Background: Novel coronavirus disease (COVID-19) is one of the worst pandemics known to mankind. It affects all the age groups but children present with milder symptoms and may also be asymptomatic. In the current scenario paediatric dentists pose high risk of the disease due to close contact with not just children but also with their parents. Additionally, majority of paediatric dental procedures advocate the use of handpiece which generates immense aerosol increasing the transmission risk by manifold. Objective: This review aims to highlight the transmission of COVID-19 in dental setting, its impact on paediatric dental setting and dental education and the new normal of paediatric dental practice. Modification in Dental Practice: With health authorities predicting that the novel coronavirus may become an endemic in the community, it necessitates modification in dental practice to adapt to the new normal. It requires modification in behaviour management techniques, tele-triaging of patients, stringent infection control, minimising AGPs and replacing them with minimally invasive techniques along with use of adequate isolation. The ongoing pandemic has also severely impacted the dental education therefore advocating modifications in the same with the advent of online teaching and webinars. Conclusion:Paediatric dentists are at high risk of acquiring the infection, hence it is the need of the hour to adapt to the new normal of practice at the earliest. We are an important part of the community; hence it is our foremost duty to contain the spread of this virus and not act as an aid in its transmission.
Objectives Cleft lip and palate (CLP) is one of the most common congenital deformities with worldwide prevalence. It causes a range of issues for infants that mainly involve difficulty in feeding due to abnormal oronasal communication. For this purpose, feeding plates are provided to infants to act as an artificial palate to aid in feeding. The most crucial procedure in fabrication of a feeding plate is creation of the impression using the traditional finger technique or impression trays. This preliminary research aims to compare the effectiveness of novel impression trays with that of the traditional finger technique for recording impressions of infants with CLP. Materials and Methods This randomized controlled trial was conducted among 30 infants who were divided into two groups based on the method of obtaining impressions Group I, finger technique; Group II, specialized acrylic tray (cleftray). Results Use of cleftray required less impression time, a reduced amount of material, no incidence of cyanosis/choking in infants, and lower anxiety among doctors compared to the traditional method. Additionally, there was no distortion of cleft impressions, recorded maxillary tuberosity, or other fine details. Therefore, the novel impression tray (cleftray) exhibited superior outcomes in all the parameters compared to the finger technique. Conclusion Within the limitations of this study, we conclude that impression trays are superior to the traditional finger, spoon, or ice cream stick methods of creating impressions of CLP. However, it is necessary to conduct more clinical trials on a larger population based on other parameters to compare the effectiveness of the two techniques to draw definitive conclusions.
A bstract Objective Rapid maxillary expansion (RME) has been extensively used in orthodontic practice for over a century, and it is claimed to benefit upper airway morphology. However, its effect in actually alleviating mouth breathing has remained unexplored. This systematic review was planned with an objective to provide a comprehensive synthesis of the effects of RME on upper airway volume and most importantly, its role in alleviating mouth breathing. Methods A literature search of electronic databases were done for the time period of 2000–2018. Randomized controlled trials (RCTs) and non-RCTs conducted on 8–15-year-old children who received bonded or banded RME and upper airway measured using three-dimensional (3D) imaging were included. Results Twelve studies (two RCTs, nine nonrandomized clinical trials, and one non-RCT) were included in this systematic review, and nine studies were included for meta-analysis. Among the evaluated parameters, nasal cavity volume showed a significant increase which was maintained even after the retention phase, whereas nasopharyngeal and oropharyngeal volume did not report a significant change. Conclusion Based on this systematic review, it can be concluded that RME causes a significant increase in nasal cavity volume, but its effect on nasopharyngeal and oropharyngeal volume is not statistically significant in majority of studies. This increase in volume may not be considered as an equivalent for enhancement of airway and function unless proven so. In order to establish its significance in the improvement of breathing, it is necessary to conduct more well-designed RCTs with samples actually comprising mouth breathers. How to cite this article Balasubramanian S, Kalaskar R, Kalaskar A. Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing. Int J Clin Pediatr Dent 2022;15(5):617-630.
A bstract Background Objectives: This systematic review aimed to evaluate the clinical effectiveness of fiber-reinforced composite space maintainer (FRCSM) and band and loop space maintainer (BLSM) in a pediatric patient. Materials and methods Eligibility criteria: Randomized controlled trials (RCTs) were conducted on 3–12-year-old children who received FRCSM and BLSM. Information sources: Literature search of electronic databases such as PubMed, Cochrane, and Google Scholar for the time period of 2000 to October 2020. Risk of bias: Cochrane collaboration's risk of bias tool was used to assess the risk of bias. Results Included studies: The search resulted in 147 published studies. After the removal of duplicate studies and full-text analysis, eight studies were selected. Synthesis of results: Fiber-reinforced composite restoration (FRCSM) was judged to be good for short-term space maintenance with good esthetics, less time-consuming, and good patient and parental acceptance. Meta-analysis was done for failure rate at 6 months and 12 months. After 6 months, the FRCSM group showed less failure, with a risk ratio of 0.83 (95% CI = 0.47–1.49; Z value = 0.61). However, after 12 months, the FRCSM group showed more failure, with a risk ratio of 1.30 (95% CI = 0.04–4.23; Z value = 0.44). Description of the effect: FRCSM performed better than BLSM for a short-term, i.e., around 6 months but after 12 months of space maintainer placement BLSM performed better than the FRCSM. Discussion Strengths and limitations of evidence: The strength of this systematic review is its complete adherence to the PRISMA statement 2009. This review attempted to evaluate the effectiveness of FRCSM when compared with BLSM which has not been evaluated before. Additionally, only RCTs were included in this review adding to its validity. This review also included a meta-analysis that compared the failure rate at the 6th and 12th month. The main shortcoming of this systematic review is the limited number of databases searched and the limited number of existing studies. Interpretation: Within the limitations of this review, it can be stated that the FRCSM is an effective space maintainer for short-term space maintenance. However, it is necessary to conduct more RCTs with larger sample size, preferably using a split-mouth design to improve the longevity of FRCSM. Additionally, it is also necessary to standardize the technique of fabrication of FRCSM since an existing study showed high heterogeneity in the technique of fabrication. Other Funding: None. Registration: The protocol of this systematic review was reg...
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