Assessment of Efficacy of Various Bracket Base Retention Qualities on Shear Bond Strength.

Introduction: Numerous manufacturers have improved bracket retention systems as a result of the frequent bond failure that occurs during orthodontic treatment. One of the elements affecting the adhesive's bond strength is the bracket retention mechanism. Objectives: This study's objective was to assess how various bracket base retention characters affected shear bond strength. Materials and Methods: Four distinct base features for brackets were evaluated. The basic design was examined using a scanning electron microscope. On the Universal testing equipment, brackets were glued to human teeth and then released. Results: The findings indicate that the polymer-coated base's overall mean SBS, which had a mean value of 21.64 ± 4.14 MPa, was considerably greater than that of the other brackets (P 0.05). The foil meshpad, photochemically etched base, and laser-structured base had mean SBS values of 15.12 ± 5.75 MPa, 16.86 ± 3.76 MPa, and 19.32 ± 4.23MPa, respectively. Conclusions: Following laser-structured base and photochemically etched base brackets in terms of shear bond strength were polymer-coated base brackets. The shear bond strength was the lowest in the plain foil mesh pads.

Three-Dimensional Assessment of Temporomandibular Joint Morphology and Facial Asymmetry in Individuals with Different Vertical Skeletal Growth Patterns.

The aim of the current study was to investigate, by means of Cone-Beam Computed Tomography (CBCT), condyle−fossa relationship, temporomandibular joint (TMJ) morphology and facial asymmetry in subjects with different vertical skeletal growth patterns. CBCT of 56 patients (112 TMJs) were categorized into three groups according to the mandibular plane angle (MP): Hypodivergent (MP ≤ 23°), Normodivergent (23° < MP < 30°), and Hyperdivergent (MP ≥ 30°). TMJ spaces, width and depth of the condyle and thickness of the fossa were measured. Horizontal and vertical measurements were used to assess facial asymmetry. One-way Analysis of Variance (ANOVA) and post-hoc Turkey tests were computed for the between-groups comparison. Statistical significance was set at p < 0.05. Larger anterior joint space and smaller condylar dimensions (medio-lateral diameter and medio-lateral thickness) were observed in the hyperdivergent group compared to the normodivergent and hypodivergent groups. Right condylar distances to midsagittal plane were significantly larger than left distances in all the three groups. A vertical pattern of growth in healthy individuals seems to be associated with condylar position and dimension, while facial asymmetry values do not differ among different vertical groups.

An In vitro evaluation of effect of implant abutment on human gingival epithelial keratinocytes.

Background: Abutment surfaces are being designed to promote gingival soft tissue attachment and integration. This confirms implant survival for long term by forming a seal around the prosthetics. Objectives: This study was done to compare the biocompatibility of three implant abutments: titanium uncoated, Ti-nitride coated, and modified polyetheretherketone (PEEK) with human gingival keratinocytes. Materials and Methods: The titanium-uncoated, titanium-nitride-coated, and modified PEEK discs (13 mm × 3 mm) were fabricated and compared with uncoated polyester cell culture discs, which were used as controls. These three implant abutments were evaluated for biocompatibility with respect to human gingival keratinocytes for viability, morphology, proliferation, and migration by scanning electron microscopy imaging and scratch wound healing assays. Measurements of roughness show changes between the investigated surfaces. Results: Keratinocytes cultured on all examined surfaces indicated adhesion and attachment. An assay of cell viability showed no substantial variances among the groups. The modified PEEK surface showed greater cell proliferation and migration among the three abutment materials. Conclusion: All three abutment material surface types showed similar epithelial biological responses. However, modified PEEK material showed the highest biocompatibility.

Résumé Contexte: Les surfaces des piliers sont conçues pour favoriser la fixation et l'intégration des tissus mous gingivaux. Cela confirme l'implantation survie à long terme en formant un joint autour des prothèses. Objectifs : Cette étude a été réalisée pour comparer la biocompatibilité de trois Piliers Implantaires : titane non revêtu, revêtu de nitrure de titane et polyétheréthercétone modifié (PEEK) avec des kératinocytes gingivaux humains. Matériaux et Méthodes: les disques PEEK non revêtus de titane, revêtus de nitrure de titane et modifiés (13 mm × 3 mm) ont été fabriqués et comparés à des disques de culture cellulaire en polyester non revêtus, qui ont été utilisés comme témoins. Ces trois piliers implantaires ont été évalués pour biocompatibilité vis-à-vis des kératinocytes gingivaux humains pour la viabilité, la morphologie, la prolifération et la migration par balayage électronique l'imagerie microscopique et les tests de cicatrisation des plaies. Les mesures de rugosité montrent des changements entre les surfaces étudiées. Résultats: Les kératinocytes cultivés sur toutes les surfaces examinées ont indiqué une adhérence et une fixation. Un test de viabilité cellulaire n'a montré aucune écarts entre les groupes. La surface PEEK modifiée a montré une plus grande prolifération et migration cellulaire parmi les trois matériaux de pilier. Conclusion: Les trois types de surfaces de matériaux de pilier ont montré des réponses biologiques épithéliales similaires. Cependant, le matériau PEEK modifié a montré la biocompatibilité la plus élevée. Mots-clés: Biocompatibilité, implant, kératinocytes, prothèses, microscopie électronique à balayage.

Effect of various malocclusion on maximal bite force- a systematic review.

Objective: This systematic review evaluates the variation in molar bite force (MBF) with the type and severity of dental malocclusion in young adults with permanent dentition. Methods: We searched seven electronic databases until December 31, 2021, and identified 1898 articles, of which 22 full-texts were reviewed. Eight clinical studies with subjects having permanent dentition with various dental malocclusions and quantifying maximal bite force were included for the review. Newcastle Ottawa scale was used to assess the risk of bias and GRADE to study the certainty of evidence. Articles were evaluated for the primary outcome (variation of MBF in different malocclusion groups) and confounding factors affecting MBF. Results: All studies measured MBF in individuals with normal and malocclusion, with 2329 subjects having permanent dentition. A positive correlation of Class I normal occlusion with the bite force was seen compared to Class II and III malocclusion. Unilateral crossbite patients had lesser bite force. Six studies with 1023 males and 1175 females showed MBF more in males than females. In 3 studies (332 subjects), no significant difference for MBF between the right and left sides of the jaws was measured. Conclusion: MBF decreases significantly with vertical and transverse craniofacial and dental discrepancy. Normal sagittal occlusion has more molar bite force than patients with different malocclusions. Also, MBF is more in males than females, and it increases with age. Registration: PROSPERO CRD42021249328.

A CBCT assessment of bone density changes after accelerated orthodontic retraction of canine by microosteoperforations.

AIM: The study was conducted to assess the changes in bone density before and after performing accelerated orthodontic maxillary canine retraction by microosteoperforations (MOPs). MATERIALS AND METHODS: Forty patients (120 cone-beam computed tomography [CBCT] images) within the age group of 15 to 25 years undergoing fixed orthodontic treatment with bilateral maxillary first premolar extraction were enrolled in this study. The right and left sides of the maxillary jaw in the same patients were selected as experimental and control sites. To accelerate the tooth movement, MOPs were performed distal to the canine root in the extraction space under local anesthesia with a miniscrew. Thereafter, the maxillary canine retraction was initiated using a NiTi closed coil spring. The CBCT images were taken and evaluated at the following time intervals: 1 week before MOPs(T0);1 week after MOPs(T1);3 weeks after MOPs(T2). RESULTS: A statistically significant reduction in bone density was observed at the center of resistance of canine on the experimental site (after MOPs) at 1 week and 3 weeks (T0-T1 = 0.000,0.115; T1-T2 = 0.0025,0.0117), whereas a statistically non-significant difference was found 1 week before and 3 weeks later in the control group. CONCLUSION: Accelerated orthodontics by MOPscan result in a substantial reduction in bone density during canine retraction, leading to an increase in the tooth movement rate, hence lowering the overall orthodontic treatment time.

Delaying Intraoral Radiographs during the COVID-19 Pandemic: A Conundrum.

BACKGROUND: The COVID-19 pandemic has made dentists very assiduous about cross-infection during dental treatment, thereby delaying dental radiographs for treatment. However, patients needing dental emergency treatment in the ongoing pandemic require relevant intra/extraoral dental radiography for adequate diagnosis and treatment planning. METHODS: This article is aimed at adding to the hot debate: Is delay for intraoral radiographs justified or a possible proxy? As a narrative review, it provides an insight into the reasons for delaying intra-oral dental radiographs during in the pandemic and options of the nontraditional radiographic techniques available until the pandemic subsides. Discussion and Conclusion. Cross-contamination concerns through respiratory droplets grow while using intraoral film holders that stimulate gag reflex, coughing, saliva secretion, and if proper disinfection protocols are not applied. Since the patients' acquiring emergency dental treatment cannot be neglected, the return-to-work guidelines by the health regulatory bodies urge to prioritize extraoral radiographic imaging techniques to curb the infection, offering the best diagnostic efficacy. The dental professionals can consider cone-beam computed tomography (CBCT) scans and sectional dental panoramic radiographs (SDPRs), followed by a risk assessment for COVID-19, a safer modality in reducing cross-contamination and assuring an innocuous environment for both patient and coworkers.

Three-Dimensional Evaluation of Condyle-Glenoid Fossa Complex Following Treatment with Herbst Appliance.

The purpose of the present retrospective observational study was to compare the effects of treatment with Herbst appliance and fixed therapy with elastics on the condyle and glenoid fossa complex. Thirty patients aged between twelve and sixteen years with skeletal Class II malocclusion who met the inclusion criteria were included in the study: fifteen patients treated with Herbst appliance (Group 1), and fifteen patients treated with orthodontic camouflage using MBT prescription (MBTTM Versatile+ Appliance System) (Group 2). For Group 2, patients had CBCT scans taken before treatment either after Herbst appliance removal or at the end of treatment. CBCT scans were evaluated for changes in condyle-glenoid fossa complex using the In Vivo Dental 5.1 software. Statistical significance was set at p ≤ 0.05. On inter-group comparison, the Herbst group showed statistically significant increases in the condylar height of 1.35 mm (p ≤ 0.001) on the right and 1.21 mm (p ≤ 0.01) on the left side, and a condylar volume of 111.03 mm3 (p ≤ 0.01) on the right and 127.80 mm3 (p ≤ 0.001) on the left side. The Herbst group showed anterior remodelling on the postero-superior aspect of glenoid fossa. Herbst appliance treatment induced growth at the condylar head and anterior remodelling of glenoid fossa, thereby improving the maxilla-mandibular relationship in growing skeletal Class II patients.

Comparative Evaluation of Implant Stability, Insertion Torque, and Implant Macrogeometry in Different Bone Densities Using Resonance Frequency Analysis.

AIM AND OBJECTIVE: Evaluation and comparison of insertion torque (IT) and the implant stability of two different implant macrogeometry in different bone densities using resonance frequency analysis. MATERIALS AND METHODS: A total of 48 implants (with two implant types having regular and novel macrogeometry) were classified into 4 groups with 12 samples in each group. Group A regular implant without surface treatment, group B regular implant with surface treating, group C novel implant deprived of surface treating, and group D was new dental implant with surface treatment were used. Implant stability quotient (ISQ), implant IT, removal torque (RT) percentage, and torque reduction percentage were calculated. RESULTS: The mean ± SD ISQ value of bone 1 in group A was 56.7 ± 3.2, in group B was 58.6 ± 2.4, in group C was 57.1 ± 3.5, and in group D was 59.3 ± 2.9. In bone 2, the value was 57.8 ± 1.4, 59.5 ± 1.5, 58.2 ± 2.6, and 59.5 ± 2.4 among A, B, C, and D groups correspondingly. In bone 3, it was 59.4 ± 2.4, 60.3 ± 2.3, 60.4 ± 2.8, and 62.7 ± 2.5 among A, B, C, and D groups correspondingly. In bone 4, it was 67.2 ± 3.4, 69.5 ± 2.7, 68.7 ± 2.4, and 69.4 ± 2.3 among A, B, C, and D groups correspondingly. There was a substantial difference in IT and nonsignificant difference in RT in different groups. CONCLUSION: There was a low IT value with new implant macrogeometry as compared to regular implant macrogeometry. There was absence of association between IT and implant stability. CLINICAL SIGNIFICANCE: Calculation of torque insertion score helps in implant placement. Higher bone density scores produce a higher option of decreasing the initial torque. Low IT of new implant types is useful to reduce failure.

Evaluating the efficacy of desensitizing dentifrices on dentinal hypersensitivity management: A scanning electron microscopic analysis.

INTRODUCTION: Dentin hypersensitivity (DH) adversely affects quality of life by impairing the ability to eat and drink certain foods, therefore, should be addressed promptly with a contingency plan that includes initial treatment with a noninvasive prophylactic home care approach, followed by in-office treatment if desired result is not achieved. AIM: The purpose of this study was to evaluate the effectiveness of four different pastes containing 5% NovaMin (Sensodyne Repair and Protect®), Propolis (Phytoshield Propolis®), 5% potassium nitrate (Sensodyne®), and 8% arginine (Colgate Sensitive Pro Relief®) based toothpastes in the treatment of DH. MATERIALS AND METHODS: One hundred dentin slices were cut from the crown section of molars. Etching with 37% orthophosphoric acid was done to open the tubules. Scanning electron microscope (SEM) study was done to ensure that the tubules are opened. The dentin specimens were divided into four groups: Group 1 -5% NovaMin, Group 2 - Propolis, Group 3 - 5% potassium nitrate, and Group 4 - 8% arginine. Samples were brushed for 2 min twice daily with a soft toothbrush for 15 days and were stored in distilled water. The samples were rinsed under running water to remove the toothpaste. The SEM was performed to check the obliteration of tubules. RESULTS: 5% NovaMin group showed more completely occluded dentinal tubules when compared to other groups. The differences among all the groups were statistically significant (P ≤ 0.05). CONCLUSION: In the present study, all materials, NovaMin, Propolis, potassium nitrate, and arginine, were effective in occluding dentinal tubules but NovaMin appeared most proficient in occluding tubules, followed by arginine, potassium nitrate, and Propolis. Topical NovaMin is an upcoming agent demonstrating desensitization and remineralization properties.

Marginal bone loss around axial and straight implants supported with prefabricated SFI-Bar with mandibular overdentures.

To assess the role of prefabricated SFI-Bar in peri-implant bone loss around immediately axially loaded and straight implants. This study comprised of 40 complete denture wearer patients who received two axially parallel implants connected by SFI-Bars in group I and two 15° mesially tilted implants connected by SFI-Bars in group II. Peri- implant bone loss (PiBL) was measured at 1 year, 2 years and 3 years. The mean PiBL at 1 year in group I was 0.21 mm and I group II was 0.22, at 2 years in group I was 0.26 mm and in group II was 0.23 mm and at 3 years, in group I was 0.29 mm and in group II was 0.34 mm. The difference was significant at 3 years (P< 0.05). The mean mesial PIBL at 1 year in group I was 0.18 mm, in group II was 0.20 mm, at 2 years in group I was 0.19 mm and in group II was 0.07 mm and at 3 years, in group I was 0.25 mm and in group II was 0.29 mm. The difference found to be significant in each time duration in both groups (P< 0.05).The mean distal PIBL at 1 year in group I was 0.23 mm, in group II was 0.22 mm, at 2 years in group I was 0.33 mm and in group II was 0.39 mm and at 3 years, in group I was 0.34 mm and in group II was 0.39 mm. The difference found to be significant at 2 and 3 years in both groups (P< 0.05). Authors found that mandibular overdentures retained with Prefabricated SFI-Bar with axial and straight inserted implants may be useful in patients with reduced bone height.

Evaluation of Remineralizing Capacity of P11-4, CPP-ACP, Silver Diamine Fluoride, and NovaMin: An In Vitro Study.

AIM AND OBJECTIVE: To determine and compare remineralizing efficacy of NovaMin, CPP-ACP, silver diamine fluoride (SDF), and P11-4. MATERIALS AND METHODS: Sixty permanent premolars were divided into four groups with 15 samples in each group; group I: self-assembling peptide (P11-4), group II: SDF, group III: Casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP), and group IV: NovaMin. Mineral content was assessed using a scanning electron microscope at 7, 14, and 21 days after remineralization with each agent. RESULTS: The mean remineralization in group I at 7 days was 1.73 ± 0.02, at 14 days was 1.79 ± 0.01, and at 21 days was 1.90±0.03. Mean remineralization in group II was 1.61 ± 0.01, 1.64 ± 0.02, and 1.73 ± 0.03 at 7, 14, and 21 days, respectively. Mean remineralization in group III was 1.62 ± 0.01, 1.65 ± 0.02, and 1.74 ± 0.05 at 7, 14, and 21 days, respectively. Mean remineralization in group IV was 1.59 ± 0.02, 1.62 ± 0.07, and 1.70 ± 0.09 at 7, 14, and 21 days, respectively. The maximum value was obtained on day 21. There was a significant difference in mean remineralization values between group I vs group II, group I vs group III, and group I vs group IV (p < 0.05). CONCLUSION: Self-assembling peptides showed maximum remineralization in tested specimens followed by CPP-ACP, SDF, and NovaMin-containing toothpaste. CLINICAL SIGNIFICANCE: CPP-ACP, SDF, and NovaMin-containing toothpaste can be indicated for remineralization of initial caries in clinical use.

Auxiliary Aids to Alleviate Pain and Anxiety during Local Anesthesia Administration: A Comparative Study.

INTRODUCTION: In dentistry, pain and anxiety have been the most challenging aspect in the management of a pediatric patient. When every effort to perform local anesthesia (LA) is not successful, the result would be more stressful for both the dentist and the patient. The so-called clichéd paradigm that "pain and dentistry are inseparable" can be resolved by updating the knowledge and skills of the practitioner by using the more advanced techniques in controlling and managing the pain. An array of techniques for administering the LA to improve the comfort level of our patients has been the area of interest. AIM AND OBJECTIVE: To evaluate and compare the efficacy of various adjunctive aids of LA in reducing pain and anxiety in pediatric patients of the 6-8 years age-group. A total of 90 child dental patients were selected and randomly divided into six groups, i.e., control, topical gel, audio, audiovisual, transcutaneous electric nerve stimulation (TENS), and Vibraject group. Physiological parameters, psychological parameters, and pain assessment were recorded. RESULTS: As reflected by the results, the minimum pulse rate "during" and "after" LA administration is seen in A/V (D) and TENS (E) "during" LA administration. Children were less anxious and more relaxed in the audiovisual group and TENS group. Transcutaneous electric nerve stimulation and Vibraject groups showed maximum reduction in pain. CONCLUSION: A/V (D) and TENS (E) groups exhibited the least anxiety. Also, the minimum pain was felt using TENS (E) and Vibraject (F) and hence, may be considered as adjunctive aids in pain reduction during LA administration. HOW TO CITE THIS ARTICLE: Midha V, Midha V, Dua R, et al. Auxiliary Aids to Alleviate Pain and Anxiety during Local Anesthesia Administration: A Comparative Study. Int J Clin Pediatr Dent 2021;14(1):104-108.

Effect of Craniofacial Morphology on Pharyngeal Airway Volume Measured Using Cone-Beam Computed Tomography (CBCT)-A Retrospective Pilot Study.

BACKGROUND: The present study aimed to determine the correlation between pharyngeal airway volume and craniofacial morphology through cone-beam computed tomography (CBCT). Additionally, the study analyzed the influence of gender on pharyngeal airway volume. (2) Methods: 80 CBCT scans of 40 male and 40 female patients (mean age: 15.38 + 1.10 years) fulfilling the eligibility criteria were included. CBCT scans were evaluated for pharyngeal airway volume using the In Vivo Dental 5.1 software. Additionally, CBCT-derived lateral cephalograms were used to assess various craniofacial morphology parameters. To examine the influences of gender on airway volume, T-test was carried out. Correlation between airway volume and craniofacial parameters were measured using Pearson correlation followed by regression analysis. The value of p < 0.05 was considered statistically significant. RESULTS: The mean airway volume was significantly greater in males than in females. A statistically significant negative correlation was found between maxillary plane inclination and pharyngeal airway volume. In contrast, a positive correlation was observed between mandibular length and lower molar inclination with oropharyngeal and total pharyngeal airway volume. Females showed a statistically significant positive correlation between the pharyngeal airway volume and sagittal position of maxilla and mandible; they also showed a negative correlation between oropharyngeal airway volume and the mandibular plane angle. CONCLUSIONS: Overall, the pharyngeal airway space differs significantly between males and females. Craniofacial morphology does have a significant effect on the pharyngeal airway, especially on the oropharyngeal airway volume.

Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns.

BACKGROUND: In growing patients with skeletal discrepancies, early assessment of functional factors can be vital for the restoration of normal craniofacial growth. AIM: To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship, thereby assessing the association between cephalometric variables and airway morphology. METHODS: Cone-beam computed tomography volume scans, and lateral cephalograms, 3-dimensional airway volume and cross-sectional areas of 120 healthy children (54 boys and 66 girls mean age 15.19 ± 1.28) which were done for orthodontic assessment were evaluated. The subjects were divided into 2 groups based on the angle formed between point A, Nasion and point B (ANB) values and cephalometric variables (such as anterior and posterior facial height, gonial angle etc.) airway volumes, and cross-sectional measurements were compared using independent t tests. Pearson's correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables. RESULTS: Means and standard deviations for cephalometric, cross-sectional, and volumetric variables were compared. ANB, mandibular body length and facial convexity were statistically highly significant (P < 0.01) whereas condylion to point A, nasal airway and total airway volume (P < 0.05) were statistically significant. The nasal airway volume and the superior pharyngeal airway volume had a positive correlation (P < 0.01), nasal airway was correlated to middle (P < 0.05) and total airway superior had a relation with middle (P < 0.05), inferior and total airway (P < 0.05), middle was related to all other airways; inferior was also related to all the airways except nasal. Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume (P < 0.05). Additionally, ANB angle was significantly correlated with total airway volume and superior airway (P < 0.05). CONCLUSION: The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.

Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms.

BACKGROUND: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. METHODS: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. RESULTS: When comparing, the plotting of points posterior nasal spine (PNS) (p < 0.05), anterior nasal spine (ANS) (p < 0.01), upper 1 root tip (p < 0.05), lower 1 root tip (p < 0.05), malare (p < 0.05), pyriforme (p < 0.05), porion (p < 0.01), and basion (p < 0.05) was statistically significant. CONCLUSION: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms.

Intra- and Interobserver Reliability of Bone Volume Estimation Using OsiriX Software in Patients with Cleft Lip and Palate Using Cone Beam Computed Tomography.

The objective of the current study was to evaluate intra- and interobserver bone volume measurements and effect of orientation on the reliability of bone volume evaluation in as-acquired vis-à-vis oriented cone beam computed tomography scans using Osirix software and possible correlation between gender, age, and bone volume required. For this, 31 cone beam computed tomography (CBCT) scans of 14 girls and 17 boys (aged 9-13) with unilateral cleft lip and/or palate who met the inclusion criteria were analyzed. Efficacy and reliability of third party software Osirix for bone volume calculation was assessed using as acquired and oriented volumes by three specialists (a radiologist, an orthodontist, and an oral maxillofacial surgeon). The dataset and readings were anonymized to prevent any bias. Two-way mixed model analysis on as-acquired and oriented observations exhibited intra-class coefficient (ICC) values ≥ 0.90. Wilcoxon signed rank test (p = 0.10) and Kruskal-Wallis ANOVA (p = 0.46) indicated that although a clinical difference in volume assessment was seen between as-acquired and oriented observations (inter-observer and intra-observer), it was statistically insignificant. Spearman's bi-variate correlation analysis revealed a significant relation between the type (side) of cleft and bone volume required to fill the defect (p < 0.05). Although there was clinical difference in bone volume measurement by the three observers, it was insignificant statistically. Clefts on the left side in the patients had significantly more bone required than the right side, whereas age and gender had no relation with bone needed to fill the defect. OsiriX software provided good reliability in measurements of bone volume.

Comprehensive management of malocclusion in maxillary fibrous dysplasia: A case report.

BACKGROUND: Fibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla. CASE SUMMARY: A 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion. CONCLUSION: The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.

Dentistry during and after COVID-19 Pandemic: Pediatric Considerations.

This article is a rumination on the outbreak of the dreaded coronavirus disease-2019 (COVID-19) pandemic which has engulfed both the developed and the developing countries, thereby causing widespread global public health concerns and threats to human lives. Although countries have made varied efforts, the pestilence is escalating due to the high infectivity. It is highly likely that dental professionals in upcoming days will come across COVID-19 patients and SARS-CoV-2 carriers, and hence must ensure a tactful handling of such patients to prevent its nosocomial spread. Despite the avalanche of information that has exploded in relation to this rapidly spreading disease, there is a lack of consolidated information to guide dentists regarding clinical management including precautions to take materials to use and postprocedure care, during and after the COVID-19 pandemic. Available sources of information have been analyzed, while relying on peer-reviewed reports followed by information available from the most respected authoritative sources, such as WHO, Centers for Disease Control and Prevention (CDC), and ADA. This review aims to provide a comprehensive summary from the available literature on COVID-19, its insinuation in dentistry, recommendations that have been published, and the actual in-practice implications, so a plan can be formulated and adapted to the circumstances of each dental practice during the pandemic and the times to follow. HOW TO CITE THIS ARTICLE: Kochhar AS, Bhasin R, Kochhar GK, et al . Dentistry during and after COVID-19 Pandemic: Pediatric Considerations. Int J Clin Pediatr Dent 2020;13(4):399-406.