Reliability of three pain assessment tools in children requiring dental treatment: A comparative clinical study.

Background: The appropriate intervention of pain is based on its accurate evaluation, which is a challenge in the pediatric population as they often do not have the language development or cognitive sophistication to describe it correctly. Untreated pain has a negative impact on the psychosocial well-being of children. Aim and Objectives: The study aimed to evaluate and compare the reliability of different pain assessment scales, namely, the Wong Baker Facial Pain Rating scale (WBFPS), Modified Emoji Pain Scale (MEPS), and indigenously developed indigenously made GIF Pain Scale (SPGPS) in children undergoing dental treatment under local anesthesia (LA). Materials and Methods: The study included 152 children aged 4-6 years with a Frankl behavior rating of score 3 and 4 (positive and definitely positive) requiring dental treatment under LA. After local infiltration, each child with two independent observers was asked to record the response of the current pain on the WBFPS, MEPS, and SPGPS. The reliability of the pain scales was assessed on the basis of similar responses given by all three individuals. Results: The Pearson correlation test was performed to determine the correlation among the scales. A very strong correlation was found between the WBFPS and SPGPS (r = 0.848), while a moderate correlation was found among the WBFPS and MEPS (r = 0.691). A strong correlation was found between the SPGPS and MEPS (r = 0.723). Conclusion: The SPGPS proved to be a more reliable pain assessment tool compared to the WBFPS and MEPS in clinical pediatric dentistry.

Comparative evaluation of antibacterial efficacy of active oxygen containing versus other dentifrices against Streptococcus mutans count in children with early childhood caries: A clinico-microbiological study.

Background: Fluoridated dentifrices have been used for the prevention of dental caries since ages. However, to avoid the risk of fluorosis, the use of newer nonfluoridated options in dentifrices has shown a great interest in reducing Streptococcus mutans (SM) in early childhood caries (ECC). Aim: The study aimed to evaluate the antimicrobial efficacy of active oxygen (AO)-based dentifrice with amine fluoride (AF)-, sodium monofluorophosphate (SMP)-, herbal (HB)-, and tricalcium phosphate (TCP)-based dentifrices on SM count in children with ECC. Materials and Methods: Two hundred and fifty children aged 3-6 years with def ≥4 were selected and randomly divided into five groups of 50 each, based on the type of dentifrices used; Group I: AO-based, Group II: TCP, Group III: SMP, Group IV: AF, and Group V: HB dentifrice, and were asked to brush twice daily for 15 days. The saliva samples were collected at baseline, and after 15 days, cultured for SM colonies count. Results: Difference in colony-forming units (CFU)/ml between baseline and 15 days was highly significant in all the five groups (P < 0.001). Significant difference was observed in SM count after 15 days between Groups I and IV (P = 0.017), while nonsignificant differences were seen when compared with Groups II, III, and V (P = 0.975, 0.137, and 0.992). Conclusions: All the dentifrices were efficacious in reducing SM count in children with ECC. Although AO dentifrice showed superior results when compared to SMP, TCP, and HB, it did not prove to be superior to AF.

Peripheral cemento-ossifying fibroma - A rare case report.

Peripheral cemento-ossifying fibroma (PCOF) is a relatively rare tumor classified between fibro-osseous lesions. PCOF is an osteogenic neoplasm that ordinarily presents as an epulis-like growth with uncertain pathogenesis. It predominantly affects young adults, with peak prevalence between the first and second decades of life. We present here the case report of a 15-year-old girl, which was previously surgically excised twice and had recurred both the times. The disease duration was 2 years and a follow-up of 1-year was done. Clinical, radiographic, and histological characteristics are discussed with recommendations regarding the treatment is provided.

Efficacy of Root Canal Instrumentation and Fracture Strength Assessment in Primary Molars after Preparing Two Different Shapes of Access Cavity: An Ex Vivo Histological Study.

AIM AND OBJECTIVE: To evaluate the efficacy of root canal instrumentation and fracture strength assessment in primary molars after preparing different shapes of access cavity design. MATERIALS AND METHODS: Sixty extracted primary mandibular molars with at least 2/3rd roots were randomly, equally divided into two groups based on shapes of the access cavities; Group I: Traditional access cavity (TAC), Group II: Conservative access cavity (CAC). Each group was further subdivided into two subgroups with 15 samples each. After, root canal debridement, samples in subgroup 1 were sectioned for histological evaluation of root canal instrumentation efficacy, while subgroup 2 were assessed for fracture strength using a Universal Testing Machine. The data were analyzed statistically using Mann-Whitney and post hoc Tukey tests, with a p value <0.05. RESULTS: Traditional access cavity showed statistically significant root canal debridement efficacy (p < 0.05) compared with CAC. Statistically significant differences were obtained between fracture strength values among the two groups (p < 0.05), with considerably higher fracture strength in the CAC group than TAC. CONCLUSION: Traditional access cavity design resulted in complete root canal debridement but caused weakening of tooth structure due to low fracture strength, necessitating the use of full coverage restoration postendodontic therapy. HOW TO CITE THIS ARTICLE: Singhal Y, Srivastava N, Rana V, et al. Efficacy of Root Canal Instrumentation and Fracture Strength Assessment in Primary Molars after Preparing Two Different Shapes of Access Cavity: An Ex Vivo Histological Study. Int J Clin Pediatr Dent 2021;14(4):518-524.

Comparison of the Conventional Band and Loop Space Maintainers with Modified Space Maintainers: A Split-mouth Randomized Clinical Trial.

AIM AND BACKGROUND: Space maintainers (SMs) are used to preserve space created by premature loss of primary teeth. The most commonly used band and loop (B&L) SMs have several demerits, e.g., non-functional, poor gingival health, limited survival, laboratory work for fabrication and multi-sitting procedure, etc. This study aimed to compare the efficacy of conventional B&L SMs with conventional tube and loop (CTL), bonded tube and loop (BTL) and bonded B&L in terms of gingival health, survival time, and patients' and parents' satisfaction. MATERIALS AND METHODS: Fifteen children between 4 years and 8 years of age with at least two fresh extraction sites of primary molars contra- or bilaterally in each child (total 30 fresh extraction sites) were included in the study. Conventional B&L on one site while bonded loop (BL)/CTL or BTL on the other site were delivered, based on random allocation. An evaluation was done at 1st, 3rd, 6th, and 9th months for survival time, gingival health, and patients'/parents' satisfaction. Results were statistically analyzed using independent t-test and Chi-square test under SPSS version 20.0 software. RESULTS: 100% B&L and CTL while only 60% BL and 80% BTL survived till the end of the study. For gingival health, statistically significant differences were obtained at 1st, 3rd, 6th, and 9th month's intervals (p < 0.05) when CTL was compared with B&L, BL, and BTL. In terms of patients' acceptance, all the SMs were well accepted by the patients. However, on the intergroup comparison, patients' acceptance was higher with bonded SMs. CONCLUSION: Conventional tube and loop SMs were found to be most efficacious in terms of survival time, gingival health, and patients' satisfaction. CLINICAL SIGNIFICANCE: To find a better alternative for the conventional B&L SMs. HOW TO CITE THIS ARTICLE: Tyagi M, Rana V, Srivastava N, et al. Comparison of the Conventional Band and Loop Space Maintainers with Modified Space Maintainers: A Split-mouth Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(S-1):S63-S68.

Effectiveness of different behavior guidance techniques in managing children with negative behavior in a dental setting: A randomized control study.

BACKGROUND: Dental fear is a common cause of uncooperative behavior among young children, which poses a challenge in providing effective dental treatment. With the advancements in technology, several behavior guidance techniques in the form of distraction have emerged over time for managing uncooperative pediatric dental patients. AIM: The aim of this study is to compare and evaluate the effectiveness of four different behavior guidance techniques in managing uncooperative pediatric patients by measuring pre- and post-operative dental fear/anxiety levels using physiological and nonphysiological parameters. METHODOLOGY: Sixty systemically healthy children aged 5-8 years with negative behavior as per Frankl's Rating Scale, requiring restoration were included in the study and randomly divided into four equal groups (n = 15), based on the guidance techniques used: Tell-Show-Do (TSD) as a control group and audio distraction, audiovisual distraction (AVD) (virtual reality [VR]) and Mobile Phone Game Distraction as test groups. Pre- and post-intervention levels of the child's fear/anxiety were assessed using both physiological (blood pressure and pulse rate) and nonphysiological (facial image scale) parameters. The data were evaluated using t-test and one-way ANOVA test. RESULTS: A statistically significant difference was observed in both physiological and non-physiological parameters post-intervention in the groups with a maximum decrease in the AVD (VR) group. CONCLUSIONS: AVD (VR) was found to be the most effective while TSD alone as the least effective behavior guidance technique in reducing dental fear/anxiety in uncooperative pediatric dental patients.

Clinical Evaluation of Restoration of Grossly Carious Primary Teeth Using Biological Approach.

BACKGROUND: To widen the treatment option of primary teeth with mutilated crown tooth structure but having more than two-thirds of root structure were restored by using natural tooth crowns with the help of adhesive materials. AIM AND OBJECTIVE: To restore the grossly decayed primary molars with biological crowns and to evaluate them for longevity, change in color, occlusal wear, marginal integrity, and patient/parent acceptance. MATERIALS AND METHODS: Twenty primary molars from 6 to 10 years old children were restored with biological crowns (extracted/exfoliated tooth crowns) and follow-up was done till 12 months. Data tabulated and results were statistically analyzed using Kaplan-Meier survival analysis. The statistical software SPSS 19.0 was used. RESULTS: 89.47% of biological restorations survived successfully till 12 months follow-up period. No occlusal wear was found in any of the samples, a breach in marginal integrity was seen only in 16.6% of cases, and only 5.5% of biological crowns showed discoloration (darker) at 12 months intervals. 65.00% of patients well accepted the treatment and showed satisfaction while 20.0% of patients remained neutral. Only 15% of patients experienced dissatisfaction at the end of the study. CONCLUSION: Biological restorations proved to be a viable alternative for the restoration of grossly mutilated primary molars. HOW TO CITE THIS ARTICLE: Singh P, Srivastava N, Rana V, et al. Clinical Evaluation of Restoration of Grossly Carious Primary Teeth Using Biological Approach. Int J Clin Pediatr Dent 2020;13(S-1):S55-S63.

Compound Odontome: A Case Report.

INTRODUCTION: Odontomas generally appear as small, solitary, or multiple radio-opaque lesions found on routine radiographic examinations. Traditionally, odontomas have been classified as benign odontogenic tumors and are subdivided into complex or compound odontomas morphologically. Frequently, they interfere with the eruption of the teeth. CASE REPORT: This paper describes the case of a compound odontoma in a 10-year-old boy diagnosed after extraction of the retained right primary mandibular first molar in the radiograph. A surgical excision was performed and the histopathological examination revealed a compound odontome. CONCLUSION: Early diagnosis of odontomas and complete removal ensures better prognosis. HOW TO CITE THIS ARTICLE: Rana V, Srivastava N, et al. Compound Odontome: A Case Report. Int J Clin Pediatr Dent 2019;12(1):64-67.

Cheek Plumper: An Innovative Anti-cheek Biting Appliance.

One of the most challenging tasks for a pediatric dentist is the management of deleterious oral habits which adversely affect the dentofacial complex. However, if these habits can be intercepted and diagnosed well in time, they can save the patient from the psychological impact of undergoing long treatment therapies. One such rare deleterious oral habit is cheek biting that affects the buccal mucosa. Presented here is a case report which describes the interception of this deleterious habit in a 15-year-old female child who was a bilateral cheek biter with the help of an innovative intraoral appliance: The cheek plumper. How to cite this article: Rana V, Srivastava N, Kaushik N, Panthri P. Cheek Plumper: An Innovative Anti-cheek Biting Appliance. Int J Clin Pediatr Dent 2016;9(2):146-148.

Antimicrobial Efficacy of Endodontic Irrigants against Enterococcus Faecalis and Escherichia Coli: An in vitro study.

AIM: To evaluate the relative antimicrobial efficacy of five different commonly used antimicrobial agents with regard to reduction in the number of Enterococcus faecalis and Escherichia coli as compared to normal saline. An agar disk diffusion in vitro method was used to test the efficacy of the root canal irrigants against these two microorganisms. The root canal irrigants used were: 5.25% sodium hypochlorite (NaOCl), 10% citric acid, 17% ethylene diamine tetraacetic acid (EDTA), 3% hydrogen peroxide (H2O2), 0.2% cetrimide and normal saline (as control). MATERIALS AND METHODS: The sample size consisted of 120 agar plates, divided into two groups: groups I and II. Group I consisted of 60 blood agar plates for assessment of E. faecalis and group II consisted of 60 MacConkey agar plates for assessment of E. coli. On each agar plate, 6 circular cellulose nitrate paper disks were placed, on which the inoculum of the respective microorganism was poured with a micropipette. After incubation, these paper disks were removed and put in test tubes containing the particular root canal irrigants, and were vortexed for 60 seconds.The microbial count was then assessed using a microbial colony counter. RESULTS: RESULTS showed that in the group I (E. faecalis), maximum reduction was achieved with cetrimide, followed by NaOCl, H2O2, citric acid and then EDTA. In group II (E. coli), maximum reduction was achieved with NaOCl, followed by cetrimide, H2O2, citric acid and then EDTA. How to cite this article: Kaushik N, Rehani U, Agarwal A, Kaushik M, Adlakha V. Antimicrobial Efficacy of Endodontic Irrigants against Enterococcus Faecalis and Escherichia Coli: An in vitro study. Int J Clin Pediatr Dent 2013;6(2):178-182.

Comparative analysis of the amount of plaque formation and associated gingival inflammation in deciduous, mixed and permanent dentition.

Periodontal diseases in children and adolescents comprise mainly of gingivitis. Gingivitis is an inflammation involving the gingival tissues next to the teeth. Marginal gingivitis is the most common form of periodontal disease and starts in early childhood. However, severe gingivitis is relatively uncommon in children, although a large population has a mild, reversible type of gingivitis. The major etiologic factors associated with gingivitis and more significantly periodontal diseases are uncalcified and calcified bacterial plaque. The gingival tissues in children are different from those in adults. Due to these differences in the structure between the gingival tissues of the child and the adult, even the clinical features and disease manifestations differ according to the age of an individual. It has been observed in earlier studies that children with a deciduous dentition seem to respond to plaque formation with less gingivitis than adults with a permanent dentition. Thus, in this study, the occurrence of gingivitis in response to plaque was studied and compared in the deciduous, mixed and permanent dentitions.