Prevalence and Etiology of Traumatic Injuries to the Anterior Teeth among 5 to 8 Years Old School Children in Mathura City, India: An Epidemiological Study.

OBJECTIVES: To assess the prevalence of traumatic injuries to the anterior teeth among the 5 to 8 years old children attending the schools in Mathura city. STUDY DESIGN: A total of 1657 children of the age groups: 5, 6, 7 and 8 years from 20 schools situated in various parts of Mathura city were included in this study, utilizing stratified cluster random sampling method. RESULTS: The prevalence of traumatic injuries to the anterior teeth in 5 to 8 years old age group was found to be 2.7%. Males accounted for 3.1% whereas females accounted for 2.3%. Overall, males experienced more traumatic injuries than the females with male to female ratio of 1.8:1. The etiology of traumatic injuries was mostly due to falls, followed by bicycle accidents, collisions, violence and bike accidents in that order. How to cite this article: Gojanur S, Yeluri R, Munshi AK. Prevalence and Etiology of Traumatic Injuries to the Anterior Teeth among 5 to 8 Years Old School Children in Mathura City, India: An Epidemiological Study. Int J Clin Pediatr Dent 2015;8(3):172-175.

Management of pediatric mandibular fracture: a case series.

A pediatric mandibular fracture can cause a child severe pain and the parent or caregiver extreme worry. While the pattern of fractures and associated injuries in children is similar to adults, the incidence is low. Due to a number of factors, including the anatomical complexity of the developing mandible in a child, management of such fractures differs from that of adults and can greatly challenge the pediatric dentist. Various treatment modalities of managing mandibular fracture are available, such as closed/open cap splint with circummandibular wiring, arch-bar fixation, and cementation of the cap splint. This article reviews 19 cases in the management of pediatric facial fracture using varied treatment methods.

Alternative approach to management of early loss of second primary molar: a clinical case report.

Preservation of space after premature loss of the second primary molar is essential to prevent mesial drifting of the permanent first molar. Various modifications of distal shoe space maintainers, which have been documented, are all nonfunctional in nature. This paper describes an innovative design of a functional distal shoe space maintainer that is intended to overcome the disadvantages of conventional non-functional space maintainers and that does not hamper the periodontal status of the abutment tooth.

Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: This was a flexible-dosed study to evaluate the efficacy and safety of duloxetine 30-120 mg once daily in the treatment of generalized anxiety disorder (GAD) in older adult patients. METHODS: Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140). The primary efficacy measure was the Hamilton Anxiety Rating Scale (HAM-A) total score, and the primary endpoint was at week 10. Global functioning was assessed by the Sheehan Disability Scale (SDS). Safety and tolerability was assessed by the occurrence of treatment-emergent adverse events, serious adverse events, laboratory analyses, and vital signs. Analyses were conducted on an intent-to-treat basis. RESULTS: The overall baseline mean HAM-A total score was 24, and SDS global score was 14. Completion rates were 75% for placebo and 76% for duloxetine. At week 10, duloxetine was superior to placebo on mean changes from baseline in HAM-A total scores (-15.9 vs. -11.7, p < 0.001) and in SDS global scores (-8.6 vs. -5.4, p < 0.001). Treatment-emergent adverse events occurred in ≥5% of duloxetine-treated patients and twice the rate than with placebo including constipation (9% vs. 4%, p = 0.06), dry mouth (7% vs. 1%, p = 0.02), and somnolence (6% vs. 2%, p = 0.14). CONCLUSION: Duloxetine treatment was efficacious in the improvement of anxiety and functioning in older adult patients with GAD, and the safety profile was consistent with previous GAD studies.

Solitary median maxillary central incisor syndrome associated with unique cleft palate: a rare case report.

Solitary median maxillary central incisor (SMMCI) syndrome is a rare dental anomaly that affects 1:50,000 live births. SMMCI syndrome is characterized by the presence of a single central incisor located on the maxillary midline in both primary and permanent dentitions. It may occur as an isolated finding or in association with developmental defects and systemic involvement. Congenital anomalies associated with SMMCI syndrome can include short stature, mild forms of deviation in craniofacial morphology, mild to severe intellectual disability, congenital heart disease, and cleft lip and/or palate. This report describes a clinical case of a 7-year-old girl with SMMCI syndrome--in addition to bilateral residual cleft and associated nasal regurgitation--that was treated with a removable maxillary obturator.

Effect of moisture and moisture-insensitive primer on bond strength of composite resin to enamel and dentin.

This article sought to compare the influence of moisture and the effect of moisture-insensitive primer (MIP) on shear bond strength (SBS). This study divided 160 extracted teeth randomly into 2 groups (n = 80): Group 1 (enamel) and Group 2 (dentin). Groups 1 and 2 were divided into 4 subgroups (n = 20), according to the surface treatment administered. Subgroup A samples were etched and primed, and received composite resin; Subgroup B samples were etched, contaminated with artificial saliva, and primed before application of composite resin; Subgroup C samples were etched, primed, and contaminated before application of composite resin. Subgroup D samples were etched, primed, contaminated, and primer was applied a second time before application of composite resin. All the specimens were stored in distilled water and thermocycled for 500 cycles; at that point, SBS was tested. According to Tukey's test, only the mean values in Subgroups A and C revealed statistically significant differences (P < 0.05). The use of MIP on contaminated etched tooth surfaces achieved comparable bond strength to noncontaminated tooth surfaces and might have a role in restorative dentistry cases where moisture contamination is inevitable.

Esthetic management of a primary double tooth using a silicone putty guide: a case report.

The term double tooth is often used to describe fusion and gemination. The development of isolated large or joined teeth is not rare, but the literature is confusing when the appropriate terminology is presented. The objective of this paper is to present a case of a primary double tooth in a 5-year-old girl with a history of trauma. The tooth was endodontically treated and esthetic management was carried out using a silicone putty guide.

Clinical and microbiological evaluation of the carious dentin before and after application of Papacarie gel.

OBJECTIVE: To evaluate clinically and microbiologically the efficacy of Papacarie in the removal of carious dentin in both permanent and primary teeth. STUDY DESIGN: Thirty permanent and primary molars with dentinal carious lesions were excavated and subjected to clinical and microbiological assessment before and after application of Papacarie. The gel was further tested for in vitro antimicrobial efficacy against standard cariogenic micro-organisms using agar diffusion assay. RESULTS: Papacarie was able to differentiate between infected and affected dentin clinically along with high patient comfort during caries excavation. The mean time taken for caries removal and restoration was observed to be 4.17 +/- 0.40 min. and 8.57 +/- 0.45 min. for permanent teeth and 4.21 +/- 0.36 min. and 9.24 +/- 0.58 min. for primary teeth. There was a significant reduction in the total viable colony forming units from the dentin samples before and after application of Papacarie. It was also observed that Papacarie had no inhibitory effect on standard cariogenic microorganisms in the agar diffusion assay. CONCLUSIONS: Papacarie is an effective caries removal method clinically in both permanent and primary teeth. The number of viable microorganisms after complete caries excavation using Papacarie still appears to be high and this bacterial count should be tackled by a suitable restorative material with potent antimicrobial activity.

Multiple supernumerary teeth associated with an impacted maxillary central incisor: Surgical and orthodontic management.

Various anomalies in the size, shape, number, structure and eruption of the teeth are often observed clinical conditions. Supernumerary teeth can be found in almost any region of the dental arch, and most of the times they are asymptomatic, and are routinely found during radiographic evaluation. The most common cause of impacted maxillary incisors is the presence of the supernumerary teeth. This paper describes a case of multiple supernumerary teeth associated with an impacted permanent maxillary central incisor in an 11-year old child along with its surgical and orthodontic management.

Effect of toothbrush grip on plaque removal during manual toothbrushing in children.

Toothbrushing is fundamental to oral hygiene. Children differ in manual dexterity and their grip on toothbrushes. We videotaped toothbrushing sessions and observed the grip type, duration of brushing, and brushing technique used among 100 children aged 8-12 years. We then investigated the association between grip type and plaque removal, using plaque scores obtained at various time points. We further examined the effect on plaque scores of standardizing both brushing technique and duration among the same participants. The most common grip was the distal oblique, followed by the oblique; the spoon and precision grips were rare, and no child used a power grip. Mean brushing duration for most children was 1.43 ± 0.85 min, and the most common brushing technique was horizontal scrubbing. We conclude that grip preference is inherent and that the distal oblique grip was better than the oblique grip in removing plaque.

Fiber reinforced composite loop space maintainer: An alternative to the conventional band and loop.

The stainless steel band and loop appliance is the most commonly used fixed space maintainer in pediatric dentistry. But there are several disadvantages with this appliance such as the need for a cast or a working model, decalcification of the abutment tooth, loosening because of breakage or dissolution of the luting agent, tendency to get embedded in the soft tissue and the possibility of metal allergy. The purpose of this article is to present a simple, laboratory design of a "Fiber Reinforced Composite" (FRC) loop space maintainer and discuss the advantages over the traditional band and loop space maintainers.

Evaluation of minimum inhibitory and minimum bactericidal concentration of nano-silver base inorganic anti-microbial agent (Novaron(®)) against streptococcus mutans.

OBJECTIVE: We attempted to find the possibility of determining the minimum inhibitory concentration and minimum bactericidal concentration needed for nano-silver base inorganic anti-microbial agent (Novaron(®) AG 300, AG 1100) against Streptococcus mutans in vitro using broth dilution assay. MATERIALS AND METHODS: An ampoule of freeze-dried S. mutans NCTC reference strain was revived, and the colony-forming units (CFU) were calculated. The MIC and MBC was determined by broth dilution assay using different concentrations of Novaron(®) AG 300 and Novaron(®) AG 1100 against 1 × 10(5) CFU/ml of S. mutans. RESULTS: The MIC and MBC of Novaron(®) AG 300 and Novaron(®) AG 1100 against S. mutans were found to be 40 µg/ml. CONCLUSIONS: Novaron(®) has anti-bacterial effect against S. mutans. Further studies are needed to explore the applicability of these silver-supported anti- microbial agents in clinical dentistry.

Measurement and assessment of pain in children--a review.

Pain is a common experience during childhood. Despite the magnitude of effects that pain can have on a child, it is often inadequately assessed and treated. Numerous myths, insufficient knowledge among caregivers, and inadequate application of knowledge contribute to the lack of effective management. The pediatric pain experience involves the interaction of physiologic, psychologic, behavioral, developmental, and situational factors. Pain is an inherently subjective multifactorial experience and should be assessed and treated as such. Pediatric Dentists are responsible for eliminating or assuaging pain and suffering in children when possible. To accomplish this, we need to expand our knowledge, use appropriate assessment tools and techniques, anticipate painful experiences and intervene accordingly. As an assessment of pain which constitutes the foundation for all pain treatment, developing valid measures is both a clinical and research challenge. Clinicians and researchers should select measures with full knowledge of their psychometric strengths and weakness, as well as in keeping with their explicit conceptual model of pain. The purpose of this paper is to address potential sources of pain measurement, and responses to pain control and distractions based on the pediatric developmental stages.

Comparative Evaluation of the Adhesive Properties of Two Generations of Dentin Bonding Agents by Checking the Microleakage in the Primary Teeth: An in vitro Study.

Early childhood caries is now affecting the children in dangerous proportions. There is a widespread loss of the tooth material irrespective of the type of the carious lesion. Restoration of such lesions with a strong permanent bond between the dental tissues and the restorative dental materials would be a highly desirable requisite of any restorative material. Ultramorphological characterizations show that the interfa-cial morphology and the chemical characterization of the bonding systems appear to be strongly associated with each other and, therefore, observing and understanding the interfacial phenomenon and its quality would be of great importance in the selection of a dental adhesive for its use in pediatric restorative dentistry.

Conservative non-surgical management of an infected radicular cyst.

The radicular cyst arises from epithelial remnants stimulated to proliferate by an inflammatory process originating from pulpal necrosis of a non-vital tooth. Radiographically, the classical description of the lesion is a round or oval, well-circumscribed radiolucent image involving the apex of the tooth. Radicular cyst is usually sterile unless it is secondarily infected. This article presents a successful case of conservative non-surgical management of an infected radicular cyst associated with an immature permanent mandibular second molar (47) in a 14-year-old child.

Malunited fracture of the body and condyle of the mandible : A Case Report.

Mandibular fractures are the most common facial fractures seen in hospitalized children and their incidence increases with age. Treatment options include soft diet, intermaxillary fixation with eyelet wires, arch bars, circummandibular wiring, or stents. Alternative options include open reduction and internal fixation through either an intraoral or extraoral approach. Many factors complicate the management of pediatric mixed-dentition mandibular fractures: tooth eruption, short roots, developing tooth buds and growth issues. One major factor is the inherent instability of the occlusion in the mixed deciduous-permanent tooth phase. This case report documents a child in mixed dentition period with a complication arising due to direct fixation of the fractured mandible.

Unusual objects in the root canal of deciduous teeth: a report of two cases.

Accidental foreign body ingestion or aspiration is a common problem in children. Children often have a habit of inserting objects into their mouth. Some of these objects can be accidentally ingested or even aspirated which can be frightening and a stressful experience. But the presence of foreign objects in the teeth are rare. The foreign objects in the teeth may act as a potential source of infection and pain. In most of the cases, children avoid informing their parents due to fear of punishment. This paper presents two cases of foreign objects embedded in the deciduous teeth. In both the cases, parents were not aware of foreign body ingestion by their children.