumption and the duration of residence in a place with high water fluoride content.

This was to study the prevalence of molar incisor hypomineralisation (MIH) among school children residing in a fluorosis endemic area in Tamilnadu (Salem, India). A target sample of 5000 children of age ranging between 9 and 14 years, comprising 250 children from each of 20 blocks of Salem, participated in this study. The examination was completed in their respective schools by a calibrated examiner using EAPD criteria. Of 4989 children examined, 384 children had MIH. A prevalence of 7.3 %. The MIH found in girls was 8.9 % compared with 6.1 % in boys. Single-tooth involvement of MIH was seen predominantly in incisors (2.24 %), whereas with molars usually three teeth were involved (1.1 %). MIH with caries involvement was found in 51 % of the teeth. The prevalence of MIH in the endemic fluorosis district was found to be 7.3 %. A gradual increase in MIH was seen with age due to post enamel breakdown. Caries involvement was also seen in more than 50 % of the MIH-involved teeth. This prevalence study for molar incisor hypomineralisation (MIH) is rare in the literature, especially in a fluorosis endemic district in Tamilnadu.

Antioxidants are substances that when present at very low concentration inhibits the oxidation of a molecule. It has the capacity to nullify the ill effects of oxidation caused by free radicals in the living organisms. The unpaired electrons of these free radicals are highly reactive and neutralize the harmful reactions of human metabolism. Protection of the body against free radicals is provided by some enzymes which come under a distinctive group, concerned solely with the detoxification of these radicals. Superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase are the key enzymatic antioxidants of this defense system by which the free radicals that are produced during metabolic reactions are removed. This review highlights the mechanism of action of enzymatic antioxidants SOD, GPX and catalase and its role in oral disease.

Gorlin-Goltz syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities.

Aim: This study evaluates erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration in vitro. Materials and Methods: Test medias used in this study included carbonated beverage, noncarbonated beverage, high-energy sports drink medicated cough syrup, distilled water as the control. A total of 110 previously extracted human premolar teeth were selected for the study. Teeth were randomly divided into two groups. Test specimens were randomly distributed to five beverages groups and comprised 12 specimens per group. Surface roughness (profilometer) readings were performed at baseline and again, following immersion for 14 days (24 h/day). Microleakage was evaluated. The results obtained were analyzed for statistical significance using SPSS-PC package using the multiple factor ANOVA at a significance level of P < 0.05. Paired t-test, Friedman test ranks, and Wilcoxon signed ranks test. Results: For surface roughness high-energy sports drink and noncarbonated beverage showed the highly significant difference with P values of 0.000 and 0.000, respectively compared to other test media. For microleakage high-energy sports drink had significant difference in comparison to noncarbonated beverage (P = 0.002), medicated syrup (P = 0.000), and distilled water (P = 0.000). Conclusion: High-energy sports drink showed highest surface roughness value and microleakage score among all test media and thus greater erosive potential to enamel while medicated syrup showed least surface roughness value and microleakage among all test media.

Pierre Robin syndrome or Pierre Robin sequence (PRS) is a congenital etiologically heterogeneous condition presenting with various malformations. Here we are reporting the surgical management of an 18-month-old female baby who was referred from Department of Pediatrics with a complaint of a large cleft palate. She was taken up for palatoplasty with consent for elective tracheostomy. After genetic evaluation, the authors conclude that the presented case was a PRS in isolation with mild cardiac anomalies and an inferiorly placed hypoplastic epiglottis. Patient should be followed up and growth modifications of the jaws should be done.