Evaluation of the Caries-Arresting Potential of Silver Diamine Fluoride Gel With Potassium Iodide Versus Sodium Fluoride Varnish: An Observational Study.

Introduction Silver diamine fluoride (SDF) with potassium iodide (KI) has emerged as a promising, aesthetic, non-invasive management by limiting the staining caused by SDF. However, no studies are comparing the caries-arresting potential of SDF gel with KI. The study aims to observe and evaluate the caries-arresting potential of SDF gel with KI compared to sodium fluoride (NaF) varnish. Materials and methods The present observational study was conducted with a split-mouth design. A total of 33 participants, in the age group of two to six years, with occlusal caries of the International Caries Detection and Assessment System (ICDAS) I and II involving both right and left upper or lower primary molar teeth, were included. SDF gel with KI and fluoride varnish (FV) was applied to the contralateral teeth on the same arch. Participants were recalled at 3, 6, 9, and 12-month intervals to monitor the progression or arrest of carious lesions. Result At the end of 12 months, 66.7% and 70.5% of the teeth showed arrest of caries with SDF gel with KI and FV, respectively. Intra-group analysis using the Friedman test shows significant differences in both groups across the timeline (p=0.001). Intergroup analysis using the Whitney U test reveals no significant difference in caries-arresting potential between the groups at various timelines (p=0.231). Conclusion There was no significant difference in arresting enamel caries of primary teeth between the use of 5% NaF and 38% SDF with KI. However, there was a significant difference within the group between the 3rd and 12th-month follow-up. Hence, the biannual application is recommended in both FV and SDF with KI.

Efficiency of a Sensory-Adapted Dental Environment Versus Regular Dental Environment in Neurotypically Healthy Children: A Parallel-Arm Interventional Study.

Introduction The basic principle of a sensory adaptive dental environment is that an individual's sensory experiences have a significant impact on their emotional and psychological well-being. Taste, smell, touch, hearing, and sight are the five basic senses that affect our perception and responses to the environment. The study aimed to assess the effectiveness of a Sensory-Adaptive Dental Environment (SADE) compared with a Regular Dental Environment (RDE) in reducing anxiety, improving behavior, and providing a smooth experience for children undergoing dental treatment. Materials and methods  This parallel-arm pilot study was conducted at the outpatient Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Chennai, from January 2024 to March 2024. A total of 148 children who met the inclusion criteria were divided into two groups: Group I (intervention group) received SADE or MSE (Multi-Sensory Environment) intervention, while Group 2 (control group) underwent dental treatments in a Regular Dental Environment (RDE). Patient behavior was assessed using Frankl's behavior rating scale, and anxiety levels were measured using Ayesha's Oddbodd anxiety scale. Additionally, heart rate and oxygen saturation (SpO2) were evaluated using a pulse oximeter. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY), with significance set at a p-value less than 0.05. Results Before the procedure, there were no notable differences in behavior or anxiety levels. However, after the procedure, children undergoing treatment under SADE resulted in markedly improved behavior and notably lower anxiety levels. Also, this correlated with reduced anxiety levels, indicated by lower heart rates and higher oxygen saturation levels. Conclusion The study concluded that there were notable differences in patient experiences between SADE and RDE. After their dental procedures, participants in the SADE group were found to behave better and feel less nervous. Still, in the conventional setting, only improved behavior was noted, with no significant difference in anxiety levels. Overall, our study suggests that dental offices can significantly enhance patient experiences by providing a sensory-friendly setting that helps children feel more at ease, improves patient outcomes, and less nervous during their visits.

Comparative Evaluation of Gingival Health Among Children With Stainless Steel Crowns and Stainless Steel Bands: A Split-Mouth Randomized Controlled Trial.

Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction appliance to maintain the space for the eruption of underlying teeth in case of early loss in children are some of the most commonly practised procedures that pediatric dentists undertake in their day-to-day lives. Maintaining good oral hygiene for better gingival health is important. If it is not taken care of, gradual destruction of supporting soft and hard tissues of the teeth occurs. There were numerous studies conducted over the past few years, but no split-mouth study compares the crowns and bands. Hence, this study compares the gingival health between stainless steel crowns and band and loop space maintainers. Materials and methods This split-mouth randomised controlled trial included 31 children aged between four and nine years who had stainless steel crowns on one side and a band and loop space maintainer on the other side of the mandibular arch. The split-mouth study was carried out to minimise the outcome bias as oral hygiene practices differ from one individual to another. Presence/absence of bleeding on probing (BOP) and the Gingival Index (GI) using the Loe and Silness GI were assessed at baseline and at six months. Data was entered in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and analysed in IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). The significance level was fixed as 5% (α = 0.05). The Shapiro-Wilk test was used to assess the normality of parameters of gingival health. The parameters are described in terms of mean, standard deviation, frequency and percentages. Intragroup analysis was done using Friedman tests across the timelines. Intergroup analysis using Mann-Whitney U tests was done between the groups at different timelines.  Results At the beginning of the study, 46 children (22 girls and 24 boys) were enrolled considering the dropout. However, 15 children did not attend the follow-up review, resulting in a loss to follow-up. Consequently, only 31 children, each with a band and loop space maintainer and a stainless steel crown, were included for the final interpretation of the results in this study. At one month, both BOP and GI were significantly different (p<0.05) between the stainless steel crown and stainless steel band where the crown showed better gingival health and absence of bleeding than the band and loop. At three months and six months, gingival health improved in both groups, but there was no significant difference between the groups. The Friedman test revealed that both the stainless steel crown and stainless steel band groups had a significant difference at six months from baseline. Mann-Whitney tests were done to analyse the difference in parameters at baseline and at six months between both groups. There was no significant difference in the baseline in the parameters between the groups. Conclusion Within the limitations of the study, this study concludes that the gingival health based on BOP and GI shows a significant difference across the timeline within the groups, namely, stainless steel crown and stainless steel band, but no significant difference between the groups at various timelines.

Histologic Assessment of a Fast-Set Mineral Trioxide Aggregate (MTA) and Two Novel Antibacterial-Enhanced Fast-Set MTAs for Apexification and Periapical Healing of Teeth With Incomplete Root Formation in a Rat Model: An In Vivo Animal Study.

Background Pulp necrosis in incomplete root formation halts dentine development, resulting in larger canals with fragile walls and an open apex, complicating canal instrumentation and apical stop formation. Bioactive endodontic cements such as mineral trioxide aggregate (MTA) are crucial for creating artificial apical barriers or inducing apical foramen closure, but challenges remain regarding their antimicrobial efficacy and cytotoxicity. Modifications to MTA formulations aim to address these concerns. Methods This in vivo animal study involved 80 Wistar albino rats, with incomplete root formation induced by pulp exposure. Rats were divided into four groups receiving different MTA formulations for apexification: conventional MTA, modified MTA, and MTA enhanced with metronidazole or doxycycline. Histopathological evaluations were conducted at seven and 28 days post-treatment to assess calcific barrier formation, inflammatory reactions, and antimicrobial efficacy. Results By day 7, modified MTA formulations exhibited enhanced antibacterial activity compared to conventional MTA (p = 0.000), with fewer inflammatory reactions and microorganisms. By day 28, modified formulations showed superior calcific barrier formation, particularly in the metronidazole- and doxycycline-enhanced groups compared to conventional MTA (p = 0.000). These outcomes suggest that modifications to MTA formulations improve antimicrobial efficacy and calcific barrier formation in vivo. Conclusion Novel modified MTA formulations, particularly those enhanced with metronidazole or doxycycline, exhibit superior antibacterial efficacy and calcific barrier formation compared to conventional MTA. Further long-term studies are warranted to validate these findings for potential clinical translation.

The Association of Change in Weight During Radiotherapy Treatment With Clinical Outcomes in Patients With Stage I-III Esophageal Cancer.

Esophageal carcinoma (EC) and nutritional status are strongly linked due to swallowing disruptions and treatment-related toxicities. Therefore, malnutrition and weight loss (WL) occur in 85% and 79% of EC patients, respectively. WL is frequently associated with worse EC patient outcomes, however, WL during radiation therapy (RT) and EC patient outcomes have not been well established. The purpose of this study is to retrospectively review the association of WL during RT treatment of EC with clinical outcomes. Non-metastatic EC patients from our institution treated between 2010 and 2018, receiving total prescribed dose >40 Gy and aged >18 years, were included. Patients were analyzed by WL during RT, with categories of ≥5% vs. <5% and ≥10% vs. <10%. Patient characteristics and treatment regimens were similar across all WL groups. In univariate analysis, ≥5% and ≥10% WL were significantly associated with both worse overall survival (OS) and progression-free survival (PFS), and ≥10% WL was significantly associated with increased local recurrence. In multivariate analysis, ≥5% WL was significantly associated with OS and PFS. With both ≥5% and ≥10% WL throughout the radiation treatment being detrimental to OS and PFS. The importance of nutritional support in EC patients receiving radiotherapy is further validated.

Interrelationship Between Intelligence Quotient and Space Maintainers Among Children: A Cross-Sectional Comparative Study.

Introduction Intelligence quotient (IQ) is an indicator to measure a child's cognitive ability to learn or understand and to deal with new situations with their logical and analytical skills. Children with better IQ exhibit increased cooperation when undergoing dental treatments, leading to a positive attitude toward dental care. The primary aim of the study was to assess the interrelationship between the IQ of children, space maintainer therapy, and the behavior of children aged 6-10 years. Materials and methods A total of 104 children were divided into two groups: group 1 included children undergoing space maintainer therapy and group 2 included children who did not undergo space maintainer therapy. Their IQ scores were assessed using Raven's Coloured Progressive Matrices and behavior and the Frankl behavior rating scale. The data were analyzed by SPSS Version 23 (IBM Corp., Armonk, NY). Independent t-tests were used to evaluate the differences between IQ and children with space maintainers, and Mann-Whitney U tests were used to assess the differences between behavior and space maintainers. Results The mean age of the participants was approximately 8.28 years. The mean IQ score of the group of children undergoing the space maintainer therapy was 90.69 ± 7.65 and that of the control group was 105.59±10.71. Based on the Frankl behavior rating scale, the mean score in the space maintainer group was 35.44 and that of the control group was 69.56. There was a significant association between IQ, behavior, and the presence of space maintainers. Conclusion The group of children undergoing space maintainer therapy demonstrated comparatively lesser IQ, and the majority of children exhibited negative behavior. Also, children wearing space maintainers had undergone one or multiple extractions, which is traumatic for children and may lead to them likely exhibiting a negative behavior than children in the control group. Hence, it may be concluded that intelligence, behavior, and space maintainers are all significantly associated with each other.