Evaluation of Changes in the Occlusion and Occlusal Vertical Dimension in Children Following the Placement of Preformed Metal Crowns Using the Hall Technique.

Objectives: To evaluate the time taken and the mechanism through which the occlusion settles following the placement of a preformed metal crown (PMC) using the Hall technique. The secondary objective was to assess any temporo mandibular joint dysfunction (TMD) resulting from the Hall technique through a questionnaire. Study Design: 44 children fulfilling the inclusion criteria were evaluated for changes in overbite and occlusal vertical dimension (OVD) following the placement of preformed metal crowns (PMCs) using the Hall technique. The overbite and OVD measurements were taken before treatment, immediately post treatment, then at one, two, three and four weeks post treatment. After four weeks, a questionnaire recorded the occurrence of any signs or symptoms of TMD. Results: At the fourth week, the overbite measurement did not show a statistically significant difference (p value= 0.58) compared to baseline values indicating that the occlusion settled by the fourth week. By the third week the OVD values obtained did not show a significant difference compared to the baseline (p value= 0.42) indicating that the OVD had been restored. The questionnaire provided at the end of four weeks showed negative response for signs and symptoms of TMD in all the children. Conclusion: Any changes in occlusion following the placement of a Hall crown settles in four weeks. The OVD settles three weeks post placement implying that extrusion of teeth do not play a role in settling of the occlusion. The children do not develop any signs or symptoms of TMD post a Hall crown.

Comparison of Patient Comfort During the First Stage of Conventional Versus Modified Two-Stage Inferior Alveolar Nerve Blocks in Pediatric Patients.

Our aim was to compare the comfort of pediatric patients during the first stage of the conventional 2-stage inferior alveolar nerve block (IANB) versus the modified 2-stage IANB. This was a parallel group, single-blinded, randomized controlled trial. Pediatric patients meeting the inclusion criteria were randomly allocated to 1 of the 2 groups receiving IANB, group 1 (31 subjects) utilized a conventional 2-stage technique, and group 2 (33 subjects) utilized a modified 2-stage approach. Patient comfort was assessed indirectly by 2 observers using the Face, Legs, Activity, Cry, Consolability (FLACC) scale during the first stage of the injections. FLACC score data between the 2 groups were analyzed using the chi-square test, and interobserver reliability was measured using kappa statistics. During the first stage of the injections, lower FLACC scores of 0 indicating a relaxed/comfortable patient experience were found in 57.6% of group 2 subjects compared with only 25.8% group 1 subjects, which was a statistically significant difference (p-value .013). Interobserver reliability assessed using kappa coefficients (κ = 0.812) indicated excellent agreement. FLACC scores for the pediatric patients during the first stage of the modified 2-stage IANB technique were significantly lower than during the first stage of the conventional 2-stage IANB technique.

Evaluation of the effectiveness of a custom-made toothbrush in maintaining oral hygiene and gingival health in cerebral palsy patients.

AIM: To evaluate and compare the efficacy of customized toothbrushes in maintenance of oral hygiene and gingival health with that of conventional toothbrushes in children with cerebral palsy. METHODS: Thirty patients with cerebral palsy in the age group of 6 to 18 years were randomly divided into two groups-group I (normal toothbrush) and group II (customized toothbrush). Common oral hygiene instructions were given to both the groups. Before beginning the study, plaque index (PI) and modified gingival index (MGI) were recorded, following which patients were made to practice their routine twice a day brushing with either normal toothbrush or custom-made toothbrush for 3 weeks. At the end of 3 weeks, PI and MGI were rerecorded. The subjects belonging to group II were also made to perform muscle exercises using the modified brush head. RESULTS: Significantly high percentage drop between the pre- and post-PI as well as MGI (31.55% and 30.23%, respectively) was observed in the custom-made toothbrush group, while the percentage drop of only 8.34% (PI) and 14.51% (MGI) was seen in the normal toothbrush group. CONCLUSIONS: Custom-made tooth brushes increased the efficiency of maintaining oral hygiene and gingival health of individuals with cerebral palsy.