Transmission of mutans streptococci in mother-child pairs.

BACKGROUND & OBJECTIVES: Dental caries is an infectious, transmissible disease. Maternal transfer of mutans streptococci (MS) has been a subject of research. The aim of this study was to evaluate the transmission of MS from mother to children through genetic analysis. METHODS: Thirty mother-child pairs were included and divided into three groups according to the age of the children. Saliva samples were collected and MS colonies from each mother-child pair were isolated. After inoculation and incubation, MS colonies were submitted to amplification technique by polymerase chain reaction (PCR) for identification and arbitrarily primed PCRs (AP-PCRs) to determine various MS genotypes. RESULTS: From birth to six months of age, 30 per cent of children exhibited MS colonization, and by the age of 30 months, 100 per cent harboured the bacteria (P < 0.001). Factors associated with MS colonization were eruption of teeth (P < 0.001), feeding habits with mean colony count being significantly lower in breast-fed as compared to bottle-fed children (P < 0.001) and a significant association between mean MS count of child and mother's practice of sharing spoon with child (P < 0.001). The AP-PCR fingerprinting profile analysis showed 17 MS groups (clusters) containing identical or highly related isolates in mother-child pairs with a high level of similarity (77.27 %). INTERPRETATION & CONCLUSIONS: The presence of matching MS genotypes suggested vertical transmission from mothers to children. Feeding habits, gum cleaning and number of erupted teeth in children had significant effect on MS colonization. There is a need to develop strategies to present MS colonization in children.

Apexification of anterior teeth: a comparative evaluation of mineral trioxide aggregate and calcium hydroxide paste.

PURPOSE: This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Trioxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors. METHODS: Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups--Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months. RESULTS: The mean time taken for barrier in Group I was 4.50 +/- 1.56 months whereas for Group II was 7.93 +/- 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 +/- 1.49 months whereas the time period for Group II was 6.43 +/- 2.59 months (p value- 0.0067). CONCLUSION: MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.

Comparison of oral ketamine and oral midazolam as sedative agents in pediatric dentistry.

The safe and effective treatment of uncooperative or combative preschool children with extensive dental needs is one of pediatric dentist's ongoing challenges. The traditional methods of behavior management are no longer acceptable to parents as they are not ready to spare more time for dental treatment of their children. Keeping this in mind, the present study was designed and carried out to evaluate the sedative effects of oral ketamine and oral midazolam prior to general anesthesia. Twenty uncooperative children in the age-group of 2-6 years were selected after thorough medical examination and investigations. Informed consent was obtained from the parent. This was a randomized double-blind study. An anesthesiologist administered either 0.5 mg/kg midazolam or 5 mg/kg ketamine orally. The heart rate, respiratory rate, and oxygen saturation were recorded at regular intervals. The sedation and anxiolysis scores were also recorded. The parents were asked to answer a questionnaire at the follow-up session the next day on the surgical experience of the parent and the child and side effects experienced, if any. When the data was subjected to statistical analysis, it was observed that both drugs resulted in adequate sedation at the end of 30 min, with oral midazolam providing significantly better anxiolysis. The heart rate and respiratory rate were marginally higher with oral ketamine. The questionnaire revealed a better response with oral midazolam; side effects were more prominent with oral ketamine.

Comparison of salivary fluoride levels following use of dentifrices containing different concentrations of fluoride.

Many industrialized countries have reported a decline in caries prevalence over the past few decades. These reductions have been related to the regular use of fluoride dentifrices. Fluoride dentifrices are the most cost-effective and efficient means of caries prevention. However, there have been concerns regarding the risk of fluorosis in children due to the ingestion of dentifrices. This has led to the use of dentifrices with low concentration of fluoride. Salivary fluoride levels after tooth-brushing have been shown to be related to the anticaries efficacy of fluoride dentifrices. The present study was designed to evaluate the effect of the concentration of fluoride in the dentifrice, on the salivary fluoride level in children. Twenty children in the age group of five to six years were randomly selected and divided into two groups using, either 500ppm or 1000ppm fluoride dentifrice (sodium monofluorophosphate). Salivary fluoride levels at 0, 15, 30, 45, 60, minutes after brushing were estimated. The data collected was statistically evaluated using the unpaired t-test. The results showed that salivary fluoride levels following use of 500ppm fluoride dentifrice were significantly lower than 1000ppm fluoride dentifrice. The low salivary fluoride levels may thereby reduce the anticaries efficacy. Hence, the pros and cons of recommending a low fluoride concentration dentifrice must be judiciously considered.

Dentigerous cysts of anterior maxilla in a young child: a case report.

Dentigerous cysts are the most common bony lesions of the jaws in children. It is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars; the other teeth that are commonly affected are, in order of frequency, the maxillary canines, the maxillary third molars and, rarely, the central incisor. Radiographically, the cyst appears as ovoid well-demarcated unilocular radiolucency with a sclerotic border. The present case report describes the surgical enucleation of a dentigerous cyst involving the permanent maxillary right central incisor; the surgery was followed by oral rehabilitation. Careful evaluation of the history and the clinical and radiographical findings help clinicians to correctly diagnose the condition, identify the etiological factors, and administer the appropriate treatment.

Loss of permanent mandibular lateral incisor and canine tooth buds through extraoral sinus: report of a case.

Extraoral sinus tract may occur as a result of an inflammatory process associated with the necrotic pulp. Several non odontogenic disorders may also produce an extraoral sinus tract, the differential diagnosis of these clinical findings is of prime importance in providing appropriate clinical care. Presented here is a case report of 4 year old female child with extraoral sinus tract through which the tooth buds of mandibular permanent left lateral incisor and mandibular permanent left canine were lost. The extraoral sinus was due to mandibular left primary canine with class IX fracture (Ellis and Davey's classification).

Management of nasally erupting deciduous canine in operated cleft lip and alveolus patient.

Nasally erupting tooth is a rare finding seen associated with cleft lip and alveolus. It may be diagnosed as a result of symptoms such as difficulty in breathing, pain on sneezing or blowing the nose or may remain asymptomatic. A case of a 4 year old male child operated for bilateral cleft lip and alveolus with unilateral right sided nasally erupting deciduous canine is presented here.

Correlation between dental caries experience and mutans streptococci counts by microbial and molecular (polymerase chain reaction) assay using saliva as microbial risk indicator.

BACKGROUND: The aim of this study was to assess the relationships of quantitative salivary levels of mutans streptococci (MS) in children, aged 3-6 years and 12-15 years, exhibiting variable patterns of caries activity, and to compare the association of MS in saliva using microbial and molecular (polymerase chain reaction [PCR]) assay. MATERIALS AND METHODS: In this cross-sectional observational study, eighty children were included, forty children each in Group I (3-6 years) and Group II (12-15 years). Children were further divided into two subgroups (Group IC, INC and Group IIC, IINC) based on their dental caries status. Saliva samples were collected and plated onto Mitis Salivarius-Bacitracin agar plates. After detection of MS, DNA was isolated and purified, and MS were evaluated using the PCR and AP-PCR. RESULTS: Of the selected 80 children, 42 were male and 38 were female. In Group IC, the mean colony count was 2.27 ± 0.54 × 105 CFU/ml, and in Group INC, the mean colony was found to be 1.61 ± 0.54 × 105 CFU/ml. In Group II, where mean colony count of 3.31 ± 0.85 × 105 CFU/ml and 2.44 ± 0.54 × 105 CFU/ml was observed in Group IIC and Group IINC, respectively. CONCLUSION: The mean colony count increased with increasing age and was also more in children with dental caries. Based on the matrices generated by the PCR analysis using coefficient slipped-strand mispairing, wide range of genetic diversity was seen in cases of children with and without clinically detectable caries.

Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study.

BACKGROUND: To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)2) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. MATERIALS AND METHODS: The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). RESULTS: In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)2 group. CONCLUSION: MTA and Ca(OH)2, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.

Calcium hydroxide and zinc oxide eugenol as root canal filling materials in primary molars: a comparative study.

Calcium hydroxide, a material widely used for the treatment of permanent teeth has not been used frequently for endodontic treatment in primary teeth. A comparative evaluation of calcium hydroxide and zinc oxide eugenol used as root canal filling materials in primary molars is presented.

Epidemiological study of dental caries.

A total of 2000 children (1-14 year age group) attending pediatric OPD, school clinic & well body clinic of Dr. R.N. Cooper Municipal Hospital & K.E.M Hospital, Mumbai were examined for caries prevalence and 35.6% had dental caries. Parental income was not shown to have any bearing on caries prevalence. Parental literacy, particularly maternal literacy was shown to influence caries prevalence in children. The prevalence was low in well-nourished children and in those taking vegetarian type of diet. Frequency of sweet consumption was shown to be associated with prevalence of dental caries. In 1-4 year age group it was noted that bottle fed children were more affected by dental caries. Tooth brush with paste was the commonest method used for cleaning their teeth in all age groups in our study. Caries prevalence was low in those children using tooth brush than in those using tooth powder. Those children who were using neem datun were found to be less affected with dental caries. Dental caries was also found to be low in those who rinsed their mouth with water after food.

Comparative evaluation of calcium hydroxide and zinc oxide eugenol as root canal filling materials for primary molars: a clinical and radiographic study.

Calcium hydroxide, a material widely used for the treatment of permanent teeth has not been used frequently for pulpectomy in primary teeth. A comparative evaluation of calcium hydroxide and zinc oxide eugenol used as root canal filling materials in primary molars is presented.

Comparative study of oral health status of mentally sub-normal, physically handicapped, juvenile delinquents and normal children of Bombay.

Prevalence study on dental caries and periodontal disease carried out in 94 mentally subnormal, 92 physically handicapped, 74 juvenile delinquents and 206 normal children (11-14-year-old) revealed high prevalence of periodontal disease in handicapped (95 to 100%) and low in normal children (54.37%). The point prevalence of dental caries was higher in normal children (84.9%, DMFS 6.19) followed by juvenile delinquents (75.67%, DMFS 4.3), physically handicapped (73.91%, DMFS 4.3) and mentally subnormal (64.9%, DMFS 4.48).

Comparative evaluation of Midazolam and Propofol as intravenous sedative agents in the management of unco-operative children.

Dental treatment of very young children (toddlers) as well as children with highly negative behaviour is known to be difficult. Management of these children requires special skill and at times the support of pharmacological means. A study was planned and carried out to evaluate and compare the efficacy and safety of Propofol and Midazolam as Intravenous sedative agents in the management of uncooperative children belonging to age group 2-5 years, ASA I Category and Frankl's behaviour rating 1 and 2. The results showed both agents to be effective sedative agents, for short pedodontic procedures with minimal side effects.

Effect of a specially formulated remineralizing solution on the remineralizing capacity of saliva.

The present study was carried out to assess whether the remineralization of artificial caries like lesion by artificial saliva can be improved by daily 5 minute treatment in a specially formulated remineralizing solution containing Ca, P, Zn, Sr, F. Extracted human premolars were dipped for 24 hours in artificial saliva and subsequently daily for 5 minutes in the remineralizing solution for 3 weeks. Lesions were assessed using transverse microradiography, electron probe microanalysis (EPMA) and scanning electron microscope (SEM). The results showed that remineralization by specially formulated solutions repair the enamel lesion and enhances the salivary remineralizing potential.

The effect of carbon dioxide laser on acid resistance of human tooth enamel: an evaluation by wet chemical analysis and scanning electron microscopy.

The use of the laser in improving acid resistance of tooth enamel has captured the imagination of most researchers. Man's susceptibility to dental caries presents itself as one of the most complicated problems to solve. The carbon dioxide laser at a wavelength of 10.6 microns is highly efficient for dental purposes as this wavelength is close to optimum absorption of dental enamel. A study was carried out using a pulsed carbon dioxide laser to find the effects of laser beam on human tooth enamel in an energy range of 2-20 J/cm2 at a pulse rate of 5 Hz. The effective resistance to acid was determined by wet chemical analysis whereas superficial changes seen on the surface were determined using the scanning electron microscope.

Fluoride profiles of enamel following topical application of neutral and acidulated NaF solution using x-ray photoelectron spectroscopy (ESCA)--an in vitro study.

An in vitro analysis of fluoride in the surface enamel using x-ray photo-electron spectroscopy carried out on sound untreated teeth, sound teeth treated with neutral NaF and acidulated NaF and teeth with artificial caries treated with NaF and acidulated NaF revealed Ca/F ratio at surface and 360 degrees A as 0.140:1 and 0.140:1; 0.636:1 and 0.192:1; 1.112:1 and 0.908:1. 1.2:1 and 1.289:1; 2.11:1 and 1.87:1 respectively.

Dental caries and oral hygiene amongst 12-14 years old handicapped children of Bombay, India.

The present study was carried out to assess the oral health status of children suffering from different handicapping conditions studying in various schools of Bombay. A total of 593 handicapped children in the age group of 12-14 years were included in the study. The prevalence and severity of dental caries was found to be highest in the cerebral palsy group and lowest in the blind group. In general, in all the groups the decayed (D) component took predominance over the missing (M) and filled (F) components. Periodontal status was assessed using the CPITN and it was found that the bleeding & calculus components were higher than the healthy components in all the groups and almost all the children required treatment in the form of deep scaling and/or prophylaxis and oral hygiene instructions. The study confirmed the need of curative and preventive services towards these neglected children of the society.

The comparative evaluation of release profiles of aluminium, fluoride, sodium and strontium by resin modified and conventional glass polyalkenoate cements in neutral and acidic medium--an in vitro study.

The present study was carried out to evaluate the Al, F, Na and Sr release profiles of conventional and resin modified glass polyalkenoate cements in neutral (deionized water) and acidic medium (lactic acid). Twelve pellets of each material were prepared under standardised conditions and were immersed in their respective solutions for a study period of 90 days. Fluoride analysis was carried out by Orion Electrode and the other elemental analysis were done by Atomic Absorption Spectrophotometer. Statistical analysis revealed no significant difference in the Al, F and Na release profiles between the two materials in both neutral and acidic media.

Etching of young permanent teeth with acid gel--a comparison between the effect of 15 seconds & 60 seconds of etching.

The purpose of present study was to compare the effect of 15 seconds & 60 seconds of etching of young permanent teeth in vitro with 50% phosphoric acid gel using scanning electron microscope. 25 pairs of enamel surfaces selected for the study were divided into 3 experimental groups. The control group consisted of unetched enamel surfaces. In Group II, the effect of 50% phosphoric acid gel was compared with 37% phosphoric acid solution for 15 seconds whereas in group III, the effect of 15 seconds & 60 seconds of etching with 50% phosphoric acid gel was compared. The degree of etching pattern was evaluated by using scoring pattern from 1-3. Results showed no significant difference between the etching pattern obtained with the use of 37% solution and 50% gel for 15 seconds. But it was observed that etching with 50% for 15 seconds resulted in equal or even an enhanced etching pattern as compared to the pattern obtained in 60 seconds with 50% phosphoric acid gel.