Enhancing special care dentistry with sensory-adapted dental environment: A comparative study.

Aim: To compare and evaluate the effect of sensory-adapted dental environment (SADE) and regular dental environment in reducing anxiety levels in children with intellectual disabilities. Materials and Methods: This study was carried out in children with mild intellectual disabilities aged 8-13 years. The developmental screening test was utilized in screening and including these children with IQ scores between 52 and 67, and after random allocation, children were subjected to oral prophylaxis in the SADE and regular dental environment. Anxiety levels were assessed at baseline, 5 min, and at the end of the procedure using Venham's anxiety rating scale, pulse rate, and blood pressure values. Results: The data were coded and analyzed using software SPSS (IBM version 22.0) for statistical analysis. Comparison between the groups was done using independent t-test and repeated measured ANOVA for objective assessment of intergroup and intragroup anxiety levels, respectively, and using Mann-Whitney U-test and Friedman's test for subjective assessment of intergroup and intragroup anxiety levels, respectively. Conclusion: These findings suggest that SADE significantly decreased anxiety levels and cooperative behavior in children with mild intellectual disability and can be used as an alternative behavior management technique in effectively handling children with intellectual disability.

Conceptual combination of disinfection in regenerative endodontics: Conventional versus laser-assisted disinfection.

BACKGROUND: Successful regeneration depends on four key elements of tissue engineering such as stem cells, growth factors, scaffold and sterile environment. Therefore, regenerative endodontic therapy requires higher degree of disinfection for successful outcomes. AIMS AND OBJECTIVE: To evaluate the clinical and radiographic outcome using conventional and laser assisted disinfection in regenerative endodontics at 1, 3 and 6 months. MATERIALS AND METHODS: 18 children with necrotic young permanent teeth were selected for the study. In Group A, in the first appointment AAE (American Association of Endodontics, Clinical Consideration for Regenerative Endodontic Procedure - 2016) disinfection protocol was employed. In Group B laser assisted disinfection (810 nm diode laser, 1 W, 20 ms Pulse length and 20 ms interval duration) was performed. Microbial samples were obtained before and after disinfection to check the level of disinfection. The cases were followed up at 1 month, 3 months and 6 months interval and evaluated for clinical outcome, periapical healing and apical response. Data were statistically analyzed with level of significance set 1% or 5% accordingly (P<0.01 or P<0.05). RESULTS: On intragroup comparison there was significant reduction in bacterial count before and after disinfection with respect to laser assisted disinfection group. (P value = 0.007) There was no significant change in the clinical outcome score in laser group at 1,3- and 6-months interval. Periapical healing score showed statistically significant results in laser group when followed from 3 months to 6 months (P value = 0.04). CONCLUSION: Along with AAE 2016 protocol, use of laser assisted disinfection resulted in improved quality of disinfection and an expeditious clinical outcome and periapical healing in necrotic young permanent teeth. Keywords: Disinfection; laser; regenerative endodontics; sodium hypochlorite; tooth apex.

Microbiologic Evaluation of Cotton and Polytetrafluoroethylene (PTFE) Tape as Endodontic Spacer Materials in Primary Molars An in Vivo Study.

OBJECTIVE: PTFE tape, which is commonly used as plumber's tape is an inorganic, non-fibrous, ribbon like material. The aim of this study was to evaluate PTFE tape as endodontic spacer material and to compare it with commonly used spacer material that is cotton, in primary teeth. STUDY DESIGN: Seventeen children undergoing pulpectomy of lower second primary molar bilaterally were included in the study. Cotton and PTFE tape were placed as spacers on each side randomly. Samples were taken from the access cavity at baseline and after seven days to check for microbial leakage. Spacer materials were also checked for microbial contamination. RESULTS: The results revealed that there was a significant increase in the bacterial colony count after seven days in cotton group. The access cavities were also positive for microbial leakage in the cotton group where the spacers showed positive growth. In PTFE group only two samples showed microbial contamination of spacer and out of two only one sample showed contamination of access cavity along with spacer. CONCLUSION: Within the limitations of this study, it can be concluded that PTFE tape performed better than cotton as endodontic spacer material. Thus, PTFE tape can be recommended as an endodontic spacer material as an alternative to cotton in primary teeth.

Effect of Whitening Dentifrice on Micro Hardness, Colour Stability and Surface Roughness of Aesthetic Restorative Materials.

INTRODUCTION: Whitening agents present in the novel whitening dentifrices may have deleterious effects over the aesthetic restorations. AIM: The present study evaluated the invitro effect of whitening dentifrice on micro hardness, colour stability and surface roughness on aesthetic restorative materials. MATERIALS AND METHODS: Forty specimens each of compomer and of composite were prepared using brass mould. Specimens were equally divided into 4 groups. Group I (20 disks of compomer are subjected to brushing with conventional tooth paste) Group II (20 disks of composite subjected to brushing with conventional tooth paste), Group III (20 disks of compomer subjected to brushing with whitening tooth paste). Group IV (20 disks of composite subjected to brushing with whitening toothpaste). Each group was further divided into two subgroups, where 10 sample were subjected for two weeks of brushing with respective tooth paste and other 10 were subjected for four weeks of brushing. For the evaluation of micro hardness, colour stability and surface roughness, micro hardness testing machine, spectrophotometer and surface testing machine were used respectively. Initial and final readings were taken for each specimen and difference obtained was subjected to statistical analysis. One-way ANOVA was used for multiple group comparison followed by post-hoc Tukey's-test. The paried t-test was used for intra group comparison and unpaired t-test for comparing independent sample groups. RESULTS: The compomer and composite showed no significant difference in micro hardness either with conventional or whitening tooth paste both at two and four weeks. Although there was a highly significant colour change observed after using whitening tooth paste for both compomer and composite. Regarding surface roughness, there was a significant change in roughness in both conventional and whitening tooth paste with compomer and composite. However, whitening tooth paste had a significant change in surface roughness compared with conventional tooth paste. Roughness further increased at four weeks interval when compared to two weeks. CONCLUSION: Colour, surface-roughness and micro-hardness are the inherent properties of the aesthetic restorative materials. Use of whitening tooth paste will cause colour change and surface roughness of restorative material making it prone to deformation and also affects the clinical success of restoration.

Comparative evaluation of pH and antibacterial effect of various calcium hydroxide combinations on E. faecalis and its effect on root strength: An in vitro study.

AIM: To evaluate and compare the pH and antibacterial property of Ca(OH)(2) combined with iodine potassium iodide (IKI) or chlorhexidine (CHX) on E. faecalis and to assess and compare their effect on fracture resistance of root dentin. MATERIALS AND METHODS: CHX (0.5%) The following test materials were used: Group I Calcium hydroxide + saline, Group II Calcium hydroxide + CHX (0.5%) and Group III Calcium hydroxide + IKI (2%). For antibacterial activity, 60 root dentin blocks (20 in each group) were infected by E. faecalis followed by placement of medicaments. At the end of 24 h and 7 days, 10 samples from each group were randomly chosen and assessed for antibacterial activity. For evaluation of root strength, 30 teeth were used and stored in sterile saline after placement of medicament. At the end of 30 days, samples were subjected to fracture resistance testing on the Universal Strength Testing Machine. Hounsfield strength testing machine, UK pH of the various calcium hydroxide combinations was determined with a digital pH meter. STATISTICAL ANALYSIS: Kruskal Wallis test, Mann Whitney U test, and one-way ANOVA test for intergroup comparison and Wilcoxon's signed rank test and student's paired t test for intragroup comparison. RESULTS: Group III showed significantly greater antibacterial activity against E. faecalis, followed by group II and control group. There was no statistically significant change in the pH and root strength values among all the groups. CONCLUSION: The present study revealed that IKI or CHX in combination with Ca(OH)2 is an effective medicament against E. faecalis.

Esthetic rehabilitation of severely decayed primary incisors using glass fiber reinforced composite: a case report.

Restoration of primary maxillary incisors severely damaged by caries or trauma is a clinical challenge in pediatric dental clinics. Early childhood caries is observed in approximately half the child population. In the past, the only treatment option would have been to extract the affected teeth and replace them with prosthetic substitutes. With the introduction of new adhesive systems and restorative materials, alternative approaches in treating these teeth have been proposed. The purpose of this paper was to describe the rehabilitation of primary anterior teeth in a 5-year-old patient using glass fiber reinforced composite resin as an intracanal post.

Coronal pulp dimensions in noncarious and restored deciduous second molars: a radiovisiographic study.

PURPOSE: The purpose of this study was to measure the coronal pulp dimensions in primary maxillary and mandibular second molars and to evaluate the influence on restorative procedures on them. METHODS: Included in this study were 80 4-7 year-old male and female patients with occlusal or proximal restorations on primary maxillary or mandibular second molars and with noncarious antimeres. Radiovisiographic images were captured utilizing standard bitewing radiographs via the parallel cone technique. Morphometric analysis was performed using Dexis and AutoCAD 2000 software, and data was analyzed using student's t test (unpaired). RESULTS: A significant difference was found in crown and coronal pulp dimensions in noncarious (sound) primary maxillary and mandibular second molars, even though no significant reductions were found in restored primary second molars. CONCLUSIONS: Crown and coronal pulp dimensions were significantly greater in noncarious primary mandibular second molars than in maxillary second molars. The mesiodistal crown width of maxillary molars was greater in males than in females. Nonsignificant reductions were observed in amalgam restored primary maxillary and mandibular second molars over a period of six months. No significant difference in pulpal dimensions was observed when Class I restorations were compared with Class II restorations in either arch.

Endodontic treatment of primary teeth using combination of antibacterial drugs: an in vivo study.

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate clinical and radiographic success of endodontic treatment of infected primary teeth using combination of ciprofloxacin, metronidazole, and minocycline. MATERIALS AND METHODS: The treatment was performed on selected 60 teeth, which were randomly divided into two groups, viz. Group A and B with 30 teeth in each group. In Group A, only the necrotic coronal pulp was removed, whereas in Group B both necrotic coronal as well as all accessible radicular pulp tissue was extirpated. The orifice of the canal was enlarged in both the groups and was termed as "Medication cavity." The medication cavity was half-filled with antibacterial mix, sealed with glass-ionomer cement and reinforced with composite resin. Resolution of clinical signs and symptoms was evaluated within a month after the treatment. At every subsequent visit, clinical and radiographic evaluation was done once in 6 months for a period of one year. RESULTS: Both the groups showed considerable clinical and radiographic success, but Group B showed greater clinical and radiographic success than Group A.

The effect of water purification systems on fluoride content of drinking water.

OBJECTIVE: The purpose of the present study was to determine the effect of different water purification systems on the fluoride content of drinking water and to compare the efficacy of these water purification systems in reducing the fluoride content. MATERIALS AND METHODS: Five different water purification systems were tested in this study. They were reverse osmosis, distillation, activated carbon, Reviva , and candle filter. The water samples in the study were of two types, viz, borewell water and tap water, these being commonly used by the people of Davangere City, Karnataka. The samples were collected before and after purification, and fluoride analysis was done using fluoride ion-specific electrode. RESULTS: The results showed that the systems based on reverse osmosis, viz, reverse osmosis system and Reviva showed maximum reduction in fluoride levels, the former proving to be more effective than the latter; followed by distillation and the activated carbon system, with the least reduction being brought about by candle filter. The amount of fluoride removed by the purification system varied between the system and from one source of water to the other. INTERPRETATION AND CONCLUSION: Considering the beneficial effects of fluoride on caries prevention; when drinking water is subjected to water purification systems that reduce fluoride significantly below the optimal level, fluoride supplementation may be necessary. The efficacy of systems based on reverse osmosis in reducing the fluoride content of water indicates their potential for use as defluoridation devices.

Evaluation of the clinical behavior of resin modified glass ionomer cement on primary molars: a comparative one-year study.

AIM: The objectives of the present study were to evaluate and compare the clinical behavior of resin modified glass ionomer cement (RMGIC) on primary molars with conventional and modified cavity preparations. METHODS AND MATERIALS: Forty-two children, 5-9 years of age, having bilateral initial occlusal caries on the mandibular primary second molars were selected for the study. A split mouth design was employed where conventional Class I cavities with a 90 degrees cavosurface angle were prepared randomly on primary second molars on one side and modified cavities with a 1 mm straight bevel along the cavosurface margin on the contra-lateral side. These cavities were restored with RMGIC. The restorations were evaluated during subsequent visits, for a period of one year. RESULTS: At the end of one year, 90% of the restorations survived in the conventional cavity group whereas 100% of the restorations survived in the modified cavity group. CONCLUSION: Incorporation of a bevel in Class I cavities increases the survival rate of RMGIC restorations. There was no significant difference in the clinical behavior between the two groups. However, beveling does contribute to long term clinical success of these restorations. CLINICAL SIGNIFICANCE: Incorporation of a straight bevel in conventional cavities will improve the retention of RMGIC by increasing the bonding area and enhancing the desired properties of the material.

A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients.

Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits--screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child's anxiety level in each visit was assessed using a combination of four measures: Venham's picture test, Venham's rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.

Music distraction--its efficacy in management of anxious pediatric dental patients.

Managing the anxiety of pediatric dental patient has long been the purview of dentists over many years. Various techniques have been used with moderate and variant success rates over the last few years. The main aim of this study was to ascertain if music distraction is an effective means of managing anxiety in pediatric dental patients. Forty children aged between 4 and 8 years were selected for the study. The assessment of anxiety was done using Venham's picture test, Venham's anxiety rating scale, pulse rate, and oxygen saturation during different treatment visits. The values were statistically analyzed and it was concluded that audio distraction did decrease the anxiety level in pediatric dental patients, but not to a very significant level.

Triple teeth: case report of an unusual fusion of three teeth.

An unusual case of fusion between primary central incisors, lateral incisors, and a supernumerary tooth is reported. The fusion was at the enamel and cementum only, and the tooth was extracted.

Comparison of shear bond strength of composite, compomer and resin modified glass ionomer in primary and permanent teeth: an in vitro study.

The aim of this study was to determine the difference in shear bond strength between Composite, Compomer and Resin modified glass ionomer cement in primary and permanent teeth. Thirty extracted primary molars and thirty premolars were selected and buccal surfaces of all the teeth were made smooth with the help of 300 grit silicon carbide paper. These specimens were then divided into 6 groups. Restorative materials were placed on the buccal surfaces of respective specimens with the help of acrylic template. All the specimens were subjected to thermocycling and shear bond strength was tested under the Honsfield testing machine and results were recorded in megapascals (MPa). The resultant scores were tabulated and statistically analysed. It was observed that in case of primary teeth resin modified glass ionomer exhibited significantly higher shear bond strength as compared to composite and compomer, where as on permanent teeth composite demonstrated a significantly higher shear bond strength than that of the resin modified glass ionomer and compomer, where as compomer gave poor shear bond strength in both primary and permanent teeth.

The marginal seal of a flowable composite, an injectable resin modified glass ionomer and a compomer in primary molars--an in vitro study.

The present study was carried out to compare the marginal microleakage of some newer materials viz. a flowable composite, an injectable resin modified glass-ionomer and a compomer in Class I cavities of 30 non carious primary molars. After 0.5% basic fuchsin dye penetration and sectioning, the teeth were studied under stereomicroscope. The results obtained revealed that flowable composite showed significantly lower microleakage (p<0.05) as compared to injectable resin-modified glass ionomer and compomer. However, no significant difference was observed when injectable resin modified glass-ionomer cement was compared to compomer. This concludes that flowable composite materials adhere better to the primary teeth than resin modified glass ionomer and compomer.

Applicability of Demirjian's method of age assessment in children of Davangere.

The assessment of age is an important facet in providing information in demographic studies and is of clinical use to diagnose and plan the treatment. The objective of this study was to determine whether the standards of dental maturation given by Demirjian et al are applicable to Davangere children and to assess the relationship between the obtained dental age and skeletal age. The study group comprised of 151 healthy children of 6-15 years age. It was found that Davangere children were dentally more advanced. Demirjians method gave an over estimation of 1.20 +/- 1.02 years and 0.90 +/- 0.87 years in males and females respectively. The obtained dental age was found to be different from the skeletal age. It may be concluded that Demirjians method of dental maturation is not applicable to the children of Davangere.

Laser and visible light cured pit and fissure sealants--comparison of microleakage at enamel-sealant interface: an in vitro study.

The efficacy of Argon laser in comparison with Visible light was assessed by the extent of marginal leakage of three commercially available pit and fissure sealants at enamel sealant interface. Enameloplasty and penetration by Rhodamine dye revealed higher degree of microleakage in Argon laser cured samples. Concise Sealant (3M) showed lesser amount of microleakage in both the curing techniques.

A comparison of oral hygiene status and dental caries in children on long term liquid oral medications to those not administered with such medications.

Young chronically ill children receive a greater sugar load from liquid medications than do healthy children. They receive variety of oral liquid medications that healthy children do not This study was planned to know the levels of oral hygiene and Dental caries in children on long term liquid oral medicines (LOM) and to know out if any difference existed between these and children not on LOM. 51 children on LOM were compared to 54 not on LOM after equalising for age, oral hygiene and diet intake. Highly significant difference was found for dmft and dmfs in 2-6 year age group and dmft+ DMFT for 6-13 years age group, mostly posterior teeth were affected and for this the difference was statistically significant in 2-6 year old children. Percentage of children with dmft>5 significantly increased in 2-6 years old children on LOM, when compared to that of control. Percentage of various grades of lesions (relating to the severity) also increased with an increase in the duration of LOM.

Foreign body in a mandibular permanent molar--a case report.

A thirteen-year-old boy was examined in the Department of Pedodontics during a school-screening programme. On examination the left mandibular first permanent molar was found to be grossly destroyed. On radiographic evaluation a radio opaque screw shaped foreign object was seen in the pulp chamber of the said tooth. Retrieval of the foreign object was tried but the attempt was unsuccessful and an extraction was planned. A case of a unique foreign object in the pulp chamber of the tooth is reported.