@kids.edu.in
Head of the department/ Pediatric & Preventive Dentistry
karpaga vinayaga dental college
MDS Pediatric & Preventive Dentistry
Dentistry, Dentistry
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Lamea Afnan, SunnyPriyatham Tirupathi, Swetha Alahari, and Ramasubbareddy Challa
Medknow
Background: Adrenaline or clonidine is used as adjuncts in conjunction with lignocaine to improve the depth of local anaesthesia in dental procedures. Objectives: This systematic review and meta-analysis intends to compare the haemodynamic parameters when clonidine or adrenaline is used in conjunction with lignocaine for third-molar surgical removal. Data Sources: Cochrane, PubMed and Ovid SP databases were searched using “MeSH” terms (((nerve block) OR (IANB)) AND ((clonidine) OR (adrenaline))) AND (lignocaine). Study Eligibility Criteria: Clinical studies where Clonidine + lignocaine and Adrenaline + lignocaine were compared directly during nerve block administration exclusively for third molar surgical removal were selected. Participants, Study Appraisal: This current systematic review is registered in Prospero database CRD42021279446. Two independent reviewers were involved in collection, segregation and analysis of electronic data. The data were compiled in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search was conducted till June 2021. Synthesis Methods: Qualitative analysis of the selected articles was performed for systematic review. Meta-analysis is performed using RevMan 5 Software. Heterogeneity through the I2 statistics. Change in the haemodynamic parameters was the primary outcome evaluated, and secondary outcomes evaluated were onset and duration of anaesthesia in both the groups. Results: In all databases, 1141 records were screened, out of which a total of 21 articles were included for the evaluation for full-text analysis. Out of these, 16 articles were excluded and 5 articles were included for the final systematic review. Meta-analysis was performed only for 4 studies. Conclusion: Amongst the evaluated haemodynamic parameters, there was a significant reduction in the heart rate (baseline to intraoperative period) in clonidine and lignocaine groups than in adrenaline and lignocaine groups during nerve block administration for third molar surgical removal. There was no significant difference between other primary and secondary outcomes evaluated. Limitations: Blinding was not performed in all the studies, randomisation was performed in only three studies. The volume of local anaesthesia deposited varied in the studies (2 mL in three studies and 2.5 mL in two studies). Most of the studies (n = 4) were evaluated on normal adults and only one study evaluated mild hypertensive patients.
Ramasubbareddy Challa, SV S.G. Nirmala, Swetha Alahari, and Sivakumar Nuvvula
Medknow
Aim: The present study aimed to determine the risk factors related to permanent maxillary incisors and soft tissue injuries along with providing information about the age distribution of trauma, overjet, lip competence and physical activity. Methods and Materials: The sample consisted of 2100 school children aged 8–14 years from 15 schools in the Nellore district. The sample was selected adopting a stratified random sampling method and screened applying WHO criteria for the oral examination. The screening was done in classrooms to obtain demographic data, including name, age, gender and children's experience to the maxillary incisor and soft tissue injuries. The injuries were categorized according to Andreasen classification. Overjet and lip competences were recorded, and physical activity was assessed using a questionnaire (PAQ-C). Results: Of the 2100 children, 228 (10.8%) had suffered traumatic injuries. Boys were 1.6 fold more prone to trauma than girls. Enamel fractures were a common type of trauma, and the commonly involved were maxillary central incisors. The relative risk for trauma is 1.215 times higher in increased overjet when compared to normal overjet. Incompetent lips showed 1.189 times greater risk of trauma. The high physical activity showed 1.692 times higher risk for trauma when compared to low physical activity. Conclusion: The prevalence of traumatic dental injuries among 8-14 year children was 10.8%. Boys were more commonly injured than girls. Increased overjet incompetent lips and high physical activities are risk factors for trauma. Enamel fracture was the most common type, and maxillary central incisors were the most common teeth having traumatic injuries.
S.V. S. G. Nirmala, SK Inthihas, Dhigvijay Aerpogu, CRama Subbareddy, and Sivakumar Nuvvula
Medknow
Introduction: Dental treatment for children requires the use of behaviour guidance techniques (BGTs), which are used in the dental office to make children cope with dental treatment. Aim: Evaluate how children and parents felt towards BGTs used in a dental office, by attitude meter and to correlate them. Materials and Method: Children (200) from 7–17 years and their parents were selected randomly to participate in the study. Each child and parent was asked to watch four video scenes of live BGTs, which include Tell Show Do (TSD), Modeling, Reward system, and Hand holding. A questionnaire collected demographic data, and their expressive attitudes were assessed using Line of favour (LOF) scale and Kruskal-Wallis Test. Results: Most preferred BGTs for Group I was modeling, Group II Reward, Group III Tell Show Do, and Group IV was Modeling, with a mean score of 5.95, 6.04, 5.57, and 5.78, respectively. Gender wise preferences, 32% of boys and 34% of girls preferred modeling in Group I, whereas, in Group II, 20% of boys and 21% of girls preferred reward, respectively. Chi-square test revealed that there is no significant difference between the groups and gender for the preference of BGTs in Group I (P=0.893) and Group II (P=0.592). There was no significant correlation between preferences of children and their parents. Conclusion: Modeling was the most preferred BGT for primary school children and parents of High school children. A reward was the most preferred BGT for high school children. TSD was the most preferred BGT for parents of primary school children.
Karthik Anchala, Ramasubbareddy Challa, Yamini Vadaganadham, Rekhalakshmi Kamatham, Vemula Deepak, and Sivakumar Nuvvula
Medknow
Background: Caries assessment spectrum and treatment (CAST) index was developed as an innovative instrument for evaluating dental caries in epidemiological studies. Aim: The aim of the study was to assess the usefulness of CAST in evaluating caries prevalence and treatment needs among children in primary dentition stage. Materials and Methods: Children in the age range of 5-6 years were selected and their caries status, along with the treatment needs, was recorded using CAST index. The differences in caries status between maxillary and mandibular arches, right and left quadrants as well as boys and girls were assessed using Mann–Whitney U test with the level of significance set at 0.05 and correlation of the distribution of CAST codes among the evaluated teeth was explored through Spearman's rank correlation coefficient. Results: A strong correlation was found between the status of the teeth from the right and left sides of the oral cavity. The correlation coefficient (r) for neighboring maxillary anteriors was 0.67 and 0.57, whereas 1 for all mandibular anteriors (P < 0.001). The correlation coefficient (r) for neighboring maxillary posteriors was <0.3, whereas it was 0.48 and 0.18 for mandibular posteriors (P < 0.001). Correlations were found to be weak (r 0.07-0.29) between maxillary and mandibular arches. Conclusions: In the evaluated population, the strongest correlation was found for the distribution of caries stages in primary incisors as well as molars on the right side of the mouth and the percentage of molars with carious lesions was especially high for second primary molars.
S.V.S.G Nirmala
JCDR Research and Publications
A 12-year-old girl reported for a routine dental checkup. Radiographic survey disclosed the presence of two developing structures resembling premolars one on either side of the mandible in premolar region, which were of supplemental type and surgical removal of supernumerary premolars facilitated eruption of the left second premolar. On six months follow-up, there was radiographic evidence of another supernumerary premolar in the left side of mandible that is left in situ, patient is on regular follow-up. This emphasizes the importance of thorough clinical and radiographic examination, early diagnosis and follow-up of the developing dentition in children. The patient has been followed-up from the age of 12 year to 17 year. This paper describes a case of recurrent supplemental supernumerary premolars in the mandible along with review of literature.
S. Nuvvula, S. Alahari, R. Kamatham, and R. R. Challa
Springer Science and Business Media LLC
Sivakumar Nuvvula, Rekalakshmi Kamatham, Ramasubbareddy Challa, and Sharath Asokan
Medknow
The successful practice of dentistry involves a good combination of technical skills and soft skills. Soft skills or communication skills are not taught extensively in dental schools and it can be challenging to learn and at times in treating dental patients. Guiding the child's behavior in the dental operatory is one of the preliminary steps to be taken by the pediatric dentist and one who can successfully modify the behavior can definitely pave the way for a life time comprehensive oral care. This article is an attempt to revisit a simple behavior guidance technique, reframing and explain the possible psychological perspectives behind it for better use in the clinical practice.