Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible. Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Apexification of anterior teeth: a comparative evaluation of mineral trioxide aggregate and calcium hydroxide paste

PURPOSE

This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Trioxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors.

METHODS

Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups--Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months.

RESULTS

The mean time taken for barrier in Group I was 4.50 +/- 1.56 months whereas for Group II was 7.93 +/- 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 +/- 1.49 months whereas the time period for Group II was 6.43 +/- 2.59 months (p value- 0.0067).

CONCLUSION

MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.

Comparison of oral ketamine and oral midazolam as sedative agents in pediatric dentistry

The safe and effective treatment of uncooperative or combative preschool children with extensive dental needs is one of pediatric dentist's ongoing challenges. The traditional methods of behavior management are no longer acceptable to parents as they are not ready to spare more time for dental treatment of their children. Keeping this in mind, the present study was designed and carried out to evaluate the sedative effects of oral ketamine and oral midazolam prior to general anesthesia. Twenty uncooperative children in the age-group of 2-6 years were selected after thorough medical examination and investigations. Informed consent was obtained from the parent. This was a randomized double-blind study. An anesthesiologist administered either 0.5 mg/kg midazolam or 5 mg/kg ketamine orally. The heart rate, respiratory rate, and oxygen saturation were recorded at regular intervals. The sedation and anxiolysis scores were also recorded. The parents were asked to answer a questionnaire at the follow-up session the next day on the surgical experience of the parent and the child and side effects experienced, if any. When the data was subjected to statistical analysis, it was observed that both drugs resulted in adequate sedation at the end of 30 min, with oral midazolam providing significantly better anxiolysis. The heart rate and respiratory rate were marginally higher with oral ketamine. The questionnaire revealed a better response with oral midazolam; side effects were more prominent with oral ketamine.