| Dentists as Vanguard of Oral Health Rooban Thavarajah Journal of Orofacial Sciences 2018 10(2):57-58 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Clinical Complications in Procedures for Horizontal Bone Augmentation Through Autologous Onlay Grafts Obtained From the Mandibular Ramus: An Observational Study Daniel R.B de Resende, Aline Siqueira, Eduardo Rosas, Eduardo Borie Echevarría Journal of Orofacial Sciences 2018 10(2):59-62 Aim and Objective : The aim of this study was to describe clinically the prevalence of postsurgical complications in a group of patients treated with autologous bone grafts obtained from the mandibular ramus. Materials and Methods: Data were obtained from a sample of 76 adults, who were subjected to a surgical procedure of horizontal bone augmentation through autologous onlay bone grafts obtained from the oblique line of mandible. A total of 113 onlay grafts were removed and placed in 152 recipients’ area, previously fitted to the receptor site and stabilized through two fixation screws. All complications were recorded in relation to the recipient and donor sites, and the follow-up time of the sample was of 2 years. Results: Of the entire sample studied, 69.7% did not show any type of postsurgical complication; however, 30.3% of them exhibited a type of complication, with temporary paresthesia being the most prevalent (7.9%). Conclusion: More than 30% of the patients that received horizontal bone augmentation through autologous onlay bone grafts obtained from the oblique line according to the conventional technique showed some type of postsurgical complication. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Age Estimation by Modified Demirjian's Method in Children and Adolescents of Hyderabad Population—A Panoramic Study M. Priyanka, G. Kiran, R. Poornima, R. Shravani, K. C. Shobhita, P. Preethi Journal of Orofacial Sciences 2018 10(2):63-68 Introduction: Human identification is one of the most important tasks of forensic practitioner. Estimation of age is one of the essential factors which play a significant role in each aspect of life, including forensic medicine and dentistry, wherein race, age, and sex determination are used in person identification. Aims and Objectives: To correlate the relationship between chronological age (CA) with dental age (DA) using modified Demirjian’s method and to establish the applicability of modified Demirjian’s method in Hyderabad population. Materials and Methods: Our study samples consist of 113 randomly selected samples (39 males and 74 females) of age ranging from 8 to 20 years of Hyderabad population for children and adolescents. Panoramic radiographs of these patients were evaluated based on the modified Demirjian’s method. The obtained data were tabulated and analyzed using SPSS version 20.0. Results: The present study showed a significant correlation between CA and DA in both females (r = 0.84) and males (r = 0.882). The overall mean difference between the DA and CA for females and males was +1.14 and +0.86, respectively. In the whole sample, DA was found to be over estimated by +1.04 with CA. Conclusion: DA overestimated the CA by +1.04 years. According to the present study, there was a difference and overestimation of DA in comparison with CA in Hyderabad population and hence population specific formula for each area is necessary. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Comparison of the Shear Bond Strength of Treated and Untreated Brackets on Treated and Untreated Enamel Surfaces in Rebonding Delal Dara Kilinc, Gülşilay Sayar Journal of Orofacial Sciences 2018 10(2):69-74 Aim and Objective: This study aimed to compare the shear bond strength (SBS) of treated and untreated brackets on treated and untreated enamel surfaces in rebonding. The null hypothesis was that there was no difference between the SBS of the treated and untreated rebonded brackets on treated and untreated enamel surfaces. Materials and Methods: Fifty extracted premolars were bonded by the same conventional bonding method and then debonded, and the SBS of each tooth was recorded. The debonded brackets and teeth were divided into two equal groups. In the first group, the debonded brackets were recycled by direct flaming followed by alumina oxide sandblasting, and the teeth were treated with a tungsten carbide bur applied with a low-speed hand piece. In the second group, neither the teeth surfaces nor the bracket bases were treated. Rebonding was performed followed by debonding, and the SBS of each tooth was recorded again. Results: Both rebonded bracket groups showed lower SBS results than that of the first debonding tests. A statistically significant difference was found within the untreated bracket groups between the first and second debonding test (P < 0.001). Conclusion: The rebonding of treated enamel surfaces and treated bracket bases showed higher SBS values compared to the untreated ones. The null hypothesis was rejected. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Association of Maternal and Child Dental Anxiety With Dental Caries Experience and Dental Attendance Pattern of the Child Shruti Balasubramanian, Suprabha B Shrikrishna, Ramya Shenoy, Arathi Rao Journal of Orofacial Sciences 2018 10(2):75-79 Introduction: Children with early childhood caries may have dental anxiety. Maternal anxiety can influence the child dental anxiety. Aims and Objective: To explore the association of maternal and child dental anxiety with the dental caries experience and the dental attendance pattern of the child. Materials and Methods: This cross-sectional study involved 227 mother–child dyads with children aged between 3 and 6 years. Mothers answered a questionnaire on dental attendance pattern. Corah’s dental anxiety scale was used to assess maternal anxiety, and facial image scale was used to assess dental anxiety in children. The “dmft” index of the child was recorded by a calibrated dentist. Statistical tests (Chi-square and Student’s t-tests) were employed to analyze the data, and P < 0.05 was considered significant. Result: Maternal anxiety was significantly associated with the mean number of missing and filled teeth in children (P = 0.005; P < 0.001, respectively). Child anxiety was significantly associated with the mean number of missing teeth (P < 0.001), increased frequency of missed dental appointments (P = 0.003), and decreased the frequency of dental visits (P = 0.008). Conclusion: Both maternal and child dental anxiety can influence the dental caries experience of the child. The dental anxiety of the child can influence the dental attendance pattern. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Assessment of Sagittal Skeletal Base Relationship of Maxilla and Mandible by Horizontal Appraisal Method—A Comparative and Reliability Study Paoulomi Roy, Supriya Nambiar, B. Unnikrishnan, Asavari Desai, C. Suresh Journal of Orofacial Sciences 2018 10(2):80-85 Introduction: The evaluation of antero-posterior apical base relationship is crucial before orthodontic diagnosis and treatment planning. Aim and Objectives: The present study is aimed to compare the credibility of five cephalometric measurements in assessing the antero-posterior jaw relationship and to assess the correlation between various measurements used for antero-posterior discrepancy, including ANB, Yen angle, Beta angle, Wits appraisal, and horizontal appraisal. Materials and Methods: A total of 99 patients aged 16 years and above patients were subdivided into skeletal Classes I, II, and III groups of 33, each based upon the ANB angle derived from the pretreatment cephalogram. Results: The results showed that AH/BH and ANB had very high sensitivity and specificity to discriminate a Class II from Class I and Class III from Class I. Wits, YEN, and Beta showed lower specificity to differentiate Class II from Class I and Wits and Yen to differentiate Class III from Class I except Beta which had 100% sensitivity to differentiate Class III from Class I. Conclusion: The horizontal appraisal method enriches the current cephalometric tools available for the clinician to assess the antero-posterior jaw relationship accurately and reproducibly. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient's Awareness Arunachalam M Anusa, Rooban Thavarajah, Dinesh Nayak, Elizabeth Joshua, Umadevi Krishnamohan Rao, Kannan Ranganathan Journal of Orofacial Sciences 2018 10(2):86-95 Aim and Objective: Schizophrenia is a psychiatric disorder that requires long-term treatment. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD), the severity of which is measured by Abnormal Involuntary Movement Scale (AIMS). This study examined the relationship among TD, orofacial musculature activity, and patient’s awareness of Abnormal Involuntary Movement (AIM). The knowledge would help dentists to deliver oral care for schizophrenics with TD. Materials and Methods: We identified 317 patients from a standard, data sharing initiative, of whom 38.3% exhibited AIM score of 2 to 15. The patient demographics, drug history, details of AIMS were subjected to descriptive and inferential statistical analysis using SPSS with P ≤ 0.05 as significance. Results: The mean of only orofacial features (n = 56) was 3.43 ± 2.68. Muscles of facial expression was involved in nine (7.9% of all TD), lip/perioral area in 27 (23.68%), jaw in 52 (45.61%), and tongue in 77 (67.54%). The patient’s perception of AIM precipitated stress when involving jaw, tongue, limbs, and trunk was statistically significant (P ≤ 0.05). The multiple regression model statistically significantly predicted TD for factors considered. Conclusion: Around 1% of global population is being diagnosed with schizophrenia, carry an inherent risk of developing TD. They might have orodental care requirements, including prosthodontic and restorative services. Primary physicians and dentists need to be aware of TD and its mechanism for appropriate patient management. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Effect of Orthodontic Sealant Containing Antimicrobial Selenium on the Shear Bond Strength of Orthodontic Bracket Pinandi S Pudyani, Fibriana Safitri, Ananto A Alhasyimi Journal of Orofacial Sciences 2018 10(2):96-100 Intoduction: Fixed orthodontic treatment has a high risk of enamel demineralization. Sealant containing selenium is a material that has been developed to prevent enamel demineralization and stated to be applicable as a primer bracket adhesion. Aim and Objective: This aim of this study was to investigate the shear bond strength (SBS) of an orthodontic bracket after application of sealant containing selenium as a primer. Materials and Methods: A total of 100 extracted human premolars were used in this study, which were randomly divided into two groups. Group I consisted of 50 teeth as the control group, to which a conventional primer (CP) was applied, whereas for group II comprising 50 teeth, a sealant containing selenium selenium primer (SP) was applied. SBS of the orthodontic brackets was measured using a universal testing machine. The adhesive remnant index (ARI) scores were calculated to determine the location of the bond failure using a stereomicroscope. A t test was used for analyzing the SBS data, whereas the Mann–Whitney test was used for analyzing the ARI scores. Results: There was no significant SBS difference (P > 0.05) between CP and SP groups. CP groups showed slightly higher SBS [9.05 ± 3.10 megapascal (MPa)] than that in the SP groups (8.21 ± 3.78 MPa). The bond failures of both the groups occurred at the adhesive–adhesive interface. Conclusion: The results showed that sealant containing selenium can be used as a primer within orthodontic adhesive material, as the physical–mechanical properties remained unchanged. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Does Darkening of Roots or Loss of White Line on Panoramic Radiographs Pose a Risk for Inferior Alveolar Nerve Damage? A CBCT Evaluation Chintan M Savani, Kishan Panicker, B. Sarat Ravi Kiran, Uday Kiran Uppada Journal of Orofacial Sciences 2018 10(2):101-107 Introduction: Surgical removal of impacted mandibular third molars may cause dysesthesia due to damage to the inferior alveolar nerve (IAN), and the risk increases when there is direct contact between the nerve and the tooth root. An accurate preoperative radiographic examination using Cone beam computed tomography (CBCT) provides precise information pertaining the relationship between the third molar roots and the inferior alveolar canal. Aim & Objective: This study was intended to correlate the two panoramic radiographic findings in predicting the absence of corticalization between the mandibular canal and the third molar on cone beam computed tomography (CBCT) images and to evaluate the possibility of inferior alveolar nerve (IAN) injury. Materials and Methods: The study was conducted on 60 patients, who were divided into two groups of 30 each. Group I included 30 patients whose panoramic radiographic findings showed darkening of the root of impacted mandibular third molar. Group II included 30 patients whose panoramic radiographic findings showed interruption of white line of mandibular canal. The patients whose panoramic radiographic findings showed darkening of the root or interruption in the white line of the canal were subjected to CBCT examination. Surgical removal of impacted mandibular third molar in all the patients was performed under local anesthesia (LA). Evaluation for any nerve injury was performed and recorded as presence or absence of paresthesia at regular postoperatively. Results: The results of this study showed that 46.7% patients had absence of cortication in Group I (darkening of roots), whereas it was absent in 33.3% of patients in Group II (loss of white lines). Presence of cortication was seen in 53.3% of patients in Group I when compared to 66.7% in Group II. The difference between the groups was not found to be statistically significant. Conclusion: Darkening of roots and interruption of white line observed on panoramic radiographs, both as isolated findings and in association, were effective in determining the risk relationship between the tooth roots and the mandibular canal necessitating CBCT evaluation. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Cytological Method of Barr Body Expression in Dental Pulp Tissue at Varying Temperature Ambika Murugesan, Sekar Balakrishnan, Indra Priyadharshini Kumaresan, Arun Jayakumar, Jayashree Mohan, Bharath Champakesan Journal of Orofacial Sciences 2018 10(2):108-111 Introduction: Natural disasters in large population need major attention in person identification. It can be performed by means of simple techniques that are easier to use. Aim: To identify the Barr body in female dental pulp by cytological method, after exposing at varying temperature. Objective: The expression of Barr bodies was compared among different age groups, various temperature, and two types of stain. Materials and Methods: Teeth obtained from 60 female individuals were divided into two groups based on their age. In each group, 30 teeth were exposed at three different temperatures (200°C, 300°C, and 400°C), 10 teeth in each temperature. The pulp tissue obtained from teeth was centrifuged and stained with hematoxylin and eosin (H&E) and Papanicolaou stain (PAP). Presence of visible sex chromatin in the nuclear periphery was considered positive for Barr chromatin test. The results obtained were analyzed by both descriptive analysis and independent t-test. Result: The peripherally condensed Barr body in hyperchromatic nuclear outline was clearly visible in younger individuals at 200°C and is more accurately expressed in H&E stain. Conclusion: In our study, based on the results obtained from the smear of pulp tissue, expression of Barr bodies’ decreases as age and temperature increases. Further study with increase in sample size is mandatory to confirm the above conclusion.
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Τετάρτη 2 Ιανουαρίου 2019
Orofacial Sciences
Τρίτη 1 Ιανουαρίου 2019
Pasteurella multocida meningitis following mastoidectomy Το P. multocida προκαλεί μια σειρά ασθενειών σε άγρια και εξημερωμένα ζώα, καθώς και σε ανθρώπους. Το βακτήριο μπορεί να βρεθεί σε πουλιά, γάτες , σκύλους, κουνέλια, βοοειδή και χοίρους. Στα πτηνά, το P. multocida προκαλεί ασθένεια της χολέρας των πτηνών ή των πτηνών. μια σημαντική ασθένεια που υπάρχει σε εμπορικά και οικόσιτα σμήνη πουλερικών παγκοσμίως, ιδιαίτερα σμήνη στρώματος και σμήνη πατρικών εκτροφέων. Τα στελέχη P. multocida που προκαλούν τη χολέρα των πτηνών στα πουλερικά συνήθως ανήκουν στους σεροβάρους 1, 3 και
| DISPATCH | |
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Pasteurella multocida meningitis following mastoidectomy: A case report and literature review
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
Department of Medicine, Federal University of Santa Maria, Santa Maria, RS, Brazil
Correspondence Address:
Jamir Pitton Rissardo
Department of Medicine, Federal University of Santa Maria, Santa Maria, RS
DOI: 10.4103/IJAMR.IJAMR_35_18
| Abstract |
Pasteurella multocida (PM) is part of the normal nasopharyngeal flora of many animals. The most common PM infections occur in soft tissue, secondary to animal contact. Meningitis is rarely associated. An adult female developed chronic right-sided otorrhea and tympanic membrane perforation. Elective mastoidectomy was performed. On the postoperative day 2, the patient experienced a decreased level of consciousness, headache, nausea, and seizures. Cerebrospinal fluid (CSF) analysis revealed low glucose, high protein, and high cellularity. Blood tests were within normal limits, except for high leukocyte count. Two days after the neurological manifestations, bacteria, identified as PM, grew in the aerobic cultures of CSF and preoperative ear swab. The isolate was sensitive to penicillins. She was started on intravenous penicillin G. The patient had a full recovery. On further questioning, she admitted having a dog, which licks on her face frequently.
Keywords: Mastoidectomy, meningitis, Pasteurella multocida
| Introduction |  |
Pasteurella multocida (PM) is a Gram-negative coccobacillus and facultative anaerobe. It is present in the nasopharyngeal flora of domestic pets.[1] Frequently, PM infections in humans are located in the soft tissue and are associated with animal bites. In rare cases, severe infection, like meningitis, can occur. In this context, it is known that surgical procedures such as mastoidectomy may contribute to meningitis, particularly in a predisposed individual.[1],[2] To the authors' knowledge, only two cases of mastoidectomy followed by PM meningitis have been reported.[3],[4] Herein, we report a case of an adult woman who had PM meningitis after mastoidectomy.
| Case Report | |
A 51-year-old female patient presented with chronic right-sided otorrhea and ipsilateral tympanic membrane perforation within 2 months of onset. She was admitted for elective mastoidectomy with tympanoplasty. Her medical history included recurrent ear infections with otorrhea through a tympanic perforation. On neurological examination, conductive hearing loss was observed. The left otoscopy was normal, and right otoscopy showed perforated tympanic membrane with tympanosclerosis. There was no evidence of otorrhea, soft-tissue mass, crusting, or desquamated debris. Her comorbid conditions were dyslipidemia, hypertension, and major depressive disorder. She was in use of sertraline, hydrochlorothiazide, enalapril, and simvastatin.
On the postoperative day 2, the patient experienced a decreased level of consciousness, headache, nausea, and seizures presenting with bilateral tonic-clonic movements and impaired awareness. There was no fever or focal neurological signs. Cranial computed tomography scan showed the mastoidectomy and the absence of mass or hematoma [Figure 1]. Cerebrospinal fluid (CSF) analysis revealed low glucose (5 mg/dL), high protein (114 mg/dL), and high cellularity (158/mm3) with 85% of neutrophils. Blood tests, including glucose level (90 mg/dL), were within normal limits, except for the presence of leukocytosis (20,010/mm3). Initial gram stain of the CSF showed abundant neutrophils and the absence of microorganisms. She was treated empirically for bacterial meningitis with intravenous (IV) ceftriaxone and vancomycin.
 | Figure 1: Images of computed tomography scan showing the right mastoidectomy, the communication between the right ear and right middle cranial fossa (indicated by the arrow). Coronal (a) and axial (b) views of head computed tomography scan. Axial with brain window (c) and coronal with bone window (d) views of computed tomography scan of the temporal bone Click here to view |
Two days after the neurological manifestations, PM grew in the aerobic cultures of CSF and preoperative ear swab. The isolate was sensitive to penicillin. She was started on IV penicillin G 2 million units, every 4 h, for 14 days. After 10 days, the patient had a full recovery.
On further questioning, she admitted having a dog which lives inside her house and licks on her face frequently. In the follow-up, investigation for immunosuppression was negative.
| Discussion | |
PM meningitis was first documented in 1925 by Claudius.[5] Since 1950, about 39 cases have been reported in the English literature. In these cases, the infection was generally associated with cranial surgery or trauma, chronic otitis media, and soft-tissue infection with secondary spread.[1],[2],[6] History of recent animal contact was reported in 89% of cases.[2]
There are only a few case reports of PM meningitis following mastoidectomy. We identified two cases after a review of the English literature, and we compared them with the present case [Table 1].[3],[4] Literature search was performed in Embase, Google Scholar, Lilacs, Medline, Scielo, and ScienceDirect, using a set of terms that included mastoidectomy, meningitis, and PM.
 | Table 1: Reported cases of Pasteurella multocida meningitis following mastoidectomy Click here to view |
In the case reported by Dammeijer and McCombe, PM meningitis occurred after a modified radical mastoidectomy due to recurrent cholesteatoma.[4] On the other hand, in the study from Pond et al., PM meningitis was associated with a typanomastoidectomy and removal of the incus and malleus with tympanoplasty performed for chronic otorrhea related to tympanic membrane perforation.[3]
The pathogenesis in PM meningitis following mastoidectomy is probably related with the contiguous spread of the bacteria from a colonized external acoustic meatus, which has contaminated the CSF during the surgery. This hypothesis is based on the preoperative growth of PM in the ear swab, the absence of clinical meningitis signs, and the development of the infection 24 h after the mastoidectomy.[3],[4]
We agree with the statement of Pond et al.[3] and Dammeijer and McCombe,[4] that any patient requiring mastoidectomy should be asked about contact with animals, and in the case of a positive answer, a preoperative ear swab is mandatory since it allows early intervention and prevents possible complications.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |
| 1. | Weber DJ, Wolfson JS, Swartz MN, Hooper DC. Pasteurella multocida infections. Report of 34 cases and review of the literature. Medicine (Baltimore) 1984;63:133-54.  |
| 2. | Green BT, Ramsey KM, Nolan PE. Pasteurella multocida meningitis: Case report and review of the last 11 y. Scand J Infect Dis 2002;34:213-7. |
| 3. | Pond ED, El-Bailey S, Webster D. An unusual case of meningitis. Can J Infect Dis Med Microbiol 2015;26:e62-4. |
| 4. | Dammeijer PF, McCombe AW. Meningitis from canine Pasteurella multocida following mastoidectomy. J Laryngol Otol 1991;105:571-2. |
| 5. | Claudius M. The bacteria plague-like. Ugesk Laeger 1925;87:194-5. |
| 6. | Kumar A, Devlin HR, Vellend H. Pasteurella multocida meningitis in an adult: Case report and review. Rev Infect Dis 1990;12:440-8. |
| Figures |
[Figure 1]
| Tables |
[Table 1]
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