Comparative Evaluation of the Regenerative Potential of Blood Clot and Platelet-rich Fibrin in Young Permanent Teeth Based on the Revised American Academy of Endodontics Clinical Considerations for Regenerative Procedure: 2016.

Aim: To compare and evaluate the regenerative potential of blood clots and platelet-rich fibrin (PRF) in IYNPT based on the revised American Academy of Endodontics (AAE) clinical considerations for regenerative endodontics 2016. Materials and methods: A total of 20 patients (7-12 years) with immature young necrotic permanent teeth were included and irrigation and disinfection were done using the revised AAE protocol. Teeth were randomly categorized into PRF scaffolding and conventional bleeding technique. The cases were followed up for 1, 3, and 6 months for clinical and radiographic evaluation. Result: At 6 months there was no significant difference between the groups in terms of clinical healing and periapical healing. A significant statistical difference was noted at the end of 6 months with respect to apical closure within the PRF group. A significant difference was seen in the increase in dentin thickness between groups with PRF showing more increase. Conclusion: The PRF scaffold can be used as it induces the regenerative potential of stem cells at the apex. How to cite this article: Prakash AJ, Naik SV, Attiguppe P. Comparative Evaluation of the Regenerative Potential of Blood Clot and Platelet-rich Fibrin in Young Permanent Teeth Based on the Revised American Academy of Endodontics Clinical Considerations for Regenerative Procedure: 2016. Int J Clin Pediatr Dent 2023;16(S-2):S149-S154.

A survey on awareness and knowledge among dentist practicing regenerative endodontics towards current regenerative endodontic protocols and the scaffolds used in regenerative dentistry.

There are many inconsistencies in the protocols followed for Regenerative Endodontic Procedures (REP's).This study was formulated with an aim to conduct a survey among Pediatric Dentists, Endodontists and General Practioners treating Necrotic young permanent teeth to examine their awareness and Knowledge on Current Regenerative Endodontic Protocols and Scaffolds used in regenerative dentistry. Methods: A Cross-Sectional Survey was carried out amongst 100 Pediatric dentists,100 Endodontists and 100 General Practioners. It was web-based survey and the questionnaire was formulated and all the items in the questionnaire were tested for reliability and validity before circulation of the questionnaire for the purpose of the study. Results: The results of the study indicated that all the three groups were unaware that failure of cases should be reported to AEE (American Academy of Endodontics) REP Database and only 20.2, 20.1 and 0.3 % of Pediatric dentists,Endodontists and General Dentists preferred Regenerative Dentistry as a clinical protocol for REP. With respect to knowledge regarding irrigation and disinfection procedures all three groups were lacking in the knowledge regarding intracanal medicament for disinfection and the irrigation solutions. Conclusion: There is a lack of homogeneity in protocols followed for REP among those practicing Regenerative Endodontics as a protocol. Since it's an evolving science there is a need to bring about a uniformity in practices to increase the evidences to support the causal effect relation of regenerative endodontics.

Enhancing special care dentistry with sensory-adapted dental environment: A comparative study.

Aim: To compare and evaluate the effect of sensory-adapted dental environment (SADE) and regular dental environment in reducing anxiety levels in children with intellectual disabilities. Materials and Methods: This study was carried out in children with mild intellectual disabilities aged 8-13 years. The developmental screening test was utilized in screening and including these children with IQ scores between 52 and 67, and after random allocation, children were subjected to oral prophylaxis in the SADE and regular dental environment. Anxiety levels were assessed at baseline, 5 min, and at the end of the procedure using Venham's anxiety rating scale, pulse rate, and blood pressure values. Results: The data were coded and analyzed using software SPSS (IBM version 22.0) for statistical analysis. Comparison between the groups was done using independent t-test and repeated measured ANOVA for objective assessment of intergroup and intragroup anxiety levels, respectively, and using Mann-Whitney U-test and Friedman's test for subjective assessment of intergroup and intragroup anxiety levels, respectively. Conclusion: These findings suggest that SADE significantly decreased anxiety levels and cooperative behavior in children with mild intellectual disability and can be used as an alternative behavior management technique in effectively handling children with intellectual disability.

Knowledge and Attitude Among Various Dental Specialities Regarding Nasoalveolar Molding Procedure in Cleft Patients-A Cross-Sectional Study.

BACKGROUND: Nasoalveolar molding (NAM) is a presurgical orthopedic procedure, mainly focusing upon the aesthetic outcome of the treatment goal by reducing the number of reconstructive surgeries performed later for the purpose of esthetics. It was reported a very small proportion of pediatric dentists are providing presurgical intervention and the practice of NAM still side stepping among various dental practitioners. OBJECTIVES: The study was aimed to assess the knowledge and attitude among various dental specialties regarding NAM procedure in cleft patients. MATERIALS AND METHODS: A questionnaire-based cross-sectional survey was carried out among 180 dental professionals (pedodontists, orthodontists, prosthodontists, oral surgeons). A total of 180 questionnaires were prepared, out of which 98 were filled through direct personal interview and 82 were circulated via Google forms. Results were analyzed using chi-square test, Mann-Whitney U test, and Kruskal-Wallis test. RESULTS: There was statistically significant difference in the cumulative knowledge scores between specialty with P < .001; 99% of the participants think one should opt for NAM before cleft lip and palate surgery and 39% participants prefer pedodontists to carry out NAM procedure. CONCLUSION: Dental specialists in India have a positive attitude toward presurgical orthopedics. Majority of them agreed that there is great improvement in the aesthetic outcomes of surgeries after NAM intervention.

Conceptual combination of disinfection in regenerative endodontics: Conventional versus laser-assisted disinfection.

BACKGROUND: Successful regeneration depends on four key elements of tissue engineering such as stem cells, growth factors, scaffold and sterile environment. Therefore, regenerative endodontic therapy requires higher degree of disinfection for successful outcomes. AIMS AND OBJECTIVE: To evaluate the clinical and radiographic outcome using conventional and laser assisted disinfection in regenerative endodontics at 1, 3 and 6 months. MATERIALS AND METHODS: 18 children with necrotic young permanent teeth were selected for the study. In Group A, in the first appointment AAE (American Association of Endodontics, Clinical Consideration for Regenerative Endodontic Procedure - 2016) disinfection protocol was employed. In Group B laser assisted disinfection (810 nm diode laser, 1 W, 20 ms Pulse length and 20 ms interval duration) was performed. Microbial samples were obtained before and after disinfection to check the level of disinfection. The cases were followed up at 1 month, 3 months and 6 months interval and evaluated for clinical outcome, periapical healing and apical response. Data were statistically analyzed with level of significance set 1% or 5% accordingly (P<0.01 or P<0.05). RESULTS: On intragroup comparison there was significant reduction in bacterial count before and after disinfection with respect to laser assisted disinfection group. (P value = 0.007) There was no significant change in the clinical outcome score in laser group at 1,3- and 6-months interval. Periapical healing score showed statistically significant results in laser group when followed from 3 months to 6 months (P value = 0.04). CONCLUSION: Along with AAE 2016 protocol, use of laser assisted disinfection resulted in improved quality of disinfection and an expeditious clinical outcome and periapical healing in necrotic young permanent teeth. Keywords: Disinfection; laser; regenerative endodontics; sodium hypochlorite; tooth apex.

CPP-ACP and Fluoride: A Synergism to Combat Caries.

AIMS: The aim of this study is to evaluate and compare the demineralization inhibitory effect, fluoride release at varying time intervals, and antibacterial property of MI varnish and fluor protector varnish. MATERIALS AND METHODS: Twenty-four extracted human premolars were sectioned mesiodistally. The buccal and the lingual halves of the teeth were utilized to evaluate the demineralization inhibitory effect and fluoride release of MI varnish and fluor protector varnish, respectively. To evaluate the demineralization inhibitory effect, 150-µm axial longitudinal section was obtained that was photographed and evaluated under a polarized light microscope. To evaluate the fluoride release, a fluoride-specific ion electrode was used. To evaluate the antibacterial susceptibility, the disk diffusion test (Kirby-Bauer method) was done. RESULTS: Statistical analysis was done using the Students unpaired t test for intergroup comparison and the p value <0.01 was obtained for all the three parameters, i.e., demineralization inhibitory effect, antimicrobial property, and fluoride releasing property at different time intervals. CONCLUSION: A combination of casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) in fluoride varnish seems to enhance the caries preventive potential of fluoride varnish and antibacterial activity against Streptococcus mutans. CLINICAL SIGNIFICANCE: MI varnish, a combination of CPP-ACP and fluoride varnish could be the future of minimally invasive dentistry as it is minimally invasive yet an effective modality for caries prevention. HOW TO CITE THIS ARTICLE: Attiguppe P, Malik N, et al. CPP-ACP and Fluoride: A Synergism to Combat Caries. Int J Clin Pediatr Dent 2019;12(2):120-125.

Nanotechnology in Dentin Disinfection: Can We Preserve the Bond?

AIMS: The aim of this study is to evaluate the effect of cavity disinfection with 2% chlorhexidine (CHX) and Ag-Au nanoparticles on microleakage and resin tag penetrability of composite restoration under in vitro conditions. MATERIALS AND METHODS: Twenty-five human permanent molars extracted for therapeutic reasons were used in the study. Class V cavity of standard dimension was prepared on the buccal and lingual surfaces of the teeth. The teeth were randomly allocated into two groups based on the cavity disinfectant used: group I being 2% CHX gluconate (chlorhexidina Friedrich and Bianca Mittelstadt (FGM)) and group II being cavity disinfectant containing Ag-Au nanoparticles (nanocare gold). In both the groups, the dentin was etched with 37% phosphoric acid and cavity disinfectants were applied following which dentine bonding agent and composite resin were applied and cured. The specimens were then viewed under a stereomicroscope and a scanning electron microscope for microleakage and resin tag formation, respectively. RESULTS: The results were statistically analyzed using an independent "t" test. No significant difference was seen between the two groups with respect to both microleakage and resin tag penetration values (p > 0.05). CONCLUSION: The cavity disinfectant containing Ag-Au nanoparticles did not affect the sealing ability and resin tag penetrability of composite resin in permanent molars when compared with 2% CHX. HOW TO CITE THIS ARTICLE: Attiguppe P, Tripathi AP, et al. Nanotechnology in Dentin Disinfection: Can We Preserve the Bond? Int J Clin Pediatr Dent 2019;12(1):42-46.

Efficacy of Caries Removal by Carie-Care and Erbium-doped Yttrium Aluminum Garnet Laser in Primary Molars: A Scanning Electron Microscope Study.

AIM: To compare and evaluate morphological changes and bacterial deposits in primary carious molars after caries excavation with Carie-Care, erbium-doped yttrium aluminum garnet (Er:YAG) laser, and round tungsten carbide bur. MATERIALS AND METHODS: Thirty human carious primary molars extracted for therapeutic reasons were sectioned mesiodistally. These sectioned samples were allocated into three groups (20 samples each): group I: Carie Care, group II: Er:YAG laser, and group III: round tungsten carbide bur. After caries excavation, all samples were processed and examined under conventional light microscope to examine for bacterial deposits. Representative samples from each group were processed and analyzed to examine the morphology of caries-excavated tissue by scanning electron microscope (SEM). Statistical analysis was done using Fisher's exact test, Kruskal-Wallis test, and Mann-Whitney U test. RESULTS: The Er:YAG laser showed best results with no smear layer followed by chemomechanically excavated surfaces with Carie-Care. Amount of bacterial deposits was observed to be more in group I while least in group II (p-value < 0.001). Mann-Whitney U test and Fisher's exact test revealed that there was statistically significant difference among all the three groups. CONCLUSION: Among the three different methods of caries excavation, Er:YAG laser was found to be more effective compared with Carie-Care and round tungsten carbide bur. CLINICAL SIGNIFICANCE: Laser-induced caries excavation by Er:YAG laser and chemomechanical method of caries removal by Carie-Care can be considered as future of noninvasive pediatric and preventive dentistry.How to cite this article: Prabhakar A, Lokeshwari M, Naik SV, Yavagal C. Efficacy of Caries Removal by Carie-Care and Erbium-doped Yttrium Aluminum Garnet Laser in Primary Molars: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2018;11(4):323-329.

Nanotechnology in Dentin Disinfection: Can We Preserve the Bond?

AIMS: The aim of the present study is to evaluate the effect of cavity disinfection with 2% chlorhexidine (CHX) and Ag-Au nanoparticles on microleakage and resin tag penetrability of composite restoration under in vitro conditions. MATERIALS AND METHODS: Twenty-five human permanent molars extracted for therapeutic reasons were used in the study. Class V cavity of standard dimension was prepared on the buccal and lingual surfaces of the teeth. The teeth were randomly allocated into two groups based on the cavity disinfectant used; group I being 2% chlorhexidine gluconate (chlorhexidine FGM) and group II being cavity disinfectant containing Ag-Au nanoparticles (nanocare gold). In both the groups, the dentin was etched with 37% phosphoric acid and cavity disinfectants were applied following which dentine bonding agent and composite resin were applied and cured. The specimens were then viewed under stereomicroscope and scanning electron microscope for evaluation of microleakage and resin tag formation, respectively. RESULTS: The results were statistically analyzed using independent 't' test. No significant difference was seen between the two groups with respect to the microleakage and resin tag penetration values (p >0.05). CONCLUSION: Cavity disinfectant containing Ag-Au nanoparticles had no effect on the sealing ability and resin tag penetrability of composite resin in permanent molars when compared with 2% CHX. CLINICAL SIGNIFICANCE: Use of Cavity disinfectant containing Ag-Au nanoparticles with etch and rinse system can be preferred as it satisfies the ideal property of a cavity disinfectant which includes excellent antimicrobial action and non-detrimental effect on the sealing ability and resin tag penetrability. HOW TO CITE THIS ARTICLE: Ramasetty PA, Tripathi AP, Sugandhan S, Naik SV, Deepak BM. Nanotechnology in Dentin Disinfection: Can We Preserve the Bond? Int J Clin Pediatr Dent, 2018;11(6):468-473.

Comparative Evaluation of Different Modes of Laser Assisted Endodontics in Primary Teeth: An In vitro Study.

INTRODUCTION: The presence of bacteria in root canals has been considered to be responsible for endodontic treatment failure, even in case of primary teeth. The use of lasers can be a valuable addition in removing bacterial load in areas where traditional methods may fail to succeed. Methods like direct laser irradiation of canals, Laser Activated Irrigation (LAI) with sodium hypochlorite (NaOCl) and Photodynamic Therapy (PDT) seem to be a promising alternative for disinfection. AIM: This study was designed to compare the efficacy of latest advancements in disinfection techniques using diode laser namely direct laser irradiation, photodynamic therapy and laser activated irrigation using sodium hypochlorite. MATERIALS AND METHODS: Sixty freshly extracted primary teeth either single or multi-rooted teeth with two third of their root length intact were collected. Instrumentation was completed to size 30 H-file. Teeth were randomly divided into Group 1- Direct Laser- irradiation, Group 2 - Photodynamic therapy; Group 3- Laser activated irrigation with 2.5% NaOCl. The tooth specimens were inoculated with Enterococcus faecalis. The bacterial colonies were counted preoperatively. Laser irradiation was performed for all groups in accordance to the groups each tooth belonged to. Postoperatively the bacterial colonies were counted. One-way Analysis was applied to compare bacterial count at baseline and post-test between three groups. Tukey's post-hoc test was applied for pairwise comparison between groups. Paired t-test was applied to compare the mean baseline bacterial count with post-test mean bacterial count. RESULTS: The results obtained with all the three groups postoperatively were highly significant (p-value<0.001). Statistically significant difference between results of Group 1 and Group 2 and also between Group 1 and Group 3 was found (p-value≤ 0.001). However, no statistical difference between Group 2 and Group 3 was found (p-value- 0.96). CONCLUSION: Disinfection strategies using diode laser by techniques gives promising results. Techniques like laser activated irrigation and photoactivated disinfection are better than direct laser irradiation in eliminating Enterococcus feacalis.

Solar catalysed activity against methyl orange dye, cytotoxicity activity of MCF-7 cell lines and identification of marker compound by HPTLC of Lagerstroemia speciosa.

The investigation was aimed to quantify the Gallic acid present in Lagerstroemia speciosa leaves (Lythraceae). The High-Performance Thin Layer Chromatography (HPTLC) quantification was performed for acetone (AE), methanolic (ME) and chloroform (CE) extract of leaves of L. speciosa. The pre-coated silica gel 60 F254 was used for complete separation of compounds using the mobile phase pet. Ether: ethyl acetate: formic acid (5:5:1v/v).The validation of the extracts was carried out using ICH guidelines for precision, repeatability and accuracy showing the Rf 0.49 against standard Gallic acid. Linearity range for Gallic acid was done from 200 to 1000ng/spot (AE) and200 ng to 600ng/spot (ME), with Correlation, coefficient r=0.99 (AE) and 0.54 (ME) in the said concentrations. The composition in crude leaf extract was determined to be of 49.712mg (AE) and 20.125mg (ME), while it was not found in chloroform extract against standard Gallic acid. Hence the proposed method was very simple, precise, accurate and easy for the screening of the bioactive compounds present in the acetone and methanolic extracts of the leaves of L. speciosa. It was observed that the acetone extract subjected to cytotoxicity showed promising activity at higher concentrations (100 and 200µg/ml) showed 92.9% and 87.13% inhibition against MCF-7 cell lines respectively. The photocatalytic activity of the acetone and methanolic extracts of methyl orange was found to be 90.25% (190min) and 89.03% (180min) respectively. Therefore this can be used as an indicator of purity of herbal drugs and formulation containing L. speciosa.

Isolation of quercetin from the methanolic extract of Lagerstroemia speciosa by HPLC technique, its cytotoxicity against MCF-7 cells and photocatalytic activity.

The flavonoids present in the leaves of Lagerstroemia speciosa were extracted, characterized by spectral methods and studied for its cytotoxicity activity against MCF-cell lines and photocatalytic activity against azo dye. Direct and sequential soxhlet extraction was performed and its concentrated crude extract was subjected to high performance liquid chromatography. The yield obtained by the isolated compound (MEI-quercetin) from leaves of L. speciosa was found to be 1.8g from the methanolic extract. The phytochemical analysis and the Rf value of the isolated flavonoid was found to be 3.59. The isolated compound was characterized by Infrared Spectroscopy, NMR and Mass. Based on the characterization, the structure was elucidated as quercetin - a flavonoid. The isolated compound showed the significant in vitro cytotoxicity activity against MCF-7 cell lines at 500µg/ml when compared to the crude extract. Among the various concentrations (25, 50, 100, 250, and 500µg/ml), at higher concentration the cell viability was pronounced and also compared with that of the control. It was first time to report that the isolated flavonoid showed photocatalytic against azo dye-methyl orange. The dye degradation was monitored by UV-Vis spectrophotometry. The isolated compound showed dye degradation of 91.66% with the crude extract 82.47% at 160min. Hence in the present findings, the photocatalytic degradation of MO dye under UV irradiation was investigated over isolated compound of L. speciosa. Hence we expect that this can be used to treat the waste water in near future based on the photocatalytic technique.

Photocatalytic activity against azo dye and cytotoxicity on MCF-7 cell lines of zirconium oxide nanoparticle mediated using leaves of Lagerstroemia speciosa.

Metal oxide nanoparticles are gaining interest in recent years. The present paper explains about the green synthesis of zirconium oxide nanoparticles (ZrO NPs) mediated from the leaves of Lagerstroemia speciosa. The prepared ZrO NPs were characterized by UV-vis spectroscopy, FT-IR, X-ray diffraction analysis (XRD), Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray spectroscopy (EDX) and Thermogravimetric Analysis (TGA). The photocatalytic activity of ZrO NPs was studied for azo dye by exposing to sunlight. The azo dye was degraded up to 94.58%. Also the ZrO NPs were studied for in vitro cytotoxicity activity against breast cancer cell lines-MCF-7 and evaluated by MTT assay. The cell morphological changes were recorded by light microscope. The cells viability was seen at 500µg/mL when compared against control. Hence the research highlights, that the method was simple, eco-friendly towards environment by phytoremediation activity of the azo dye and cytotoxicity activity against MCF-7 cell lines. Hence the present paper may help to further explore the metal nanoparticle for its potential applications.

Biofilm inhibition formation of clinical strains of Pseudomonas aeruginosa mutans, photocatalytic activity of azo dye and GC-MS analysis of leaves of Lagerstroemia speciosa.

The investigation was conducted to analyse the bioactive compounds from the leaf extracts of L. speciosa by GC-MS. The extracts were screened for antibacterial and antibiofilm activities against potential clinical strains. The bioactive compounds from the leaves of L. speciosa were extracted by soxhlet continuous extraction method and their chemical composition was analysed by Gas Chromatography-Mass Spectroscopy (GC-MS). The antibacterial activity was evaluated against clinical strain like Staphylococcus aureus, Escherichia coli, P. aeruginosa and Salmonella typhi by well diffusion technique. We also screened for antibacterial property against common food borne pathogens namely Listeria monocytogenes and Bacillus cereus at varied concentration 250µml-1 to 1000µml-1. Thereafter antibiofilm assay was carried out at from 250 to 1000µg/ml against P. aeruginosa (high biofilm forming pathogen) clinical strain by cover slip technique and the morphology of the pathogen was observed using Scanning Electron Microscopy-(SEM). It was observed that diverse class of secondary metabolites were found by GC-MS analysis for all the extracts upon the continuous extraction. It was found that only minimum inhibition was seen in alcoholic extract for antibacterial activity, whereas all other extracts showed negligible activity. P. aeruginosa biofilm inhibited to 93.0±2% and 91±2% at higher concentration (1000µg/ml) for methanolic and ethanolic extract respectively. Absence of extracellular matrix structure and the surface cracking of biofilm were viewed by SEM, which confirmed the antibiofilm activity. Hence this study reveals that L. speciosa showed significant antibiofilm activity against P. aeruginosa due to the phytoconstituents present in the leaf extracts which was well documented in the alcoholic extracts by GC-MS analysis. The methanolic and ethanolic extract showed good photocatalytic activity of 77.44% and 96.66% against azo dye degradation respectively. Further, isolating the novel phyto-compounds would yield better promising biological activities.

Phytoremediation of dyes using Lagerstroemia speciosa mediated silver nanoparticles and its biofilm activity against clinical strains Pseudomonas aeruginosa.

The aim of this study was to prepare silver nanoparticles by a green method using the aqueous leaves extract of Lagerstroemia speciosa. The prepared silver nanoparticles were characterized, studied for its photocatalytic and biofilm inhibition studies. The maximum absorbance peak was found at 427nm and thus confirming the formation of silver nanoparticles. The average size of silver nanoparticles synthesized was found to be 12nm using XRD and it was spherical in shape. The nanoparticles synthesized was investigated for photocatalytic activity for to two different dye molecules, methyl orange and methylene blue showing 310 and 290min degradation time respectively. The silver nanoparticles biofilm inhibition assay against clinical strains of Pseudomonas aeruginosa showed lowest accumulation at a lower concentration. The biofilm inhibition was also studied by visual interpretation through Scanning Electron Microscopy states that 50µgmL-1 exerts the highest inhibition compared against the control. This evident helps to analysis the silver nanoparticles for various applications in future.

Facile biosynthesis, characterization, and solar assisted photocatalytic effect of ZnO nanoparticles mediated by leaves of L. speciosa.

Synthesis of metal oxide nanoparticles using novel methodologies always attracts great importance in research. The use of plant extract to synthesize nano-particle has been considered as one of the eco-friendly methods. This paper describes the biosynthetic route of preparation of zinc oxide nanoparticles (ZnO NPs) from the Lagerstroemia speciosa leaf extract. This approach appears to be low-cost preparation and alternative method to conventional methods. Highly stable and hexagonal phase ZnO NPs with average particle size of 40nm were synthesized and characterized by UV-Vis absorption spectroscopy (surface Plasmon resonance), Fourier transform infrared spectroscopy (surface functionalities), X-ray Diffraction analysis (crystallinity), TEM and SEM (size and morphology), Energy Dispersive X-ray spectroscopy (elemental composition), Thermogravimetric analysis (weight loss) and Zeta potential (stability). The preliminary phytochemical experiments identify the possible chemical groups present in leaves extract. The photocatalytic properties of ZnO NPs were studied using UV-Vis spectroscopy by exposing methyl orange to sunlight and it is found to be degraded up to 93.5% within 2h. The COD values were significantly reduced from 5600mg/L to 374mg/L after 100min of solar radiation. The hemolytic activity of synthesized zinc oxide nanoparticles was performed on human erythrocyte cells. Thus the present study provides a simple and eco-friendly method for the preparation of multifunctional property of ZnO NPs utilizing the biosynthetic route.

Presurgical nasoalveolar molding: A boon to facilitate the surgical repair in infants with cleft lip and palate.

Cleft lip and palate (CLP) is the most common congenital craniofacial anomaly. Rehabilitation of CLP generally requires a team approach. Alveolar and nasal reconstruction for these patients is a challenge for the reconstructive surgeon. Various procedures have been attempted to reduce the cleft gap, so as to obtain esthetic results postsurgically. The presurgical nasoalveolar molding (PNAM) technique, developed by Grayson, is a new approach to presurgical infant orthopedics. PNAM reduces the severity of the initial cleft alveolar and nasal deformity. Thus, it enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This article presents a brief insight into PNAM with a case series of three different cases (one unilateral and two bilateral) which underwent PNAM treatment and gave an excellent surgical prognosis.

Ozone- A Biological Therapy in Dentistry- Reality or Myth?????

The usage of ozone in dentistry has been proposed because of its antimicrobial, disinfectant, biocompatibility and healing properties. In the last decade a number of therapeutic protocols with ozone have been developed to address common dental infections associated with periodontal disease, RCT and caries. Despite these advantages, therapeutic ozone's application in dentistry is limited because of its possible side effects. Hence, dental practitioners need to know the proper usage of ozone therapy that can provide better patient care and considerably cut down the time and cost of the treatment.

Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems.

BACKGROUND: Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. STUDY DESIGN: This is an experimental, in vitro study comparing the two groups. MATERIALS AND METHODS: A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. RESULTS: A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. CONCLUSION: Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49.