Comparison of distraction techniques using salivary biomarkers during local anaesthesia administration in children aged 3-5 years: A clinical study.

Aim: In paediatric dentistry, pain is adversely influenced by a child's level of anxiety. Ironically, the most common form of pain control used in dentistry, local anaesthesia, can itself produce anxiety. One of the techniques to overcome a child's anxiety is using distraction. The aim of the present study was to evaluate the effectiveness of distraction techniques, i.e. audio distraction (AD) and audio-visual distraction (AVD) by measuring salivary stress biomarker (salivary cortisol and salivary alpha-amylase) levels in 3-5 year-old children. Materials and Methods: Forty children aged 3-5 years were divided randomly into two groups; (Group I = AD, Group II = AVD). Cotton pellets were placed in the lingual vestibule to collect a sample of saliva. Children were then asked to wear overhead phones in the AD group, connected to a phone, and rhymes were played. In AVD, a cartoon movie was shown to the children using AV glasses. Simultaneously, local anaesthesia was administrated to children, after which another saliva sample was collected. Biomarker estimation was done using ELISA. Fisher's exact test was used for statistical analysis. Results: Statistically significant results were seen with Group II compared to Group I (cortisol-P = 0.009; salivary alpha-amylase-P = 0.03). Conclusion: Both distraction techniques are effective in reducing stress but compared to AD, AVD is more efficacious.

Effect of intermaxillary tooth-size discrepancy on accuracy of prediction equations for mixed dentition space analysis for Davangere population.

Context: In the mixed dentition period, malocclusion is in dormant stage, any interception should be preceded by a mixed dentition space analysis. Aims: To derive new regression equation in sample subjects (indigenous group) with no intermaxillary tooth size discrepancy (Bolton's ratio) residing in Davangere and to evaluate its accuracy. To assess the difference of tooth dimensions between males and females and difference between right and left of dental arches. Design: Descriptive study. and Methods: One hundred and fifty children (11-15 years) were included and dental casts were made. A digital Vernier caliper was used for the measurement of teeth. Bolton's ratio was calculated. Group A: Casts without Bolton's discrepancy and Group B: Casts with Bolton's discrepancy. Used: The data were analyzed with the SPSS software version 22.0. New regression equations were derived using correlation and regression analysis. Results: No statistically significant difference was recorded between the actual and predicted mesiodistal widths (MDWs) of permanent canine and premolars in maxilla and mandible, with/without Bolton's discrepancy. Males had statistically significant higher mean in maxillary and mandibular canine dimensions than female and no statistically significant difference between right and left side of dental arches was found. Conclusion: New regression equation was formulated for Davangere population, in which actual and predicted widths of permanent canines and premolars were found to be almost similar when established from sample with/without Bolton's discrepancy. In MDWs, the canine showed significant sexual dimorphism and no clinically significant variations were seen in the right and left sides of both the arches.

A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report.

The aim of this paper is to present two methods of revascularization done in traumatized immature, nonvital anterior teeth using platelet-rich fibrin (PRF) and natural blood clot as a scaffold material. This was performed after disinfection of the root canal space using tri-antibacterial paste. In one tooth, PRF prepared from autologous blood was placed in the canal and in the other tooth, natural bleeding was induced to obtain a fresh blood clot. The patient was recalled regularly at 1, 3, 6, 9, and 12 months' interval for evaluation. After 12 months, on clinical examination, both teeth showed negative response to percussion and palpation tests but positive response to cold and electric pulp tests. On radiographic examination, the tooth treated with PRF exhibited comparatively faster root lengthening, complete closure of the root apex, more thickening of the root dentinal walls, and narrowing of root canal space compared to conventionally revascularized tooth. How to cite this article: Nagaveni NB, Poornima P, Mathew MG, et al. A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report. Int J Clin Pediatr Dent 2020;13(1):98-102.

Comparative evaluation of compressive strength and surface microhardness of EQUIA Forte, resin-modified glass-ionomer cement with conventional glass-ionomer cement.

PURPOSE: The study aimed to evaluate and compare the compressive strength and surface microhardness of EQUIA Forte, light cure, and conventional glass-ionomer cement (GIC). METHODOLOGY: Fifty-four pellets of G-Coat (GC) Gold Label 2, GC Gold Label light-cured universal restorative material, and EQUIA Forte GIC were prepared of dimensions (6 × 4) mm and were divided into three groups (18) each and were stored at 37°C for 1 h and then immersed in 20 ml of deionized water, artificial saliva, and lactic acid six each, respectively, over 30 days. Samples were subjected to surface microhardness and compressive strength test on the 1st day, 7th day, and 30th day. Results were subjected to ANOVA and Bonferroni post hoc test. RESULTS: Comparing the compressive strength of EQUIA Forte from day 1 to 30 when placed in artificial saliva, there was a significant increase on day 30 (P = 0.007); compared to other groups. The surface microhardness of EQUIA Forte from day 1 to 30 when placed in artificial saliva nonsignificantly decreased comparing to other groups. CONCLUSION: Surface microhardness and compressive strength of EQUIA Forte were significantly high in comparison to the other groups.

Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach.

AIM: To evaluate the clinical and radiological results of a revascularization treatment done in a nonvital, immature permanent tooth using the amniotic membrane. CASE DESCRIPTION: A 12-year-old boy reported with a complaint of pain in the lower left back tooth since 1 month due to dental caries. On clinical examination, the mandibular left second premolar was tender on percussion and discolored due to dental caries. Radiographic examination of the same tooth revealed open apex, thin root dentinal walls, and periodontal ligament widening. An access opening was prepared, necrotic pulp extirpated completely followed by thorough irrigation. After drying the canal, closed dressing with the 3-mix antibacterial paste was given for 15 days. After 15 days, the paste was removed and the amniotic membrane was placed inside the canal extending 1 mm beyond the apex and mineral tri-oxide aggregate was placed over this followed by sealing of the cavity. The patient was followed up at 1, 3, and 6 months for clinical and radiographic evaluation. CONCLUSION: After 6 months, clinically the tooth found asymptomatic. Radiographic examination showed continued root elongation, closure in the periapical opening, thick root dentinal walls with narrowing of the canal space, and normal periradicular architecture. CLINICAL SIGNIFICANCE: Amniotic membrane can be used as a scaffold for revascularization in nonvital immature teeth. HOW TO CITE THIS ARTICLE: NB Nagaveni, P Poornima, et al. Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach. Int J Clin Pediatr Dent 2019;12(2):150-152.

Inhibition of Residual Cariogenic Bacteria in Atraumatic Restorative Treatment by Chlorhexidine: Disinfection or Incorporation.

PURPOSE: The purpose of this study was to compare the efficacy of chlorhexidine (CHX) cavity disinfection and of CHX containing glass ionomer cement (GIC) in inhibiting residual cariogenic bacteria. METHODS: Ninety, five- to nine-year-olds were randomly allocated to three groups: Group 1-CHX containing GIC; Group 2-CHX cavity disinfection; and Group 3-conventional GIC. Total viable count (TVC), Streptococcus mutans (SM), and Lactobacillus (LB) were analyzed pre-, post-, and three months after atraumatic restorative treatment (ART). The results were statistically analyzed by one-way analysis of variance. RESULTS: At three months microbial evaluation, Group 1 showed 65 percent reduction of both TVC and LB and 67 percent of SM. Group two showed 64 percent, 58 percent, and 56 percent reduction of TVC, LB, and SM respectively. Group 3 exhibited 41 percent, 42 percent, and 46 percent reduction in mean TVC, LB, and SM counts respectively. Residual microbial counts for Group 3 were 0.41, 0.61, and 0.53 (105 colony forming units) for TVC, LB, and SM, respectively, which was significantly higher (P<0.01) compared to the respective microbial counts in Groups 1 and 2. CONCLUSION: Both chlorhexidine disinfection and incorporation showed superior efficacy in inhibiting residual microbes compared to conventional ART.

Volumetric evaluation of various obturation techniques in primary teeth using cone beam computed tomography - An in vitro study.

AIM: The aim of this study was to compare and evaluate the efficiency of five different obturation methods in delivering the filling material into the canals of primary teeth using cone beam computerized tomography (CBCT) scan. METHOD: A total of fifty prepared canals of primary teeth which further divided into five groups with ten canals in each group were obturated with zinc oxide-eugenol cement using five different obturation methods such as endodontic plugger, lentulo spiral (handheld), lentulo spiral mounted on slow speed handpiece, local anesthetic syringe, and tuberculin syringe. Using CBCT scan, the pre- and post-obturation volume and the percentage of obturated volume (POV) were calculated for each group. The results obtained were statistically analyzed using one-way analysis of variance and Tukey's post hoc test. RESULTS: Following CBCT scan, the method obturated with lentulo spiral mounted to handpiece showed the highest POV value followed by the method of lentulo spiral mounted to handpiece, hand plugger, and tuberculin syringe. Local anesthetic syringe gave the least POV (P < 0.05). CONCLUSION: Lentulo spiral mounted to handpiece showed the best technique of obturation using CBCT evaluation among the five groups evaluated in primary teeth. However, more studies are highly essential to prove it a boon for estimating obturation quality in primary teeth.

Volumetric Evaluation of Different Obturation Techniques in Primary Teeth Using Spiral Computed Tomography.

BACKGROUND: Various obturation techniques have been evaluated for better filling of the root canals in primary teeth using different methods. Spiral Computed Tomography (SCT) is a new revolution in the pediatric endodontics for assessment of quality of the obturation from 3 dimensions. OBJECTIVES: To evaluate the efficiency of 5 different obturation methods in delivering the filling material into the canals of primary teeth using Spiral Computed Tomography scan. STUDY DESIGN: A total of 50 canals of primary teeth were prepared, divided into 5 groups with 10 canals in each group and obturated with Zinc Oxide Eugenol cement using 5 different obturation techniques such as Local anesthetic syringe, Tuberculin syringe, Endodontic plugger, hand held Lentulo-spiral, and Lentulo-spiral mounted on slow speed hand piece. The pre and post obturation volume and finally the Percentage of Obturated Volume (POV) were calculated using SCT scan for each group. The data obtained was statistically analyzed using One-way Analysis of Variance (ANOVA) and Tukey's post-hoc test. RESULTS: Lentulo-spiral hand held showed highest POV value followed by Lentulospiral mounted to hand piece, Tuberculin syringe and Endodontic plugger; whereas Anesthetic syringe had least POV (P < 0.05). CONCLUSION: Lentulo-spiral hand held is the best obturating technique among the 5 groups evaluated as the canals of this group showed maximum percentage of filled material. However, a further study with large sample size is highly essential.

Malocclusion and dental caries experience among 8-9-year-old children in a city of South Indian region: A cross-sectional survey.

BACKGROUND: Although numerous studies have documented malocclusion in various age groups in India, the literature on the prevalence of malocclusion in mixed dentition is scanty. Dental caries is another most common condition affecting the general health. However, its association with malocclusion in mixed dentition is not well known. AIM: The purpose of this study was to establish the prevalence of malocclusion and its association with caries experience in 8-9-year-old children of Davangere city, South Indian region. SETTING AND DESIGN: The study design was a cross-sectional survey. MATERIALS AND METHODS: A total of 800 children from 350 schools (both males and females) were randomly selected for the study. t-test and Chi-square test were used for statistical analysis. RESULTS: The overall prevalence of malocclusion among 8-9-year-old children was 40.9%. The most prevalent malocclusion was crowding (11.5%), followed by excessive overjet (9.4%), deep bite (6.8%), spacing (6.5%), crossbite (4.5%), and open bite (3.2%). Class I molar relationship prevailed in 95.5% of children. CONCLUSION: The prevalence of malocclusion in our study was in accordance with the other studies reported in India, which ranged from 19.6% to 90%. Furthermore, correlation of malocclusion and dental caries in the primary dentition, although nonsignificant, presented children with malocclusion to have a higher caries experience than children without malocclusion.

Comparative Evaluation of Longevity of Fluoride Release From three Different Fluoride Varnishes - An Invitro Study.

INTRODUCTION: Fluoride varnishes play a pivotal role in inhibition of dental caries by increasing remineralization. AIM: To determine the longevity of fluoride release from 3 different fluoride varnishes over a period of time through salivary fluoride estimation. MATERIALS AND METHODS: Twenty four extracted human deciduous anterior teeth were divided into four groups, i.e., ClinproTM XT, Flouritop SR, Flourprotector and Control group. Fluoride varnishes were applied on 3mm x 3mm window on labial surface of the teeth and then the teeth were immersed and stored in artificial saliva. The concentration of fluoride in ppm was measured after 1 week, 1 month, 3 months and 6 months. Fluoride release at each time interval for different groups was statistically analyzed using ANOVA and Post Hoc Tukey's test. RESULTS: Although all the fluoride varnishes released fluoride, with greatest release observed during 1(st) week by Fluoritop SR (66.92±16.30ppm), ClinproTM XT Varnish released consistently and substantially more fluoride than Fluoritop SR and Fluorprotector during 6 months analysis (p<0.05). Fluorprotector showed the lowest rate of F release among all the groups compared. CONCLUSION: Over a period of 6 months ClinproTM XT Varnish released consistently and substantially more fluoride than other tested products.

Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study.

OBJECTIVES: To compare CPP-ACP, Tri-calcium phosphate and Hydroxyapatite on remineralization of artificial caries like lesions on primary enamel. STUDY DESIGN: Ten extracted Primary molars coated with nail varnish, leaving a window of 2×4 mm on buccal and lingual surface were immersed in demineralizing solution for 96 hours and sectioned longitudinally to obtain 40 sections (4 sections per tooth) and were randomly divided into 4 groups (A to D) n=10; Group A: negative control, Group B: CPP-ACP, Group C: Tri-calcium phosphate, Group D: Hydroxyapatite. Sections were subjected to pH cycling for 10 days and were evaluated by polarized light microscope before and after treatment. RESULTS: Intra group comparison of demineralization and remineralization was done by paired t-test. One way ANOVA was used for multiple group comparisons followed by post HOC TUKEY'S Test for group wise comparisons. Remineralization was found more with Group D followed by Group B, C and A. CONCLUSION: Hydroxyapatite showed better remineralization when compared to CPP-ACP and Tri-calcium phosphate.

Prevalence of a few variant dental features in children aged 11-16 years in Davangere, a city in Karnataka.

CONTEXT: Variations in morphology of shape of teeth have always been of interest to dentists from ancient times. But to our surprise, till date, no studies related to the prevalence of dental features have been conducted in any part of the world. AIMS: To evaluate the prevalence of a few variant dental features in a group of children aged from 11 to 16 years in the city of Davangere that belongs to the state of Karnataka, India. MATERIALS AND METHODS: A cross-sectional survey was conducted where children aged 11-16 years were selected (both girls and boys) and type III clinical examination was done. They were checked for the following features - Carabelli's cusp, 3-cusped maxillary 2(nd) molar, 5-cusped maxillary 1(st) molar, 4-cusped mandibular 1(st) molar, 5-cusped mandibular 2(nd) molar, cusp 6 present in mandibular 1(st) molar, and 7-cusped mandibular 1(st) molar. STATISTICAL ANALYSIS USED: The Chi-square test was used to analyze the categorical data. P value of 0.05 or less was considered for statistical significance. RESULTS: Around 99.3% of the school children examined had at least one of the dental variations that were examined in relation to the shape of teeth. CONCLUSIONS: This study definitely provides us with baseline data, but further epidemiological studies are required to determine the prevalence of the above mentioned dental anomalies.

Dental health in children with congenital bleeding disorders in and around Davangere: A case-control study.

AIM: The present study was carried out to investigate the dental and some other aspects of oral health status of young patients with congenital bleeding disorders (CBDs) and compared with controls. MATERIALS AND METHODS: Decayed, missed, filled tooth surfaces (DMFS-dmfs) in permanent and primary teeth scores, simplified oral hygiene index, occlusion, occurrence of hypoplasia, fluorosis other hard tissue and soft tissue findings of 50 CBD patients at the age range of 4-15 years and 50 of other children as control were compared. Data were analyzed by Chi-square and Student's unpaired t-test. RESULTS: Patients were significantly more caries-free with less decayed teeth in primary-permanent dentition (P < 0.05) and with lower scores for overall hygiene. CONCLUSION: By this, it can be concluded that children with CBD have a significantly lower prevalence of dental caries and better oral hygiene compared with matched, healthy controls.

Revascularization Induced Maturogenesis of Non-Vital Immature Permanent Tooth Using Platelet-Rich-Fibrin: A Case Report.

The aim of this report is to describe a novel method of revascularization therapy done in a non-vital, immature permanent tooth using Platelet-rich fibrin (PRF),in a recently developed scaffold material to overcome limitations associated with the traditional method of revascularization using natural blood clot. PRF prepared from autologous blood was placed in the root canal and patient was followed up regularly at one, three, six, nine and 12 months for detailed clinical and radiographic evaluation. At 12 months, radiographic examination revealed root elongation, root end closure, continued thickening of the root dentinal walls, obliteration of root canal space, and normal periradicular anatomy. However, more long term prospective trials and histological studies are highly needed before to testify PRF a panacea for the regenerative endodontic therapy in children.

Comparative evaluation of microleakage of conventional and modifications of glass ionomer cement in primary teeth: An in vitro study.

AIMS: The aim of the present study was to evaluate the microleakage among conventional, resin modified glass ionomer cements (GIC), and compomer cements in primary teeth. MATERIALS AND METHODS: Forty-five over retained non carious primary molars beyond exfoliation time were collected and randomly divided into three groups (n = 15). Group A: GC Fuji II; Group B: Vitremer; Group C: Compoglass F. A standard Class V cavity was prepared on the buccal surface of each tooth with no mechanical retention and restored accordingly. Then all the samples were subjected to thermocycling for 250 cycles at different temperatures and covered with nail varnish. Later, samples were immersed in 0.5% methylene blue dye for 24 h. Teeth were sectioned buccolingually through the center of the restoration and studied under a stereomicroscope for dye penetration. Data obtained were analyzed using Kruskal-Wallis ANOVA and Mann-Whitney U-test. RESULTS: Samples restored with vitremer showed comparatively higher microleakage than the samples in other groups. However, overall there were no significant difference between the microleakage scores of the samples in all three groups (P > 0.05). CONCLUSION: It can be concluded that none of the three GICs was free from microleakage. Hence, further research is required to compare microleakage of the newer material.

Revascularization of immature, nonvital permanent tooth using platelet-rich fibrin in children.

The purpose of this paper was to present a new approach wherein revascularization of the immature, nonvital permanent tooth was performed using platelet-rich fibrin (PRF) as a novel scaffold material. This was performed after disinfection of the root canal space using triple antibiotic paste followed by placing a PRF membrane in the root canal. The patient was followed up regularly at three-, six-, nine-, and 12-month intervals for review. After 12 months, clinical examination showed negative response to percussion and palpation tests but positive response to cold and electric pulp tests. Radiographic examination revealed continued thickening of the root dentinal walls, narrowing of root canal space, root lengthening, and closure of the root apex with normal periradicular architecture. However, more clinical research using large samples is necessary to prove it advantageous for regenerative endodontic therapy in children.

Management of an endo-perio lesion in an immature tooth using autologous platelet-rich fibrin: a case report.

Treatment of an endo-perio lesion involving a non-vital young permanent tooth is a highly challenging task to Pediatric Dentists. There is a quest for the newer biological approach to management of these lesions as traditional methods have various disadvantages. Recently, platelet-rich fibrin (PRF), a second-generation platelet concentrate, is rich in growth factors have been used in the periodontal regeneration procedure. The purpose of this paper is to describe the efficacy of PRF in the treatment of a deep intra bony defect associated with an endo-perio lesion in an immature right mandibular first premolar of 12-year-old female patient. A freshly prepared autologous PRF membrane was placed in the bony defect following debridement. Clinical and radiographic follow-up were performed at regular intervals that revealed absence of pain, gain in clinical attachment level, reduction in probing depth, and excellent bone regeneration indicating successful outcome.

Tooth fragment embedded in the lower lip for 10 months following dentoalveolar trauma: A case report with literature review.

Traumatic injuries to maxillary anterior teeth are a common finding in children because of falls while playing. Sequelae of trauma to dental hard tissue include broken, lost, aspirated and swallowed teeth. One additional hazard is the embedding of fractured tooth fragments in the soft tissues, particularly in the lip. A 10-year-old male patient complained of pain in the lower lip. There was a history of trauma to the upper anterior tooth 10 months previously. Clinical examination showed scarring and discoloration over the lower lip, and the presence of a hard mass was felt on palpation. Intraoral examination revealed an Ellis and Davey class II fracture of number 11. A radiograph of the lip was taken, which showed a radiopaque structure similar to the shape of the missing tooth fragment. Under local anesthesia, the tooth fragment was removed successfully, and the class II fracture was restored with composite. Therefore, proper clinical and complete radiographic examination of both hard and soft tissues following dental trauma is essential to rule out such occurrences.

Prevalence of taurodontism in primary mandibular first molars of ethnic Indian children.

The objective of this study was to determine the prevalence of taurodontism in primary mandibular first molars in ethnic Indian children using periapical radiographs. Periapical radiographs of 274 children obtained from December 2008 to August 2010 were retrospectively screened and examined. Radiographs of 196 patients (99 boys and 97 girls; ages 2.5-10.5) with bilateral primary mandibular first molars were randomly selected and evaluated. The gender, symmetry, and frequencies of occurrence of taurodont primary mandibular first molars were compared and the obtained data were statistically analyzed using the x2 test. Eight (4.08%) taurodont primary mandibular first molars were found with a bilateral incidence of a symmetrical distribution of 38% (3/8). The prevalence of taurodontism in primary mandibular first molars did not differ significantly between right and left sides or with gender (P ≥ 0.05). The results of the present study indicate that approximately 4% of Indian children had taurodontism in primary mandibular first molars. Clinicians should be aware of the prevalence of this anatomic variant in primary mandibular first molars among the Indian population for early identification of taurodonts and for rendering the best care during dental treatment.

An unusual occurrence of multiple dental anomalies in a single nonsyndromic patient: a case report.

Dental anomalies are the formative defects caused by genetic disturbances or environmental factors during tooth morphogenesis. Simultaneous occurrence of various multiple anomalies has been reported previously, particularly in cases of chromosomal abnormalities that often manifest with multisystem involvement. Very few cases of multiple anomalies have been documented in patients with no known generalized abnormalities. The present paper shows an unusual occurrence of a combination of dental anomalies like mandibular canine transmigration, taurodontism in permanent mandibular molars, congenital agenesis of 14 numbers of permanent teeth excluding third molars, canine impaction, primary molars with pyramidal roots, midline diastema and generalized microdontia in an apparently normal 13-year-old Indian girl.