Role of Mandibular Parameters in Gender Determination: A Systematic Review and Meta-Analysis.

Forensic anthropology and forensic medicine both have been fascinating fields that deal with mandibular characteristics and sex determination. Researchers may determine an individual's biological sex with amazing precision by examining the size, shape, and proportions of the mandible. This information is useful for anthropological studies and criminal investigations. This systematic review aims to evaluate the consistency and validity of using mandibles as a method for gender determination across different populations. A systematic search was conducted in PubMed, Web of Science, and Scopus databases. Further, a manual search was carried out to find additional studies. Mandibular parameters and other relevant data about research were extracted from the included studies. Random effects meta-analysis was carried out for four parameters. A total of nine studies were included in the systematic review out of 76 initial search results. All studies were in vitro. Nine studies were included in the qualitative analysis, whereas only seven studies were included in the meta-analysis. A total of 2385 individuals (1193 male and 1192 female) were evaluated in the included studies. The parameters assessed were as follows: minimum ramus breadth (MiRB), maximum ramus breadth (MaRB), projective ramus height (PRH), bigonial width (BGW), gonial angle (GA), and antegonial angle (AGA). Meta-analysis was conducted for four parameters out of six. For the two parameters, meta-analysis was not conducted as only one study was evaluated. Meta-analyses of PRH obtained a high degree of heterogeneity (99%), mean difference (MD) of 4.06 mm, and p-value of p=0.09. Meta-analysis of BGW obtained 93% heterogeneity, MD of 9.03 mm, and p=0.0007. Meta-analysis of GA showed 99% heterogeneity, MD of 3.44 mm, and p=0.66. Meta-analysis of AGA obtained a low heterogeneity of 30%, MD of -0.77 mm, and p=0.23. The parameter, BGW, can be considered a useful tool in identifying sex. The parameters, PRH, GA, and AGA, cannot be preferred as a reliable tool in identifying the sex of an individual in forensic contexts.

Evaluation of Forensic Luminol in Detection of Blood Stains in Instruments Following Dental Treatment.

Background Saliva and blood, being biological materials with a high potential for infectious transmission in dental environments, pose significant risks to dental professionals, assistants, and patients alike. Therefore, practitioners must adopt stringent security measures to ensure patient care, considering all parties as potential carriers of microorganisms capable of causing infectious diseases. Currently, various methods of disinfection and sterilization are employed to maintain the aseptic chain effectively. Having reliable methods for detecting substances in liquids, particularly body fluids, is crucial and highly convenient. Luminol, a chemiluminescent agent widely used in forensic science for detecting minute traces of blood that are invisible to the naked eye, presents itself as a valuable tool. Blood, a major bodily fluid often present in instruments following dental procedures, underscores the importance of its detection. Hence, in this study, luminol was utilized to detect blood traces in dental instruments following dental treatment, both before and after sterilization or disinfection. Objective Blood and saliva splashes, together with highly contagious aerosols, are always a part of dental procedures. The objective of the current study is to detect traces of blood stains on face shields, surgical instruments, and endodontic files using luminol before and after sterilization. Materials and methods Sample size calculation was done with G*Power software (Version 3.1.9.4, Düsseldorf, Germany), and a total of 30 instruments were selected for the study. In the present study, a total of 30 items were collected and utilized, including 14 instruments used after implant placement, 12 endodontic files employed after root canal treatment, and four face shields utilized during these procedures. Meanwhile, a freshly prepared luminol solution was applied to these instruments, and they were viewed in a dark environment both before and after sterilization procedures. Luminescence generated by luminol was observed in the instruments, indicative of the presence of blood not visible to the naked eye. Statistical analysis for both groups was done with IBM SPSS Statistics for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA). Intragroup comparison was done using the Friedman test, and intergroup comparison was done using the Wilcoxon signed-rank test. Results Blood stains and chemiluminescence were visualized in two out of 10 endodontic files (one #15 K-file and #20 K-files) and two out of four face shields. The intragroup comparison was done using the Friedman test, and it was found to be statistically significant (p < 0.05). Intergroup comparison was done using the Wilcoxon signed-rank test and was found to be statistically insignificant (p > 0.05). Conclusion Following sterilization and disinfection, there were no visual blood stains or chemiluminescence. Therefore, luminol was found to be effective in detecting blood stains in endodontic files, surgical instruments, and face shields, as well as in validating the sterilization and disinfection processes. Hence, sterilization in dentistry stands as a critical measure to guarantee patient safety, halt the dissemination of infections, and uphold exemplary clinical care standards.

Analyzing Mandibular Characteristics for Age and Gender Variation Through Digital Radiographic Techniques: A Retrospective Study.

Background Forensic odontology has emerged as a crucial method for identifying skeletal or dental remains. Due to the restricted accuracy of current techniques for estimating age at death, researchers have endeavored to illustrate age-related alterations in dental hard tissues. Bone remodeling constitutes an ongoing and intricate process throughout our lifespan. It is believed that morphological changes in the mandible during an individual's lifetime are influenced by both dental condition and the individual's age. Objectives This study aims to evaluate the efficacy of mandibular parameters such as projective ramus height (PRH), maximum ramus breadth (MaRB), bigonial width (BGW), antegonial depth (Ant.D), and antegonial angle (Ant.A), as a gender-determining tool and compare and analyze the mandibular parameter measurements using digital orthopantomography. Methodology In this study, the total number of samples used was 500 out of which 250 were males and 250 were females. Planmeca software (Version 6.0, Planmeca Romexis, Charlotte, NC) was used and the accuracy test, analysis of variance (ANOVA), multiple regression, and discriminant analysis for gender were performed using SPSS for Windows, Version 16.0 (SPSS Inc., Chicago, IL). Results For age estimation, the least standard error of 0.008 was observed for BGW. A maximum standard error of 0.230 was observed for Ant.D. For sex determination, the coefficient function was positive for PRH, BGW, and Ant.A, with values of 0.202, 0.805, and 0.052, respectively. Ant.D and MaRB both exhibited negative values of -0.204 and -0.379, respectively.  Conclusions Out of all the parameters assessed, BGW is the most preferred parameter for age estimation and Ant.A can be preferred for sex estimation. Age and gender can be estimated using the two parameters in the Indian population.

Longitudinal Study on Dental Status, Caries Risk Assessment, and Oral Health-Related Quality of Life in 3-6-Year-Old Children Receiving Nitrous Oxide Inhalational Sedation.

Introduction Dental caries prevention in early childhood is crucial, necessitating timely assessments by dental professionals and parents. The oral health of children during their early years can significantly impact both the children themselves and their parents' quality of life. This study seeks to assess the changes in oral health-related quality of life after treatment under nitrous oxide sedation in anxious preschool children, for whom treatment otherwise is quite difficult chairside. Aim The aim of this study is to assess the association between dental caries status, risk assessment, and oral health-related quality of life (OHRQoL) in 3-6-year-old children, before and after undergoing treatment under nitrous oxide inhalation sedation. Materials and methods Eighty children were assessed for caries risk and dental status using the caries risk assessment for treatment (CRAFT) tool. Nitrous oxide sedation was employed for dental treatment, and assessments were conducted pre-treatment and post-treatment. Statistical analyses performed were paired t-tests, correlation analyses, and Chi-Square tests. Results The study revealed a mean age of 4.033 ± 0.96, with a balanced gender distribution (47.5% boys, 52.5% girls). Post-treatment, significant negative correlations were observed between OHRQoL and treatment outcomes, emphasizing improved oral health-related quality of life. Associations were found between OHRQoL, pufa index, and caries risk post-treatment. Conclusion The current research suggests that treatment done under nitrous oxide sedation could improve the OHRQoL in preschool children. Integrating risk assessment and OHRQoL enhances understanding, facilitating targeted prevention and treatment strategies. Addressing untreated dental caries is imperative for optimizing the overall well-being of children in this age group.

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.

Forensic Gender Prediction by Using Mandibular Morphometric Indices: A Panoramic Radiograph Study.

Aim and objective This study aims to assess the accuracy of gender estimation using gonial and antegonial angles and determine the gender of the given samples using gonial and antegonial angles. Introduction An essential component of the human skull, the mandible, exhibits sexual dimorphism, making it a valuable tool in forensic and anthropological investigations for detecting sex. This procedure can be especially difficult in situations where there are large numbers of casualties, natural disasters, or widely dispersed remains. The mandible is an accurate indicator of age and sex because it responds to patterns of growth. Sex determination through the gonial angle and antegonial angle involves analyzing the angles formed by the lower jaw bone in individuals. Examining these angles contributed to remarkable accuracy. Materials and methods A total of 500 samples, 250 male and 250 female panoramic radiographs, were carefully chosen for the study. The chosen samples ranged in age from 20 to 30 years. Orthophantomograms were measured in Planmeca software (Planmeca Romexis®, Version 6.0, USA INC.) and the descriptive statistics (paired t-test) were performed in SPSS Statistics version 16.0 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). Results Gonial angle for males obtained the highest value of 127.27±5.29, followed by females at 127.08±5.18. This was followed by the antegonial angle for males of 10.74±3.14, and the least value was obtained by females of 10.67±3.30. The p-value for the gonial angle showed no statistical significance for males or females (p=0.679). Antegonial angle showed statistical significance in both males (p=0.008) and females (p=0.001). Conclusion Among both the parameters considered, the antegonial angle showed significance in determining the gender of the given samples. Hence, to assess the accuracy of gender estimation, the antegonial angle can be used as a parameter.

Comparative Evaluation of Wear Strength and Compressive Strength of Two Pit and Fissure Sealants with a Nanofilled Resin Coating: An In Vitro Study.

Introduction: The role of sealants for pits and fissures has been emphasized in caries prevention. Considering the advantages of a surface sealer and the effects of its application over restorative materials; the study is aimed at evaluating two pit and fissure sealants with a nanofilled resin coating. Materials and methods: In this in vitro double-blinded study, a total of 60 caries-free extracted third molars were collected and divided into two groups of 30 each receiving either a resin-based sealant (Helioseal F) or a glass ionomer-based sealant (GC Fuji VII). Each sample was then applied with GCoat Plus surface sealer. 15 samples each containing GC Fuji VII and 15 containing Helioseal F were then subjected to wear. Another 15 samples of GC Fuji VII and 15 of Helioseal F were subjected to compressive load. Results: On assessing the wear strength, the weight loss in group I (resin sealant with surface sealer) was 1.73 ± 0.50 (µg) which was statistically significant (p = 0.023). There was no significant difference in comparing the wear depth between both groups. There was a high statistically significant difference when assessing the compressive strength, group II (glass ionomer sealant with surface sealer) had 3566.4 ± 757 (µm) when compared to group I (resin sealant with surface sealer) 1568.53 ± 680 (p ≤ 0.01). Conclusion: Sealants are known for their poor retention and keeping that in mind we designed this study to evaluate the physical properties of sealants with a resin coating over them. Within the limitations of this study, the conclusions are glass ionomer sealant showed greater resistance to wear when compared to the resin-based sealant and the resin-based sealant showed higher compressive strength values than the glass ionomer sealant. How to cite this article: Gunasekaran R, Sharmin D, Baghkomeh PN, et al. Comparative Evaluation of Wear Strength and Compressive Strength of Two Pit and Fissure Sealants with a Nanofilled Resin Coating: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(1):31-35.

Exploring Age and Gender Identification Through Mandibular Parameters Using Orthopantomography: An Observational Study.

Aim This study aims to examine five mandibular parameters: coronoid ramus height, condylar ramus height, projective ramus height, minimum ramus breadth, and gonial angle, using orthopantomography (OPG). Introduction The mandible, a crucial part of the human skull, demonstrates sexual dimorphism, which makes it an important tool for determining sex in forensic and anthropological investigations. Its form and structure are relatively resistant to significant changes after death. Among all skeletal components, the mandible stands out as a primary indicator of sexual differences. In forensic investigations, establishing the age and sex of an individual is considered a crucial initial step. This process can be particularly challenging in scenarios involving mass casualties, natural calamities, or extensively fragmented remains. Due to its responsiveness to growth patterns, the mandible is adept at accurately determining both age and sex. Materials and methods This study employed a sample size of 500 individuals, split equally between males and females, with 250 participants each. The age bracket chosen for this cohort ranged from 20 to 30 years, considering that bone growth characteristics within this range can assist in sex determination. The height of the mandibular ramus was assessed using Planmeca software, and subsequent data analysis was conducted using SPSS. Results When estimating age, the condylar ramus height exhibited the smallest standard error (0.010), whereas the maximum standard error for the gonial angle was 0.028. Positive t values were observed for the gonial angle (1.182), minimum ramus breadth (0.114), and coronoid ramus height (0.733). In terms of determining sex, the gonial angle, coronoid ramus height, and projective ramus height demonstrated positive coefficient functions, specifically 0.676, 0.090, and 0.286, respectively. Conversely, both the minimum ramus breadth and the condylar ramus height displayed negative values of -0.385 and -0.126, respectively. Conclusion Among the parameters evaluated, condylar ramus height emerges as the most suitable choice for estimating age, while gonial angle, coronoid ramus height, and projective ramus height are preferable for determining sex.

Comparative Evaluation of Push-Out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, a Modified Mineral Trioxide Aggregate, and Two Novel Antibacterial-Enhanced Mineral Trioxide Aggregates.

Background The challenges associated with incorporating antimicrobial agents, such as the potential diminishment of the cement's physical properties, highlight the need for comprehensive evaluations. Balancing antimicrobial efficacy with the maintenance of structural integrity is a crucial aspect of material development. The acknowledgment of cytotoxic properties associated with tricalcium aluminate, a major constituent in conventional mineral trioxide aggregate (MTA), is critical in terms of long-term evaluation of treatment procedures. The primary focus of the push-out test is to evaluate the resistance of the tested material to dislodgement. Greater push-out strength implies stronger adhesion between the tested material and the tooth surface. Aim This study aims to evaluate the push-out bond strength of two antibacterial-enhanced MTAs with conventional MTA and Biodentine. Material and methods A total of five materials were tested: a) modified MTA, b) doxycycline-enhanced MTA, c) metronidazole-enhanced MTA, d) conventional MTA, and e) Biodentine. All the materials were mixed based on a predetermined powder:liquid ratio and then carried using a plastic instrument to the desired experimental design. Single-rooted permanent teeth, preferably incisors, were used in the present study. Teeth were embedded vertically in a rubber mold, and sectioning of the tooth was performed. A single operator instrumented the canal space in each slice using Gates-Glidden burs, and the mixed cements were placed in the respective groups and stored for 72 hours. A push-out test was carried out using a universal testing machine. Following the bond failure, the slices were examined under a stereomicroscope to determine the nature of the bond failure. The collected data was subjected to a one-way analysis of variance test, post hoc test, and chi-square test for statistical analysis. Results The mean push-out bond strength was found to be the highest for Biodentine (43.25 ± 0.62 megapascals (MPa)), followed by doxycycline- and metronidazole-enhanced MTAs (39.54 ± 0.65 MPa and 39.29 ± 0.16 MPa, respectively), modified MTA formulation (37.75 ± 0.73 MPa), and the lowest for conventional MTA (25.93 ± 0.7 MPa). Conventional MTA samples had an adhesive failure (89.4%), while Biodentine samples had a cohesive failure (80.3%). Mixed failures were noticed with the samples containing modified MTA formulation (71.3%), doxycycline-enhanced MTA (76.6%), and metronidazole-enhanced MTA (78.0%). Conclusion Despite not surpassing Biodentine in bond strength, antibacterial-enhanced MTAs are considered potential alternatives to conventional MTA in day-to-day clinical practice.

Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates.

AIM: To evaluate the push-out bond strength of two newly modified mineral trioxide aggregates (MTAs) with conventional MTA and biodentine. MATERIALS AND METHODS: Material preparation: Two commercially available bioactive bioceramics: Group I: Mineral trioxide aggregate; Group II: Biodentine; and two newly formulated modified MTAs: Group III: Doxycycline incorporated MTA formulation; Group IV: Metronidazole incorporated MTA formulation was used in the present study. All the test materials were then carried using a plastic instrument to the desired experimental design. Teeth sample preparation: A total of 120 teeth samples were collected and divided into four groups of test materials with 30 teeth samples per group. Single-rooted permanent teeth, that is, incisors were collected and stored in saline until the study was performed. Sectioning of the teeth into 2.0 ± 0.05-mm thick slices was performed perpendicular to the long axis of the tooth. The canal space was instrumented using Gates Glidden burs to achieve a diameter of 1.5 mm. All four prepared materials were mixed and placed in the lumen of the slices and placed in an incubator at 37°C for 72 hours. Push-out test and bond failure pattern evaluation: The push-out test was performed using a universal testing machine. The slices were examined under a scanning electron microscope (SEM) at 40× magnification to determine the nature of bond failure. All the collected data were recorded and statistically analyzed. RESULTS: The mean push-out bond strength was found to be the highest for group II (37.38 ± 1.94 MPa) followed by group III (28.04 ± 2.22 MPa) and group IV (27.83 ± 1.34 MPa). The lowest mean push-out bond strength was noticed with group I (22.89 ± 2.49 MPa). This difference was found to be statistically significant (p = 0.000). Group I samples had the predominantly adhesive type of failure (86.4%), while group II samples showed the cohesive type of failure (94.2%). Both the modified MTAs (groups III and IV) primarily showed mixed types of failures. CONCLUSION: Both the antibacterial-enhanced MTAs had better pushout bond strength compared to conventional MTA but did not outperform biodentine. Hence, it could serve as a substitute for conventional MTA due to its augmented physical properties. CLINICAL SIGNIFICANCE: Carious pulp exposure and nonvital open apices pose a critical challenge to pediatric dental practitioners. In such circumstances, maintaining the vitality of pulp and faster healing would help in a better prognosis. Novel MTAs without any cytotoxic components, and enhanced antibacterial contents with augmented physical properties can help in treating such clinical conditions. How to cite this article: Merlin ARS, Ravindran V, Jeevanandan G, et al. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024;25(2):168-173.

Comparative evaluation of volumetric changes between two pediatric rotary files (Kedo-S plus, Kedo-SG blue) and manual files (hand K-files) during canal preparation of primary mandibular molars: an in-vitro nano-CT analysis.

Pediatric endodontics has become popular due to advancements in cleaning, shaping and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo-S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular molars using nano-CT (computed Tomography). To evaluate the volumetric changes of two recently introduced pediatric rotary file systems in comparison with conventional hand file systems in primary mandibular molar using an ultra-high resolution nano-CT. This in-vitro study was performed in extracted primary mandibular molar based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the pre-operative scan using a high resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and Hand K-files. A post-operative scan was performed similar to pre-operative scan. Image reconstruction was performed with NRecon software for 3D volumetric visualization and analysis of the root canals. Kedo-SG blue file systems had the highest mean difference in the canal volume (8.85%). Hand K-files had the least difference at (1.24%) of canal volume. Kedo-S plus file system had a mean canal volume difference (6.14%) which is closer to hand K-files. Rotary file systems resulted in a significant enlargement of canals compared to hand files.

Comparative Evaluation of the Physical and Antimicrobial Properties of Mineral Trioxide Aggregate, Biodentine, and a Modified Fast-Setting Mineral Trioxide Aggregate Without Tricalcium Aluminate: An In Vitro Study.

Background Tricalcium aluminate, one of the major constituents of mineral trioxide aggregate (MTA), has been shown to have cytotoxic properties. Mineral trioxide aggregate has moderate to low antimicrobial activity against the most common endodontic pathogen, Enterococcus faecalis. Aim To assess the physical and antimicrobial properties of a newly modified formulation of mineral trioxide aggregate. Materials & methods The final setting time, compressive strength, and antimicrobial properties were tested for three groups of materials. The material used for Group 1 was mineral trioxide aggregate (white MTA, Angelus, Londrina, Brazil); the material for Group 2 was Biodentine (Septodont, Saint Maur des Fossés, France); and for Group 3, a modified MTA formulation was used. Results Group 1 had the longest setting time, and Group 2 had the shortest setting time. Group 3's material was set at 83.65 ± 0.28 minutes. This difference among the groups was statistically significant (p < 0.05). The highest mean compressive strength during all the time periods was seen in Group 2, followed by Group 3, and the least in Group 1. This difference in compressive strength was statistically significant (p=0.001). The largest zone of inhibition against Enterococcus faecalis, Candida albicans, and Streptococcus mutans was seen in Group 3, followed by Group 2 and Group 1. Conclusion Under the limitations of the present study, the newly modified MTA could serve as an alternative to the conventional MTA in terms of faster setting, higher strength, and better antimicrobial properties.

Comparative Evaluation of Extrusion of Apical Debris in Primary Maxillary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study.

Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in postoperative complications. The aim of this study was to evaluate and compare the number of debris apically extruded during canal preparation using two different pediatric rotary file systems and conventional hand file systems in primary teeth. 60 primary maxillary central incisors that were extracted due to trauma or untreated dental caries with no signs of resorption were taken. Canal preparation was executed using three different file systems: Group A: Group A hand K file system, Group B Kedo S Plus, Group C Kedo SG Blue. For each of these files using the Myers and Montgomery model, the pre- and post-weight of the eppendorf tube was assessed to quantify the number of apical debris. The maximum extrusion of apical debris was noticed with the Hand K-file system. The least debris was noticed in the Kedo S Plus file system. Statistical analysis revealed that there were highly significant differences in apical extrusion and debris when comparing hand files and rotary files and also between the two rotary files used. Apical debris collection is an unavoidable outcome of canal instrumentation. Among the file systems compared, rotary files had lesser extrusion when compared to hand files. Among the rotary files, Kedo S plus showed normal extrusion compared to SG Blue.

The Cytotoxic Assessment of Antibacterial-Enhanced Mineral Trioxide Aggregate Compared to Commercially Available Bioceramic Cements by Using Methyl-Thiazoldiphenyl-Tetrazolium (MTT) Assay on Human Dental Pulp Stem Cells: An In Vitro Study.

Background and objective Preserving the vitality of the tooth is of prime significance during therapies such as direct pulp capping and pulpotomy that promote tertiary dentine formation and healing of pulp stumps. Procedures like apexogenesis and apexification also stimulate dentin and bone formation for root growth and closure. Conventional mineral trioxide aggregate (MTA) has good biocompatible and physical properties like longer setting time, presence of a cytotoxic component, i.e., tricalcium aluminate (TCA), moderate compressive strength, and moderate antimicrobial activity. Eliminating TCA and the addition of antibacterial components would improve the properties of the cement. In this study, we aimed to assess the cytotoxicity of MTA Angelus, Biodentine, and two antibacterial-enhanced MTAs by using methyl-thiazoldiphenyl-tetrazolium (MTT) assay. Materials and methods Human dental pulp was extirpated from extracted third molars, and human dental pulp stem cells (HDPSCs) were isolated and characterized by flow cytometry. HDPSCs were treated with MTA, Biodentine, or two antibacterial-enhanced MTAs depending on the study group. The control group constituted the untreated HDPSCs. The cell viability of HDPSCs was assessed using an MTT assay on days one, three, and seven. Results Varied levels of cytotoxicity were noticed at different time periods assessed using the tested materials, which was statistically significant (p=0.01). At all time periods assessed, the highest cell viability was noticed with Biodentine (88.7% on the first day, 80.4% on the third day, and 91.8% on the seventh day). Antibacterial-enhanced MTAs, either added with metronidazole or doxycycline, had more mean viable cells compared to conventional MTA on the third and seventh day (p=0.043 and 0.018 respectively). Conclusion Antibacterial-enhanced MTAs showed reduced cytotoxic properties when compared to conventional MTA. Biodentine was associated with the highest cell viability at all time periods.

Age Determination in Children Using Camirere's Indian Specific Formula: A Radiographic Study Using Orthopantomographs.

AIM: Determination of age is a pivotal part of forensic dentistry. Since many dental age determination methods are invasive, Cameriere introduced a radiographic method where age evaluation was carried out using an orthopantomogram (OPG). An adaptation of the same formula was later formulated by Rai et al. for the Indian population. The aim of the study was to assess the age and to dictate the efficiency of the Indian version of Cameriere's formula in the Chennai subpopulation. MATERIALS AND METHODS: This study consisted of radiographs belonging to 50 individuals with an age range of 5-15 years. Radiographs were taken using the OPG and the soft copies obtained were analyzed. The variables such as seven left and right permanent mandibular teeth and the number of teeth with closed apical, and with open apical, ends of roots were examined and measured. The obtained data, after substituting in the formula was statistically analyzed using paired and unpaired t-test and Pearson's correlation coefficient test. RESULTS: On comparing dental age and chronological age, statistically significant results were obtained on both sides of the radiograph. Between genders, both sides of the radiograph showed non-significant results. On correlating the sides, the left side showed greater accuracy in age determination compared to the right side of the OPG. CONCLUSION: Age estimation using Indian-specified formula provides a near good estimate and hence can be a reliable method to measure the chronological age of the participants. CLINICAL SIGNIFICANCE: The Indian version of the Cameriere's formula can be used as a rational tool to assess the age of young children and adolescents.

Comparative evaluation of the antimicrobial effects of probiotic milk and probiotic powder on the salivary Streptococcus mutans counts and the plaque scores in children aged 3-6 years: A randomized controlled trial.

BACKGROUND: Probiotics have been shown to have a positive influence on systemic and oral health. The prevention of dental caries and gingival diseases through the consumption of probiotics has been studied extensively. OBJECTIVES: The aim of this research was to determine the effects of a short-term intake of probiotic milk and powder on the salivary levels of Streptococcus mutans (S. mutans) and the plaque scores in children. MATERIAL AND METHODS: In this short-term study, 34 healthy 3-6-year-old children were randomly assigned to group A (control), group B (enKor­D) or group C (Yakult). The probiotics were taken for 7 days. To screen for the amount of S. mutans measured in colony-forming units per milliliter of saliva (CFU/mL), unstimulated saliva samples were collected and cultured on Mitis Salivarius Agar plates before and after the intervention. The plaque scores were also recorded at preand post-intervention visits. RESULTS: A statistically significant reduction of salivary S. mutans was recorded after the consumption of probiotic milk (Yakult®) and powder (enKor®-D) (p < 0.05), with the decrease being greater for the enKor­D group. However, only the consumption of Yakult decreased the plaque scores significantly (p < 0.05). CONCLUSIONS: A short-term use of Yakult and enKor­D can have a cariostatic effect by lowering oral microbial load in children with certain risk profiles. Further research is required to confirm this probiotic effect over a long-term period. Prior to prescribing or promoting Yakult or enKor­D as an adjunct caries prevention therapy for children, a thorough risk evaluation may be needed.

Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial.

BACKGROUND: Profound local anesthetic delivery promotes successful treatment for children in terms of easing their fear, anxiety, and discomfort during dental procedures. Local anesthetic injections are the utmost anticipated or anxious stimuli in the dental operatory. Precooling the oral mucosa by application of cryotherapy before local anesthetic injections can alter the pain perception in children. AIM AND OBJECTIVES: To compare the efficacy of cryotherapy application and 20% benzocaine gel at reducing pain perception during buccal infiltration in pediatric patients. MATERIALS AND METHODS: In this split-mouth study, 30 pediatric patients between 7 years and 10 years of age who needed maxillary buccal infiltration of local anesthetics bilaterally for dental treatment were selected. They received cryotherapy (ice pack) on one quadrant (test group) for 2 minutes and 20% benzocaine topical gel on the contralateral quadrant (control group). A pediatric dentist blinded to the study assessed sound, eye, motor (SEM) scale based on patients' reaction during injection (objective method), and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection (subjective method). Statistical analyses were performed using Wilcoxon and Mann-Whitney U tests. RESULTS: The cryotherapy group had significantly reduced pain scores on the VAS scale (40.66 ± 14.60) when compared with the topical anesthetic gel group (61.33 ± 9.73). The cryotherapy group had reduced pain scores on the SEM scale as well (1.2 ± 0.1) when compared with the topical anesthetic gel group (1.6 ± 0.1), which was not statistically significant. CONCLUSION: When compared with topical anesthetic gel, precooling the injection site with cryotherapy is beneficial in reducing pain before local anesthesia injection in pediatric patients. CLINICAL SIGNIFICANCE: Cryotherapy application eliminates the fear of pain ascribed to injection of local anesthesia and assists in providing pertinent dental care. HOW TO CITE THIS ARTICLE: Lakshmanan L, Ravindran V. Efficacy of Cryotherapy Application on the Pain Perception during Intraoral Injection: A Randomized Controlled Trial 2021;14(5):616-620.

Video modelling technique used to manage the behaviour of uncooperative children in a dental set up / Técnica de modelagem em vídeo usada no manejo de comportamento de crianças não cooperativas no consultório odontológico

Objective: To investigate if video modelling is an effective technique in behaviour modelling of a child in a dental set up. Material and Methods: Fifty children aged 4-6 years indicated for pulpectomy were enrolled in this study. They were selected based on their behaviour using Frankl behaviour rating scale. Children with Frankl behaviour rating 1 and 2 were selected for this study. The video of a child who was cooperative while undergoing pulpectomy was shown to these children. The behaviour was assessed using Frankl behaviour rating scale after the video was shown to the children included in the study. Results: There was a statistically significant difference in the behaviour rating score of the children before after the video of the cooperative child was shown to them. Conclusion: It was observed that video modelling is an effective technique in managing the behaviour of an uncooperative child in a dental set up. (AU)

Objetivo: Investigar se a modelagem em vídeo é uma técnica eficaz no manejo do comportamento de crianças no consultório odontológico. Material e Métodos: Cinquenta crianças, de 4 a 6 anos, indicadas para pulpectomia foram incluídas neste estudo. Elas foram selecionadas com base em seu comportamento utilizando a Escala de Classificação de Comportamento de Frankl. Crianças com classificação de comportamento Frankl 1 e 2 foram selecionadas para este estudo. O vídeo de uma criança que cooperou durante o procedimento de pulpectomia foi mostrado a essas crianças. Posteriormente, o comportamento das mesmas foi avaliado usando a Escala de Classificação de Comportamento de Frankl. Resultados: Houve uma diferença estatisticamente significativa na pontuação da classificação do comportamento das crianças antes e depois do vídeo da criança cooperativa ter sido mostrado a elas. Conclusão: Observou-se que a modelagem em vídeo é uma técnica eficaz no manejo do comportamento de uma criança não cooperativa em um ambiente odontológico (AU)

Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial.

AIM: The purpose of this randomized clinical trial was to evaluate the intensity and duration of postoperative pain after pulpectomy of primary teeth using three preparation techniques. MATERIALS AND METHODS: A total of 60 patients were randomly allocated to three groups of 20 patients each, according to the root canal instrumentation techniques used. In group I, the teeth were prepared using manual NiTi K flex files till size 35. In group II, the teeth were prepared using NiTi K flex files till size 35 in reciprocating motion. In group III, the teeth were prepared using Kedo-S pediatric rotary files. After root canal preparation, the canals were obturated with endoflas paste and were restored permanently with composite filling material. The intensity and duration of postoperative pain were evaluated after 6, 12, 24, 48, and 72 hours, using a four-point pain-intensity scale. RESULTS: There was a statistically significant difference among the groups, wherein the postoperative pain was more in NiTi K flex files used in reciprocating motion followed by manual NiTi K flex files and Kedo-S pediatric rotary files. CONCLUSION: Postoperative pain was more with NiTi K flex files in reciprocating motion and was less with Kedo-S rotary files after root canal preparation in primary maxillary molars. HOW TO CITE THIS ARTICLE: Jeevanandan G, Ravindran V, Subramanian EMG, et al. Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13(1):21-26.

Assessing the quality of root canal filling and instrumentation time using kedo-s files, reciprocating files and k-files / Avaliando a qualidade de obturação e tempo instrumentação usando limas kedo-s, limas reciprocantes e limas k manuais

Objective: Pulpectomy is the conservative treatment approach that retains and preserves the primary tooth in the dental arch in its normal function and non-pathologic state until its exfoliation. Over the years, pulpectomy has been performed using various instrumentation techniques. The aim of this study was to compare the quality of root filing and instrumentation time using Kedo-S files, Reciprocating files and K-files in primary teeth. Material And Methods: A randomized clinical trial was performed on 45 primary molars equally distributed for instrumentation with Kedo-S files, reciprocating files and K-Files. Immediate post-operative digital radiographs were taken to evaluate the quality of root filing and root canal instrumentation time was also recorded. Results: Mean instrumentation time with Kedo-S was 75.6 seconds, reciprocating file was 190.6 seconds and K-file was 95.4 seconds. Highest optimal fill was obtained with Kedo-S file group, highest overfill was obtained with Kedo-S group and highest under fill was obtained with reciprocating file group. Conclusion: Kedo-S rotary system provides better quality of root canal filling in minimum instrumentation time. (AU)

Objetivo: A pulpectomia é o tratamento conservador que retém e preserva o dente decíduo na arcada dentária em sua função normal e estado não patológico até sua esfoliação. Ao longo dos anos, a pulpectomia foi realizada usando várias técnicas de instrumentação. O objetivo deste estudo foi comparar a qualidade da obturação do canal radicular e do tempo de instrumentação usando limas Kedo-S, limas reciprocantes e limas K em dentes decíduos. Material e Métodos: Foi realizado um ensaio clínico randomizado em 45 molares decíduos distribuídos igualmente para instrumentação com limas Kedo-S, limas reciprocantes e limas K. Radiografias digitais pós-operatórias imediatas foram realizadas para avaliar a qualidade da obturação e também foi registrado o tempo de instrumentação do canal radicular. Resultados: O tempo médio de instrumentação com Kedo-S foi de 75,6 segundos, com limas reciprocantes foi de 190,6 segundos e com limas K foi de 95,4 segundos. O maior índice de obturação ideal foi obtido com o grupo de limas Kedo-S, o maior índice de sobreobturação foi obtido com o grupo Kedo-S e o maior índice de infraobturação foi obtido com o grupo de limas reciprocantes. Conclusão: O sistema rotatório Kedo-S fornece melhor qualidade de obturação do canal radicular em tempo mínimo de instrumentação.(AU)