Saturday, November 16, 2019

Dermatoglyphic Patterns with Rampant Caries

Dermatoglyphic Patterns with Rampant Caries A Twin City Study Correlating the Dermatoglyphic patterns with Rampant Caries and Early Childhood Caries Abstract : Background and Aim : This study was undertaken to investigate and analyze the correlation between dermatoglyphic pattern and caries prevalence in young children in twin cities of Pune and Mumbai. Materials and methods : Two centers were selected in Pune and Mumbai . A total of 300 patients (150 patients in each center) were included in this study. The mean age ranged from 3-5 years. The samples were divided into two groups; Group I: Caries and Group II: caries-free groups.Group I was further divided into children with early childhood caries and children with rampant caries Dental caries were detected clinically using mouth mirror and probe(only to remove debris not probed into the fissures) in daylight or suitable light source. Fingerprints were obtained by the conventional ink method .Statistical analysis using the students t-test was used to determine mean values and gender differences in the findings using SPSS version 11.0 Results : The evaluation and comparison of patterns in children with caries and caries-free children in both right and left hands showed increase in the number of whorls in children with rampant caries as compared to children with early childhood caries. However , this was not statistically significant. Conclusion : The present study showed a definite variation in dermatoglyphics between the ECC ; rampant caries and caries-free group .However the rampant caries group showed more number of whorls as compared to the earl childhood caries group but they were statistically insignificant .Dermatoglyphics has proven to be an extremely useful, non-invasive and cost-effective tool for preliminary investigations into conditions with a suspected genetic base like dental caries. Keywords : Dermatoglyphics , rampant caries , early childhood caries. INTRODUCTION : The word dermatoglyphics comes from two Greek words (derma, skin and glyphe, carve) and refers to the friction ridge formations which appear on the palms of the hands and soles of the feet .(1) Dermatoglyphics is the scientific study of fingerprints. Since each person’s fingerprints are unique, we can understand one’s innate potential, personality, and preferences by analyzing dermatoglyphics. Dermatoglyphic patterns are highly variable from person to person, while genetic aberrations generally produce consistent phenotypes. A twin-city survey was conducted in Mumbai and Pune reviewing a total of 300 children. Twin citiesare a special case of twocitiesor urban centres that are founded in close geographic proximity and then grow into each other over time, losing most of their mutual buffer zone.Cities twinned by proximity do not necessarily match demographically, economically, or politically . The main focus of dermatoglyphic study is in the papillary ridges, the small markings that make up your fingerprints and exist on all primates skin. The formation of these papillary ridges occurs during a short window of development (2), and is influenced by a combination of genetics and the environment in utero. Being affected by the environment at such a time means thatmonozygotic twinswould have different dermatoglyphic markings .(3,4,5) The ridges do not change over post-natal life, which lends itself into forensic uses. The twin city survey was undertaken to evaluate the fingerprint patterns of children with dental caries ( Study groups-rampant caries versus early childhood caries ) and caries free individual (control group). Materials and Methods : Two centers were selected in Pune and Mumbai . A total of 300 patients (150 patients in each center) were included in this study. The mean age ranged from 3-5 years The samples were divided into two groups; Group I: Caries and Group II: caries-free groups.Group I was further divided into children with early childhood caries and children with rampant caries. Dental caries were detected clinically using mouth mirror and probe(only to remove debris not probed into the fissures)6 in daylight or suitable light source. Finger and palm prints were recorded using the ink method described by Cummins and Midlo.1The hands of the children included in this study were washed with soap and water to remove dirt and oil from the ridged skin and blot dried to improve the quality of the prints . Statistical analysis using the students t-test was used to determine mean values in the findings using SPSS version 11.0 Recording Interpretation of Dermatoglyphic patterns : Fingerprints : The fingerprints of all subjects were recorded using black duplicating ink ,the fingers were uniformly pressed on the ink pad after which the digits were pressed firmly against the white paper by the operator to avoid bias . The fingerprints obtained were checked for their clarity with a magnifying glass (Ãâ€"2) . INTERPRETATION OF HANDPRINTS The handprints were observed in a sequential manner under a magnifying glass with Ãâ€"2 power, from the left hand 4 th digit until the thumb followed by the thumb of right hand until the 4 th digit. This study included qualitative analysis that is the fingertip patterns (Loops, whorls,arches) The frequency of true patterns of loops, whorls, and arches was counted on the fingertips of all the 10 digits of children in all the groups. They were assessed for increase or decrease in mean frequencies. QUALITATIVE DERMATOGLYPHIC ANALYSIS Type of dermatoglyphic pattern Different types of dermal patterns were identified .(7) A loop is recognized as a series of ridges that enter the pattern area on one side of digit, recurves abruptly and leaves the pattern area on the same side. A single triradius is present, which is located laterally on the fingertip, where the loop is closed. If the ridge opens on ulnar side it is called as ulnar loop and if it opens toward the radial side it is called as radial loop. A whorl differs from the loop in the aspect of concentric arrangement of ridges, with two or more triradii in the latter. A whorl may be spiral, symmetrical, double looped, central-pocketed or accidental, depending upon the internal structure of the whorl pattern. In all the dermatoglyphic patterns seen, arches show the simplest ridge pattern, which is formed by the succession of one or more parallel ridges, which cross the finger from one side to the other without recurving. These patterns usually do not show the presence of triradii, except when the tented arch is present that will have a triradii point near its midline. RESULTS : Statistical results were obtained by one-way analysis of variance (ANOVA) with Post-Hoc Tukey’s correction for multiple group comparisons . The average no. of loops did not differ significantly between ECC and Rampant caries group (P-value>0.05). The average no. of loops is significantly higher in control group compared to ECC and Rampant caries group (P-value0.05). The average no. of whorls is significantly higher in ECC and Rampant caries group compared to Control group (P-value0.05 for all). Table 1) The intergroup comparison of finger print pattern. Values are Mean  ± Standard Deviation. P-values by one-way analysis of variance (ANOVA) with Post-Hoc Tukey’s correction for multiple group comparisons. P-value Figure 1 The intergroup distribution of finger print pattern (Right+Left). DISCUSSION : Widespread interest in epidermal ridges developed only in the last several decades when it became apparent that many patients with chromosomal aberrations had unusual ridge formations 10. Dermatoglyphic patterns make good material for genetic studies, because unlike stature, intelligence, and body weight, they are not significantly influenced by age or by postnatal environmental factors. 8,9,10 Dermatoglyphics have the advantage of remaining stable throughout life and therefore can be compared among individuals of different ages. The basis of considering dermatoglyphic pattern as genetic marker for dental caries is that the epithelium of finger buds as well as enamel which is the most susceptible dental tissue to dental caries have ectodermal origin and both develop at the same time of IU life.12 In this study , the evaluation and comparison of patterns in children with caries and caries-free children in both right and left hands showed increase in the number of whorls in children with rampant caries as compared to children with early childhood caries. However , this was not statistically significant. These results were substantiated by Atasu et al. who found an increased frequency of ulnar loops in caries-free children and an increased frequency of whorls in children with dental caries. The majority of whorl patterns in the control group were spiral while the caries group showed spiral, central pocket and double loop . Arches were least common patterns in both the groups.13,14 A definite correlation in the dermatoglyphic patterns between children with caries and caries-free children can be seen in this study. Thus, recording the dermatoglyphic patterns of children at an early age, during their first dental visit will be handy in predicting whether the child belongs to the high risk group or the low risk group and thereby can aid in planning a definitive preventive and treatment strategies. CONCLUSION : The dermatoglyphic patterns may be utilized effectively to study the genetic basis of dental caries. In a developing country like India , it might prove to be a non invasive , inexpensive and effective tool for screening . These patterns may represent the genetic make up of an individual and therefore it suggests an individual s predisposition to certain diseases . Since dermatoglyphics is still an counterfactual and imprecise science at the present time, it requires further extensive research to ascertain the significance of these variations in the dermatoglyphic features of children with dental caries . REFERENCES : Schaumann B, Alter M. Dermatolglyphics in Medical Disorders. New York, Heidel Berg, Berlin: Springer-Verlage; 1976. p. 14-75 Uchida JA, Solton HC. Evaluation of dermatoglyphics in medical genetics. Pediatr Clin North Am 1963;10:409-22. Pons J. Genetics of the A-B ridge count on the human palm. Ann Hum Genet 1964;27:273-7. 8. Venkatesh E, Bagewadi A, Keluskar V,Shetti A. Palmar dermatoglyphics in oralleukoplakia and oral squamous cell carcinoma patients. Journal of IndianAcademy of Oral Medicine and Radiology 2008;20:94-9. Hirsch W, Schweichel JU. Morphological evidence concerning the problem of skin ridge formation. J Ment defic research 1973;17:58-72. Penrose LS. Fingerprints, palms and chromosomes. 1963;197:933-8. Cummins. Revised methods of interpretation and formulation of palmar dermatoglyphics. Am J Phy Anthr 1929;12:415-502 Cummins. Study of error in interpretation and formulation of palmar dermatoglyphics. Am J Phy Anthr 1928;11:501-21 Okajima M. Development of dermal ridges in the fetus. J Med Genet 1975;12:243-50. Carter CO. Genetics of common disorders. Brit Med Bull 1969;25:2-57 Matsunaga E. Hereditary factors in congenital malformations. Igakunoayumi 1977;103:910-5 11. Verbov J. Clinical signifi cance and genetics of epidermal ridges-A review of dermatoglyphics. J Invest Dermatol 1970;54:261-71. 12. Madan N, Rathnam A, Bajaj N. Palmistry: A tool for dental caries prediction Indian J Dent Res 2011;22:213-8. 13. Atasu M. Dermatoglyphic fi ndings in dental caries: A preliminary report. J Clin Pediatr Dent 1998;22:147-9. 14. Ahmed RH, Mohammed I. Aref, Rania M Hassan and Noura R Mohammed. Dermatoglyphic study on patients with dental caries restored with dental fi llings and its correlation to apoptosis induced by dental fi llings. Nat Sci 2010;8:54-7.

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