Treatment Predicament for Pediatric Dentist: Gender-wise Comparative Correlation of Biological and Chronological Age in 8-15-year-old Children.

Introduction: The chronological age (CA) of a patient does not always correspond to the events of growth surge; therefore treatment strategies need good knowledge of biological markers. Aim: The aim of the present study was to investigate the relationships between the skeletal age (SA), dental age (DA), and CA along with the stages of calcification of teeth and the cervical vertebral maturity (CVM) stages in Indian subjects. Materials and methods: A sample of 100 pairs preexisting radiographs, both orthopantomogram and lateral cephalogram, of the individuals in the age-group of 8-15 years were procured and were analyzed for the level of dental and skeletal maturity using Demirjian scale and cervical vertebral maturity index, respectively. Results: A high correlation coefficient (r) was found to be 0.839 (p = 0) between chronological and dental age (DA), 0.833 (p = 0) between chronological and skeletal age (SA), and 0.730 (p = 0) between skeletal and DA. Conclusion: The current research showed that the overall correlation between all three ages was found to be high. It was found that the SA assessed by the CVM stages had a high correlation with the CA. Clinical significance: Within the limits of the present study, there exists a high degree of correlation between biological ages and chronological age, but still it is imperative for a correct assessment of biological age of individual patients for quality treatment outcomes. How to cite this article: Gandhi K, Malhotra R, Datta G, et al. Treatment Predicament for Pediatric Dentist: Gender-wise Comparative Correlation of Biological and Chronological Age in 8-15-year-old Children. Int J Clin Pediatr Dent 2022;15(5):569-574.

Comparative Evaluation of Success of Biodentine and Mineral Trioxide Aggregate with Formocresol as Pulpotomy Medicaments in Primary Molars: An In Vivo Study.

AIM: The study was designed to evaluate and compare the success of Biodentine and mineral trioxide aggregate (MTA) in comparison to formocresol as pulpotomy medicaments over 9 months of the follow-up period. MATERIALS AND METHODS: The sample of 60 deciduous molars of patients aged 4-7 years were incorporated in the study. The molars were randomly allocated to the experimental and control groups. Following coronal pulp removal and achieving hemostasis, the radicular pulp was covered with either Biodentine or MTA (experimental groups). In the control group, a cotton pellet soaked with diluted formocresol (one-fifth dilution of Buckley's formocresol) was placed over the radicular pulp for 1 minute. All pulpotomized molars were later restored with stainless steel crowns (SSCs). RESULTS: The achieved clinical success over 9 months of the follow-up period was 100, 95, and 70% with Biodentine, MTA, and formocresol, respectively. The achieved radiographic success over 9 months of the follow-up period was 95, 60, and 25% with Biodentine, MTA, and formocresol, respectively. CONCLUSION: Favorable biological, physical, mechanical, and good manipulation properties of Biodentine show that this material can be used efficiently as a pulpotomy medicament in the clinical practice. HOW TO CITE THIS ARTICLE: Ahuja S, Surabhi K, Gandhi K, et al. Comparative Evaluation of Success of Biodentine and Mineral Trioxide Aggregate with Formocresol as Pulpotomy Medicaments in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(2):167-173.

Phlebotomy for obtaining platelet-rich fibrin autograft in children for pediatric dental procedures: Parental views, understanding, and acceptance.

BACKGROUND: The negative perception of parents toward invasive dental procedures has always created a barrier in delivering successful treatment to pediatric patients. Surprisingly, little is known about the perspective of parents and the impact of demographic and psychological factors guiding their decision. AIM: To evaluate the acceptability of phlebotomy for obtaining platelet-rich fibrin (PRF) to be used in pediatric endodontic procedures among parents of children. DESIGN: A cross-sectional study design was used for the survey. The design involved interviewing the parents of children aged 3 to 14 years, who fulfilled the inclusion criteria and were indicated for regenerative pulp therapy using PRF. MATERIALS AND METHOD: The sample included one hundred and fifty shortlisted parents who were made to answer questionnaires on sociodemographic data and psychological variables. A single pediatric dentist educated the parents individually on the procedure, risks, and benefits of PRF, following which parental consent and views were recorded in the developed performa. RESULTS: Consent of 63.3% was recorded at the end of the study. Parenting pattern and parental dental anxiety were found to have significant correlation with the treatment acceptance. CONCLUSION: It is the responsibility of the pediatric dentist to communicate the treatment strategies in a manner that is acceptable to the parents for which a thorough knowledge about parental factors is necessary. This study helps in identifying such factors and highlights the importance of demonstration aids in parental education and motivation.

Prevalence and Correlation of Dental Caries with its Specific Risk Factors in 5-15-year-old School-going Children in Urban Population of Ghaziabad.

Dental caries is a rapidly emerging oral health problem amid the children with differing prevalence rate in different states of India. The data available from Ghaziabad city regarding dental caries are scarce; therefore, the study was conducted in 5-15-year school-going children in urban population of Ghaziabad. PURPOSE: The objectives of this study were to determine the prevalence of dental caries in school-going children of 5-15-year age groups in urban population of Ghaziabad and to assess and intercorrelate its relationship with the form, frequency and total sugar exposure, socioeconomic status (SES) of family, and fluoride in drinking water. MATERIALS AND METHODS: The study was conducted in 3,000 school-going children aged 5-15 years (divided into three age groups of 5-6, 7-12, and 13-15 years) studying in the government and private schools in the urban area of Ghaziabad city. A specifically designed pro forma was used for recording the personal data; sociodemographic profile; World Health Organization oral health assessment form for dental caries; 24-hour dietary recall to record the form, frequency, and total number of sugar exposure; and SES of the family (Kuppuswamy scale) of children. The concentration of fluoride in collected samples of drinking water was measured by the visual spectrophotometric method test. The results were tabulated and statistically analyzed. RESULTS: The overall caries prevalence in 5-15-year age group was found to be 54.6%. There was a statistical significant difference found when the age-group comparison (p = 0.001), gender-wise comparison (p = 0.001), SES comparison (p = 0.002), the physical form of sugar intake (p = 0.038), frequency of sugar consumption at/between meals (p = 0.001), and total number of sugar exposure during last 24 hours (p = 0.001) were evaluated with caries prevalence. The mean water fluoride level in the surveyed area was found to be 0.48 ppm and was found to be nonsignificantly (p = 0.248) associated with caries prevalence. CONCLUSION: The risk factors, such as age, gender, physical form of sugar, frequency of sugar consumption at and between meal and total number of sugar exposure during the last 24 hours, and SES of parents, were found to be associated with the prevalence of dental caries in school-going children of 5-15-year age group. HOW TO CITE THIS ARTICLE: Kumar D, Gandhi K, Maywad S, et al. Prevalence and Correlation of Dental Caries with its Specific Risk Factors in 5-15-year-old School-going Children in Urban Population of Ghaziabad. Int J Clin Pediatr Dent 2020;13(1):72-78.

A Comparative Evaluation of Efficacy of Electronic Apex Locator, Digital Radiography, and Conventional Radiographic Method for Root Canal Working Length Determination in Primary Teeth: An In Vitro Study.

AIM: Pulpectomy in the primary tooth has unique challenges due to morphological variations in root pattern and physiological root resorption. The electronic apex locator (EAL) is one of the recent methods to determine the estimation of working length without much radiation exposure to the patient as well as the operator. The present study was undertaken for evaluating and comparing the efficacy of EAL, conventional radiography, digital radiography, and actual visual method for the estimation of in the root canal working length (RCL) in extracted primary teeth. MATERIALS AND METHODS: Ninety extracted, single-rooted primary teeth were selected. Working length estimation was done with an EAL, conventional, and digital radiographic method, and compared it with an actual visual method. RESULTS: Accuracy of EAL was observed to be 99.7% followed by digital radiograph (98.1%) and conventional radiograph (96.1%). Both EAL and digital radiographic methods showed a high correlation as compared to conventional. The comparative efficacy of an EAL with a visual method was found to be statistically non-significant (p > 0.005). CONCLUSION: Root canal working length determined through the electronic method was found to be an accurate and effective tool in single-rooted primary teeth and can be indicated for clinical implementation in endodontic treatment of primary teeth. HOW TO CITE THIS ARTICLE: Sahni A, Kapoor R, Gandhi K, et al. A Comparative Evaluation of Efficacy of Electronic Apex Locator, Digital Radiography, and Conventional Radiographic Method for Root Canal Working Length Determination in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(5):523-528.

Comparative evaluation of instrumentation timing and cleaning efficacy in extracted primary molars using manual and NiTi rotary technique - Invitro study.

AIM: To compare the timing of instrumentation and cleaning efficacy between manual K files and NiTi rotary files in extracted primary molars. STUDY DESIGN: in-vitro study was conducted in 90 root canals of extracted primary molars which were subdivided in three groups viz. Control (No instrumentation), Manual (K files), Rotary (ProFiles) with 30 canals in each group. Mesiobuccal (MB) and Mesiolingual (ML) canals of mandibular molars, and MB and Distobuccal (DB) canals of maxillary molars were included in the test group whereas Distal canals in mandibular molars and Palatal canals in maxillary molars were included in the control group. METHOD: Teeth were mounted and canals were injected with India ink to stain the canal walls. Canal preparation was done as per the group. After instrumentation, teeth were demounted, decalcified and cleared to make them transparent for scoring according to the extent of removal of India ink. Timing of instrumentation and cleaning efficacy of canals in coronal, middle and apical thirds were assessed in each sample. RESULTS: Mean timing of instrumentation in rotary group was 3.54 ±â€¯1.14 min and 4.32 ±â€¯1.04 min in manual group. Mean cleaning efficacy scores in manual and rotary groups were 2.03 and 1.66 in coronal third, 1.08 and 1.18 in middle third and 0.67 and 1.08 in apical third respectively. Inter-group comparisons showed no statistically significant difference in cleaning efficacy among test groups in all thirds of root canals. CONCLUSION: NiTi rotary technique has comparable cleaning efficacy, with significantly less timing of instrumentation compared to manual K-files.

A Comparative Study to evaluate Parent's Ability to assess Dental Fear in their 6- to 10-year-old Children using Children's Fear Survey Schedule-Dental Subscale.

AIM: Parental presence often provides unique challenge in dental operatory and is directly related to the quality dental treatment. The present study was done to investigate parent's ability to assess dental anxiety of their 6- to 10-year-old child and to determine how parent's and children's fear assessments correlate with each other. MATERIALS AND METHODS: Prior to dental treatment, 94 child-parent combinations were included to complete Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) questionnaire, and Frankl score was assigned to children during treatment by operator. RESULTS: Mean dental anxiety score reported by the children was 27.74, whereas by their parents was 39.64. There was a poor consistency of parents to predict their child dental fear (p < 0.05). Parents reported higher dental fear for their children. CONCLUSION: Parents assessment of their child's fear may vary in accordance to factors, including their own dental fear. Such input may prevent dentists from establishing an accurate association with the child's patient.How to cite this article: Malhotra R, Gandhi K, Kumar D, Ahuja S, Kapoor R, Sahni A. A Comparative Study to evaluate Parent's Ability to assess Dental Fear in their 6- to 10-year-old Children using Children's Fear Survey Schedule-Dental Subscale. Int J Clin Pediatr Dent 2018;11(3):205-209.

Assessment of the effect of parental presence in dental operatory on the behavior of children aged 4-7 years.

BACKGROUND: Child presents a unique challenge to accept a dental treatment, and such a challenge gets modified by the presence or the absence of a parent in the operatory. Many dentists have reportedly and controversially used parental separation anxiety as a tool to control behavior of an uncooperative child and also to deliver quality dental treatment in young children. But is the parental separation beneficial for dentist to gain child cooperation? AIMS AND OBJECTIVES: The objective is to evaluate the influence of parental presence or absence in the operating room on child's behavior during dental procedure on children of 4 years and above. MATERIALS AND METHODS: The study was carried out on 30 children of 4-7 years of age group, 16 (4-6 years) preschoolers, and 14 (6-7 years) early schoolers. Two consecutive restorative procedures were carried out. On a first visit, parents were present and on a second visit, separation of parents was done. Behavior rating was done by commonly used Frankel's Behavior Rating Scale. RESULTS: Chi-square test was performed for the statistical analysis. There was no significant difference found in the child's behavior by the presence or absence of parents in the perception of dental treatment in the dental operatory. In contrast to that there was a significant increase in cooperative behavior of some children due to other factors influencing the behavior of the child with a Chi-square value = 35.296, P < 0.001. CONCLUSION: Parents can be excluded from the dental operatory to eliminate many behavior-related problems during the course of treatment.

Prevalence of Oral Complications occurring in a Population of Pediatric Cancer Patients receiving Chemotherapy.

Multiagent chemotherapy, radiotherapy, or a combination of both are the contemporary methods of cancer treatment. With medical advancements, though cure rates have increased considerably, focus is now shifted to the potential early and late complications of the same. The aim of this study was to assess the early oral complications in pediatric patients receiving chemotherapy. Sixty-two children with cancer undergoing chemotherapy with the mean age of 7.42 ± 3.6 years were included in the study. The various types of malignancies and oral problems during chemotherapy were recorded in the subjects. The most commonly encountered malignancy was acute lymphoblastic leukemia at 35.5%. Various oral and associated complications like mucosal inflammation with ulcerations, oral pain, xerostomia, and secondary infections were commonly seen, with mucositis being the most commonly observed complication in 58.1% of the subjects undergoing chemotherapy. Clinical importance of timely medical and dental interventions by a multidisciplinary team involving a pediatric dentist at different stages of anticancer treatment is also emphasized to minimize discomfort, increase treatment compliance, and improve the quality of life of pediatric patients. HOW TO CITE THIS ARTICLE: Gandhi K, Datta G, Ahuja S, Saxena T, Datta AG. Prevalence of Oral Complications occurring in a Population of Pediatric Cancer Patients receiving Chemotherapy. Int Int J Clin Pediatr Dent 2017;10(2):166-171.

Formulation and Evaluation of Sol-Gel Drug Delivery System for Intracanal pH Sensitive Controlled Delivery of Chlorhexidine.

INTRODUCTION: Persistence of viable micro-organisms even after thorough chemomechanical debridement has been cited as a major cause for endodontic failure. Chlorhexidine is a drug, which has shown marked efficacy against Enterococcus faecalis and Candida spp., which are mostly accounted for endodontic failure and it has demonstrated high degree of substantivity to dentin by adsorption. Another issue with chlorhexidine and other intracanal medicaments is the excessive or premature peaking of the drug leading to possible side effects. AIM: The objective of this experimental work undertaken was to formulate a pH sensitive sol-gel sustained drug delivery system containing chlorhexidine. MATERIALS AND METHODS: The formulations were prepared using different concentrations of GELRITE® (0.1% and 0.2%) and Chlorhexidine (0.1% and 0.2%). The prepared solutions were evaluated for pharmacological properties like sterility test, viscosity, drug content, drug release characteristics, drug excipient compatible study. RESULTS: The drug excipient compatibility studies showed no interaction between the excipient and the active constituent. The microbial analysis showed good efficacy against the test micro-organisms and Minimum Inhibitory Concentration (MIC) values against Candida albicans (ATCC® 14053™) was observed as 4 µl/ml for both formulation containing 0.1% and 0.2% of GELRITE® Gellan (polymer). Whereas, MIC values against Enterococcus faecalis was observed to be 3.2 µl/ml and 6 µl/ml for formulation containing 0.1% and 0.2% of GELRITE® Gellan (polymer) respectively. CONCLUSION: From the present study, it could be successfully demonstrated that sol-gel formulations can be simple, easy to administer mode of intracanal drug delivery system. Localized pH changes present within the canal can trigger sol-gel conversion thereby releasing the drug in sustained manner with less toxicity and side effects.

Fracture resistance of endodontically treated permanent anterior teeth restored with three different esthetic post systems: An in vitro study.

BACKGROUND: Esthetic coronal reconstruction of fractured anterior teeth is often performed using intra radicular posts. Most of the commonly used commercially esthetic post systems do not exhibit similar physical properties as dentin resulting in failures. AIM: To evaluate and compare the fracture resistance and mode of failure of simulated traumatized permanent central incisors restored with three different post systems including biologic dentin posts. MATERIALS AND METHODS: A total of 40 recently extracted human maxillary central incisors with similar dimensions were decoronated 2 mm above the cemento-enamel junction and endodontically treated. Ten specimens were randomly selected as the Group I - Control group (core built teeth without intraradicular posts). The remaining 30 teeth were equally divided and restored with zirconia (Group II, n = 10), fiber re-inforced composite (FRC) (Group III, n = 10) and biologic dentin posts (Group IV, n = 10) using resin bonded cement and their cores built-up. These samples were embedded in acrylic resin and then secured in a Universal Testing Machine and subjected to fracture resistance testing. The location of failure in the specimens was evaluated using a stereomicroscope. RESULTS: Intergroup comparison revealed that the control group and zirconia post group (522 ± 110 N) demonstrated the least fracture resistance, while dentin post group (721 ± 127 N) the highest. There was no statistically significant difference between fiber post and dentin post groups. Fractures that were repairable were observed in fiber post and dentin post groups, whereas mostly unrestorable, catastrophic fractures were observed in the zirconia post group. CONCLUSION: Teeth restored with the biologic dentin post system demonstrated the highest fracture resistance and repairable fractures, closely followed by FRC post system. The least fracture resistance and most catastrophic fractures were demonstrated by the zirconia post system.