Estimation and Association of Total Protein Concentration with Early Childhood Caries in 3-6-year-old Children: A Randomized Clinical Trial.

Background and objective: Caries is a common problem witnessed in children, early childhood caries (ECC) is the most predominant chronic disease which not only leads to distress and pain but also poor quality of life, thus affecting the overall well-being of children. Salivary protein plays a vital part in monitoring health status or disease. It was stated that the salivary proteins could regulate the equilibrium of oral health, preserve a stable ecosystem, and constrain the growth of cariogenic bacteria. Aim: The aim of this study is to estimate the total protein concentration in saliva and its correlation to ECC. Materials and methods: A total of 20 patients with ECC in the age-group of 3-6 years were selected as the experimental group and 20 patients without caries for the control group. Unstimulated saliva samples were collected and subjected to spectrophotometry. The data obtained was subjected to statistical analysis. Independent student's t-test was used for the comparison of mean salivary pH between the caries group and the control group. Mann-Whitney test was used for a comparison of salivary total protein concentrations between the two groups. Results: The mean pH of the carious group showed a statistically significant slightly lower value than that of the noncarious group. On the contrary, the mean total protein concentration of the carious group presented a statistically significant higher value than that of the noncarious group. Age-wise comparison of mean salivary proteins in the carious group and the noncarious group showed an increase in the protein concentration in the children aged 4 years or younger. Conclusion: Based on the results of this study, it can be concluded that there is a strong association between the total protein concentration in saliva and ECC. There exists a significant increase in the total protein concentration in children with ECC. As age increases, total protein concentration decreases with age. Clinical significance: Total protein concentration and particular protein estimation and quantification help us in assessing the risk of caries in children at the earliest and prevention of caries through preventive measures. Estimation of total salivary protein concentration in children can be a marker for ECC in children. How to cite this article: Thimmegowda U, Pai S, Chikkanarasaiah N, et al. Estimation and Association of Total Protein Concentration with Early Childhood Caries in 3-6-year-old Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(1):36-40.

Determination and correlation of matrix metalloproteases profile and total antioxidant capacity in severe early childhood caries children - A randomized clinical trial.

Background and Objective: Matrix metalloproteinases (MMPs) are a multigene family that belongs to the metalloproteinase class of endopeptides, responsible for the remodeling and degeneration of extracellular matrix molecules. MMPs are collectively called Matrixins are known to participate in tooth development and dentin-caries progression. Total antioxidant capacity (TAC) is the measure of the amount of free radicals scavenged by a test solution, being used to evaluate the antioxidant capacity of biological samples. Oxidative stress can affect the initiation and progression of many inflammatory and infectious diseases such as dental caries. Early childhood caries (ECC) is a serious public health problem that adversely affects children's physical and mental health. Aim: The study aims to investigate and correlate the presence of MMPs and TAC in saliva of children with ECC. Materials and Methods: The present study was done on 50 children aged 3-6 years with severe ECC. Unstimulated, whole saliva samples were collected and stored and all 50 samples were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis to determine MMPs and were subjected to spectrometry to assess the TAC of saliva. The samples with the presence of MMPs and increased TAC values were subjected to liquid chromatography-mass spectrometry to check the correlation of MMPs and TAC in ECC. Results: TAC was 0.81 ± 0.14 mmol/l in the caries-active group and 0.15 ± 0.05 mmol/l in the caries-free group and was statistically significant at P < 0.001. MMP level in the caries-active group was 715.75 ± 102.42 µg/ml, whereas, in the caries-free group, it was 250.89 ± 86.51 µg/ml and was statistically significant at P < 0.001. The salivary MMP and TAC levels showed a significant positive moderate correlation with caries scores in the caries-active group and the finding was statistically significant at P < 0.001. Conclusion: From our results, it can be concluded that the both MMPs and TAC levels were high in caries active group than in the caries-free group. The salivary MMPs showed a moderate positive correlation with TAC in the ECC group. In age-wise comparison, the mean MMP levels in the caries active group were higher in children between 3 and 4 years than in 5-6 years. In the caries-free group, the mean MMP level was similar in both the age groups.

Global Developmental Delay in Children with Full Mouth Rehabilitation: A Case Series.

Global developmental delay (GDD) is a chronic neurological disturbance that includes defects in one or more developmental domains. Although some diagnosed delays are benign, certain presentations are more worrisome. The developmental domains can be motor, cognitive, daily activities, speech or language, and social or personal development. The etiology of GDD can be prenatal, perinatal, or postnatal. It can be diagnosed early in childhood as the delay or absence of one or more developmental milestones. Hence the role of pediatric dentists and pediatricians becomes more crucial in identifying this condition. How to cite this article: Thimmegowda U, Chikkanarasaiah N, P A, et al. Global Developmental Delay in Children with Full Mouth Rehabilitation: A Case Series. Int J Clin Pediatr Dent 2023;16(3):522-527.

Identification and Correlation of Streptococcus mutans and Streptococcus sanguinis in Caries-active and Caries-free Children: A PCR Study.

Aim and objectives: Dental caries is currently considered an ecological imbalance within the oral biofilm leading to the dissolution of the tooth's hard tissues. It has been traditionally thought that two species belonging to the Streptococci group, Streptococcus mutans (SM) and Streptococcus sanguinis (SS), are the etiologically responsible for the onset of dental decay. Materials and methods: The present in vivo study was conducted on 40 children with caries-active (CA) and caries-free (CF). They were allocated into two groups, group I (CA) = 20 and group II (CF) = 20. The whole saliva was collected into the vials with buffer solution and was stored in cold storage. Polymerase chain reaction (PCR) was done to identify and correlate SM and SS in CA and CF children. Results: Comparison of mean SM level between CA and CF groups showed a statistically significant result at p = 0.001. Spearman's correlation between caries score and SM showed a strong correlation of 0.77 between caries score and SM, which was statistically significant at p = 0.001. Similarly, SS and caries scores showed a weak correlation of 0.22. Simple linear regression analysis to SM and caries score showed a significant increase of 4.74 units for 1 score increase in caries score, which is statistically significant. Conclusion: The presence of SM levels in children with caries is significant, whereas, in CF children, SS levels are present in increased levels. A strong correlation was seen between caries scores and SM. The simple linear regression analysis predicts a statistically significant increase by 4.74 units per increase of 1 score of caries at p < 0.001. As caries increase, SM count increases, but SS count decreases; as SS count increases, there is a reduction in SM counts. How to cite this article: Thimmegowda U, Belagatta V, Chikkanarasaiah N, et al. Identification and Correlation of Streptococcus mutans and Streptococcus sanguinis in Caries-active and Caries-free Children: A PCR Study. Int J Clin Pediatr Dent 2023;16(1):9-15.

Bilateral Incisiform Superlative Maxillary Permanent Lateral Incisors in a Nonsyndromic Young Girl: A Review and Report of a Case with Comprehensive Management.

Aim and objective: This case report aims to describe the management of a case of non-syndromic bilateral incisiform superlative lateral incisors in a young girl. Background: Supernumerary teeth are an excess number of teeth as compared to the normal dental formula. Supernumerary teeth closely resembling normal tooth shape and morphology are called superlative tooth. Superlative incisiform lateral incisors occurring bilaterally is very rare in the arch. Case description: This paper describes a case of non-syndromic bilateral incisiform superlative lateral incisors in a 16-year-old female patient and its management by pediatric and orthodontic therapy. Conclusion: In this case as both the teeth were equally formed, the tooth which is more out of occlusion and causing discomfort will be extracted under local anesthesia and continued with orthodontic treatment for the correction of crowding. Clinical significance: When superlative teeth are present, they should be investigated and diagnosed properly. Superlative teeth should be managed according to the presenting clinical feature so that further complications can be minimized in the developing dentition. How to cite this article: Thimmegowda U, Nagarajshetty PM, Amrutha B, et al. Bilateral Incisiform Superlative Maxillary Permanent Lateral Incisors in a Nonsyndromic Young Girl: A Review and Report of a Case with Comprehensive Management. Int J Clin Pediatr Dent 2022;15(3):376-379.

Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial.

Aim: The main objective of the present study was to estimate the production of hydrogen peroxide present in saliva and correlate it to early childhood caries using high-performance liquid chromatography [HPLC] method. Design: The study was conducted on children aged 3-6 years with a sample size of 20 who had decayed, missing, or filled teeth in accordance to WHO pro forma and were divided into two groups: Study group: Caries active [CA][n = 10] and Control group caries free [CF] [n = 10]. The whole saliva was collected into the vials with a buffer solution and was stored in cold storage. HPLC was done to estimate, detect, and correlate the amount of production of H2O2 in CA and CF groups. To compare age and gender distribution among two groups, Independent student "t" test was used. To compare the mean production of H2O2 levels between two study groups with a significance of p > 0.05 was done using Mann-Whitney U test. Spearman's correlation was done between caries and H2O2. Results: Comparison of mean H2O2 levels [in ppm] between groups was statistically significant at p = 0.03, which showed as age increases H2O2 production also increases. Age-wise estimation of H2O2 obtained a statistically significant result [p = 0.04]. However, gender-wise comparison of mean H2O2 levels [in ppm] in both the groups showed no difference. Conclusion: Findings in our study strongly suggested that H2O2 levels are more in children without any caries experience. H2O2 production is the same among males and females but according to age, H2O2 production increases as the child grows with age. How to cite this article: Thimmegowda U, Belagatta V, Krishnamurthy NH, et al. Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(S-2):S140-S146.

Knowledge, Attitude and Behavior Regarding the Hazards of Tobacco Use and Cigarette and Other Tobacco Products Act among Parents Visiting Pediatric Dental Clinic: A Cross-sectional Questionnaire Survey.

Aim: "Today's adolescents are tomorrow's citizens." Tobacco use in children and adolescents is reaching pandemic levels as they are the most vulnerable population to initiate tobacco use. It is well established that most of the adult users of tobacco, start the use of tobacco either in their childhood or adolescence. Parents are the best route to reach a child and can help lead to bring better outcomes for children. Hence, the aim of this study is to assess the knowledge, attitude, and behavior regarding the hazards of tobacco use and Cigarette and Other Tobacco Products Act (COTPA) among the parents visiting pediatric dental clinic. Materials and methods: A cross-sectional survey was conducted using a self-administered questionnaire regarding knowledge, attitude, and behavior regarding the hazards of tobacco use and COTPA law. Samples size of 400 parents of adolescents aged between 10 and 16 years visiting to the department of Pediatrics and Preventive Dentistry were included in the study, data thus obtained was subjected to statistical analysis. Results: Smoking tobacco product known to the parent population in the present study is cigarette (88.8%) and smokeless tobacco product is pan masala (65.2%). The tobacco health hazard known is cancer by 70.5 and 85.3% parent populations were aware of mandatory display of pictorial health warnings in COTPA law. Strict implementation of COTPA law was opted by 61.8%. Conclusion: Knowledge, attitude, and behavior of parents is required to educate and motivate adolescents. Parents have given their positive attitude regarding the strict implementation of COTPA law in India and realize the role of tobacco as a causative factor for health hazards both in children and adults. COTPA law should be made aware for both young and old to educate and motivate and to prevent the use of tobacco in India. How to cite this article: Kattimani S, Thimmegowda U, Nagarathna C. Knowledge, Attitude and Behavior Regarding the Hazards of Tobacco Use and Cigarette and Other Tobacco Products Act among Parents Visiting Pediatric Dental Clinic: A Cross-sectional Questionnaire Survey. Int J Clin Pediatr Dent 2022;15(1):47-53.

Knowledge about the Harmful Effects of Environmental Tobacco Smoke, Perceptions toward Initiation of Smoking and Factors Influencing Smoking in Adolescents: A Cross-sectional Study.

Background: The main hope of a nation lies in the proper education of its adolescents because the youths of today are the leaders of tomorrow. About 15% of children of ages 13-15 years are ingesting tobacco in certain forms and are getting addicted to tobacco. Hence, tobacco has become a burden in our society. Similarly, environmental tobacco smoking (ETS) is more dangerous than smoking and is common among young adolescents. Aim: This study is aimed to explore the knowledge about the hazards of ETS and the factors which are responsible for adolescents to initiate tobacco smoking among parents visiting the pediatric dental clinic. Materials and methods: A cross-sectional survey on the knowledge about the harmful effects of ETS and factors influencing the initiation of tobacco use among adolescents was assessed using a self-administered questionnaire. A sample size of 400 parents of adolescents aged between 10 and 16 years visiting the pediatric clinics was included in the study; data thus obtained was subjected to statistical analysis. Results: The effect of ETS in increasing the risk of cancer was known to be 64.4%. But the effect on premature babies was least known by 37% of the parent population, which is statistically significant. About 14% of parents perceive that children initiate smoking to experiment or relax, which is statistically significant. Conclusion: Parents have very little knowledge regarding the effects of ETS on children. They can be counseled regarding types of smoking and smokeless tobacco products, health hazards, the deleterious health effects of ETS, and passive smoking, particularly in children with respiratory diseases. How to cite this article: Thimmegowda U, Kattimani S, Krishnamurthy NH. Knowledge about the Harmful Effects of Environmental Tobacco Smoke, Perceptions toward Initiation of Smoking and Factors Influencing Smoking in Adolescents: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(6):667-671.

Evaluation of Anatomical Variations in Root and Canal Morphology of Primary Maxillary Second Molars: A Cone-beam Computed Tomography Study.

INTRODUCTION: Visualizing the pulp cavity requires adequate knowledge of the size, morphology, and variation of the root canals of primary teeth. The morphology of the root canals in deciduous teeth causes difficulties during endodontic treatment. There have not been many studies on root canal variations in primary teeth in the Indian population. AIM AND OBJECTIVE: To assess the variation in the root and canal morphology of primary maxillary second molars using cone-beam computed tomography (CBCT) in the pediatric Indian population. MATERIALS AND METHODS: The institutional database and private diagnostic centers were used to gather CBCT images of 25 children (50 images) between the age-group of 5 years and 9 years. The CBCT images were rebuilt using Scanora software, and the data were assessed and analyzed using the SPSS version for Windows. RESULTS: Out of 50 primary maxillary second molars, the majority of the second molars had three roots and three canals (Variant I) which account for 66% of teeth. Variant II had three roots and three canals with distobuccal and palatal roots fused in 14% of cases whereas 18% of cases showed three roots and four canals in which mesiobuccal root had two canals (Variant III). The remaining 2% of cases showed four roots with four canals (Variant IV) which were statistically significant. CONCLUSION: We concluded that within the constraints of our study, there was a difference in the root canal configuration of primary maxillary second molars in the investigated group of the Indian population. HOW TO CITE THIS ARTICLE: Krishnamurthy NH, Jose S, Thimmegowda U, et al. Evaluation of Anatomical Variations in Root and Canal Morphology of Primary Maxillary Second Molars: A Cone-beam Computed Tomography Study. Int J Clin Pediatr Dent 2021;14(5):628-632.

Applicability of new proposed novel tooth numbering system for primary teeth: An observational study.

OBJECTIVE: The aim of the present study was to check the reliability and applicability of new proposed tooth numbering system (TNS) for primary teeth that will aid the dentist to overcome the disadvantages of existing TNS and enable to note the primary teeth in an easier and more precise way. STUDY DESIGN: This observational questionnaire survey was conducted in an institution consisting 11 questions in English format. Four hundred samples were randomly selected which included under graduates, postgraduates, and faculty. Self-structured questionnaires were given in order to assess the reliability and applicability of the new proposed TNS. Data obtained were subjected to statistical analysis. Chi-square test was used to compare the responses between different study groups, and P value was set at P < 0.05. RESULTS: According to the participants, the new TNS maintains the anatomical midline, easily readable, written and typed though required extra concentration. It is easy to converse and can be followed by beginners. It does not require extra timing and can be used routinely. With mixed dentition, it does not take more time, but there are chances of confusion or overlap while recording. CONCLUSION: The new Havale's Alphaneumarical Dental Notation system can be used routinely by undergraduates and postgraduates as well as clinicians and can apply or follow the system in regular dental practice.

Identification of Specific Anaerobic Bacteria in Endodontic Infections of Primary Teeth-A PCR Study.

INTRODUCTION: Invasion of microorganisms and their multiplication in root canals (RCs) results in endodontic infections of primary teeth. Acute and chronic inflammation may be present in the periapical area and are based on the amount and virulence of microorganisms, especially anaerobic bacteria present in the RC. To identify microorganisms very precisely in endodontic infections, polymerase chain reaction (PCR) is used. AIM: The aim of the present study is to identify the specific anaerobic bacteria like Porphyromonas gingivalis, Prevotella intermedia, and Actinomyces naeslundii in the RCs of primary teeth using real-time PCR. METHODOLOGY: Fifteen subjects aged 3-8 years who had endodontic infections in primary molars were selected. The cases who had been selected did not receive any endodontic treatment and antibiotics within 3 months, and children with systemic diseases were not included. SAMPLE COLLECTION: Samples were taken by placing absorbent paper points into the largest canals of maxillary and mandibular molars for 60 seconds and are then transferred to a sterile Eppendorf tube with tris-hydochloride EDTA (TE) buffer. The samples were stored at -80°C. All samples were subjected to PCR analysis. RESULT: The specific anaerobes detected in the samples were A. naeslundii (93.3%), Prevotella intermedia (53.3%), and Porphyromonas gingivalis (13.3%). CONCLUSION: The results suggested a high bacterial diversity in the RCs of infected primary teeth. HOW TO CITE THIS ARTICLE: Thimmegowda U, Thomas J, et al. Identification of Specific Anaerobic Bacteria in Endodontic Infections of Primary Teeth-A PCR Study. Int J Clin Pediatr Dent 2019;12(1):1-4.

Applicability of Tanaka Jhonston Method and Prediction of Mesiodistal Width of Canines and Premolars in Children.

INTRODUCTION: Essential part of diagnostic procedures in mixed dentition analysis is to determine adequate space available for the erupting permanent teeth. Various methods of analysis for mixed dentition are available; among them Tanaka Johnston method of space analysis for children was developed for North American children and is widely used. Its reliability among different racial and ethnic groups is yet to be determined. AIM: To check the applicability of Tanaka Jhonston method and to derive the mesiodistal width of unerupted canines and premolars and also derive new regression equations for Bangalore population. MATERIALS AND METHODS: Considering the selection criteria, 400 subjects of Bangalore aged 13-16 years were randomly selected and study models were prepared. Mesiodistal widths of permanent lower incisors, canines and premolars were measured. Estimated width of upper, lower canines and premolars were also derived using Tanaka Jhonston method. Data was utilized to predict mesiodistal widths of erupting permanent canines and premolars. Descriptive analysis, independent student t-test, correlation and regression analysis were carried out. RESULTS: Measured and estimated widths of upper and lower canines and premolars were compared and the results showed that estimated widths of upper and lower canines and premolars over estimated as to the actual measurements. A new regression equation was developed by using the formula Y=a+b(X) where Y= predicted width of canine and premolars, "a" and "b" are the constants and X= lower incisal width. Regression equations for males and females were derived separately. CONCLUSION: The original Tanaka Jhonston method over estimated for local Bangalore population. New regression equations and prediction tables were derived for males and females separately, which should be more conveniently used chairside by the clinician.

Validity of Moyers Mixed Dentition Analysis and a New Proposed Regression Equation as a Predictor of Width of Unerupted Canine and Premolars in Children.

INTRODUCTION: The Moyer's mixed dentition analysis forms an essential part of diagnostic procedures to determine adequacy of the space available for the erupting permanent teeth. However, its reliability among different racial groups has been questioned. OBJECTIVES: The objectives of this study were to test the reliability of Moyer's method and to produce new regression equation for Bangalore population for predicting the mesiodistal diameters of the unerupted permanent canines and premolars. MATERIALS AND METHODS: Data was collected from study models of 400 randomly selected Bangalore subjects aged 13 to 16 years with fully erupted, intact dentitions and no significant malocclusion. The mesiodistal widths of the incisors, canines and premolars of both arches were measured. This data was then utilized to predict the mesiodistal widths of canines and premolars and further compared with Moyer's table. CONCLUSION: It was found that 50% is more applicable to boys and 75% to girls. The canine premolar segment in both arches is statistically larger in men than in women (p<0.05). New regression equation was formulated, the accuracy of which needs to be evaluated further in a larger sample.

A Nonsyndromic Autosomal Dominant Oligodontia with A Novel Mutation of PAX9-A Clinical and Genetic Report.

Oligodontia is congenital absence of one or more teeth which has familial abnormality and attributable to various mutations or polymorphisms of genes often associated with malformative syndromes. The present case reports a rare case of non syndromic oligodontia in an 8-year-old girl with missing 14 permanent teeth excluding third molars in mixed dentition. It is a rare finding which has not been frequently documented in Indian children. Mutations in MSX1 and PAX9 have been described in families in which inherited oligodontia characteristically involves permanent incisors, lateral incisors, premolars and molars. Our study analysed one large family with dominantly inherited oligodontia clinically and genetically. This phonotype is distinct from oligodontia phenotypes associated with mutations in PAX9. Sequencing of the PAX9 revealed a novel mutation in the paired domain of the molecule. The multiple sequence alignment and SNP analysis of the PAX9 exon 2 revealed two mutations.