Pediatric Dentistry

Incontinentia pigmenti: A case report and literature review Chaitanya Prakash Puranik, Deborah A Redford-Badwal Journal of Pediatric Dentistry 2017 5(2):29-35 Incontinentia pigmenti (IP; OMIM#308300) is a rare multisystem disorder with an incidence of 0.7:100,000 live births. IP is rare and predominantly seen in females. Mutations in IKBKG gene (Xq28, GenBank: NM_003639.3, OMIM#300248) were reported as underlying cause of IP. IKBKG encode NFkB protein, which controls the expression of other genes involved in cell proliferation, immunity, and inflammation. Oro-dental abnormalities have been documented in 50%–75% IP cases. We present a case report of a 16-year-old female with probable clinical IP, Arnold–Chiari malformation, hydrocephalus, delayed psychological development, and seizures. The IP hallmark feature: hyperpigmentation of the skin along the Blaschko's lines was present only on the left side of the body. Left-sided hemifacial and tongue hypertrophy were present, which have not been reported previously. Consistent with published reports, tooth size and shape discrepancies were present. However, unlike previous reports, discrepancies were prominent on affected versus unaffected side. This paper provides IP literature review, clinical considerations, and insight on management.

Pain perception and effectiveness of palatal approach anterior superior alveolar block anesthesia using single tooth anesthesia in children: A randomized controlled trial Sherine B Y Badr, Riad H Bacho Journal of Pediatric Dentistry 2017 5(2):36-42 Background: Restoring multiple anterior teeth in children using conventional infiltration is challenging due to the need of multiple injections, a considerable amount of anesthetic solution, and lip numbness. The palatal approach anterior superior alveolar block injection (P-ASA) using the Wand single tooth anesthesia (STA) provides an alternative and innovative technique that overcomes several challenges and should be furtherly tested. Aim: The aim of this study was to compare the pain perception and the effectiveness of P-ASA injection using STA (Milestone Scientific, Inc.) and a 30 G × 0.5 inch needle, to the regular multiple maxillary infiltration local anesthetic technique (MIT) in restoring primary anterior maxillary teeth. Design: This study was designed as a randomized controlled clinical trial in which 64 healthy children who need restoration and/or pulp treatment on primary maxillary anterior teeth were assigned to either receiving P-ASA block injection or regular (MIT). Children's behavior was assessed during anesthesia administration objectively using face, legs, activity, cry, and consolability behavioral pain assessment scale (FLACC). Children's self-reported pain was evaluated subjectively at two different time points (directly after injection of anesthesia and after full dental treatment) using the Wong–Baker FACES pain rating scale (WBFPRS). Data were statistically analyzed using SPSS version 13.0 and statistical significance was determined as P ≤ 0.05. Results: Children receiving the P-ASA reported less pain both during and after anesthesia administration (P = 0.0001). Similar results of pain were reported after treatment completion using both techniques (P = 0.464). Conclusion: P-ASA can be considered as an excellent alternative to administer deep, fast, effective, and less painful anesthesia of the upper primary anterior teeth and related gingival tissues compared to MIT.

Evaluation of pediatric oral and maxillofacial biopsies from a Tertiary Hospital in Sub-Saharan Africa Olujide Oladele Soyele, Adetayo O Aborisade, Abiodun S Olatunji, Henry Ademola Adeola Journal of Pediatric Dentistry 2017 5(2):43-49 Introduction: Despite the large number of published studies on indications for biopsy during investigation of adult oral and maxillofacial pathologies, there is a dearth of literature focusing on biopsies for pediatric orofacial pathologies (particularly in sub-Saharan Africa). Objectives: Hence, this study analysed data on maxillofacial pediatric lesions from the surgical pathology archives of the Oral Maxillofacial surgery/Oral pathology unit of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria. Method: Data was collected over a ten year period (2007-2016). Result: From a total of 790 biopsies recorded within the study period, only 105 (13.3%) were found to be pediatric cases. Lesions such as ameloblastoma (24%), benign bone pathologies (25%), hyperplastic reactive lesions (22%) and primary oro-facial malignancies (6%), were found within the 105 pediatric cases. Lesions tended to occur more in the mixed dentition to permanent dentition, than primary dentition age groups. A female preponderance in frequency of lesions was also observed in our study. The commonest non-odontogenic tumor was found to be fi brous dysplasia, while pyogenic granuloma was the most prevalent hyperplastic reactive lesions. Lymphangioma and Heck's disease were the commonest soft tissue tumours, and mucous extravasation phenomenon was equally the most frequent salivary gland lesion. Malignancies were found to be rare in pediatric age groups. Overall, we compared our findings to previously published literature on pediatric biopsies. Conclusion: We are hopeful that the knowledge provided in this study, may assist general dental practitioners, oral pathologists, and pediatric dentists in sub-Saharan Africa in making precise diagnostic and management decisions.

Dental sequelae of pediatric maxillofacial trauma Sanjay Naran, Liliana Camison, Brian Lam, Osama Basri, Lindsay Schuster, Brian Martin, Joseph E Losee Journal of Pediatric Dentistry 2017 5(2):50-53 Purpose: Our goal was to explore dental complications in the pediatric population following facial trauma and identify those at risk. Patients and Methods: We queried children with fractures of tooth-supporting regions presenting from 2000 to 2014. Data elements included demographics, treatment method, and dental outcome measures. Results: A total of 117 subjects were identified. The average age at injury was 10.41 years, and average follow-up was 2.9 years. Fractures were grouped as mandibular (62.39%), maxillary (22.22%), or combination (15.39%). Dentition at time of injury was classified as primary (17.95%), mixed (38.46%), or permanent (43.59%). Conservative management was employed in 41.88%, open reduction and internal fixation (ORIF) in 49.57%, and closed reduction and external fixation in 8.55%. The majority (67.52%) did not experience any dental trauma or sequela. Dental avulsion (10.26%), subluxation (10.26%), dysgenesis (5.13%), and development of a crossbite (5.13%), openbite (3.42%), and occlusal cant (0.85%) were observed. Avulsion was more likely in subjects requiring ORIF (P < 0.05). Development of an openbite, crossbite, or occlusal cant was more likely in subjects requiring ORIF or with combination fractures (P < 0.05). Conclusions: Fracture severity, treatment method, and dental age are all strong predictors for adverse dental complications. Treating specialists should be cognizant of the increase in risk of complication in these patients.