Targeting AnxA2-EGFR signaling: hydroxychloroquine as a therapeutic strategy for bleomycin-induced pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a disease that causes progressive failure of lung function, and its molecular mechanism remains poorly understood. However, the AnnexinA2-epidermal growth factor receptor (EGFR) signaling pathway has been identified as playing a significant role in its development. Hydroxychloroquine, a common anti-malarial drug, has been found to inhibit this pathway and slow down the progression of IPF. To better understand the role of the AnxA2-EGFR signaling pathway in pulmonary fibrosis, an in vivo study was conducted. In this study, mice were induced with pulmonary fibrosis using bleomycin, and HCQ was administered intraperitoneally the next day of bleomycin induction. The study also employed nintedanib as a positive control. After the induction, the lungs showed increased levels of fibronectin and vimentin, along with enhanced expression of AnxA2, EGFR, and Gal-3, indicating pulmonary fibrosis. Additionally, the study also found that HCQ significantly inhibited these effects and showed antifibrotic properties similar to nintedanib. Overall, these findings suggest that HCQ can attenuate bleomycin-induced pulmonary fibrosis by inhibiting the AnxA2-EGFR signaling pathway. These results are promising for developing new treatments for IPF.

Catheter-associated Bloodstream Infection in Children with Tunneled Central Venous Catheters: A Single-center Experience.

Background: Tunnelled catheters improve venous access in haematological diseases and malignancies, but are associated with complications. We prospectively analysed the episodes of CABSI and its associated risk factors. Aims: To study the incidence and risk factors for CABSI in children with tunnelled central venous catheters (both Hickmans and Chemoports). Materials and Methods: This is a prospective observational study done at our institute. Children under the age of 18 who underwent insertion of a Hickman or Chemoport from March 2018 to Dec 2022 were enrolled. Episodes of CABSI were noted and its risk factors were analysed. Results: In total, 258 catheters were inserted in 250 children. Age ranged from 1 month to 18 years (median 67 months) with 60% being boys. A total of 152 Hickmans, 106 chemoports were inserted. Indications for insertions were for requirement of BMT and chemotherapy in majority of cases. CABSI were seen in 28.6% of catheters. Younger children (< 4years), Neutropenia (counts < 1000) and use of TPN were significantly associated with CABSI(p value<0.05). Infection was more with externalized catheters (Hickman) than implantable ports (Chemoports) but was not statistical significant(p value>0.05). Almost 30% of catheters with CABSI required removal because of florid sepsis. Others could be salvaged with aggressive antibiotics. Conclusions: CABSI is a serious complications related to tunnelled catheter. Smaller children (<4 years), neutropenia and usage of TPN is a risk factor for development of CABSI. It can be treated with appropriate antibiotics and required removal in almost a third of all the cases.

Transplanting Livers in Young Children - Looking Back at 100 Cases.

Introduction: Despite advances in medical therapy, liver replacement continues to be the only definitive mode of therapy for children with end-stage liver disease (ESLD). However, its acceptance in India has been discouraging more due to financial and logistic reasons than the availability of expertise. This report outlines our journey and highlights issues pertinent to circumstances in an emerging economy like India. Aim: The aim is to review a single center's 100 case experience with liver transplantation (LT). Materials and Methods: A prospective analysis of all children who underwent LT since 2005 at our institute was done. The data were collated from a maintained structured database. Results: Hundred children underwent LT. Sixty-four were boys. Age ranged from 5 to 144 months, with a median of 17 months. The mean weight of the cohort was 7.5 kg (ranging from 3.7 to 31.5 kg), with 60% of our children weighing between 5 and 10 kg. Biliary atresia is the most common indication (57%); others include metabolic disorders, progressive familial intrahepatic cholestasis, and hepatoblastoma. Two patients were for acute liver failure. Ninety-one children underwent live donor LT (mothers being the majority of the donors). None of the donors had any major postoperative complications. Major intraoperative complications include sepsis (39%), vascular complications (17%), biliary leak (11%), and intestinal complications (11%). Early postoperative deaths occurred in 18% of patients with sepsis being most common cause. The mean follow-up was 8.5 years and the overall survival is 70%. The mean survival is time (months) = 176.1. All surviving patients were followed up and had achieved good catch up growth by 3rd and 5th years posttransplant. The long-term sequalae include recurrent intercurrent infections, graft rejection (9%), posttransplant lymphoproliferative disease (5%), and portal vein stenosis (5%). Conclusion: Our experience demonstrates the feasibility of LT in children with ESLD in India. With longer-living grafts, patients often struggle with other issues such as compliance with follow-up, financial issues, recurrent infections, and neurological problems. Close monitoring with regular follow-up of patients helps in early recognition and treatment of late-onset complications, thus helping the overall long-term outcomes.

Redo Surgeries in Anorectal Malformations: A Single-center Experience.

Aims and Objectives: Complications following posterior sagittal anorectoplasty (PSARP) for ARM are well known. In this article, we present our experience of managing five patients who required major redo surgeries for complications resulting from previous attempts to correct ARM. Materials and Methods: We reviewed all patients who underwent major redo surgeries in our hospital for complications from previous repairs for ARM, from June 2013 to June 2019. Data was obtained from hospital records and analysed. Results: Five patients whose ages ranged from 5 months to 14 years were included in the study. Four were boys and 1 was a girl. All patients had undergone PSARP in other hospitals. The presentations were retained distal bowel causing urinary retention and constipation (n=1), pulled through proximal urethra and bladder neck presenting as passage of urine from neo-anus (n=1), retained common channel (of cloaca) causing a 'H' type configuration (n=1), mispositioned neo-anus (n=1) following a primary PSARP and lastly undivided recto-urethral fistula causing fecaluria (n=1). All of them underwent redo repairs by posterior sagittal approach with documented improvement in their symptoms. Two of them required total bowel management to remain clean. Conclusion: All the complications reported here have been described in literature nevertheless, this report will add to the body of experience. Posterior sagittal approach (PSA) has proved to be very successful technique in correcting these complications.

In Vitro Evaluation of Reliability and Validity of International Caries Detection and Assessment System II Coding for Occlusal Caries using Magnification.

Aim: To check the reliability and validity of International Caries Detection and Assessment System (ICDAS) II coding in occlusal caries detection under unaided visual and enhanced visual examination. Materials and methods: This study included 100 extracted premolars and molars. Two examiners independently scored occlusal caries using ICDAS II criteria without magnification and under 6x magnification in the dental operating microscope. The examination was repeated after one month to check the intraexaminer reliability. The examined samples were sectioned and the carious lesions were scored using Ekstrand-Ricketts-Kidd (ERK) histological criteria under 20x magnification in stereomicroscope. The ICDAS II scores given by the examiners were compared with the histological scores. Results: The κ values for interexaminer reproducibility of unaided and enhanced visual examinations were 0.695 and 0.626, respectively (substantial agreement), and 0.984 (almost perfect agreement) for histological examination. Intraexaminer reproducibility for unaided and enhanced visual examinations were 0.835 and 0.910, respectively (almost perfect agreement). Spearman's correlation coefficients of ICDAS II unaided visual and enhanced visual examinations to ERK histological scores were 0.724 and 0.689, respectively, which infers that there is a strong correlation between unaided visual and histological examination and a moderate correlation between enhanced visual and histological examination. For unaided visual examination, specificity is 100% and sensitivity is 92%, whereas for enhanced visual examination, specificity is 50%, and sensitivity is 100%. Conclusion: Unaided visual examination demonstrated good reliability and validity for ICDAS II coding, whereas enhanced visual examination exhibited good reliability but relatively lower validity. Clinical significance: This study reveals that magnification did not have any added benefits in occlusal caries diagnosis using ICDAS II coding compared to unaided visual examination. The use of magnification did not improve the validity and led to a drop in the specificity, which indicates higher chances of false positive results. How to cite this article: SasiRekha G, Chandrasekhar R, Vinay C, et al.In Vitro Evaluation of Reliability and Validity of International Caries Detection and Assessment System II Coding for Occlusal Caries using Magnification. Int J Clin Pediatr Dent 2023;16(S-2):S138-S141.

Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation.

Aim: To evaluate the effectiveness of laser-activated irrigation (LAI) and ultrasonic irrigation (UI) in the removal of calcium hydroxide [Ca(OH)2] and modified triple antibiotic paste (MTAP) from the root canals. Materials and methods: Root canals of freshly extracted human permanent maxillary incisors (n = 80) were prepared. The root canals of half sample (n = 40) were filled with Ca(OH)2 and the other half (n = 40) with MTAP, in which propylene glycol was used as a vehicle. After 14 days, roots were randomly assigned to four groups (n = 20) according to the irrigation technique used-group I [Ca(OH)2 with UI], group II (MTAP with UI), group III [Ca(OH)2 with LAI], group IV (MTAP with LAI). The roots were sectioned, and the intracanal medicament residues were evaluated at 25× magnification under stereomicroscope using 4-grade scoring system. Statistical analysis: One-way analysis of variance (ANOVA) and post hoc Tukey tests were performed. Results: Laser-activated irrigation (LAI) was found to be superior compared to UI. Ca(OH)2 was better removed compared to MTAP with either of the irrigation techniques. A statistically significant difference was found between the Ca(OH)2 with LAI and MTAP with UI groups in all the regions, that is, coronal, middle, and apical thirds. Conclusion: Laser-activated irrigation (LAI) was superior to UI in removing Ca(OH)2 and MTAP. Ca(OH)2 was better removed than MTAP, irrespective of the technique used. However, none of the irrigation techniques could completely remove the intracanal medicament from the root canals. How to cite this article: Swathi P, Uloopi KS, Vinay C, et al. Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation. Int J Clin Pediatr Dent 2023;16(S-1):S1-S5.

Impact of Parenting Style on Child's Behavior and Caries Experience in 3-6-year-old Children: A Cross-sectional Study.

Aim: The aim of the study is to evaluate the impact of parenting style on a child's behavior and caries experience in 3-6-year-old children. Materials and methods: This cross-sectional study included 1,216 parent-child pairs of 3-6-year-old preschool children. Parenting style was determined using Parenting Style and Dimensions Questionnaire (PSDQ). Child behavior was assessed using Frankl's behavior rating scale, and caries experience was recorded using the decayed, extracted and filled deciduous teeth surfaces index. Results: Out of the 1,216 parents, the authoritative parenting style is seen in 70%, authoritarian in 20%, and permissive parenting style in 9.5%. Children with a permissive type of parenting style have shown more negative behavior. Children of authoritative parents had 4.1 times higher odds of exhibiting definitely positive behavior, which is statistically significant (p = 0.004). Children of positive child behavior had 2.4 times higher odds of avoiding caries which is statistically significant (p = 0.0001). Children of authoritarian parents had 1.45 times higher odds of exhibiting caries than children of permissive parents; however, this difference is not statistically significant. Conclusion: Children of authoritative parents demonstrated low caries experience and desirable behavior in the dental office. On the contrary, children of permissive parents exhibited undesirable dental behavior, and children of authoritarian parents had high caries experience. Clinical significance: Twenty-first-century parents are less controlling and are more permissive leading to problematic child behavior in the dental office. Parenting styles have an impact on the effectiveness of behavior management as well as dental treatment. Pediatric dentists should identify different parenting styles and anticipate the child's behavior. This study emphasizes the effect of different parenting styles on a child's behavior and dental caries experience. How to cite this article: Shalini K, Uloopi KS, Vinay C, et al. Impact of Parenting Style on Child's Behavior and Caries Experience in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):276-279.

Evaluation of Dentin Remineralization with Zinc Oxide and Calcium Fluoride Nanoparticles - An In vitro Study.

Background: Partially demineralized dentin is remineralizable when mineral ions are made available in the near vicinity. Nanoparticles (NPs) have wide applications in remineralization process. Zinc promotes remineralization and has a synergistic effect when combined with fluoride. Hence, zinc oxide and calcium fluoride NPs were considered for dentin remineralization. Aim: The aim of this study was to evaluate the remineralizing ability of zinc oxide and calcium fluoride NPs on demineralized dentin individually and in combined form. Settings and Design: This was an in vitro study. Materials and Methods: Forty-eight dentin disks were prepared from the crowns of 12 extracted human molars and were allocated into four groups of 12 each, i.e., Group I - nano zinc oxide (nZnO), Group II - nano calcium fluoride (nCaF2), Group III - combined group (nZnO + nCaF2), and Group IV - artificial saliva (AS, control group). The specimens were demineralized with 37% phosphoric acid and placed in the respective remineralizing solutions for 24 h and 1 month. Calcium (Ca) and phosphorous (P) uptake was measured using energy-dispersive X-ray spectrometry, and structural changes were analyzed using scanning electron microscopy (SEM). Statistical Analysis: One-way analysis of variance, Student's t-test, and post hoc Tukey's test were used for statistical analysis. Results: At 1-month interval, all the groups showed an increase in Ca/P ratio, with highest being the combined group (4.24), followed by nCaF2 (3.30), nZnO (1.71), and AS (1.31) groups, and these differences were statistically significant (P = 0.000). On SEM analysis of dentinal samples at 1 month, depositions were evident in intertubular regions, wherein the highest deposits were observed in the nZnO group, followed by nZnO + nCaF2 and nCaF2 groups. Conclusion: Dentin samples subjected to remineralization with aqueous solutions of nZnO and nCaF2 showed an increase in calcium and phosphorous uptake and also dense granular depositions were evident in intertubular regions of dentin.

A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children.

Aim: The study evaluated the effectiveness of nanosilver fluoride (NSF) in arresting dental caries in 4-8-year-old school children. Materials and methods: The two-arm, parallel-group randomized controlled trial included a total of 148 children aged 4-8 years with active carious lesions. Children were randomly divided into two groups: group I-NSF (n = 74); and group II-water (placebo and n = 74). Baseline data were recorded using the International Caries Detection and Assessment System (ICDAS) II criteria, and the teeth were treated with either of the solutions. Later, the teeth were evaluated by two blinded examiners for the lesion activity using ICDAS II criteria at 1, 3, and 6-month intervals. The obtained data were analyzed using the Chi-squared test for intergroup comparison and Cochran's Q test for intragroup comparison. Cohen's κ test was used to check the interexaminer and intraexaminer variability. Results: Carious teeth treated with NSF have shown 56.3, 59.2, and 62% arrested carious lesions, whereas the placebo group has shown 0, 2.9, and 4.4% arrested lesions at 1, 3, and 6-month intervals, respectively. NSF showed a high statistically significant difference (p < 0.001) in arresting dental caries compared to the control group at all the time intervals. Conclusion: Nanosilver fluoride (NSF) is found to be effective in arresting dental caries without staining carious lesions. Therefore, it can be used to reduce the bacterial load for caries stabilization in the initial phase of the comprehensive treatment protocol for the management of children with active caries lesions. Clinical significance: Most of the decayed teeth in the primary dentition remain untreated either because of inaccessible dental services or the uncooperativeness of children. Hence, there is an absolute need for a cariostatic agent which arrests the progression of caries in a simple and noninvasive manner. The results of this study evidence that NSF effectively arrests dental caries in primary teeth. Hence, this can be a very economical way of arresting caries in the population who don't have access to regular dental treatment. How to cite this article: Devi C, Chandrasekhar R, Vinay C, et al. A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children. Int J Clin Pediatr Dent 2023;16(5):667-670.

Effectiveness of Distraction with Virtual Reality Eyewear in Managing 6-11-year-old Children with Hearing Impairment during Dental Treatment: A Randomized Controlled Trial.

Aim: To assess the effectiveness of distraction with virtual reality (VR) eyewear along with modified tell-show-do (MTSD) on anxiety levels of 6-11-year-old children with hearing impairment (HI) during the noninvasive dental procedure. Materials and methods: The randomized controlled trial included 40 children with HI aged 6-11 years requiring oral prophylaxis. The children were randomly allocated into two groups. Oral prophylaxis was carried out in both groups, where in group I (VR + MTSD, n = 20), distraction with VR eyewear was performed along with MTSD, and in group II (MTSD, n = 20), MTSD alone was used. Pre and postoperative anxiety levels were assessed using facial image scale (FIS) (subjective) and pulse rate (PR) (objective) measures. Paired t-test and unpaired t-test were used to analyze the obtained data. Results: Postoperative (post-op) PR readings in the VR + MTSD group were reduced by 6.95, whereas it was increased in the MTSD group by 8.55, and the difference was statistically significant (p = 0.001). Post-op FIS scores were found to be reduced in the VR + MTSD group by 2.15, whereas it was increased in the MTSD group by 0.10, and the difference was statistically significant (p = 0.033). Conclusion: Distraction using VR eyewear along with MTSD is effective in reducing anxiety levels in 6-11-year-old children with HI during noninvasive dental procedures. Clinical significance: Hearing-impaired children are usually anxious about the unknown and have unmet oral health needs due to communication barriers. This study provides evidence that the distraction using VR eyewear along with MTSD is effective in reducing anxiety levels in children with HI. How to cite this article: Varshitha K, Uloopi KS, Vinay C, et al. Effectiveness of Distraction with Virtual Reality Eyewear in Managing 6-11-year-old Children with Hearing Impairment during Dental Treatment: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(6):820-823.

Black Ovary: Our Experience with Oophoropexy in All Cases of Pediatric Ovarian Torsion and Review of Relevant Literature.

Introduction: Oophorectomy is the treatment of choice in ovarian torsion if after detorsion the ovary looks bluish black. Ovarian preservation is advocated by many studies in the pediatric age group quoting the ability of the ovary to recover despite the appearance after detorsion. Aims: This study aims to review the outcome of salvage surgery (detorsion) in the management of pediatric ovarian torsion. Materials and Methods: This is a retrospective study of girls under 18 years with ovarian torsion treated from January 2016 to June 2021. Data were collated from records and analyzed. Results: Ten girls with ovarian torsion were included (mean age of 11 years). Ultrasonography and Doppler confirmed ovarian torsion in all. Emergency laparoscopy with detorsion was done in all with the mean time lapse from onset to surgery being 35 h. All the ovaries were black initially and persisted to be bluish black after detorsion. All were conserved and fixed to the lateral abdominal wall. In one child with an associated ovarian cyst, the cyst excision was also done. All girls were asymptomatic on follow-up. Ultrasonography at 3-month follow-up showed a normal-sized ovary with good blood flow in 9 out of 10 girls (90% cases). Follicular changes were seen in five girls who had attained puberty. In one girl, the ovary was very small sized and flows were not well visualized. Conclusion: Detorsion and oophoropexy should be the procedure of choice in pediatric patients with ovarian torsion. The gross appearance of the ovary after detorsion should not be the sole determinant for oophorectomy.

Hair Tourniquet of the Uvula.

Hair tourniquet syndrome (HTS) is a condition, where a strand of hair encircles the base of an appendage. We report a rare case of HTS of the uvula and review relevant literature.

Adrenocorticotropic Hormone-Independent Hypercortisolism Managed by Bilateral Retroperitoneoscopic Adrenalectomy: Report of a Case and Review of Literature.

Bilateral adrenalectomy is the reference treatment for Cushing's syndrome related to adrenocorticotropic hormone-independent macronodular adrenal hyperplasia (AIMAH). We report a case of AIMAH managed by sequential retroperitoneoscopic adrenalectomy and review the literature of the same.

Clinical Evaluation of the Retention of Self-adhering Flowable Composite as Fissure Sealant in 6-9-year-old Children: A Randomized Controlled Trial.

Aim: To evaluate the retention rate of self-adhering flowable composite as fissure sealant in comparison with the unfilled resin sealant on first permanent molars of 6-9-year-old children. Materials and methods: A 2-arm, split-mouth randomized controlled trial included 100 children of age 6-9 years with completely erupted mandibular first permanent molars. A total of 200 teeth were randomly divided into two groups, group I: self-adhering flowable composite; group II: unfilled resin sealant. Sealants were placed on the mandibular first permanent molars and the children were recalled at 6, 12, and 18 months intervals to evaluate the retention rate. Chi-square test was used to analyze the data. Results: Self-adhering flowable composite has shown a complete retention rate of 67%, 47%, and 46% at 6, 12, and 18-month intervals, respectively, whereas unfilled resin sealant has shown 41%, 8%, and 5% retention rate at 6, 12, and 18-month intervals, respectively. The difference in the complete sealant retention rates between the groups is found to be statistically highly significant at all the follow-up intervals (p = 0.0004, 0.0001, and 0.0001 at 6, 12, and 18-month intervals, respectively). In both groups, maximum sealant loss occurred between 6 and 12-month intervals. Retention rates were higher at 6 months intervals which were significantly reduced over 18 months intervals. Conclusion: Self-adhering flowable composite has shown a higher retention rate compared to unfilled resin sealant at all the time intervals. The retention rate of both materials decreased with time. However, the loss of sealant was more with unfilled resin sealant. Clinical significance: In pediatric dental practice, the elimination of a step in restorative dentistry protocol makes a big difference as time is a critical factor in obtaining children's cooperation. The use of self-adhering materials eliminates the step of bonding agent application, which simplifies the restorative protocol and makes the clinical practice effective. Therefore, these self-adhering flowable composite resin materials can be considered fissure sealants in routine clinical practice. How to cite this article: Bhuvaneswari P, Vinay C, Uloopi KS, et al. Clinical Evaluation of the Retention of Self-adhering Flowable Composite as Fissure Sealant in 6-9-year-old Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(3):322-326.

Clinical performance of one shade universal composite resin and nanohybrid composite resin as full coronal esthetic restorations in primary maxillary incisors: A randomized controlled trial.

Background: Strip crowns are the first treatment of choice for restoring anterior teeth affected with early childhood caries. However, shade matching of resin composites is still an issue. The broad color matching ability of a recently introduced single shade composite, Omnichroma eliminates the need for shade-matching procedure, reduces composite inventory, and minimizes chair-side time. Aim: The aim is to evaluate the color match, color stability, and retention of one shade universal composite resin, Omnichroma and nanohybrid resin composite, Tetric-N-Ceram. Design: The study design involves split-mouth randomized controlled trial. Methods: The study was conducted on 25 children aged 3-5 years with multi-surface caries lesions in primary maxillary anterior teeth. Teeth were allocated to two groups randomly: Group 1 - One shade universal composite, Omnichroma (n = 25), Group 2 - Nanohybrid composite, Tetric-N-Ceram (n = 25). After caries excavation and tooth preparation, teeth were restored with corresponding materials using strip crowns. Color match at baseline, color stability, and retention after 6- and 12-month follow-up were evaluated using the Modified United States Public Health Services criteria. Analysis: The Mann-Whitney U test and Wilcoxon signed-rank test were used to analyze the data. Results: On comparison of Omnichroma and Tetric-N-Ceram groups, no statistically significant difference was observed in the color match at baseline (P = 0.716) as well as color stability (P = 0.575 at 6 months and 0.990 at 12 months) and retention (P = 0.153 at 6 months and 0.226 at 12 months) at both 6- and 12-month intervals. On intragroup comparison, the difference in the color stability at 6 and 12-month interval was statistically significant (P = 0.001) for both the groups, indicating that the color stability of restorations was better at 6-month interval compared to 12-month interval. In both Omnichroma and Tetric-N-Ceram groups, retention of restorations was better at 6-month interval compared to 12-month interval and this difference was statistically significant (P = 0.025 and 0.014, respectively). Conclusion: The clinical performance of Omnichroma in terms of color match, color stability, and retention was comparable to nanohybrid composite, Tetric-N-Ceram.

Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial.

Aim and objective: To evaluate the clinical efficacy of propolis as pulpotomy medicament in human primary molars. Materials and methods: This randomized controlled trial is a two-arm, parallel group study with blinded outcome assessment. The study included a total of 60 primary molars that require pulpotomy treatment in 4- 8-year old children. Teeth were assigned to two groups randomly: Propolis (Test group); Mineral trioxide aggregate (MTA) (Control group). All the pulpotomized teeth were given stainless steel crowns and the teeth were evaluated clinically and radiographically at 6, 12, and 24 months to grade them as either success or failure. Chi-square test was employed to analyze the data. Results: Success rates of pulpotomy with propolis and MTA were 80% and 93.1% respectively at 24 months of follow-up interval. Propolis has shown success rates of 90% and 80% at 6- and 12-month follow-up, while MTA has shown a consistent success rate of 93.1% at all the follow-up intervals. The difference in success rate between the groups at all the time intervals is statistically nonsignificant. Conclusion: Propolis has demonstrated a clinically acceptable success rate comparable to MTA as pulpotomy medicament in primary teeth. Clinical significance: Biocompatible materials with regenerative potential have drawn the momentum in vital pulp therapy. In this regard, MTA has been emerged as most successful material, but its high cost has limited its use. Hence, there is an absolute need of cost-effective pulpotomy material with regenerative potential. This study provides an evidence that propolis has clinically acceptable success rate as pulpotomy medicament. Considering its low cost and ready availability, it can be recommended as a cost-effective alternative for primary teeth pulpotomy. How to cite this article: RojaRamya KS, Chandrasekhar R, Uloopi KS, et al. Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(S-1):S3-S7.

Evaluation of caries arresting potential of silver diamine fluoride and sodium fluoride varnish in primary molars: A randomized controlled trial.

Background: Caries management in the modern era has shifted away from the traditional surgical method toward a medical paradigm, which often includes fluoride therapy. Fluoride used in various forms has been proven to be effective in dental caries prevention. Silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish are effective in arresting caries in primary molars. Aim: This study aimed to evaluate the effectiveness of 38% SDF and 5% NaF varnish in arresting caries in primary molars. Settings and Design: This study was a split-mouth randomized controlled trial. Materials and Methods: The randomized controlled trial comprised 34 children aged 6-9 years with teeth having caries in both right and left primary molars without pulpal involvement. Teeth were randomly allocated into two groups. In Group 1 (n = 34), 38% SDF + potassium iodide was applied and in Group 2 (n = 34), 5% NaF varnish was applied. The second application was done after 6 months in both groups. Children were recalled at 6- and 12-month intervals and evaluated for caries arrest. Statistical Analysis: Chi-square test was used to analyze the data. Results: Caries arresting potential was found to be higher in the SDF group compared to the NaF varnish group at both 6-month (SDF - 82% and NaF varnish - 45%) and 12-month intervals (SDF - 77% and NaF varnish - 42%) and the difference was found to be statistically significant (P = 0.002 and 0.004, respectively). Conclusion: SDF was more effective in arresting dental caries in primary molars compared to 5% NaF varnish.

A Randomized Controlled Trial for Evaluation of the Effectiveness of Oral Irrigator and Interdental Floss for Plaque Control in Children with Visual Impairment.

Aim: To evaluate the effectiveness of oral irrigator and interdental floss as adjuncts to manual tooth brushing in 8-16 years old children with visual impairment. Materials and methods: A three-arm, parallel-group randomized controlled trial with blinded outcome assessment was carried out with the inclusion of 90 institutionalized children with visual impairment of age 8-16 years. They were equally allocated to three groups: group I: tooth brushing along with interdental flossing, group II: brushing along with a powered oral irrigator, and group III: brushing alone (control). Baseline oral hygiene index-simplified (OHI-S), gingival index (GI), and plaque index (PI) scores were recorded for all the samples and compared with post-intervention scores at 14 and 28 days intervals. Repeated measures of analysis of variance (ANOVA), one-way ANOVA, and post hoc Tukey tests were used for statistical analysis. Results: At 28 days interval, children in group II showed a highly statistically significant reduction in OHI-S (0.46; p = 0.0001), PI (0.16; p = 0.0001), and GI (0.24; p = 0.0001) scores compared to control group. They also showed a significant reduction in OHI-S (0.25; p = 0.018), PI (0.15; p = 0.011), and GI (0.15; p = 0.0001) scores compared to group I. There is no significant reduction in the scores of children of group I compared to control group except for the GI score (0.08; p = 0.02). Conclusion: Oral hygiene maintenance using oral irrigator along with brushing was found to be more effective in visually challenged children. Interdental flossing, along with brushing and brushing alone was found to be less effective. Clinical significance: This study underlines the fact that comprehensive oral hygiene care should include interdental cleaning aids for effective plaque control to prevent dental diseases in children with visual impairment. Since these children have less manual dexterity to perform good oral hygiene practices, electrically driven interdental cleaning aids like oral irrigator may help them to overcome the problem. How to cite this article: Deepika V, Chandrasekhar R, Uloopi KS, et al. A Randomized Controlled Trial for Evaluation of the Effectiveness of Oral Irrigator and Interdental Floss for Plaque Control in Children with Visual Impairment. Int J Clin Pediatr Dent 2022;15(4):389-393.

Association of serum Vitamin D and salivary calcium and phosphorus levels in 3-11-year-old schoolchildren with dental caries.

BACKGROUND: Vitamin D plays an essential role in the formation of healthy teeth, protection against dental caries, and the appropriate secretion of salivary calcium. Salivary calcium and phosphate help in maintaining equilibrium between demineralization and remineralization of teeth. If we know the association between serum Vitamin D and salivary calcium and phosphorus, we may get a clue regarding serum Vitamin D levels which in turn is essential for good oral health. AIM: The aim of this study was to assess the association of serum Vitamin D levels and salivary calcium and phosphorus levels in children with dental caries. SETTINGS AND DESIGN: This was a comparative cross-sectional study. MATERIALS AND METHODS: One hundred children of age 6-11 years, 50 with Decayed, Missing, and Filled Teeth (DMFT) ≥5 (test group) and 50 with DMFT = 0 (control group), were included in the study. Oral examination was carried out and DMFT/deft scores were recorded. Serum 25-hydroxy Vitamin D levels and salivary calcium and phosphorous levels were measured. STATISTICAL ANALYSIS: Independent sample t-test, linear regression analysis, and Pearson correlation test were used for statistical analysis. RESULTS: Children with dental caries have shown lesser mean serum Vitamin D levels (15.37 ± 3.53) than caries-free children (17.26 ± 3.16). Children with decayed teeth have exhibited lower salivary calcium levels (3.92 ± 0.99) than those without caries (4.42 ± 1.37). Conversely, children with dental caries have shown higher mean salivary phosphate levels (6.27 ± 1.74) than caries-free children (5.18 ± 1.47). There is a significant decrease in salivary calcium (P = 0.018) and serum Vitamin D (P = 0.004) with a significant increase in number of decayed teeth. The greater the Vitamin D deficiency, the lesser are the salivary calcium levels observed (P = 0.001). CONCLUSIONS: Children with Vitamin D deficiency have lower salivary calcium levels. Vitamin D deficiency and lower salivary calcium levels can be the potential risk factors for the occurrence of dental caries.