An In Vivo Evaluation of Postoperative Pain after Root Canal Instrumentation Using Manual K-files and Kedo-S Rotary files in Primary Molars.

Aim: To determine postoperative pain after root canal instrumentation using manual K-file and rotary Kedo-S files in primary molars. Material and Method: Thirty-six primary mandibular molars from 4- to 8-year-old children requiring pulpectomy were randomly split into two groups of 18 teeth each, that is, manual file K-file (Group I) and Kedo-S rotary file (Group II). Children's pre- and postoperative pain was assessed using a four-point scale at different time intervals. Results: From the result of the present study, it was observed that the Kedo-S group showed significantly less pain after 24, 48, and 72 h. Conclusion: It was concluded from the present research that patients enrolled in the Kedo-s group experienced less pain.

A Correlation between Clinical Classification of Dental Pulp and Periapical Diseases with its Patho Physiology and Pain Pathway.

Background: Dental pain due to pulpal involvement is difficult to diagnose due to the apparent inaccessibility of pulp to the clinical tests, indistinct symptoms, and referred toothache originating from the periodontal tissues. Though we have various clinical classification systems to categorize pulpal diseases, we are yet biased about the exact pathophysiology and pain pathway associated with it. Dental pulp has a complex physiology, and so is its pathophysiology. Aims & objectives: To concisely reviews the basic understanding of the pathophysiology of pulp, pain pathway, and its correlation with the classification of various clinical conditions of pulpal inflammation and periapical diseases. Methodology: Literature search on pulpal diseases and pathophysiology from the sources: MEDLINE, PubMed, Web of Science and Cochrane Databases dated from 1965 till December 2020 was carried on to collect 163 articles. Results: Filtered search on the pathophysiology of pulp, pain pathway, and classification of various clinical conditions of pulpal inflammation resulted us to precise 36 articles required for our understanding and demystifying the correlation. Conclusion: The emphasis should be laid on understanding the minute changes occurring inside the pulp in due course of inflammation to aid its diagnosis and a treatment plan accordingly. How to cite this article: Samir PV, Mahapatra N, Dutta B, et al. A Correlation between Clinical Classification of Dental Pulp and Periapical Diseases with its Patho Physiology and Pain Pathway. Int J Clin Pediatr Dent 2023;16(4):639-644.

Comparing the Effectiveness of Low-Level Laser Therapy and Topical Steroid Therapy Combination Regimen With Routine Topical Steroid Therapy in the Management of Oral Lichen Planus Symptomatic Patients.

BACKGROUND: For symptomatic oral lichen planus (OLP), a wide range of therapeutic approaches have been suggested. To minimize discomfort and symptoms among individuals with symptomatic OLP, extensive therapy is frequently needed. Therefore, finding a new therapeutic approach that may effectively manage OLP's symptoms and signs while having few adverse effects continues to be a difficult task. Recently, low-level laser therapy (LLLT) has become a popular alternative therapy option for OLP with no serious side effects. AIM: The present research was designed to compare the effectiveness of a combination regimen of LLLT in addition to topical steroids with routine topical steroid therapy separately in order to manage patients with bothersome OLP with an extended period of follow-up. MATERIALS AND METHODS: In our trial, 60 patients were chosen and given sequential numbers as they signed up to take part. The participants were divided randomly into two categories: category A (LLLT plus topical steroids) and category B (only topical steroids). The data were entered into the aforementioned prepared case template after receiving informed consent. The aforementioned prepared case template included the following criteria for evaluating the result of the treatment: pain, recurrence, burning sensation, clinical remission, and size of the lesion. Applying the visual analog scale (VAS), pain, as well as burning sensations, were assessed in both categories. With the aid of the Electronic Digital Vernier Caliper (Mitutoyo, China), these individuals were assessed for the dimension of the lesion. RESULTS: The pain score on day 21 of intervention in category A was 2.5, while it was 4.63 in category B. The difference in findings was significant statistically at day 21 (p = 0.0032). The pain score on day 28 of intervention in category A was 1.3, while it was 3.0 in category B. The difference in findings was significant statistically at day 28 (p = 0.003). The pain score was greater in the control category as compared to the intervention category. The burning sensation score on day 21 of intervention in category A was 2.5, while it was 4.5 in category B. The difference in findings was significant statistically (p = 0.0024). The burning sensation score at the follow-up phase on day 45 of intervention in category A was 1.1, while it was 3.4 in category B. The difference in findings was significant statistically (p = 0.002). CONCLUSION: Newer therapeutic techniques are becoming accessible to oral specialists for controlling oral mucosal disorders as a result of evolving dental trends. The gold standard for treating people with symptomatic OLP continues to be topical corticosteroids. The therapeutic advantages of topical corticosteroids, however, are considerably outweighed by their complementary effect when paired with newer treatment methods like LLLT.

Comparative Evaluation of Adhesive Bond Strength of Conventional GIC and Cention N to Enamel and Dentin of Primary Teeth: An In Vitro Study.

Aim: The aim of this in vitro study was to evaluate and compare the adhesive bond strength of conventional glass ionomer cement (GIC) and Cention N to the primary enamel and dentin using an accelerated fatigue test. Materials and methods: A total of 30 sound human primary molars were collected and were mounted on a metal cylindrical block using acrylic resin, embedding the root up to cemento-enamel junction (CEJ). Proximal box was prepared on both mesial and distal surfaces, one of the cavity was restored with GIC (Type 9) and the other proximal cavity with Cention N. A nonretentive cavity design was followed for both the materials so as to maintain the uniformity between the two specimens were then placed under a universal testing machine (Instron) and subjected to accelerated cyclic loads till a separation fracture occurs at the tooth-restoration interface. The number of endured cycles a particular restoration could withstand before getting fractured was registered. Results: Cention N resisted significantly more number of endured cycles before separation from the cavity as compared to GIC (p < 0.001). Conclusion: Within the limitations of the study, it can be concluded that newly developed material Cention N is preferred alternative over conventional GIC for the restoration of proximal cavities in primary molars. How to cite this article: Dhull KS, Dutta B, Pattnaik S, et al. Comparative Evaluation of Adhesive Bond Strength of Conventional GIC and Cention N to Enamel and Dentin of Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(4):412-416.

Knowledge, Attitude, and Practice of Mothers towards Infant Oral Healthcare.

BACKGROUND: Among all the oral diseases, dental caries is the most common chronic disease affecting the children. Early childhood caries is one of the most severe forms of dental caries affecting the children less than 3 years. Though dental caries is preventable, not much importance has been given to the preventive aspect of dental caries. This is because of the lack of oral health education. Vertical colonization occurs from caregiver usually mother to the child. Since mother play an important role in a child's life, their knowledge about child's oral health will have a significant impact on the child's oral health status. A proper knowledge for the mothers regarding infant's oral health care will be beneficial in reducing the burden of dental caries in children. Hence a study was conducted to evaluate the mother's knowledge, attitude and practice towards infant oral health care. MATERIAL AND METHODS: A cross-sectional study was conducted among a convenient sample of 185 first time mothers with a child aged 9 to 24 months of age visiting Department of Pediatrics and Department of Pedodontics and Preventive Dentistry. Permission to carry out the study was obtained from the Institutional Ethical Board. Data were collected using a structured questionnaire. The questionnaire used in this study was divided into two sections. The first section contained demographic details and the second section contained knowledge about primary teeth and practice of oral health care. All the participants fulfilling the inclusion criteria were enrolled. The purpose of the study and the questionnaire were explained to each participant. The questionnaire was completed and returned before leaving the clinic. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22. RESULTS: Total 52.5% of the mothers responded that first tooth erupt after 6 months. A total of 86.5% of the mothers were not aware of the first dental visit. 77.8% did not agree that caries causing bacteria is transferred from mother to the child; 53% mothers did not agree that night time bottle feeding causes dental caries and 78.4% disagreed that nocturnal breastfeeding can cause dental caries in children. A total of 65.4% mothers feel dental check-up is not necessary when the first tooth erupt, and 95.7% mother did not have any information on infant oral health care. 72.4% of mothers started using toothbrush and paste after all the primary teeth erupted and only 5.9% of the mother had the knowledge about proper dispensing of toothpaste for children. CONCLUSION: Overall knowledge and attitude of mothers towards oral health care of children is poor. Health care professionals like a gynecologist, pediatrician Anganwadi workers who contact first-time mothers need to be trained to disseminate appropriate infant oral health care information. The mother needs to be educated about oral health during their antenatal check upHow to cite this article: Dhull KS, Dutta B, Devraj IM, Samir PV. Knowledge, Attitude, and Practice of Mothers towards Infant Oral Healthcare. Int J Clin Pediatr Dent. 2018;11(5):435-439.

Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study.

INTRODUCTION: Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. AIM: To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution. MATERIALS AND METHODS: A total of 48 nonvital primary teeth were included in this study. After access opening first microbiological sample (s1) was collected by using absorbent paper point introducing into canal. Second microbilogical sample (s2) was taken following chemomechanical preparation and the teeth were divided into four groups: Group I: calcium hydroxide (CH) powder with distilled water; group II: CH with 2% chlorhexidine solution; group III: triple antibiotic powder with distilled water; group IV: triple antibiotic paste with 2% chlorhexidine solution. Then the canals were filled with any one group of the medicament and cavity was temporarily sealed with zinc oxide eugenol. After 1 week, a postmedication sample (s3) was collected. Then the canal was filled with Metapex, restored with glass ionomer cement. CONCLUSION: From the experiments carried out in this study, with the limitations, an inference can be drawn that a combination of antimicrobial agent used as intracanal medicament is definitely better than single agent like Ca(OH)2. HOW TO CITE THIS ARTICLE: Dutta B, Dhull KS, Das D, Samir PV, Verma RK, Singh N. Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(3):267-271.

Assessment of hypoxia, sedation level, and adverse events occurring during inhalation sedation using preadjusted mix of 30% nitrous oxide + 70%oxygen.

PURPOSE: To assess the efficacy of nitrous oxide (N2O)-oxygen (O2) inhalation sedation by rapid induction technique using preadjusted mix of 30% N2O and 70% O2 in children. MATERIALS AND METHODS: Sixty children with a treatment plan which included pulp therapy were recruited for the study. Children categorized 3 and 4 of Frankl behavior rating scale and American Society of Anesthesiologists health status I and II were included for the study. Children were distributed into study group (Group-I) and control group (Group-II) by fishbowl randomization. Children in Group-I were induced inhalation sedation using a preadjusted mix of 30% N2O and 70% O2 through rapid induction technique, and children in Group-II were exposed to inhalation sedation by conventional slow induction technique. Parameters such as least oxygen saturation, sedation levels by Richmond Agitation-Sedation Scale, time taken to achieve ideal sedation, maximum N2O concentrations used, and adverse events were recorded and evaluated for each procedure. Data were analyzed using independent sample t-test and Chi-square tests. RESULTS: Analysis of data showed statistically significant difference between both groups in time taken to achieve ideal sedation (P < 0.001). No significant difference was seen in incidence of hypoxia (P < 0.512), maximum N2O concentrations used (P < 0.118), and occurrence of any adverse events. CONCLUSION: None of the children from both groups exhibited hypoxia. Sense of detachment was seen in one child each from both groups. Rapid induction by preadjusted mix resulted in ideal sedation in 57% children of the Group-I; rest had achieved these levels at 40% N2O. There was a significant difference in the time taken to achieve ideal sedation by rapid induction which was almost half the time taken with slow induction.