PUBLICATIONS by Dr. Uday Kumar Umesan
Dental Traumatology, 2014
Dental injuries are probably the most common orofacial injuries sustained during sports and play.... more Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8-year-old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re-eruption failed to facilitate re-emergence of the tooth beyond 2 mm. The recommended wait-and-see strategy in anticipation of spontaneous re-eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re-positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radio-graphically by the completion of root development, an intact lamina dura and no evident signs of resorption.
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Asian Journal of Dental Sciences, 2020
Aims: To evaluate orthodontic treatment eligibility and appropriateness of new orthodontic referr... more Aims: To evaluate orthodontic treatment eligibility and appropriateness of new orthodontic referrals made by the general dental practitioners (GDPs) to the Specialist Orthodontic Unit, National Dental Centre (NDC) for orthodontic assessment from government dental clinics in Brunei-Muara district using Index of Orthodontic Treatment Need (IOTN) as an objective measure. Material and Methods: Patients' data were collected from Brunei Health Information Management Systems (Bru-HIMS) for one-year period from 1 st January 2018 to 31 st December 2018. From this patient pool, a total of 147 patients who underwent orthodontic assessment were identified. The data collected were imported to RStudio to perform appropriate statistical analyses. Results: Of 147 new patient referrals, 72.1% were female and 27.9% were male, with a mean age of 18.3 years (SD 5.8 years). Patients with age range of 9 to 39 years were evaluated. A total of Original Research Article Tahir et al.; AJDS, 3(3): 31-41, 2020; Article no.AJDS.58898 32 87.8% of new patient referrals were eligible under IOTN. The predominant incisor relationship referred was class II division 1 (33.3%) and the prevalence of class III was high at 30.6%. The most common malocclusion trait referred was a severe dental contact point displacements >4 mm, grade 4d (53.1%). Conclusion: A total of 87.8% of new patient referrals were deemed eligible by specialist orthodontists utilizing IOTN. A total of 83.7% of new patient referrals were in a definite need for orthodontic treatment. It is highly recommended for general dental practitioners to have training in utilizing IOTN and necessitate establishment of proper referral guidelines.
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American Journal of Orthodontics & Dentofacial Orthopedics, 2011
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American Journal of Orthodontics & Dentofacial Orthopedics, 2012
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Therapeutics and Clinical Risk Management , 2012
Among the myriad emergencies that could arise in the dental clinical setting there are a few that... more Among the myriad emergencies that could arise in the dental clinical setting there are a few that occur occasionally despite being entirely preventable. Ingestion or aspiration of dental materials, appliances, or instruments comprises this category. Regardless of incidence, foreign body ingestion or aspiration episodes are recognized as potential complications in the specialty of orthodontics. Despite their infrequent occurrence, the morbidity from a single incident and the amount of specialty medical care that may be needed to manage such incidents is too high to ignore. There is also the associated risk of malpractice litigation given the fact that these incidents are preventable. At present, no clear guidelines exist regarding prevention of this emergency in practice. This article attempts to review relevant literature and aims to formulate certain recommendations based on best available evidence to minimize the incidence of such events, while also suggesting guidelines toward making their management more effective. A flow chart outlining management options and strategies to aid the clinician in the event of such an emergency is also presented.
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Papers by Dr. Uday Kumar Umesan
Therapeutics and Clinical Risk Management, 2012
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Dental Traumatology, 2013
Dental injuries are probably the most common orofacial injuries sustained during sports and play.... more Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8-year-old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re-eruption failed to facilitate re-emergence of the tooth beyond 2 mm. The recommended wait-and-see strategy in anticipation of spontaneous re-eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re-positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radiographically by the completion of root development, an intact lamina dura and no evident signs of resorption.
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American Journal of Orthodontics and Dentofacial Orthopedics, 2012
Orthodontic archwires or fractured appliances that are accidentally swallowed can become lodged i... more Orthodontic archwires or fractured appliances that are accidentally swallowed can become lodged in the airway or gastrointestinal tract. Inadvertent ingestion or aspiration of an appliance or archwire piece during orthodontic appliance adjustment is a medical emergency with potentially serious complications, including possible death from asphyxiation. This article reports the accidental ingestion of a piece of orthodontic archwire that became impacted in the larynx; it was subsequently retrieved. Some potential complications are discussed, along with suggested precautions to prevent such mishaps when using fixed appliances.
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American Journal of Orthodontics and Dentofacial Orthopedics, 2013
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American Journal of Orthodontics and Dentofacial Orthopedics, 2011
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This study assesses inter-examiner reproducibility in recording various malocclusion parameters a... more This study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal d...
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Aims: To evaluate orthodontic treatment eligibility and appropriateness of new orthodontic referr... more Aims: To evaluate orthodontic treatment eligibility and appropriateness of new orthodontic referrals made by the general dental practitioners (GDPs) to the Specialist Orthodontic Unit, National Dental Centre (NDC) for orthodontic assessment from government dental clinics in Brunei-Muara district using Index of Orthodontic Treatment Need (IOTN) as an objective measure. Material and Methods: Patients’ data were collected from Brunei Health Information Management Systems (Bru-HIMS) for one-year period from 1st January 2018 to 31st December 2018. From this patient pool, a total of 147 patients who underwent orthodontic assessment were identified. The data collected were imported to RStudio to perform appropriate statistical analyses. Results: Of 147 new patient referrals, 72.1% were female and 27.9% were male, with a mean age of 18.3 years (SD ± 5.8 years). Patients with age range of 9 to 39 years were evaluated. A total of 87.8% of new patient referrals were eligible under IOTN. The pr...
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Cleidocranial dysplasia (CCD) is a rare, hereditary, congenital disorder inherited in an autosoma... more Cleidocranial dysplasia (CCD) is a rare, hereditary, congenital disorder inherited in an autosomal dominant pattern and is characterised by cranio-facial, skeletal and oro-dental malformations. The typical patient is short, presents a brachiocephalic skull with bossing of the frontal and parietal bones. Cephalic sutures and fontanelles exhibit delayed closure. The mid-face is hypoplastic, giving a misleading appearance of mandibular prognathism. The development of the clavicles is often defective and may range from a small medial gap to total agenesis. Medical issues include delayed attainment of developmental milestones, scoliosis, skeletal, pelvic and thoracic abnormalities. However, oro-dental malformations are important and can be significant. A 17-year-old Malay girl presented to the National Dental centre with complaints of unsightly front teeth. General and radiographic examination revealed features consistent with CCD. Dental clinical findings corroborated radiographically u...
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The occurrence of radio-opaque embedded foreign entities on dental radiographs, especially after ... more The occurrence of radio-opaque embedded foreign entities on dental radiographs, especially after dental treatment or maxillofacial trauma is not uncommon. Alongside such commonplace radiopacities, there is the occasional report of disparate artifacts being observed as incidental findings on dental pantomographs. One such entity is Susuk, or charm needles that are implanted subcutaneously in the facial region and elsewhere in the body. While this phenomenon has been reported primarily from the South-east Asian region; increasing international travel in the modern Case Study Umesan et al.; IJRRD, 3(2): 30-34, 2020; Article no.IJRRD.59325 31 age could render these radiopaque entities a diagnostic challenge for the unacquainted clinician. In a deviation from the classically reported needle-type susuks, this paper reports a case involving insertion of multiple, springy type, filamentous, strands in the orofacial region; manifesting on the pantomograph as a meshedveil that has never been ...
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This study assesses inter-examiner reproducibility in recording various malocclusion parameters a... more This study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal d...
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American Journal of Orthodontics and Dentofacial Orthopedics
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Cleidocranial dysplasia (CCD) is a rare, hereditary, congenital disorder inherited in an autosoma... more Cleidocranial dysplasia (CCD) is a rare, hereditary, congenital disorder inherited in an autosomal dominant pattern and is characterised by cranio-facial, skeletal and oro-dental malformations. The typical patient is short, presents a brachiocephalic skull with bossing of the frontal and parietal bones. Cephalic sutures and fontanelles exhibit delayed closure. The mid-face is hypoplastic, giving a misleading appearance of mandibular prognathism. The development of the clavicles is often defective and may range from a small medial gap to total agenesis. Medical issues include delayed attainment of developmental milestones, scoliosis, skeletal, pelvic and thoracic abnormalities. However, oro-dental malformations are important and can be significant. A 17-year-old Malay girl presented to the National Dental centre with complaints of unsightly front teeth. General and radiographic examination revealed features consistent with CCD. Dental clinical findings corroborated radiographically u...
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The Journal of Indian Orthodontic Society
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PUBLICATIONS by Dr. Uday Kumar Umesan
Papers by Dr. Uday Kumar Umesan