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Pandey R.K.,University of Lucknow | Bahetwar S.K.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital | Saksena A.K.,University of Lucknow | Chandra G.,University of Lucknow
Journal of Clinical Pediatric Dentistry | Year: 2011

Objective: The objective of this study was to compare and evaluate the efficacy and safety of drops and atomized administration of intranasal ketamine (INK) in terms of behavioral response for agent acceptance during administration and for agent efficacy and safety for the sedation of young uncooperative pediatric dental patients. Study design: Thirty Four uncooperative ASA grade-1 children, requiring dental treatment were randomly assigned to receive INK as drops and atomized spray in one of the subsequent visit. This was a two stage cross-over trial and each child received INK by both modes of administration. The vital signs were monitored continuously during each visit. Results: A statistically significant difference in patients acceptance (P<0.0001) was observed in the atomized administration when compared to drops administration for the procedural event of drug administration. Moreover, there were also significant differences (P<0.05) between onset of sedation and recovery time between two groups. All the vital signs were within normal physiological limits and there were no significant adverse effects in either group. Conclusions: INK is safe and effective by either mode of intranasal (IN) drug administration for moderate sedation in facilitating dental care for anxious and uncooperative pediatric dental patients. Moreover, INK when administered with the mucosal atomization device, the acceptance of the drug was associated with less aversive reaction, rapid onset and recovery of sedation, as compared to the drop administration of the same agent. Source


Bahetwar S.K.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital | Pandey R.K.,University of Lucknow | Saksena A.K.,University of Lucknow | Girish C.,University of Lucknow
Journal of Clinical Pediatric Dentistry | Year: 2011

Objective: The purpose of this study was to evaluate and compare the efficacy and safety of intranasal (IN) administration of midazolam (M), ketamine (K) and their combination (MK) to produce moderate sedation in young, uncooperative pediatric dental patients. Study design: In this three stage crossover trial forty five uncooperative ASA type-1 children, who required dental treatment, were randomly assigned to receive one of the three drugs/combination by IN route during three subsequent visits. The efficacy and safety of the agents were assessed by overall success rate and by monitoring of vital signs, respectively. Results: The onset of sedation was rapid with K as compared to M and MK. The difference was statistically significant (P<0.01) between K and M. The overall success rate was 89% with K, MK was 84% and 69% with M. The difference between the overall success rates of K and M was statistically significant (P<0.01). Vital signs were within physiological limits and there were no significant adverse effects with any medication. Conclusions: M, K and MK are safe and effective by IN route to produce moderate sedation for providing dental care to pediatric dental patients who have been otherwise indicated for treatment under general anesthesia. Source


Lambade P.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital
Journal of Surgical Technique and Case Report | Year: 2013

Amongst the cysts of the jaw dentigerous cyst (DC) is one of the most prevalent types of odontogenic cysts, which is associated with the crown of an unerupted or developing tooth. DC is more commonly seen with mandibular third molar and maxillary canine and rarely other teeth are involved. These cysts seldom associate with supernumerary teeth. The purpose of this article is to describe a case of large dentigerous cyst associated with supernumerary teeth and an ectopic canine, which is a rare presentation along with its management. Source


Lambade P.,Hope Multispecialty Hospital and Research Center | Dawane P.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital | Thorat A.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital
Oral and Maxillofacial Surgery | Year: 2016

Purpose: Various surgical treatment modalities have been advocated in the surgical management of oral submucous fibrosis with variable results. This prospective study evaluates the efficacy of buccal fat pad in the surgical treatment of oral submucous fibrosis. Patients and Method: In the present study, 20 patients were treated for oral submucous fibrosis with interincisal mouth opening less than 16 mm. Surgical procedure included fibrotomy, all third molar extractions, and coronoidotomy or coronoidectomy followed by reconstruction of fibrotomy defect with buccal pad of fat. Postoperatively, patients were prescribed nutritional and antioxidant supplements along with vigorous mouth opening exercise for 6 months. Regular follow-up was carried out for 2 years. Results: Excellent increase in the interincisal mouth opening was noticed relieving trismus. Patient’s ability of masticate and tolerance to regular food was increased significantly. Buccal fat pad underwent rapid epithelization within a period of 5–7 weeks. Conclusion: Buccal fat pad can be used effectively in the surgical management of oral submucous fibrosis with good functional and esthetic outcome, with only drawback of supple lobulated fat, which requires delicate handling and its limitation to reach anteriorly beyond the canine region. © 2016 Springer-Verlag Berlin Heidelberg Source


Lambade P.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital | Lambade D.,P.A. College | Dolas R.S.,Sarswati Dental College | Virani N.,Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital
Oral and Maxillofacial Surgery | Year: 2013

Background: A tooth is said to be ectopic if it is malpositioned either due to congenital factors or displaced due to pathological lesions. The incidence of osteomyelitis of condyle has a rare occurrence, very few cases have been reported, either their etiology is unknown or is due to hematogenous spread or a tuberculous focus. This particular case may be a rare of its kind, as recent literature did not reveal any case where an ectopic mandibular third molar led to osteomyelitis of the condyle. Case report: This report presents a unique case where an ectopically placed mandibular third molar led to extraoral sinus and scar formation below the ear lobule with osteomyelitis of the mandibular condyle and proposes various indications for its removal along with literature review. Discussion: Ectopic eruption of a tooth into the dental environment is common, whereas ectopic eruption of tooth in other sites is rare. The exact etiology of ectopic eruption of mandibular third molar in condyle is a rare occurrence and to the best of our knowledge, only 14 cases have been reported in the literature. Management of such cases should be meticulously planned after ruling out various local as well as systemic factors as an underlying cause for osteomyelitis and on the basis of the position and type of ectopic tooth and related potential trauma which could be caused by surgical intervention with less morbidity. Conclusion: This particular case may be the unique of its kind, as recent literature did not reveal any case where an ectopic mandibular third molar led to osteomyelitis of the condyle. Diagnosis and management in such cases deserve very special attention to rule out various local and systemic causes which can cause osteomyelitis to affect very unusual site like mandibular condyle. The aim of surgical intervention should be to cause minimum morbidity without affecting the functional efficiency of the mandibular condyle. In this report, we also have proposed the indications for surgical intervention to remove ectopically erupted teeth. © 2012 Springer-Verlag. Source

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