Titanium Dioxide Nanoparticles and Cetylpyridinium Chloride Enriched Glass-Ionomer Restorative Cement: A Comparative Study Assessing Compressive Strength and Antibacterial Activity.

OBJECTIVE: To evaluate the addition of titanium dioxide (TiO2) nanoparticles and cetylpyridinium chloride (CPC) on the compressive strength and antibacterial activity of conventional glass-ionomer cement (GIC). STUDY DESIGN: TiO2 nanoparticles enriched GIC was prepared by adding 3% TiO2 nanoparticles (w/w) into the powder component of conventional GIC. CPC containing GIC was developed by incorporating 1% CPC (w/w) into conventional GIC powder. Samples were segregated into three groups: GIC with 3% TiO2 nanoparticles, GIC with 1% CPC and unmodified conventional GIC. Compressive strength was assessed using the universal testing machine on cylindrical specimens made from each material. Antibacterial activity was assessed by measuring inhibition zones on Mitis Salivarius Bacitracin (MSB) agar inoculated with pure strain of Streptococcus mutans (S. mutans). RESULTS: GIC containing TiO2 nanoparticles exhibited significantly greater compressive strength as compared with CPC and conventional GIC groups (P < 0.01). However, there was no significant difference between the compressive strengths of CPC and conventional GIC group (P >0.05). Antibacterial activity was significantly greater for TiO2 group than conventional GIC (P <0.05). CPC increased the antibacterial activity of conventional GIC, though not significantly. CONCLUSION: The addition of 3% TiO2 nanoparticles improves the compressive strength of GIC as well as its antibacterial activity against S. mutans.

A study on the severity and prevention measures of COVID-19 among dental professionals in clinical practice management.

BACKGROUND: Medical professionals, especially dental professionals, have been adversely affected by the pandemic of COVID-19 due to an increased chance of exposure to patients because of close contact during treatments. OBJECTIVES: This study aimed to evaluate knowledge about the disease and assess ways of precautions to be taken during the pandemic. METHODS: A questionnaire was developed and registered at Google Forms. The study population included dental practitioners, working in hospitals and clinics. A total of 495 dental practitioners from 14 different countries across the world responded. Most dentists were aware of the required modifications in the management of patients. The points allotted for each correct/best answer by participants for a group of questions regarding each component (Knowledge, Perceptions, and Practices) were added/summed to generate an overall score for each of the three components. RESULTS: Both univariate and multivariate analysis employed for the evaluation of results. Moreover, the total practice score was significantly associated with gender and sector of practice. Multivariable analysis model using multiple linear regressions was formulated by including those variables which were significant at the univariate stage. Hence, the practice sector was the only variable found to be significantly associated with the total knowledge score (p-value < 0.05). CONCLUSION: This study, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and infection in dental settings.

Effect of Fluoride Concentration in Drinking Water on Dental Fluorosis in Southwest Saudi Arabia.

This study was intended to evaluate the fluoride concentration in drinking water and its effect on dental fluorosis in Southwest Saudi Arabia. Water samples were gathered rom wells, filtration plants and commercial brands (bottled water) in distinct urban and rural areas of Asir region of the Kingdom of Saudi Arabia (KSA). Overall, 63 water samples were collected from 12 locations and 9 brands of bottled water. ExStik® FL700Fluoridemeter was used in the analysis of water samples for fluoride levels. The total number of screened patients for dental fluorosis, aged between 9 and 50 years, was 1150; among them, 609 were males and 541 were females. Dean's index criteria were used to examine the patients for dental fluorosis. The results revealed that fluoride levels varied between 0.03 and 3.8 ppm. People who drank well water displayed increased fluoride levels (>0.81 ppm). The prevalence of dental fluorosis was established to be 20.43% among the total number of examined patients. The findings of this study show very mild to moderate dental fluorosis prevail among the patients who consume well water in the Asir region.

Lactate Dehydrogenase and ß-Glucuronidase as Salivary Biochemical Markers of Periodontitis Among Smokers and Non-Smokers.

OBJECTIVES: This study aimed to establish lactate dehydrogenase (LDH) and ß-glucuronidase as salivary biomarkers of periodontitis among smokers and non-smokers. METHODS: This cross-sectional case-control study was conducted at the Aligarh Muslim University, Aligarh, India, between January and June 2017. A total of 200 participants were divided into four groups based on their periodontal and smoking statuses. Unstimulated mixed saliva samples were collected to estimate LDH and ß-glucuronidase levels. In addition, total protein was estimated using Lowry's method. RESULTS: There was a significant increase in enzyme activity in the periodontitis groups compared to the non-periodontitis groups (P <0.001). However, significantly lower enzyme activity was observed among smokers, irrespective of periodontal status (P <0.001). Nevertheless, a receiver operating characteristic curve analysis indicated the diagnostic potential of both enzymes to be fair-to-excellent. CONCLUSION: Although smoking was found to significantly alter enzyme activity, LDH and ß-glucuronidase were reliable salivary biomarkers of periodontitis among both smokers and non-smokers.

Dental Caries Status of Institutionalized Orphan Children from Jammu and Kashmir, India.

INTRODUCTION: It has been well documented that the absence of family support influences the general and oral health of the children. Factors that lead to the development of disease at a given point in time are likely to have their roots in a complex chain of environmental events that may have begun years before. A number of studies have examined the relationship between dental caries and material deprivation and found a positive association between them. Though orphans contribute to 2% of world's population, literature regarding their oral health status is very scarce. This study was carried out with the aim to assess the dental caries status of institutionalized orphan children from Jammu and Kashmir. MATERIALS AND METHODS: A total of 1,664 children that included 1,201 boys and 463 girls from registered orphanages in the state of Jammu and Kashmir were included in the study. Written informed consent was obtained prior to the start of the study; decayed, extracted, filled teeth (deft)/ decayed, extracted, filled surface (defs) and decayed, missing, and filled teeth (DMFT)/decayed, missing, and filled surface (DMFS) indices were used to assess the caries status of primary and permanent dentition. Multiple choice, close-ended questionnaires were administered to assess the oral hygiene habits, knowledge, and dietary behavior of orphan children prior to examination. The study subjects were divided into three groups according to the age of ≤ 6, 7 to 11, and ≥12 years. RESULTS: Results showed that caries prevalence in primary dentition was higher in subjects' ≤6 years of age where the prevalence was 50.9%; in subjects 7 to 11 years of age, the prevalence was 25.2%. Caries prevalence in permanent dentition within the age group 7 to 11 was 69.1%, while in subjects' ≥12 years, the prevalence was 66.2%. Use of toothbrush was the most prevalent method of cleaning the teeth in both the genders, while toothpaste was reported to be the most prevalent material to be used for tooth cleaning followed by tooth-powder. Highest caries prevalence was seen in the subjects using datun sticks as a method to clean their teeth (80.5%). HOW TO CITE THIS ARTICLE: Shah AF, Tangade P, Ravishankar TL, Tirth A, Pal S, Batra M. Dental Caries Status of Institutionalized Orphan Children from Jammu and Kashmir, India. Int J Clin Pediatr Dent 2016;9(4):364-371.

Prevalence of Traumatic Dental Injuries to Anterior Teeth of 12-Year-Old School Children in Kashmir, India.

BACKGROUND: Traumatic dental injuries to anterior teeth are a significant public health problem, not only because their prevalence is relatively high, but also because they have considerable impact on children's daily lives. Traumatic dental injuries (TDIs) cause physical and psychological discomfort, pain and other negative impacts, such as tendency to avoid laughing or smiling, which can affect social relationships. OBJECTIVES: This study aimed to assess the prevalence of traumatic dental injuries to anterior teeth among 12-year-old school children in Kashmir, India. PATIENTS AND METHODS: A cross-sectional study was conducted in private and government schools of India among 1600 schoolchildren aged 12 years. In addition to recording of the type of trauma (using Ellis and Davey classification of fractures, 1970), over jet, Angle's molar relation and lip competence were also recorded. The socioeconomic status and academic performance of the study subjects were registered. The data obtained were compiled systematically and then statistically analyzed. The statistical significance for the association between the traumatic injury and the variables was analyzed using the chi-square test. Logistic regression was used to identify potential risk predictors of TDIs. RESULTS: The overall prevalence of TDI to anterior teeth was found to be 9.3%. The TDI to anterior teeth in male was more than female, but the difference was statistically nonsignificant (P < 0.01). Falls and sports were the most common causes of trauma in the present study. The highest potential risk factor for the occurrence of trauma was over jet. Academic performance was found to be significantly associated to TDI to anterior teeth, when analyzed in a multiple regression model. CONCLUSIONS: It was concluded that the prevalence of traumatic dental injuries was 9.3%. Traumatic dental injuries among children exhibit complex interaction between the victims' oral conditions and their behavior. Therefore, prevention should consider a number of characteristics such as oral predisposing factors, environmental determinants and human behavior. It is recommended that specific and proper public places for leisure and sports activities, with impact-absorbing surfaces around the items on which children are most likely to fall, should be provided.

Effect of Adhesive Application on Sealant Success: A Clinical Study of Fifth and Seventh Generation Adhesive Systems.

OBJECTIVES: The aim of the study was to compare the effect of fifth and seventh generation bonding agent on sealant success. MATERIALS AND METHODS: Sixty-four school children aged six to nine years received sealants in four permanent molars in a split mouth design, such that each patient received sealant in the first permanent molar with fifth generation bonding agent in one arch and seventh generation bonding agent in the other arch; contra-lateral molars were sealed with sealant alone. The evaluation was carried out at baseline, three months, six months and 12 months, according to the criteria by Feigal et al, in 2000. Chi- square test was used to analyze data at P<0.05 level of significance. RESULTS: Statistically significant differences were found for sealant retention between fifth generation and sealant group, and fifth generation and seventh generation groups; whereas, no significant difference was found for sealant retention between seventh generation and sealant group at three, six and 12 months. CONCLUSION: As separate etch and rinse steps are not required for seventh generation bonding agents, and almost similar results were obtained for both sealant and seventh generation groups, it can be concluded that application of sealant along with a seventh generation bonding agent may enhance sealant success and can be used for caries prevention in preventive programs.

Efficacy of dental floss and chlorhexidine mouth rinse as an adjunct to toothbrushing in removing plaque and gingival inflammation - a three way cross over trial.

BACKGROUND: Maintaining good oral hygiene is important to combat periodontal diseases. The use of tooth brush alone does not serve the purpose of removing plaque which demands the use of some adjuncts such as proximal cleaning aids. AIM: The study was conducted to compare the efficacy of Dental Floss and 0.12% Chlorhexidine Gluconate Mouthrinse as an adjunct to toothbrushing on plaque accumulation and gingival inflammation. SETTINGS AND DESIGN: Department of Public Health Dentistry, Kothiwal Dental College and Research Centre, Moradabad, India. This was a randomized, double blind, three-way cross over clinical trial. MATERIALS AND METHODS: Forty five dental students in the age group of 19-25yr. were enrolled into the study. Subjects were randomly assigned into three groups (n=15) i.e. Group A- Toothbrushing with Dental floss (TB+DF), Group B- Toothbrushing with 0.12% Chlorhexidine Gluconate Mouthrinse (TB+CHX-MR) and Group C- Toothbrushing alone (TB Alone) in a three-way crossover manner. After 21 d of trial period, plaque index (PI) and gingival index (GI) were assessed for each group, oral prophylaxis followed by a washout period for 14d. STATISTICAL ANALYSIS USED: Mean, standard deviations and p-values were obtained. ANOVA test was used to compare the intergroup difference and Post hoc test to compare between the two groups. RESULTS: The inter-group comparison for GI and PI at all interventions showed statistically significant difference (p<0.001). While comparing between group A and group C at second and third follow up, no significant difference were observed though group A showed reduction in mean values for both the clinical parameters whereas while comparing between group A and group B, statistically significant difference was observed, which is in line when compared with group B and group C. The Group B showed more reduction in plaque and gingival scores which was found to be statistically significant (p<0.001). CONCLUSION: CHX-MR when used as an adjunct to toothbrushing is more effective in the reduction of plaque and gingival scores than a toothbrush alone or in combination with DF.

Efficacy of nonsurgical periodontal therapy on glycaemic control in type II diabetic patients: a randomized controlled clinical trial.

PURPOSE: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. METHODS: Sixty subjects aged 35-45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. RESULTS: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c (R(2)=0.832, P<0.05). CONCLUSIONS: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.

Is plaque removal efficacy of toothbrush related to bristle flaring? A 3-month prospective parallel experimental study.

BACKGROUND: Toothbrushes are over-the-counter products; therefore, no special instruction is given to users when they purchase. There are scarce published studies that have investigated about how often toothbrushes should be replaced. Thus, this study aimed to verify the impact of the Progressive Toothbrush Bristle Flaring on plaque control efficacy of toothbrush. MATERIALS AND METHODS: Thirty six subjects were randomly selected and underwent complete oral prophylaxis 10 days prior to the Baseline plaque recording. All subjects were provided with new similar toothbrushes and were divided into two groups. New Brush Group changed toothbrush every month and Old month Group used single toothbrush for the whole period of the study. Both groups were assessed for plaque accumulation every month using Turesky et al, (1970) modification of the Quigley and Hein (1962) plaque index. Toothbrush head was photographed and assessed by measuring the brushing surface area on standardized photographs using National Institutes of Health Image Analysis Program (USA). RESULTS: Both groups showed similar plaque scores at the 40(th) day; progressive increase in the plaque scores in group without changing the toothbrush were recorded at the 70(th) and 100(th) days. As toothbrush flaring increased, the plaque scores also increased in the Old Brush Group. Highest plaque accumulation was recorded in Mandibular Lingual aspects in Old Brush Group. CONCLUSION: Progressive increase was seen in the plaque scores with increase in toothbrush bristle flaring.

Anti-gingivitis effects of Acacia arabica-containing toothpaste.

OBJECTIVE: To evaluate the anti-plaque and anti-gingivitis properties of Acacia arabicacontaining toothpaste in an adult population. METHODS: Sixty subjects with gingivitis were randomly assigned to a test group (Acacia arabica-containing toothpaste) or control group (regular toothpaste). An analysis of plaque index (PI), gingival index (GI) and bleeding on probing index (BOP%) were carried out at baseline and after 28 days followed by a washout period. After the washout period, the test and control groups were crossed over and the assessments were repeated. RESULTS: Reductions in PI, GI and BOP% were observed in the test group compared with the control group. CONCLUSION: Brushing with Acacia arabica-containing toothpaste may help inhibit gingivitis. It can be recommended for daily oral hygiene procedures.