Distraction With Virtual Reality Goggles in Paediatric Dental Treatment: A Randomised Controlled Trial.

AIM: The aim of this study was to examine whether screening content through virtual reality (VR) goggles can diminish pain perception during local anaesthesia administered using the inferior alveolar nerve block technique and rubber dam placement in routine paediatric dental treatment. MATERIALS AND METHODS: This is a crossover study of healthy 4- to 12-year-old children who were scheduled to receive local anaesthesia administered using the inferior alveolar nerve block technique and rubber dam placement in 2 visits. The participants were randomly assigned to undergo 1 treatment performed with Oculus GO VR goggles and the other treatment without. Pain was evaluated using the Wong-Baker FACES Pain Rating Scale and the Modified Behavioral Pain Scale (MBPS). RESULTS: The study group included 29 children with a mean age of 8.29 years (SD, 1.96). Whilst administering local anaesthesia, no significant difference was observed in the Wong-Baker FACES Pain Rating Scale and in MBPS movements between visits with and without the VR goggles. However, significantly lower pain perception was observed in the other parameters of MBPS when using the VR goggles: Face (P = .007) and Cry (P = .046). During placement of a rubber dam, significantly less pain was reported by the patients (P = .005) and observed by the assessor (Face [P = .005], Cry [P = .029], and Movement [P = 0.028]) when the VR goggles were used. CONCLUSIONS: VR can decrease pain perception during rubber dam placement in children, but it has limited benefit during administration of local anaesthesia.

Protein Activation in Periapical Reaction to Iodoform Containing Root Canal Sealer.

OBJECTIVES: An association between root canal sealers and periapical lesions in primary dentition has been suggested, yet the chemical-protein interactions that may be involved in it have not been studied. The present study explored root sealer components' effect on periapical tissue proteins using bioinformatics tools. STUDY DESIGN: For each chemical component of Endoflas F.S. root sealing material we identified the known and predicted target proteins, using STITCH (search tool for interactions of chemicals http://stitch.embl.de/ ). Identified target proteins were grouped into functional categories using the annotation clustering tool from DAVID, the Database for Annotation, Visualization and Integrated Discovery ( http://david.abcc.ncifcrf.gov/ ). STRING Protein-Protein Interaction network database identified associations between the proteins. RESULTS: Sixteen proteins identified with STITCH served as input to DAVID annotation clustering tool. Only ZnO and Eugenol targeted proteins had statistically significant annotations. Gene Ontology terms of ZnO and Eugenol targeted proteins demonstrated that these proteins respond to mechanical stimulus and to oxidative stress. They highlight these proteins' role in the positive regulation of transcription, gene expression, cell proliferation and apoptosis, and their complementary role in the negative regulation of cell death. CONCLUSION: When stimulated by Zinc Oxide, Eugenol and Calcium hydroxide, chemical-protein and subsequent protein-protein interactions result in cell proliferation in the periapical area. Our findings indicate that certain root sealers components may cause enlargement of the permanent tooth follicle. Dentists should be aware of this phenomenon and radiographically monitor root canal treated teeth until shedding.

Regenerative endodontic treatment of an immature permanent canine following infant oral mutilation.

Extracting primary canine tooth buds is a ritual ceremony that prevails in some African countries. This procedure is considered infant oral mutilation (IOM) and may damage the permanent successor and adjacent primary and permanent teeth, resulting in dysplastic or deformed teeth. The purpose of this report was to describe regenerative endodontic treatment of a permanent mandibular canine with extensive coronal hypoplasia, immature root, and a periapical radiolucency following damage to the permanent canine that was probably a result of infant oral mutilation. Regenerative endodontic treatment was initiated by irrigating the root canal, followed by applying triple antibiotic paste dressing over three weeks and creating a blood clot scaffold covered with mineral trioxide aggregate. A 4-year clinical and radiographic follow-up demonstrated healing of the periapical radiolucency. This treatment may serve as a substitute for traditional apexification with calcium hydroxide or creation of an artificial apical barrier with mineral trioxide aggregate.

Are there metallic traces in black extrinsic dental stain?

OBJECTIVE: The detection of ferric ions in samples of black extrinsic dental stain led to the idea that it is comprised of insoluble ferric compounds. The present study examined the chemical composition of black extrinsic dental stain. METHOD AND MATERIALS: Plaque was collected from 17 children with black extrinsic dental stain (study group A) and from 15 children without black extrinsic stain (control group), using sterile graphite curettes; and from 4 children with black extrinsic stain (study group B), using a standard sterile metal curette. Samples were analyzed with a scanning electron microscope (SEM) and subjected to quantitative chemical analysis (energy dispersive spectrometry). RESULTS: Except for calcium and phosphorus levels, no significant differences were found between the chemical composition of black extrinsic dental stain and dental plaque. Metallic ions were not detected in samples collected with a graphite curette (study group A), but were detected in samples collected with a metal curette (study group B). CONCLUSION: Metallic ions do not seem to be the origin of black extrinsic dental stain. Previous reports of the presence of metallic ions are probably due to contamination of the samples by the collection method.

Unsweetened ice popsicles impart a positive feeling and reduce self-mutilation after paediatric dental treatment with local anaesthesia.

AIM: The purpose of the current study was to assess whether an unsweetened ice-popsicle imparts a positive feeling to children after dental treatment in which local anaesthesia is administered, and whether it reduces the tendency of children to self-mutilate (bite the lip, cheek or tongue) after the administration of local anaesthesia. DESIGN: Crossover study of 31 children aged 4-11 years old who needed similar dental treatments on both sides of the mandible or maxilla under local anaesthesia. At the end of each appointment the child received a toy or an ice-popsicle especially made for this study. Patients and parents answered a questionnaire regarding the children's behaviour and feeling immediately after the treatment, and 10 and 30 min after receiving the ice-popsicle or toy. RESULTS: Children who received ice-popsicles after dental treatment under local anaesthesia felt less discomfort and suffered less soft tissue trauma than they did when they received a toy. Reduction in soft tissue trauma was evident 10 min after receiving the ice-popsicles. CONCLUSION: Licking of an ice-popsicle after dental treatment with local anaesthesia reduces the feeling of discomfort and the biting of soft tissue and self- mutilation.

The use of popsicles after dental treatment with local anesthesia in pediatric patients.

The purpose of the study was to assess how children felt after dental treatment when receiving apopsicle or a toy Each patient received either a popsicle or a toy after dental treatment on the first visit, and the other on the second visit. A significant difference (p = 0.0235) was found 10 minutes and thereafter 30 minutes after dental treatment. More children reported feeling better when they received a popsicle than when they received a toy.