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

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

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

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

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

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

The role of COX-2 and Ki-67 over-expression in the prediction of pathologic response of rectal cancer to neoadjuvant chemoradiation therapy.

BACKGROUND: The response to neoadjuvant chemoradiotherapy (CRT) is not the same among all cases with advanced rectal cancer. AIMS: This study investigated the association between over-expression of the two molecular markers (Cyclooxygenase-2 [COX-2] and Ki-67) and tumor response to neoadjuvant therapy. MATERIALS AND METHODS: In a retrospective cohort study, 55 patients with stage II-III rectal carcinoma were enrolled. All patients were treated with neoadjuvant therapy (45-50.4 Gy plus Capecitabine) between 2002 and 2009 in our institute. The pretreatment specimens were immunohistochemistry (IHC) stained for COX-2 and Ki-67 markers. The tumor response to neoadjuvant treatment was evaluated using a 5-point tumor regression grade (TRG) system. The induced inflammation and necrosis after CRT were also investigated. Statistical analysis was performed using SPSS version 11.5 and statistical significance was determined at P < 0.05. RESULTS: The pathologic response to neoadjuvant treatment from complete response as (TRG = 1) through no response as (TRG = 5) was found in 10 (22.2%), 8 (17%), 6 (13.3%), 16 (35.6%), and 5 (11.1%) cases. In comparison with poor responders (TRG: 4, 5), patients with good response to neoadjuvant treatment (TRG: 1, 2) were associated with lower pretreatment mean COX-2 staining extent (72.9% vs. 22.8%, P < 0.001) as well as lower mean Ki-67 staining extent (70.7% vs. 28.5%, P < 0.001). High COX-2 staining and high Ki-67 index were significantly associated with more inflammation. CONCLUSIONS: Over-expression of COX-2 and high Ki-67 index were associated with a poorer response to neoadjuvant CRT. These markers might be helpful to define those patients with rectal carcinoma who benefit more from neoadjuvant treatments.

Evaluation of probiotic milk on salivary mutans streptococci count: an in vivo microbiological study.

OBJECTIVE: The objective of the present study was to investigate the effect of probiotic Lactobacillus casei Shirota on the values of mutans streptococci counts in saliva. STUDY DESIGN: 31 children were included in this double blinded study. Study design included 4 periods which consisted of a run in period, two intervention periods and a washout period. During the intervention periods children were either given probiotic milk or control milk for 10 days. Pre and post intervention salivary samples were subjected to microbiological evaluation. Then numbers of mutans streptococci were taken by identifying colony morphology. RESULTS: A statistically significant reduction of mutans streptococci colony count was noted in the probiotic group (p=.003). The reduction in children with higher levels of mutans streptococci (105) after intervention was 34% in the probiotic group. CONCLUSION: Daily consumption of milk containing probiotic bacteria can reduce the levels of mutans streptococci and may contribute to the prevention of dental caries.

Anxiety in children during occlusal ART restorations in primary molars placed in school environment and hospital dental setup.

OBJECTIVE: To evaluate the anxiety in children during occlusal atraumatic restorative treatment (ART) in the primary molars of children; and compare the anxiety for ART procedure performed in school environment and in hospital dental setup. STUDY DESIGN: A randomized controlled trial where one dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of occlusal carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Anxiety was evaluated by Modified Venhem score and the heart rate of the children at five fixed moments during dental treatment. RESULTS: At the entrance of the children into the treatment room, statistically significant difference between treatment in school environment and treatment in hospital dental setup for venham score and heart rate could be found (P = 0.023 and P = 0.037 respectively). At the start of the treatment procedure higher venham score and heart rate was observed in children treated in hospital dental setup in comparison with the children treated in school environment, finding was statistically significant (P = 0.011 and P = 0.029 respectively). During all other three points of treatment, the Venham scores of the children treated in school were lower than those of the children treated in hospital dental setup but statistically not significant (P > 0.05). Positive co-relation between Venham scores and Heart rate was established. No statistically significant relation could be established between boys and girls. CONCLUSIONS: Overall anxiety in children for ART treatment was found to be less and the procedure was well accepted irrespective of environment where treatment was performed Hospital dental setup by itself made children anxious during entrance and starting of the treatment when compared to children treated in school environment.

High frequency of microsatellite instability in sporadic colorectal cancer patients in Iran.

Microsatellite instability in sporadic colorectal cancer patients was assessed, and the clinicopathological associations were evaluated in northeastern Iran, which is a high-risk region for gastrointestinal malignancies. Microsatellite instability (MSI) status of tumoral tissue, compared to normal tissue, was assessed with a standard panel of MSI markers on paraffin-embedded surgically resected tissues from 67 consecutive sporadic colorectal cancer patients. Eleven of the patients were under 40 years old. Female patients were significantly younger than male patients (mean age 54.2 vs 62.1 years, P = 0.020). MSI analysis revealed 18 cases of MSI-H (26.9%), 11 MSI-L (16.4%) and 38 MSS (microsatellite stable tumors; 56.7%). While a greater proportion of patients consisted of males, 56.7 vs 43.3% females, MSI-H was more frequent in females (34.5 vs 21.5%). MSI was associated with proximal location of tumor (P = 0.003) and lower stages of tumor (P = 0.002), while MSS tumors were associated with node metastasis. MSI has a higher frequency in sporadic colorectal cancer patients, suggesting that molecular epidemiology of the genetic alterations involved in colorectal cancer carcinogenesis has a different pattern in the Iranian population, which deserves further epidemiological attention. The high frequency of MSI-H in this population suggests that we should look at microsatellite instability prior to chemotherapy to determine the most appropriate chemotherapeutic strategy in our population.

Prosthetic rehabilitation of a preschooler with induced anodontia - A clinical report.

A case of prosthetic rehabilitation with complete dentures for a three year nine months old child is presented. Dental prosthesis are frequently used to avoid psychologic, speech, or swallowing problems in preschooler children. The case was followed up for a period of three years. These prosthesis were modified as the child grew and as the permanent teeth erupted into the oral cavity the dentures were trimmed from the areas of erupting teeth to facilitate their eruption.

Practical problems in use of sugar substitutes in preventive dentistry.

Sugar (sucrose) being most acceptable sweetening agent in use by mankind is considered as the "Arch Criminal" in dental caries initiation. Search for suitable sweetening agent which will satisfy all the characteristics of sugar along with being non-cariogenic is going on since decades. At this given point of time, there is no such substitute which will replace sugar in all aspects, but, cariogenic potential can certainly be reduced by using sugar substitutes. Recently, few sugar substitutes are even considered to have antimicrobial property against caries producing microbes in oral cavity. Although sweetening agents and sugar substitutes are available in market in various forms, how acceptable are they?, what are the public perceptions regarding their use?, and their use in caries prevention are few areas still very much unclear.

Microbiological evaluation of salivary Streptococcus mutans from children of age 5-7 years, pre- and post-atraumatic restorative treatment.

BACKGROUND AND OBJECTIVE: The objective of the study was to monitor Streptococcus mutans (SM) counts in saliva of children aged 5-7 years old over a period of 6 months with the subsequent use of Fuji IX, glass ionomer cement in atraumatic restorative technique (ART). MATERIALS AND METHODS: One hundred children were selected to receive ART using Fuji IX glass ionomer cement. Caries status was recorded using DMFT index (WHO 1997) and revaluated after 6 months using DMFS index (WHO 1979). Saliva was collected for microbiological assessment of SM count on four occasions, baseline, 1 week, 1 month, and 6 months after ART approach. The results of the microbiological tests were statistically analyzed using the non-parametric Mann-Whitney rank test. RESULTS: The results showed a significant reduction of SM levels in saliva immediately 1 week following the ART approach with mean SM counts of 1.5763 (10(6) CFU/ml) and 1.1286 (10(5) CFU/ml) pre- and 1 week post-ART, respectively. Reduction in the SM count was seen in 89.47% of children after 1 week of ART treatment. The mean SM count after 1 month and 6 months post-ART was 1.4814 (10(6) CFU/ml) and 1.4722(10(6) CFU/ml), respectively. CONCLUSION: It was concluded from the results that the ART technique was successful in reducing the SM counts in saliva significantly for a period of 1 week post treatment. Although the mean SM counts remained less than the baseline after 6 month evaluation, a trend toward re-establishment of SM to the baseline count was noticed.

Analysis of Reporting Pattern in Children Aged 7 to 14 Years with Traumatic Injuries to Permanent Teeth.

AIM: To analyze the pattern of traumatic injuries to permanent anterior teeth reporting to the dental department with regards to age, gender, cause, proportion of different types of injury and time of reporting. MATERIALS AND METHODS: Children aged 7 to 14 years with trauma or related sequelae were included. The data was collected retrospectively on the basis of case history, clinical findings, radiographs and vitality tests. Ellis' classification was used to record injuries to anterior teeth. RESULTS: Boys had more injuries with the highest injuries at 12 years. Various causes of trauma included Falls, RTA, hits by object/person and bicycle related. The most common injury reported were cases of Ellis' class IV (50.7%) and the maxillary central incisors being the teeth most frequently involved (75%). The time lapsed after injury was more than 1 year in 42.8% cases and 62% cases reported with complications. CONCLUSION: Our findings suggest that a large number of cases reported in the age group 10 to 13 years with Class IV Ellis' fracture largely when symptoms appear. Reporting was delayed by more than a year in several cases, the barriers for which need to be analyzed, to develop strategies regarding prevention of traumatic injuries and their consequences.

A review of tobacco cessation services for youth in the dental clinic.

Tobacco use is one of the leading preventable causes of illness and death. The most powerful predictor of adult smoking is smoking during adolescence. While general and pediatric dentists have a positive attitude regarding tobacco cessation counseling, the same is not extrapolated into practice. Several barriers to counseling in the dental clinic have been identified and research into some of these has been conducted. Evidence-based cessation programs are still in the nascent stage, but this should not hinder dental professionals from rendering these services to the child and adolescent populations. Brief interventions, self-help materials, and nicotine replacement therapy for established nicotine dependence form the mainstay of therapy. The purpose of this paper is to identify the several barriers encountered in providing cessation and discuss the current status of its implementation in the dental clinic.