To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study.

Aim: This study aimed to evaluate and compare the clinical and radiographic success of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as direct pulp capping (DPC) agents in primary molars. Materials and methods: In this study, 50 primary first and second molars from healthy children aged 5-9 years requiring pulp therapy were randomly allocated into two groups. In the PRF group, after coronal pulp removal and hemostasis, the remaining pulp tissue was covered with PRF preparation. In the MTA group, after coronal pulp removal and hemostasis, MTA was placed, followed by a zinc oxide eugenol (ZOE) base and glass ionomer cement (GIC) in both groups. Clinical and radiographic evaluations were undertaken at 1-, 3-, 6-, 9-, and 12-month intervals. Results: By the end of the 12th month, the overall success rate was 82.6% in the PRF group, whereas it was 61.9% in the MTA group. Conclusion: Platelet-rich fibrin can be used successfully as an appropriate alternative material in DPC of primary teeth when compared with MTA. How to cite this article: Tiwari T, Tyagi P, Tiwari S, et al. To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study. Int J Clin Pediatr Dent 2024;17(S-1):S25-S29.

To Compare and Evaluate Rotary and Manual Techniques in Biomechanical Preparation of Primary Molars to Know Their Effects in Terms of Cleaning and Shaping Efficacy.

Background: The introduction of the rotary file system for children was a revolution in the field of pediatric endodontics. These files are cost-effective and help in consistent obturations with shorter instrumentation time. Aim: The present randomized controlled trial (RCT) was planned for a comparative evaluation of rotary and manual techniques in biomechanical preparation of primary molars to determine their effect in terms of cleaning and shaping efficacy, working time, quality of obturation, and postoperative pain. Materials and methods: A randomized clinical trial study was conducted in 75 children aged 5-9 years requiring pulpectomy. Each tooth was randomly assigned to one of the three treatment groups: Kedo-S files, rotary K-Flex files, and hand instruments group. Results: It was observed that Kedo-S files and rotary K-Flex files were more effective in cleaning and shaping of root canals compared to hand H/K files. The postbacterial count for hand files was higher compared to rotary files. Shorter working time was seen with rotary files (3.88-5.04 minutes) compared to hand files (15.68 minutes). Rotary files showed a reduced number of voids, with Kedo-S files in 92% of cases and rotary K-Flex files in 80% of cases. Apical seal and extent of fill were maximum with rotary files, having a grade C rating in 92% of cases. Kedo-S files and rotary K-Flex files showed a significant reduction in postoperative pain compared to hand files. Conclusion: The present study showed a significant reduction in bacterial count, working time, quality of obturation, and postoperative pain with rotary files. How to cite this article: Moudgalya MS, Tyagi P, Tiwari S, et al. To Compare and Evaluate Rotary and Manual Techniques in Biomechanical Preparation of Primary Molars to Know Their Effects in Terms of Cleaning and Shaping Efficacy. Int J Clin Pediatr Dent 2024;17(8):864-870.

Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements.

The most common pathological condition, dental caries when remain untreated which shows pulpal involvement and may lead to invasive treatment, such as crown placement followed by pulp therapy. Larger carious lesions on primary molars stainless steel crowns (SSCs) placement by means of conventional tooth preparation. The modern approach to managing carious lesions concentrates on using less invasive treatment techniques, with the focus being on biofilm change. One among such alternative method of managing the primary molars is the Hall's technique. Another most important factor for the survival of a crown is its sealing ability, in which luting cements, such as adhesive cements, have a crucial role as they help in providing a suitable marginal seal and thereby cause a reduction in the microleakage. Silver diamine fluoride (SDF) has proven anticariogenic activity in arresting carious lesions. Hence the aim was to evaluate and compare the microleakage of SSCs placed by Hall's technique, Hall's technique with SDF, and the conventional crown technique using different luting cements. A total of 60 primary first and second molars with occlusoproximal caries, which were initial and moderate in nature. The blocks were randomly divided into three groups, in which precontoured SSCs were applied by using either the Hall's technique or the conventional technique. After subjecting tothermocycling, the samples were examined under stereomicroscopic for microleakage evaluation. A few samples were randomly selected from each subgroup, and a scanning electron microscopic (SEM) examination was done. Highest values of microleakage were noted with Hall's technique resin-modified glass ionomer cements (RMGIC) luting cement group. It can be concluded from the present study that the conventional technique was found to be superior over the Hall's technique with SDF and then by the Hall's group alone. SDF application beneath the Hall's crown appears to be promising approach for the reduction of microleakage. How to cite this article: Thakur NS, Tyagi P, Tiwari S, et al. Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements. Int J Clin Pediatr Dent 2023;16(1):16-21.

Sedative effects of oral midazolam, intravenous midazolam and oral diazepam.

OBJECTIVES: To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. MATERIALS AND METHODS: Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5 mg/kg orally, Group II received 0.5 mg/kg diazepam orally, Group III received 0.06 mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. RESULTS: All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p < 0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p < 0.05) more than group 2. Placebo group showed the highest negative behavior. CONCLUSION: Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.

Knowledge, Attitude, and Practice of Pediatric Dentists Regarding Oral Health Management of Visually Impaired Children.

Aim: The aim of this study is to investigate the knowledge, attitude, and practices of pediatric dentists regarding oral health management of visually impaired children. Material and methods: A combination of convenience sampling and snowball sampling was used to send an online Google form survey questionnaire to pediatric dentists all around the world. Four sections made up the questionnaire-the first asked for personal information, while the second, third, and fourth examined the knowledge, attitudes, and practices of pediatric dentists, respectively. The IBM Statistical Package for the Social Sciences (SPSS) for Windows, version 21.0, was used to analyze the data. Result: The total responses (511) were broken up according to the different continents. The Asian continent produced the most pediatric dentists (206, 40.3%). Most of the participants in the study were females (365, 71.4%), and the maximum was postgraduate students (203, 39.7%). Moreover, the participants were practicing in the private sector (445, 87.1%) and had an experience of 2-5 years (118, 23.1%). Good knowledge scores were significantly associated with work profile (p = 0.014*) years of practice, and associated countries had shown significant differences (p ≤ 0.001). Conclusion: According to this study, the majority of the pediatric dentists included have just rudimentary knowledge of children who are visually impaired. Pediatric dentists are prevented from treating and properly managing visually impaired children as a result of deficient practices in the field of visually impaired children. How to cite this article: Tiwari S, Bhargava S, Tyagi P, et al. Knowledge, Attitude, and Practice of Pediatric Dentists Regarding Oral Health Management of Visually Impaired Children. Int J Clin Pediatr Dent 2022;15(6):764-769.

Comparative evaluation of the efficacy of different herbal irrigants on the removal of smear layer of primary teeth: A scanning electron microscopy study.

AIM AND OBJECTIVES: The aim and objectives of this study are to evaluate and compare the effectiveness of Myristica fragrans - Nutmeg, Terminalia chebula - Myrobolan, Ocimum sanctum-tulsi, and 2.5% sodium hypochlorite (NaOCl) on the removal of the smear layer by the scanning electron microscope (SEM). SETTINGS AND DESIGN: Endodontic treatment aims at disinfection and then obturation of root canal system in to prevent re-infection. Root canal irrigants play a pivotal role in the disinfection process. One of the important properties of an irrigant is the removal of complete smear layer and debris. Smear layer has the potential to protect bacteria within the dentinal tubules; therefore removal may be prudent. Smear layer removal increases the bond strength of resin sealers which results in better apical seal. MATERIALS AND METHODS: Forty extracted single-rooted, primary teeth were allocated randomly into four groups of ten each: Group 1 - NaOCl, Group 2 - Nutmeg, Group 3 - Myrobolan, and Group 4 - Tulsi. Samples were stored in sterile saline (0.9% NaCl) and then decoronated at the level of the cementoenamel junction. Working length was determined followed by appropriate irrigation. The roots were split into two halves with a chisel and were stored in 2.5% glutaraldehyde solution for 24 h. After fixation, the samples were dehydrated in ethanol series (70, 90, and 95 and twice at 100%). Each specimen was mounted on Al stub and sputter coated with a 20 nm layer of gold. Samples were then examined using a SEM quantum 60 at magnification of ×2000. RESULTS: Tulsi demonstrated the most statistically significant results followed by myrobolan and nutmeg extract. All herbal extracts were found to be significantly effective than 2.5% NaOCl. CONCLUSION: Tulsi, nutmeg and myrobolan can be effectively used as an irrigant in primary teeth.

Comparison of antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of primary teeth.

AIM: Sodium hypochlorite, though considered an ideal root canal irrigant, cannot be used at required concentrations in children, due to its undesirable effects. Hence, it is imperative to search for an ideal root canal irrigant to avoid these undesirable effects which we hope to achieve with this study. The antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of the primary teeth has been compared. MATERIALS AND METHODS: Sixty patients between 4 and 8 years of age with a single-rooted deciduous tooth indicated for pulpectomy were included. The infected teeth were randomly allocated to one of the three treatment groups based on the irrigating agents used, namely normal saline, green tea extract, or ozonated water. Specimens for anaerobic culture were collected three times from the teeth: before irrigation, after initial irrigation, and on the 3rd day after final irrigation. RESULTS AND CONCLUSION: Mean colony forming unit (CFU) count after both initial and final irrigation with ozonated water was significantly lower when compared with green tea and normal saline. Further, it was observed that the mean CFU count with green tea was significantly lower than the counts obtained with normal saline on the 3rd day after final irrigation. Hence, both ozonated water and green tea could be considered a good alternative to conventional root canal irrigants in the primary teeth. Larger sample sizes with a larger variety of irrigants are recommended.

Comparison and Evaluation of Attitude and Knowledge Towards the Management of Dental Injury in School Teachers Before and After Oral Health Education.

BACKGROUND: Dental traumatic injuries are prevalent in school-going children. Therefore, It is critical to ascertain the knowledge and practices of school teachers who are in close contact with these children. AIM: To evaluate the knowledge and attitude of school teachers toward dental trauma and the effect of the educational intervention. MATERIALS AND METHODS: The interventional study was designed by two-stage cluster sampling. A total of 158 teachers were part of the research. Data was collected through a pretested questionnaire. Re-evaluation was done after an informative lecture. Results were statistically analyzed. RESULT: The knowledge was consistently lacking prior to intervention with the level of correct answer ranging from 0.6 to 56.3%. It improved significantly post education ranging up to 96.6%. A positive attitude was noticed even before the intervention was employed. CONCLUSION: Study observes a significant knowledge gap regarding the primary management of dental injuries amongst school teachers and emphasizes the need for urgent educational intervention to fill in this gap. CLINICAL SIGNIFICANCE: Suggestions derived from this study are especially important in today's scenario where, the concept of conservation, retention, prevention and early intervention of tooth structures is topmost of all the priorities.How to cite this article: Nashine N, Bansal A, Tyagi P, Jain M, Jain A, Tiwari U. Comparison and Evaluation of Attitude and Knowledge towards the Management of Dental Injury in School Teachers Before and After Oral Health Education. Int J Clin Pediatr Dent. 2018;11(5):425-429.

Mineral trioxide aggregate-induced apical closure in nonvital immature permanent maxillary incisor.

Treatment of nonvital immature permanent teeth with calcium hydroxide is associated with few difficulties such as weakened tooth root, root canal reinfection, and long treatment time. Mineral trioxide aggregate (MTA) apical plug method is an alternative treatment method for open apices and has gained popularity in the recent times. This case report describes the management of a late-referral case of periapically involved, traumatized immature permanent incisor by endodontic treatment and the use of MTA apical plug. After preparing the access cavity, the working length was determined. The root canals were irrigated with 3% sodium hypochlorite and disinfected with metapex for 2 weeks. MTA was then placed in the apical 3 mm of the root canal. The remaining part of the root canal was filled with thermoplastic gutta-percha, and the coronal restoration was finished with composite resin. After 1-year follow-up, radiograph showed successful healing of periradicular radiolucency.

Eruption Chronology in Children: A Cross-sectional Study.

AIMS AND OBJECTIVES: The purpose of this study is to determine the appropriate reference standard for eruption timing of primary teeth in infants and preschool children of Bhopal city and to determine the role of various factors affecting the eruption of primary dentition. MATERIALS AND METHODS: A cross-sectional study was conducted among the infants and preschool children (4-36 months) attending the local government or private hospitals, and vaccination centers. Prior to the study, Institutional Ethical Committee clearance and informed written consent from the parents were obtained. The data were collected from full-term infants and preschool children of 4 to 36 months from Bhopal city. Oral examination was done under adequate natural light by a single examiner using mouth mirror and probe. Teeth present in the oral cavity were noted by using Federation Dentaire Internationale system of nomenclature in the preformed pro-forma. The teeth were considered as erupted, when any part of its crown had penetrated the gingiva and was visible in the oral cavity. Height, weight, birth weight, and other close-ended questions in questionnaire were asked from parents. RESULTS AND CONCLUSION: The data collected were statistically analyzed and it was observed that significant relation exists between tooth eruption and birth weight, feeding habits, socioeconomic status, and body mass index (BMI). Based on the findings, it may be concluded that Indian children experienced delayed eruption of primary teeth when compared with children of different countries and standard norms. HOW TO CITE THIS ARTICLE: Verma N, Bansal A, Tyagi P, Jain A, Tiwari U, Gupta R. Eruption Chronology in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(3):278-282.

Custom-made ocular prosthesis for a pediatric patient with unilateral anopthalmia: a case report.

Congenitally missing eye, often called as anopthalmia, is a rare condition. This causes disfigurement of the face, which poses psychological effect on children, making them emotionally weak and conscious which, in turn, causes anxiety, stress, and depression at an early age in life. The custom-made ocular prostheses should thus be provided as soon as possible to help children improve their social acceptance. We present a case of 9-year-old boy who reported with congenital anopthalmia of right eye, which was then restored with custom-made ocular prosthesis.

Prosthodontic management of anhidrotic ectodermal dysplasia.

Ectodermal dysplasia is characterized by the absence or defects of two or more ectodermally derived structures. Anodontia or hypodontia is the most striking dental manifestation. In severe hypodontia, there is lack of alveolar development with consequent protrusion and eversion of the lips. Patients with anhidrotic forms suffer from heat intolerance due to lack of sweat glands and mild infections may lead to death in infancy from hyperthermia. A case of a 4-year-old child with anhidrotic ectodermal dysplasia with partial anodontia is presented. Dental, oral, and physical features were taken into consideration in diagnosis and treatment planning for this patient. Clinical management consisted of removable partial prosthesis in maxillary arch and complete denture prosthesis in mandibular arch. The main aim of the treatment was to improve psychological development and to promote better functioning of the stomatognathic system.

Complex Composite Odontoma.

Odontomas are hamartomas composed of various dental tissues, i.e. enamel, dentin, cementum and sometimes pulp. They are slow-growing, benign tumors showing nonaggressive behavior. Most of the odontomes are asymptomatic with unknown etiology, although occasional signs and symptoms related to their presence do occur. Presented here is the case report of 10-year-old girl with impacted left central incisor.

Tissue engineering and its implications in dentistry.

Tissue engineering is a novel and highly exciting field of research. With tissue engineering techniques it may be possible to repair damaged tissues or even create replacement organs. This article reviews the principles underlying key tissue engineering strategies and the typical components used. Examples of tissue engineering include passive approaches, such as dental implants, and inductive approaches, in which specific molecular signals are used to activate cells.