Visit to the Dentist for Oral Health Prevention at "Age One": A proposed policy report from the Indian perspective.

Early childhood caries is a major public health issue in India. The primary reason for poor oral health in children is a lack of awareness about the role of primary teeth and the importance of an early dental visit for infants and toddlers. The primary objectives of an early dental visit are to analyze the child's risk level, provide guidance to parents regarding proper oral hygiene measures, review dietary and eating habits, provide information regarding the infectivity of dental caries, review the risks of traumatic injuries and discuss factors which affect the development of occlusion. Through this paper, we are proposing an "Age One" policy that recognizes dentists, physicians, allied health professionals, community health-care workers, and nongovernmental organizations to work toward a child's overall health as partners to achieve this goal. The expectation is that this policy will provide guidance to childcare centers, pediatric dentists, other health-care professionals, and legislators regarding oral health activities and the promotion of oral health in infants. The purpose of the policy is to lay the foundation for a lifetime of preventive education and dental care, to help ensure optimal oral health beginning in childhood and continuing through the life course.

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi.

AIM: This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents' perceptions among preschool children in the 3-5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region. METHODS: A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean's fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents' perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant. RESULTS: Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3-5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child's age and parents' education level (p < 0.05). CONCLUSION: The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease's nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status.

A comparative evaluation of gingival microleakage and internal voids in Class II composite restoration with two different lining techniques: An in vitro study.

Aim: The aim of this study was to evaluate the gingival microleakage and internal voids in Class II composite restoration restored with precure and co-cure lining techniques using stereomicroscopic method. Materials and Methods: Forty-five freshly extracted permanent multirooted human molar teeth were collected and used in the study. After surface debridement and scaling of all teeth, standard Class II mesio-occlusal cavities were prepared. Forty-five samples were randomly divided into three experimental groups (n = 15), and filled according to manufacturer's instructions. Group I was precure group, Group II was co-cure group, and Group III was only bulk fill. The finishing and polishing of the restorations was done after 24 h. Then, all the specimens were subjected to thermocycling for 500 cycles. The gingival microleakage and internal voids of all the groups were evaluated using dye penetration method. Samples were then sectioned and examined under the stereomicroscope at ×40. Readings obtained were subjected to statistical analysis using SPSS ver 20.0 (IBM Corp, ARMONK USA) and Chi-square test. Results: The statistical analysis revealed that extent of microleakage was maximum in Group II (co-cure), followed by Group III (only bulk fill) and Group I (precure). The gingival voids were maximum in Group III (only bulk fill), minimum in Group II (co-cure), and least in Group I (precure). The cervical voids were maximum in Group II (co-cure) and Group III (only bulk fill), followed by Group I (precure). The occlusal voids were maximum in Group II (co-cure) and similar in Group I (precure) and Group III (only bulk fill). Conclusion: The precure lining technique was better than co-cure lining technique in terms of both microleakage and internal voids.

Knowledge and Perceptions Regarding Coronavirus (COVID-19) among Pediatric Dentists during Lockdown Period.

AIM: To assess the knowledge and perceptions of COVID-19 among pediatric dentists based on their dependent source of information. METHODS: A descriptive-analytical cross-sectional survey using a self-administered questionnaire with 23 questions was sent via Google forms to pediatric dentists. All participants were divided into three groups [postgraduate residents (PGs), private practitioners (PP), and faculty (F)]. The comparison of knowledge and perception scores was made based on occupation, source of information, and descriptive statistics used for the analysis using SPSS 21.0 (IBM, Armonk, NY, USA). RESULTS: A total of 291 pediatric dentists completed the survey, and the majority of them were females (65%). Overall, good mean scores were obtained for knowledge (9.2 ± 1.07) and perceptions (5.6 ± 1.5). The majority of the participants used health authorities (45%) to obtain updates on COVID-19, while social media (35.1%) and both (19.6%) accounted for the next two. A statistically significant difference (p < 0.05) was found among different pediatric dentists groups for relying on the source of information. CONCLUSION: Overall good pediatric dentists showed sufficient knowledge regarding COVID-19. The pediatric dentists' age, occupation, and source of information influenced knowledge regarding COVID-19, whereas perceptions were influenced by age and gender of the participants. Health authorities successfully educated pediatric dentists than the social media.

Spectrophotometric Evaluation of Color Change in Tooth Enamel Defects Using Resin Infiltrate: An In Vivo Study.

AIM: To analyze the comparative change in pretreatment and posttreatment La*b* values of color in initial nonpitted white spot lesions of fluorosed teeth after resin infiltration with DMG-Icon spectrophotometrically with VITA easy shade. MATERIALS AND METHODS: A total of 30 maxillary and mandibular permanent anterior teeth with mild, nonpitted white spot lesions (atleast one) of fluorosis [till grade IV of Thylstrup and Fejerskov (TF) index] in patients between 6 years and 14 years of age were included in the present study. Shade of selected tooth and its white spot lesion area was recorded using VITA 3D shade guide, both pre and postoperatively, i.e., after application of DMG Icon. This was followed by recording the change in corresponding La*b* values of tooth shade and white spot lesion spectrophotometrically using VITA Easy Shade. Results obtained were analyzed statistically. RESULTS: ΔE value of color change was found to be less than 3.7 in most of samples after resin infiltration and esthetically color change to naked eye was statistically significant (p value < 0.00001) postoperatively. CONCLUSION: Resin infiltration with DMG Icon can improve the color of non-cavitated white spot lesions. The esthetic effect of this treatment was evident immediately after treatment. Moreover, no cavitation occurred after etching, even when the surface layer had been eroded completely. CLINICAL SIGNIFICANCE: Achievement of esthetic results without loss of tooth structure and postoperative sensitivity. HOW TO CITE THIS ARTICLE: Dogra S, Goyal V, Gupta A, et al. Spectrophotometric Evaluation of Color Change in Tooth Enamel Defects Using Resin Infiltrate: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(2):150-154.

A comparative evaluation of fractural strength and marginal discrepancy of direct composite veneers using four different tooth preparation techniques: An in vitro study.

BACKGROUND: The direct composite veneers follow the concept of no preparation or minimal preparation that has developed an appropriate enamel bonding procedure. The composite veneers can be easily repaired and thus they are economically favorable. The long-term clinical performance of direct composite veneers depends on a number of factors, with fracture resistance and marginal adaptation being one of the significance. AIM AND OBJECTIVE: The aim of the present study was to evaluate the fractural strength and marginal discrepancy of direct composite veneers using four different tooth preparation techniques (window preparation, feather preparation, bevel preparation, and incisal overlap preparation). SETTINGS AND DESIGN: The present study is an in vitro study with the sample size of 75 participants. A total of 75 human extracted maxillary central incisors were collected and then divided into four experimental groups and one control group (n = 15 each). MATERIALS AND METHODS: A total of 75 human extracted maxillary central incisors were collected and then divided into four experimental groups and one control group (n = 15 each). Four tooth preparation techniques were performed followed by direct composite veneering. All the study samples were then splitted into two equal halves. One half of all the samples was subjected to a cell load from 0 N to 100 KN at a crosshead speed of 1 mm at 90° angulation using universal testing machine to evaluate the fractural strength. The other halves were sectioned longitudinally, and the samples were then subjected under the travelling microscope at ×200 magnification to measure the marginal discrepancy at cervical, middle, and incisal locations. STATISTICAL ANALYSIS: The data obtained were subjected to statistical analysis using SPSS Version 20.0. RESULTS: The fractural strength showed the maximum strength in Group V: Control group (273.33 ± 81.01), Group III: Bevel preparation (193.80 ± 66.59), Group IV: Incisal overlap preparation (188.93 ± 76.14), Group II: Feather preparation (160.33 ± 53.59), and least in Group I: Window preparation (147.74 ± 48.95). The marginal discrepancy showed maximum discrepancy in Group IV: Incisal overlap preparation (49.11 ± 6.33), Group II: Feather preparation (48.44 ± 6.01), Group III: Bevel preparation (46.67 ± 7.07), and least in Group I: Window preparation (45.33 ± 6.31). CONCLUSION: The fractural strength was maximum in Group V, followed by Group III, Group IV, Group II, and the least mean value score was found for the Group I, and the marginal discrepancy was maximum in Group IV, followed by Group II, Group III, and the least mean value score was found for the Group I.

Antimicrobial efficacy of 980 nm diode laser on Enterococcus feacalis in conjunction with various irrigation regimes in infected root canals: An in vitro study.

AIM: The aim of the present study was to evaluate and compare the antimicrobial efficiency of different irrigating solutions against Enterococcus faecalis with or without the use of 980 nm diode laser in infected root canals. MATERIALS AND METHODS: A total of 100 freshly extracted human single-rooted teeth were divided into three experimental groups (n = 30) and one control group (n = 10). Experimental group was subdivided into two subgroups A and B (n = 15), whereas control group was subdivided into positive and negative controls (n = 5). After access cavity preparation, the root canals were prepared using ProTaper rotary instruments. A volume of 5 ml of 5.25% sodium hypochlorite and 17% Ethylenediaminetetraacetic acid, 1.2 ml of 2% chlorhexidine gluconate, and 2 ml of neem solution was used for irrigation in Group I, II, and III, respectively. E. faecalis (ATCC 29212) was inoculated into each canal of experimental groups and incubated for 2 weeks under aerobic conditions at 37°C. In all the subgroups B, laser irradiation was performed, whereas, in subgroup A, no laser irradiation was done. In negative control, E. faecalis was not inoculated in samples, but in positive control, E. faecalis inoculation and incubation procedure was followed. With circumferential filing using #40 reamer, dentinal chips were collected using sterile paper points, vortexed in sterile saline, was then applied to UTI Hicrome agar culture plates and incubated at 37°C for 48 h. The cfu/ml for each plate was calculated using a bacterial colony counter. The data obtained were subjected to statistical analysis using SPSS software version 20.0. RESULTS: The study showed that the least number of bacterial cfu/ml was observed in Group IB. The order of bacterial colony count (cfu/ml) was observed as Group IB

Comparison of Push-Out Bond Strength of Furcation Perforation Repair Materials - Glass Ionomer Cement Type II, Hydroxyapatite, Mineral Trioxide Aggregate, and Biodentine: An in vitro Study.

BACKGROUND: A furcation perforation is mid-curvature opening into periodontal ligament space which is a worst possible outcome in root canal treatment. Perforations should immediately be repaired with a biocompatible material to seal the communication between perforation site and gingival sulcus. AIM: The aim of this study was to evaluate the push-out bond strength of glass ionomer cement, hydroxyapatite, mineral trioxide aggregate, and biodentine (BD) when used in repairing furcal perforations with and without blood contamination in permanent molars. MATERIALS AND METHODS: A total of 120 human extracted molars were collected and divided on the basis of perforation repair materials and blood contamination status (n = 15). All the materials were subjected to universal testing machine to a load cell from 0 N to 100 KN at a crosshead speed of 1 mm/min. STATISTICAL ANALYSIS: The data obtained were subjected to statistical analysis using SPSS version 20.0. Results and. CONCLUSION: The push-out bond strength was maximum in BD contaminated with blood and least for the hydroxyapatite contaminated with blood. A significant difference was found between all the perforation repair materials.

Mineral trioxide aggregate-induced apical closure in nonvital immature permanent maxillary incisor.

Treatment of nonvital immature permanent teeth with calcium hydroxide is associated with few difficulties such as weakened tooth root, root canal reinfection, and long treatment time. Mineral trioxide aggregate (MTA) apical plug method is an alternative treatment method for open apices and has gained popularity in the recent times. This case report describes the management of a late-referral case of periapically involved, traumatized immature permanent incisor by endodontic treatment and the use of MTA apical plug. After preparing the access cavity, the working length was determined. The root canals were irrigated with 3% sodium hypochlorite and disinfected with metapex for 2 weeks. MTA was then placed in the apical 3 mm of the root canal. The remaining part of the root canal was filled with thermoplastic gutta-percha, and the coronal restoration was finished with composite resin. After 1-year follow-up, radiograph showed successful healing of periradicular radiolucency.

Esthetic improvement of white spot lesions and non-pitted fluorosis using resin infiltration technique: series of four clinical cases.

White opacities have always been a major concern of esthetics for patients and can have varying etiology. In general, white discolorations of enamel might be due to dental fluorosis, early caries (white spot lesions), developmental defects etc. Conventional treatment options available for such opacities include non-invasive and invasive approaches. Recently, a new "micro-invasive" technique has been introduced as an alternative therapeutic approach that improves such opacities esthetically, in a single sitting, is painless and exhibits no complications. This case series illustrates the use of resin infiltration to treat fluorosis stains and WSLs, exhibiting significant improvement in esthetics.

Cherubism: a case report.

Cherubism, a pediatric disease, is a self limiting non-neoplastic autosomal dominant fibro-osseous disorder of jaws. It is a self limiting disease and rarely apparent before the age of two years. It occurs in children and predominantly in boys. It is characterized by clinical bilateral swelling of cheeks due to bony enlargement of jaws that give the patient a typical 'cherubic' look. Regression occurs during puberty when the disease stabilizes after the growth period leaving some facial deformity and malocclusion. Cherubism may occur in solitary cases or in many members of the family, often in multiple generations. Radiographically, lesion appears as bilateral multilocular radiolucent areas. Since it was first described by Jones in 1933, many cases have been documented. Here a case of 8 years old cherubic child, with his clinical appearance as well as radiological evaluation and discussion about clinical outcome are presented. The patient was diagnosed but not treated.