Evaluation of Different Root Canal Obturation Methods in Primary Teeth Using Cone Beam Computerized Tomography.

OBJECTIVE: To evaluate the efficiency of 3 different obturation techniques; motor driven lentulospiral, hand held lentulospiral and reamer in primary anterior teeth and presence of voids by analyzing with CBCT. STUDY DESIGN: 60 single rooted extracted primary teeth were prepared and obturated with ZOE paste. Obturation methods were divided into three groups. GROUP I- motor driven lentulo spiral, II- hand held lentulo spiral and III- reamer. Obturated samples were scanned in CBCT machine and images were analysed for the evaluation of their quality of fill comprising presence, location and size of voids. RESULTS: At all the locations, Group II had maximum number of sites with voids when compared to other two groups. However, statistically significant intergroup differences were observed only at coronal third location (p=0.001) and overall assessment (p=0.003). Number of affected sites revealed the difference between Groups I and II be significant statistically (p=0.002) while the difference between Groups I and III and between Groups II and III was not significant statistically (p>0.05). At all the locations as well as for combined assessment, Group I had minimum mean size of the void. CONCLUSION: Motor driven lentulo spiral technique demonstrated more number of optimal fills with fewer voids when compared to hand held lentulo spiral technique and reamer.

Evaluation of the Dentinal Shear Bond Strength and Resin Interface in Primary Molars after Pre-Treatment with Various Dentin Bio-Modifiers: An In Vitro Study.

Dentine adhesives have demonstrated great success with permanent teeth. Though the results in primary teeth are not well documented, some studies have demonstrated lower values of bond strength in primary teeth than those found in permanent teeth. The aim of this study was to compare and evaluate the effect of grape seed extract (6.5%) (Herbal Bio Solutions, Delhi, India), glutaraldehyde (5%) (Loba Chemie PVT. LTD., Mumbai), hesperidin (0.5%) (Herbal Bio Solutions, Delhi, India), and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) (GC Corporation, Alsip, IL, USA) on the shear bond strength of dentine of primary teeth and to evaluate the resin tags at the resin tooth interface. Seventy-five caries-free human primary molars were collected, and their occlusal surfaces were ground flat. Dentin surfaces were etched using phosphoric acid. Then teeth were randomly assigned in sequential order to five groups according to the dentinal treatment method: Group I (Control group) (no treatment), Group II (5% glutaraldehyde), Group III (6.5% grape seed extract), Group IV (0.5% hesperidin), and Group V (CPP-ACP). Ten teeth from each group were assigned for Shear Bond Strength and five for SEM analysis. ANOVA and a post hoc least significant difference test (p < 0.05) were used for statistical analysis of the collected data. The grape seed extract group showed significantly increased shear bond strength than the control group (p < 0.05), and the mean length of resin tags in different dentine bio modifiers groups was also statistically significant (p < 0.05). The use of dentin bio modifiers such as 5% glutaraldehyde, 6.5% grape seed extract, 0.5% hesperidin, and CPP-ACP in the bonding process for primary teeth did not improve the dentinal bond strength.

Microleakage and SEM analysis of flowable resin used as a sealant following three fissure preparation techniques--an in vitro study.

OBJECTIVE: Preventive procedures using pit and fissure sealants are one of the important aspects of pediatric dental practice. The objectives of this in vitro study were to comparatively evaluate microleakage and resin tag penetration of a flowable resin used as a sealant on molars after preparation with Conventional, Enameloplasty and Fissurotomy techniques. METHOD: A total of 48 teeth were divided into 3 groups (n-16). Group A (CST), Group B (EST), and Group C (FT). Following the fissure preparation sealant was applied as per manufacturer's instructions. 8 samples in each group were used for Microleakage and Resin tag analysis. Microleakage analysis was done under Stereomicroscope after Methylene blue dye immersion by using scoring system. The resin tag analysis was done by measuring the length of resin tags on scanning electron microscope (SEM) images consisting of 10 microm scale taken under optical zoom of 2000 X. RESULTS: Significantly lesser microleakage score (P < 0.01) and longer resin tag penetration (P < 0.001) observed in EST (mean score 0.5 +/- 0.53) & (12.19 +/- 1.93 microm) when compared to CST (mean score 1.75 +/- 0.89) & (5.96 +/- 1.84 microm) and FT (mean score 1.5 +/- 0.53) & (6.76 +/- 1.82 microm) which showed more microleakage and short resin tags. No statistical significance between CST and FT was found. CONCLUSION: EST has proven to be an excellent method for preparation of pits and fissures when Flowable composite is used as a sealant because of its lesser microleakage and longer resin tag penetration.

Flowable resin used as a sealant in molars using conventional, enameloplasty and fissurotomy techniques: an in vitro study.

BACKGROUND AND OBJECTIVE: Preventive procedures using pit and fissure sealants are one of the most important aspects of pediatric dental practice. The objectives of this in vitro study were to comparatively evaluate microleakage of a flowable resin used as a sealant on molars after preparation with conventional, enameloplasty and fissurotomy techniques. MATERIALS AND METHODS: A total of 24 teeth were divided into three groups of eight samples each. Pits and fissures were prepared with conventional sealant technique (CST) (Group A), enameloplasty sealant technique (EST) (Group B) and fissurotomy technique (FT) (Group C). Following sealant placement, thermocycling and sectioning of samples of Groups A, B and C were performed and microleakage was assessed under a stereomicroscope after methylene blue dye immersion. RESULTS: There was significantly lesser microleakage in EST when compared with CST and FT, which showed more microleakage. No statistical significance between CST and FT was found. INTERPRETATION AND CONCLUSION: EST has proven to be an excellent method of preparation of pits and fissures when flowable composite is used as a sealant because of its lesser microleakage.

Mother's knowledge about pre-school child's oral health.

Children under the age of 5 years generally spend most of their time with their parents and guardians, especially mothers, even when they attend pre-schools or nurseries. It has been found that young children's oral health maintenance and outcomes are influenced by their parent's knowledge and beliefs. This study was done to assess the mother's knowledge about the oral health of their pre-school children in Moradabad, India. Mothers of children aged 1-4 years, attending the hospital for vaccination or regular checkups in the pediatric division of government hospitals, were invited to participate in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary practices, oral hygiene practices and importance of deciduous teeth, was distributed to their mothers, during their visit to the hospital. Responses of the mothers were recorded on a Likert Scale. The sample comprised 406 mothers, with the mean age of children being 3.8 years. Three hundred (73.8%) mothers had a good knowledge about diet and dietary practices, while only 110 (27.1%) and 103 (25.4%) mothers were found to have a good knowledge about the importance of oral hygiene practices and importance of deciduous teeth, respectively. Mothers with higher educational qualification and information gained through dentist had a better knowledge about child's oral health. Oral hygiene habits and dietary habits are established during pre-school days and the parents, especially mothers, function as role models for their children.

Comparative evaluation and applicability of three different regression equation-based mixed dentition analysis in Northern Uttar Pradesh population.

AIMS: This study aims to examine the accuracy and comparative correlation of three regression equation-based mixed dentition analysis in children of Moradabad city, North Uttar Pradesh. SETTINGS AND DESIGN: Tanaka-Johnston, Bernabe-Flores-Mir, and Ling-Wong regression equations were developed from a sample of North European, Peru, and Southern Chinese children population, respectively. Hence, it becomes questionable when applied to children of Moradabad city situated in North Uttar Pradesh, India. SUBJECTS AND METHODS: The study was conducted on a sample of 100 school going children, age range is 11-14 years with complete permanent teeth except third molars. The mesiodistal crown dimensions of all erupted incisors, canines, premolars, and molars were measured with digital calipers with a calibration accuracy of 0.01 mm. The actual tooth measurements were then compared with predicted values using Tanaka-Johnston, Bernabe-Flores-Mir, and Ling-Wong regression equations, respectively using paired t-test. RESULTS: The mean difference between the actual and estimated values of canines and premolars using Tanaka-Johnston, Bernabe-Flores-Mir, and Ling-Wong were clinically and statistically significant (P< 0.001). CONCLUSIONS: Mesiodistal dimensions of male samples are larger than female samples. All the three regression equations are not accurately applicable to this population.

Accuracy and evaluation of a new regression equation in predicting the width of unerupted permanent canines and premolar teeth.

AIM: To assess the applicability of two regression equations based on mixed dentition analysis and to propose and evaluate a new regression equation using the mandibular incisors and first permanent molars as predictors in calculating the size of unerupted permanent canines and premolar teeth in school children. METHODS: Dental study casts of 100 children (50 males and 50 females) aged 11-14 years from schools situated in Moradabad, Uttar Pradesh, India were used. The analysis of Tanaka Johnston, Bernabe Flores-Mir and the proposed equation were tested on the casts. RESULTS: The analysis of Tanaka Johnston and Bernabe Flores-Mir tended to overestimate the mesio-distal width of the canines and premolars. The proposed equation also overestimated but the mean difference showed a closer approximation with the actual measured values compared to the other two equations. CONCLUSION: Validating studies with a similar population must be conducted to confirm the applicability and precision of the proposed equation.

Child abuse: Cross-sectional survey of general dentists.

BACKGROUND: Child abuse continues to be a social menace causing both physical and emotional trauma to benevolent children. Census has shown that nearly 50-75% of child abuse include trauma to mouth, face, and head. Thus, dental professionals are in strategic position to identify physical and emotional manifestations of abuse. AIM: A cross-sectional survey was undertaken to assess knowledge and attitude of dental practitioners regarding child abuse and to identify the barriers in reporting the same. METHODS: With prior consent, a 20-question survey including both multiple choice and dichotomous (Yes/No) questions was mailed to 120 state-registered general dentists, and the data collected were subjected to statistical analysis. RESULTS: Overall response rate to the questionnaires was 97%. Lack of knowledge about dentist's role in reporting child abuse accounted to 55% in the reasons for hesitancy to report. Pearson chi-square test did not show any significant difference between male and female regarding reason for hesitancy to report and legal obligation of dentists. CONCLUSION: Although respondent dentists were aware of the diagnosis of child abuse, they were hesitant and unaware of the appropriate authority to report. Increased instruction in the areas of recognition and reporting of child abuse and neglect should be emphasized.

Co-relation of body mass index, dental caries and periodontal status with fluorosis in different high fluoridated areas of Haryana state, India.

BACKGROUND AND AIM: The aim of the present study is to compare the effect of corticotomy versus prostaglandin E1 injection in human subjects on rate of tooth movement, anchorage loss and their effect on crest bone height and root length. SETTINGS AND DESIGN: Clinical interventional study. Split mouth design was used. MATERIALS AND METHODS: Study was done on 32 regular orthodontic patients. A volume of 100 mcg of prostaglandin E1 was injected on the right side once in 2 weeks and on the left side corticotomy was performed, and canine retraction was started on both sides simultaneously. The rate of space closure and anchorage loss was assessed with casts. The root length and crestal bone height changes were assed with IOPAs. The comparison of rate of tooth movement, anchorage loss, crestal bone height and root length changes between the sides were statistically analyzed using paired t-test. RESULTS: The average rate of space closure on right side was 0.36 mm/week with a standard deviation of 0.05 mm/week and on the left side average rate of space closure was 0.40 mm/week with a standard deviation of 0.04 mm/week. The difference between the rate of closure between the right side and left where found to be statistically significant (P=0.003). The anchorage loss, the crestal bone height changes and root length changes were not statistically significant. CONCLUSION: The rate of tooth movement was significantly more with corticotomies when compared with given dose of prostaglandin injection.

HIV patient with mucous membrane pemphigoid: a case report.

BACKGROUND: Mucous Membrane Pemphigoid, a new denomination of cicatricial pemphigoid, encompasses a group of chronic subepithelial autoimmune blistering diseases that predominantly affect the oral cavity and the eyes (conjunctivitis and symblepharon). CASE DETAILS: A rare case of Mucous Membrane Pemphigoid (MMP) in a human immunodeficiency virus (HIV) positive patient is discussed with clinicohistopathological presentation. CONCLUSION: Since our patient was HIV-positive and had lesions restricted to the oral mucosa with ocular involvement, only topical and intralesional steroids were preferred as the first line of treatment. Systemic corticosteroid therapy raises a concern regarding immunosuppression.

Sequelae of dental trauma: the malformed tooth.

Here, we report a case of 10-year-old boy who came with a complaint of missing upper front teeth and was also concerned about his aesthetics. Significant history of trauma was present in his toddler period. Diagnosis of malformed upper right central incisor (11) by radiological investigations was carried out. Surgery was performed and there was removal of the impacted malformed upper right central incisor (11). Healing was uneventful. The patient is under follow-up for aesthetic rehabilitation to be carried out.

Latest developments in non-fluoridated remineralizing technologies.

The goal of modern dentistry is to manage non-cavitated carious lesions non-invasively through remineralization in an attempt to prevent disease progression, and to improve strength, esthetics, and function of teeth. The emphasis currently is being given to new technologies for enamel remineralization which suggest the changes in the understanding of dental caries. The aim of this paper is to review the contemporary non-fluoridated systems available for remineralization therapy and ideas for their implementation into clinical practice. A search of articles from "Pubmed" and "Medline" with the keywords Remineralization-demineralization, Casein derivatives, Non-fluoridated remineralizing agents was conducted. A total of 526 abstracts were collected, out of which 172 articles that discussed current technologies of non-fluoridated remineralizing agents were read and 33 most relevant articles were included in this paper. Casein phosphopeptide based technology has been established as a strong non-fluoridated remineralizing agent fulfilling all the criteria of an ideal remineralizing material.

Congenitally missing primary mandibular lateral incisors: a case of rare occurrence.

We are reporting a rare case of missing teeth in primary dentition. The case reported with the chief complaint of missing teeth in the lower front tooth region. The concern of the parents was missing primary teeth but they were also worried about the permanent successors. Thorough evaluation of the primary dentition visually and permanent dentition radiographically was done. There was missing 72 and 82.Along with these, there were few permanent teeth, that is, lack of initiation of 35 and 45 and 22 was evident. The case was non-syndromic. At present, the case is under follow-up.

Effect of consuming different dairy products on calcium, phosphorus and pH levels of human dental plaque: a comparative study.

AIM: To determine the calcium, phosphorus and pH levels of human dental plaque after consuming different dairy products. METHODS: 68 students (34 with caries and 34 caries-free) aged 17-20 years from a private dental college, Moradabad city, who agreed to refrain from oral hygiene procedures for 48 hours were selected for the study. Calcium and phosphorus levels of harvested dental plaque were measured using an electrolyte analyser while plaque pH was measured using a digital pH meter after consuming different dairy products (cheese, milk, yogurt) and compared with the control (paraffin) group. RESULTS: Cheese and yogurt groups showed a statistically significant rise in mean plaque concentrations of calcium and phosphorus, whereas milk and control groups showed the least rise in plaque concentrations for both caries-active and caries-free subjects. Plaque pH showed a stronger correlation with plaque calcium and phosphorus concentrations in both caries-active and caries-free subjects. CONCLUSION: Cheese and yogurt without any added sugar (sucrose) are non-cariogenic and to some extent cariostatic as they increase calcium and phosphorus concentration in dental plaque. Dairy products without added sugar can be recommended as after meal desserts, especially to school children, which would help to reduce the incidence of dental caries.

CD163 and its expanding functional repertoire.

Macrophages are key players of the immune system and express a variety of surface receptors. CD163 is one such receptor which belongs to the scavenger receptor cysteine-rich super family (SRCR-SF) class B. It has four isoforms which differ in the structure of their cytoplasmic domains and putative phosphorylation sites. Expression of CD163 is tightly regulated with a general tendency of anti-inflammatory signals to induce its synthesis, while pro-inflammatory signals downregulate its expression. Previously the molecule has been shown to act as a receptor for hemoglobin-haptoglobin complexes. However, it also plays a crucial role in the control of inflammatory processes by induction of anti-inflammatory pathways. Soluble CD163, which is generated via ectodomain shedding, serves as a potential diagnostic tool in a variety of disease states, such as inflammation, atherosclerosis, transplant rejection and carcinoma. Recently, CD163 has been identified as a promising target for cell directed therapy. In this review we aim to summarize the current knowledge of CD163.

Comparative evaluation of effects of chemo-mechanical and conventional caries removal on dentinal morphology and its bonding characteristics - an SEM study.

AIM: To compare the efficacy of three caries removal techniques namely: Papacarie(®), calcium hydroxide and rotary instruments by SEM analyses of the micro-morphology of residual dentine and resin tags at resin-dentine interface. METHODS: 45 extracted human permanent molar teeth, with occlusal caries extending up to dentine, were divided into two groups (Group 1 and 2) and each group was subdivided into three subgroups: subgroup A included teeth treated with conventional rotary method, subgroup B and C included those treated with calcium hydroxide and Papacarie(®) respectively. Group 1 samples were prepared for viewing the micro-morphology of residual dentine (2000x and 5000x) and Group 2 samples were filled with composite resin and analysed for resin tag formation (1000x) under SEM. RESULTS: Papacarie(®) showed minimal smear layer and open dentinal tubules. Calcium hydroxide and rotary instruments showed a typical smear layer and occluded dentinal tubules. Resin tags obtained with Papacarie(®) were the longest and significantly superior to those obtained with rotary and calcium hydroxide. CONCLUSIONS: Papacarie(®) exhibited better bonding characteristics of residual dentine than calcium hydroxide and rotary method of caries removal. Thus, Papacarie(®) is a suitable alternative to conventional method of caries removal, especially in paediatric patients.

Initial expression of the Papillon-Lefevre syndrome in consanguine family.

A rare case of Papillon-Lefevre syndrome is discussed with clinicoradiological presentation. The purpose of the case report is to make the medical community aware of this rare syndrome and its association with consanguinity. Papillon-Lefevre syndrome is an extremely rare genodermatosis of autosomal-recessive inheritance which usually manifests itself between the ages of 6 months to 4 years characterised by diffuse palmoplanter hyperkeratosis (keratoderma), and rapidly progressive and devastating periodontitis, affecting the primary as well as permanent dentition. Papillon-Lefevre syndrome results from a combination of host and bacterial factors, including recessive gene, consanguinity, specific periodontal pathogens and lack of thorough oral hygiene. The present case report describes Papillon-Lefevre syndrome and its association with consanguinity in a 3-year-old girl.