Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial.

Aim and objective: To evaluate the clinical efficacy of propolis as pulpotomy medicament in human primary molars. Materials and methods: This randomized controlled trial is a two-arm, parallel group study with blinded outcome assessment. The study included a total of 60 primary molars that require pulpotomy treatment in 4- 8-year old children. Teeth were assigned to two groups randomly: Propolis (Test group); Mineral trioxide aggregate (MTA) (Control group). All the pulpotomized teeth were given stainless steel crowns and the teeth were evaluated clinically and radiographically at 6, 12, and 24 months to grade them as either success or failure. Chi-square test was employed to analyze the data. Results: Success rates of pulpotomy with propolis and MTA were 80% and 93.1% respectively at 24 months of follow-up interval. Propolis has shown success rates of 90% and 80% at 6- and 12-month follow-up, while MTA has shown a consistent success rate of 93.1% at all the follow-up intervals. The difference in success rate between the groups at all the time intervals is statistically nonsignificant. Conclusion: Propolis has demonstrated a clinically acceptable success rate comparable to MTA as pulpotomy medicament in primary teeth. Clinical significance: Biocompatible materials with regenerative potential have drawn the momentum in vital pulp therapy. In this regard, MTA has been emerged as most successful material, but its high cost has limited its use. Hence, there is an absolute need of cost-effective pulpotomy material with regenerative potential. This study provides an evidence that propolis has clinically acceptable success rate as pulpotomy medicament. Considering its low cost and ready availability, it can be recommended as a cost-effective alternative for primary teeth pulpotomy. How to cite this article: RojaRamya KS, Chandrasekhar R, Uloopi KS, et al. Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(S-1):S3-S7.

Evaluation of caries arresting potential of silver diamine fluoride and sodium fluoride varnish in primary molars: A randomized controlled trial.

Background: Caries management in the modern era has shifted away from the traditional surgical method toward a medical paradigm, which often includes fluoride therapy. Fluoride used in various forms has been proven to be effective in dental caries prevention. Silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish are effective in arresting caries in primary molars. Aim: This study aimed to evaluate the effectiveness of 38% SDF and 5% NaF varnish in arresting caries in primary molars. Settings and Design: This study was a split-mouth randomized controlled trial. Materials and Methods: The randomized controlled trial comprised 34 children aged 6-9 years with teeth having caries in both right and left primary molars without pulpal involvement. Teeth were randomly allocated into two groups. In Group 1 (n = 34), 38% SDF + potassium iodide was applied and in Group 2 (n = 34), 5% NaF varnish was applied. The second application was done after 6 months in both groups. Children were recalled at 6- and 12-month intervals and evaluated for caries arrest. Statistical Analysis: Chi-square test was used to analyze the data. Results: Caries arresting potential was found to be higher in the SDF group compared to the NaF varnish group at both 6-month (SDF - 82% and NaF varnish - 45%) and 12-month intervals (SDF - 77% and NaF varnish - 42%) and the difference was found to be statistically significant (P = 0.002 and 0.004, respectively). Conclusion: SDF was more effective in arresting dental caries in primary molars compared to 5% NaF varnish.

Association of serum Vitamin D and salivary calcium and phosphorus levels in 3-11-year-old schoolchildren with dental caries.

BACKGROUND: Vitamin D plays an essential role in the formation of healthy teeth, protection against dental caries, and the appropriate secretion of salivary calcium. Salivary calcium and phosphate help in maintaining equilibrium between demineralization and remineralization of teeth. If we know the association between serum Vitamin D and salivary calcium and phosphorus, we may get a clue regarding serum Vitamin D levels which in turn is essential for good oral health. AIM: The aim of this study was to assess the association of serum Vitamin D levels and salivary calcium and phosphorus levels in children with dental caries. SETTINGS AND DESIGN: This was a comparative cross-sectional study. MATERIALS AND METHODS: One hundred children of age 6-11 years, 50 with Decayed, Missing, and Filled Teeth (DMFT) ≥5 (test group) and 50 with DMFT = 0 (control group), were included in the study. Oral examination was carried out and DMFT/deft scores were recorded. Serum 25-hydroxy Vitamin D levels and salivary calcium and phosphorous levels were measured. STATISTICAL ANALYSIS: Independent sample t-test, linear regression analysis, and Pearson correlation test were used for statistical analysis. RESULTS: Children with dental caries have shown lesser mean serum Vitamin D levels (15.37 ± 3.53) than caries-free children (17.26 ± 3.16). Children with decayed teeth have exhibited lower salivary calcium levels (3.92 ± 0.99) than those without caries (4.42 ± 1.37). Conversely, children with dental caries have shown higher mean salivary phosphate levels (6.27 ± 1.74) than caries-free children (5.18 ± 1.47). There is a significant decrease in salivary calcium (P = 0.018) and serum Vitamin D (P = 0.004) with a significant increase in number of decayed teeth. The greater the Vitamin D deficiency, the lesser are the salivary calcium levels observed (P = 0.001). CONCLUSIONS: Children with Vitamin D deficiency have lower salivary calcium levels. Vitamin D deficiency and lower salivary calcium levels can be the potential risk factors for the occurrence of dental caries.

Impact of Calcium Glycerophosphate-supplemented Carbonated Beverages in Reducing Mineral Loss from the Enamel Surface.

AIM: The aim of this study was to evaluate the surface microhardness and mineral loss from enamel exposed to carbonated beverages supplemented with and without calcium glycerophosphate (CaGP). MATERIALS AND METHODS: Forty enamel blocks were prepared from 20 extracted premolars, and their initial surface microhardness was measured using the Knoop microhardness testing machine. The samples were divided into four groups based on the concentration of CaGP added to the beverage: group I: beverage without CaGP (control group), group II: beverage with 2 mM CaGP, group III: beverage with 5 mM CaGP, and group IV: beverage with 10 mM CaGP. The samples were subjected to four cycles of exposure to plain and CaGP-supplemented carbonated beverage with an intermittent buffering in artificial saliva, after which the final surface microhardness was measured. The mineral loss from enamel blocks was estimated spectrophotometrically. RESULTS: The obtained data were analyzed using paired t test and analysis of variance. A highly significant (p < 0.01) reduction in surface microhardness was observed in group I (beverage without CaGP). The reduction in surface microhardness in group III (beverage + 5 mM CaGP) and group IV (beverage + 10 mM CaGP) was not significantly different from that of sound enamel. A highly significant difference in calcium loss was observed between the groups (p = 0.00). Calcium loss reduced as the CaGP concentration increased in the groups. A similar trend was observed when phosphate loss was analyzed. CONCLUSION: Addition of CaGP to the carbonated beverages significantly prevented the reduction in surface microhardness of enamel and mineral loss. As the concentration of CaGP in carbonated beverages increased from 2 mM to 10 mM, the mineral loss is decreased. CLINICAL SIGNIFICANCE: Consumption of carbonated beverages has been increasing among the children and adolescents, leading to a higher incidence of dental erosion and caries. Hence, supplementation of these acidic beverages with buffering agents such as CaGP may help in preventing such dental problems among vulnerable populations. HOW TO CITE THIS ARTICLE: Manaswini YH, Uloopi KS, Vinay C, et al. Impact of Calcium Glycerophosphate-supplemented Carbonated Beverages in Reducing Mineral Loss from the Enamel Surface. Int J Clin Pediatr Dent 2020;13(1):1-5.

Success of root fillings with zinc oxide-ozonated oil in primary molars: preliminary results.

AIM: To evaluate the success rate of mixture of ozonated oil and zinc oxide as a primary teeth root filling material. STUDY DESIGN: Prospective randomised clinical study. METHODS: The study included 60 infected primary mandibular molars which were equally divided into study group (ozonated oil-ZnO) and control group (zinc oxide-eugenol). Pulpectomy procedure was performed and the children were followed at regular intervals. All the children were available for evaluation at the end of 12 months. The teeth were evaluated for success or failure based on clinical and radiographic criteria by a blinded investigator. STATISTICS: The proportional values were compared using χ(2) test. RESULTS: Clinical and radiographic evaluation suggested that teeth obturated with ozonated oil-zinc oxide demonstrated good success rate (93.3%) as compared to zinc oxide eugenol (63.3%). However, no statistically significant variation (p = 0.408) was observed between the groups. CONCLUSION: Ozonated oil-ZnO demonstrated a good clinical and radiographic success at 12 months follow-up and it can be considered as an alternative obturating material in infected primary teeth.

Effectiveness of two flavored topical anesthetic agents in reducing injection pain in children: a comparative study.

UNLABELLED: Topical anesthesia is widely advocated in pediatric dentistry practice to reduce pain and anxiety produced by administration of local anesthesia. There are different combinations of topical anesthetic agents that are marketed worldwide. However, sparse literature reports exist regarding clinical efficacy of these agents. AIM: To compare the clinical effectiveness of two strawberry flavored topical anesthetics viz. Precaine (8% Lidocaine + 0.8% Dibucaine) and Precaine B (20% Benzocaine) in children before intra oral local anesthetic injections and for extraction of mobile primary teeth. STUDY DESIGN: This triple blind clinical study included sixty children divided equally under three techniques--palatal injections, inferior alveolar nerve block and extraction of mobile primary teeth. Both the products were used alternately using split mouth design in two visits and the child's pain response was assessed using VAS and SEM pain scale. The scores obtained were subjected to statistical analysis. RESULTS: Precaine has shown lower mean scores in all the techniques under both the pain scales, but were statistically insignificant. Gender wise comparison has also shown lower mean scores for Precaine for both males and females, however these were statistically insignificant. On visit wise comparison, Precaine B reported significant lower scores (p < 0.05) in visit 2 compared to visit 1 for inferior alveolar nerve block and extraction of mobile primary teeth under SEM pain scale. CONCLUSION: Precaine (8% Lidocaine + 0.8% Dibucaine) can be used as effectively as Precaine B (20% Benzocaine).

Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery.

CONTEXT: Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes. AIMS: The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery. SETTINGS AND DESIGN: Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery. MATERIALS AND METHODS: Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK) cell % counts) and serum immunoglobulins (IgG, IgA and IgM). STATISTICAL ANALYSIS USED: We used analysis of covariance to compare interventions postoperatively. RESULTS: Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36). The results suggest a significant decrease in the state (P = 0.04) and trait (P = 0.004) of anxiety, depression (P = 0.01), symptom severity (P = 0.01), distress (P < 0.01) and improvement in quality of life (P = 0.01) in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% (P = 0.02) and lower levels of serum IgA (P = 0.001) in the yoga group as compared to controls following surgery. CONCLUSIONS: The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery.

CONTEXT: Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery. OBJECTIVE: The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. METHODS: Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL)-2 receptor (IL-2R), tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. RESULTS: Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36). The results suggest a significant decrease in the duration of hospital stay (P = 0.003), days of drain retention (P = 0.001) and days for suture removal (P = 0.03) in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group (P < 0.001), as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. CONCLUSION: The results suggest possible benefits of yoga in reducing postoperative complications in breast cancer patients.