Volumetric Evaluation of Different Obturation Techniques in Primary Teeth Using Spiral Computed Tomography.

BACKGROUND: Various obturation techniques have been evaluated for better filling of the root canals in primary teeth using different methods. Spiral Computed Tomography (SCT) is a new revolution in the pediatric endodontics for assessment of quality of the obturation from 3 dimensions. OBJECTIVES: To evaluate the efficiency of 5 different obturation methods in delivering the filling material into the canals of primary teeth using Spiral Computed Tomography scan. STUDY DESIGN: A total of 50 canals of primary teeth were prepared, divided into 5 groups with 10 canals in each group and obturated with Zinc Oxide Eugenol cement using 5 different obturation techniques such as Local anesthetic syringe, Tuberculin syringe, Endodontic plugger, hand held Lentulo-spiral, and Lentulo-spiral mounted on slow speed hand piece. The pre and post obturation volume and finally the Percentage of Obturated Volume (POV) were calculated using SCT scan for each group. The data obtained was statistically analyzed using One-way Analysis of Variance (ANOVA) and Tukey's post-hoc test. RESULTS: Lentulo-spiral hand held showed highest POV value followed by Lentulospiral mounted to hand piece, Tuberculin syringe and Endodontic plugger; whereas Anesthetic syringe had least POV (P < 0.05). CONCLUSION: Lentulo-spiral hand held is the best obturating technique among the 5 groups evaluated as the canals of this group showed maximum percentage of filled material. However, a further study with large sample size is highly essential.

Revascularization Induced Maturogenesis of Non-Vital Immature Permanent Tooth Using Platelet-Rich-Fibrin: A Case Report.

The aim of this report is to describe a novel method of revascularization therapy done in a non-vital, immature permanent tooth using Platelet-rich fibrin (PRF),in a recently developed scaffold material to overcome limitations associated with the traditional method of revascularization using natural blood clot. PRF prepared from autologous blood was placed in the root canal and patient was followed up regularly at one, three, six, nine and 12 months for detailed clinical and radiographic evaluation. At 12 months, radiographic examination revealed root elongation, root end closure, continued thickening of the root dentinal walls, obliteration of root canal space, and normal periradicular anatomy. However, more long term prospective trials and histological studies are highly needed before to testify PRF a panacea for the regenerative endodontic therapy in children.

Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study.

OBJECTIVES: To compare CPP-ACP, Tri-calcium phosphate and Hydroxyapatite on remineralization of artificial caries like lesions on primary enamel. STUDY DESIGN: Ten extracted Primary molars coated with nail varnish, leaving a window of 2×4 mm on buccal and lingual surface were immersed in demineralizing solution for 96 hours and sectioned longitudinally to obtain 40 sections (4 sections per tooth) and were randomly divided into 4 groups (A to D) n=10; Group A: negative control, Group B: CPP-ACP, Group C: Tri-calcium phosphate, Group D: Hydroxyapatite. Sections were subjected to pH cycling for 10 days and were evaluated by polarized light microscope before and after treatment. RESULTS: Intra group comparison of demineralization and remineralization was done by paired t-test. One way ANOVA was used for multiple group comparisons followed by post HOC TUKEY'S Test for group wise comparisons. Remineralization was found more with Group D followed by Group B, C and A. CONCLUSION: Hydroxyapatite showed better remineralization when compared to CPP-ACP and Tri-calcium phosphate.

Dental Erosion and its Associated Factors In 11-16-Year Old School Children.

UNLABELLED: Dental erosion currently stands as a great challenge for the clinician, regarding the diagnosis, identification of the etiological factors, prevention and execution of an adequate treatment. AIMS: To evaluate the prevalence, severity, and associated factors on dental erosion in 11-16-years old. STUDY DESIGN: A cross sectional study was conducted among 2000 school children who were randomly selected. A questionnaire was given to the children that included personal demographic details and habit of consuming acidic foods and drinks. An index specific for dental erosion given by O Sullivan was used to assess every affected tooth. The values were subjected to chi-square test and multivariate logistic regression analysis. RESULTS: The prevalence of dental erosion was found to be 1.4%. Females (1.6%) were slightly more affected than males (1.3%). Public school children (2.1%) were found to be affected a little more than private children (0.7%). Chi square test showed significant association between type of school and erosion prevalence (p = 0.015). Most commonly affected teeth were lateral incisor (59.72%). CONCLUSION: The prevalence of dental erosion was found to be low when compared to various studies done all over the world.

Evaluation of probiotic milk on salivary mutans streptococci count: an in vivo microbiological study.

OBJECTIVE: The objective of the present study was to investigate the effect of probiotic Lactobacillus casei Shirota on the values of mutans streptococci counts in saliva. STUDY DESIGN: 31 children were included in this double blinded study. Study design included 4 periods which consisted of a run in period, two intervention periods and a washout period. During the intervention periods children were either given probiotic milk or control milk for 10 days. Pre and post intervention salivary samples were subjected to microbiological evaluation. Then numbers of mutans streptococci were taken by identifying colony morphology. RESULTS: A statistically significant reduction of mutans streptococci colony count was noted in the probiotic group (p=.003). The reduction in children with higher levels of mutans streptococci (105) after intervention was 34% in the probiotic group. CONCLUSION: Daily consumption of milk containing probiotic bacteria can reduce the levels of mutans streptococci and may contribute to the prevention of dental caries.

Comparison of relative efficacy of two techniques of enamel stain removal on fluorosed teeth. An in vivo study.

OBJECTIVE: The present study was conducted to compare and evaluate the relative efficacy of enamel microabrasion (using 18% HCl) and bleaching with McInnes solution in the esthetic improvement of fluorosed teeth and to check postoperative sensitivity. STUDY DESIGN: 30 children aged between 9-14yrs with a mild or moderate grade of fluorosis as classified according to Dean's fluorosis index and who complained of objectionable esthetics were selected. Split mouth study design was selected in our study. Each subject had one of their maxillary central incisor randomly selected for Enamel microabrasion and the contra lateral maxillary central incisor for McInnes bleaching. Esthetic improvement was assessed by comparing the pre and postoperative digital photographs. During the evaluation session, the pre and postoperative photographs of 30 subjects were incorporated into a power point presentation and were projected side by side in a darkened room. Four calibrated and blinded examiners, including a layman rated the photographs under standardized viewing conditions. Esthetic improvement was assessed for both short and long term improvement. The postoperative sensitivity was recorded for both the procedures immediately after treatment and at one, three and six months interval. RESULTS: The results proved that both immediate and long term (6 month) esthetic improvement achieved by McInnes bleaching were superior to enamel microabrasion. There is a reduction in aesthetics of teeth in both the procedures after six months, which was very minimal in McInnes procedure and significant in enamel micro abrasion. Postoperative sensitivity in both techniques were negligible. The sensitivity observed were transient and subsided within an one-month post operatively. None of the subjects reported sensitivity at one, three and six months intervals. CONCLUSION: McInnes bleaching is a better procedure compared to enamel microabrasion in improving the appearance of fluorosed teeth. Both techniques are conservative and safe.

Allotransplantation of tooth: a case report.

Tooth transplantation has attracted great interests since ancient times. A successful case of tooth allotransplantation is presented. A mandibular first premolar from the donor was implanted into the socket of maxillary central incisor Follow up after 12 months indicated good periapical healing with no resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility. This article suggests tooth transplantation as an alternative to other restorative options.

Factor XIII deficiency: report of two cases.

Factor XIII deficiency is one of the rare clotting factor deficiencies. Although rare, it is an important disorder because of seriousness of its bleeding manifestations, in particular the incidence of intracranial hemorrhage is higher than any other bleeding disorder Hence an early diagnosis is extremely important where bleeding manifestations can be prevented by prophylactic factor XIII replacement given at every 4-6 week interval. Case1 presents the management of a factor deficiency associated with a very rare blood group AB+ve, while the case 2 reports the successful surgical management with a replacement therapy

A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report.

The aim of this paper is to present two methods of revascularization done in traumatized immature, nonvital anterior teeth using platelet-rich fibrin (PRF) and natural blood clot as a scaffold material. This was performed after disinfection of the root canal space using tri-antibacterial paste. In one tooth, PRF prepared from autologous blood was placed in the canal and in the other tooth, natural bleeding was induced to obtain a fresh blood clot. The patient was recalled regularly at 1, 3, 6, 9, and 12 months' interval for evaluation. After 12 months, on clinical examination, both teeth showed negative response to percussion and palpation tests but positive response to cold and electric pulp tests. On radiographic examination, the tooth treated with PRF exhibited comparatively faster root lengthening, complete closure of the root apex, more thickening of the root dentinal walls, and narrowing of root canal space compared to conventionally revascularized tooth. How to cite this article: Nagaveni NB, Poornima P, Mathew MG, et al. A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report. Int J Clin Pediatr Dent 2020;13(1):98-102.

Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach.

AIM: To evaluate the clinical and radiological results of a revascularization treatment done in a nonvital, immature permanent tooth using the amniotic membrane. CASE DESCRIPTION: A 12-year-old boy reported with a complaint of pain in the lower left back tooth since 1 month due to dental caries. On clinical examination, the mandibular left second premolar was tender on percussion and discolored due to dental caries. Radiographic examination of the same tooth revealed open apex, thin root dentinal walls, and periodontal ligament widening. An access opening was prepared, necrotic pulp extirpated completely followed by thorough irrigation. After drying the canal, closed dressing with the 3-mix antibacterial paste was given for 15 days. After 15 days, the paste was removed and the amniotic membrane was placed inside the canal extending 1 mm beyond the apex and mineral tri-oxide aggregate was placed over this followed by sealing of the cavity. The patient was followed up at 1, 3, and 6 months for clinical and radiographic evaluation. CONCLUSION: After 6 months, clinically the tooth found asymptomatic. Radiographic examination showed continued root elongation, closure in the periapical opening, thick root dentinal walls with narrowing of the canal space, and normal periradicular architecture. CLINICAL SIGNIFICANCE: Amniotic membrane can be used as a scaffold for revascularization in nonvital immature teeth. HOW TO CITE THIS ARTICLE: NB Nagaveni, P Poornima, et al. Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach. Int J Clin Pediatr Dent 2019;12(2):150-152.

Comparative evaluation of compressive strength and surface microhardness of EQUIA Forte, resin-modified glass-ionomer cement with conventional glass-ionomer cement.

PURPOSE: The study aimed to evaluate and compare the compressive strength and surface microhardness of EQUIA Forte, light cure, and conventional glass-ionomer cement (GIC). METHODOLOGY: Fifty-four pellets of G-Coat (GC) Gold Label 2, GC Gold Label light-cured universal restorative material, and EQUIA Forte GIC were prepared of dimensions (6 × 4) mm and were divided into three groups (18) each and were stored at 37°C for 1 h and then immersed in 20 ml of deionized water, artificial saliva, and lactic acid six each, respectively, over 30 days. Samples were subjected to surface microhardness and compressive strength test on the 1st day, 7th day, and 30th day. Results were subjected to ANOVA and Bonferroni post hoc test. RESULTS: Comparing the compressive strength of EQUIA Forte from day 1 to 30 when placed in artificial saliva, there was a significant increase on day 30 (P = 0.007); compared to other groups. The surface microhardness of EQUIA Forte from day 1 to 30 when placed in artificial saliva nonsignificantly decreased comparing to other groups. CONCLUSION: Surface microhardness and compressive strength of EQUIA Forte were significantly high in comparison to the other groups.

Comparison of digital radiography, decalcification, and histologic sectioning in the detection of accessory canals in furcation areas of human primary molars.

Although the terms lateral secondary and accessory canals are often used interchangeably they mean different things. The accessory canal is derived from the secondary canal branching off to the periodontal ligament in apical sections. Different methodology was used to study the accessory canals. Decalcification method appeared to the important in studying the accessory canals as compared to digital radiography and histological sectioning.

Volumetric evaluation of various obturation techniques in primary teeth using cone beam computed tomography - An in vitro study.

AIM: The aim of this study was to compare and evaluate the efficiency of five different obturation methods in delivering the filling material into the canals of primary teeth using cone beam computerized tomography (CBCT) scan. METHOD: A total of fifty prepared canals of primary teeth which further divided into five groups with ten canals in each group were obturated with zinc oxide-eugenol cement using five different obturation methods such as endodontic plugger, lentulo spiral (handheld), lentulo spiral mounted on slow speed handpiece, local anesthetic syringe, and tuberculin syringe. Using CBCT scan, the pre- and post-obturation volume and the percentage of obturated volume (POV) were calculated for each group. The results obtained were statistically analyzed using one-way analysis of variance and Tukey's post hoc test. RESULTS: Following CBCT scan, the method obturated with lentulo spiral mounted to handpiece showed the highest POV value followed by the method of lentulo spiral mounted to handpiece, hand plugger, and tuberculin syringe. Local anesthetic syringe gave the least POV (P < 0.05). CONCLUSION: Lentulo spiral mounted to handpiece showed the best technique of obturation using CBCT evaluation among the five groups evaluated in primary teeth. However, more studies are highly essential to prove it a boon for estimating obturation quality in primary teeth.

Inhibition of Residual Cariogenic Bacteria in Atraumatic Restorative Treatment by Chlorhexidine: Disinfection or Incorporation.

PURPOSE: The purpose of this study was to compare the efficacy of chlorhexidine (CHX) cavity disinfection and of CHX containing glass ionomer cement (GIC) in inhibiting residual cariogenic bacteria. METHODS: Ninety, five- to nine-year-olds were randomly allocated to three groups: Group 1-CHX containing GIC; Group 2-CHX cavity disinfection; and Group 3-conventional GIC. Total viable count (TVC), Streptococcus mutans (SM), and Lactobacillus (LB) were analyzed pre-, post-, and three months after atraumatic restorative treatment (ART). The results were statistically analyzed by one-way analysis of variance. RESULTS: At three months microbial evaluation, Group 1 showed 65 percent reduction of both TVC and LB and 67 percent of SM. Group two showed 64 percent, 58 percent, and 56 percent reduction of TVC, LB, and SM respectively. Group 3 exhibited 41 percent, 42 percent, and 46 percent reduction in mean TVC, LB, and SM counts respectively. Residual microbial counts for Group 3 were 0.41, 0.61, and 0.53 (105 colony forming units) for TVC, LB, and SM, respectively, which was significantly higher (P<0.01) compared to the respective microbial counts in Groups 1 and 2. CONCLUSION: Both chlorhexidine disinfection and incorporation showed superior efficacy in inhibiting residual microbes compared to conventional ART.

Malocclusion and dental caries experience among 8-9-year-old children in a city of South Indian region: A cross-sectional survey.

BACKGROUND: Although numerous studies have documented malocclusion in various age groups in India, the literature on the prevalence of malocclusion in mixed dentition is scanty. Dental caries is another most common condition affecting the general health. However, its association with malocclusion in mixed dentition is not well known. AIM: The purpose of this study was to establish the prevalence of malocclusion and its association with caries experience in 8-9-year-old children of Davangere city, South Indian region. SETTING AND DESIGN: The study design was a cross-sectional survey. MATERIALS AND METHODS: A total of 800 children from 350 schools (both males and females) were randomly selected for the study. t-test and Chi-square test were used for statistical analysis. RESULTS: The overall prevalence of malocclusion among 8-9-year-old children was 40.9%. The most prevalent malocclusion was crowding (11.5%), followed by excessive overjet (9.4%), deep bite (6.8%), spacing (6.5%), crossbite (4.5%), and open bite (3.2%). Class I molar relationship prevailed in 95.5% of children. CONCLUSION: The prevalence of malocclusion in our study was in accordance with the other studies reported in India, which ranged from 19.6% to 90%. Furthermore, correlation of malocclusion and dental caries in the primary dentition, although nonsignificant, presented children with malocclusion to have a higher caries experience than children without malocclusion.

Prevalence of a few variant dental features in children aged 11-16 years in Davangere, a city in Karnataka.

CONTEXT: Variations in morphology of shape of teeth have always been of interest to dentists from ancient times. But to our surprise, till date, no studies related to the prevalence of dental features have been conducted in any part of the world. AIMS: To evaluate the prevalence of a few variant dental features in a group of children aged from 11 to 16 years in the city of Davangere that belongs to the state of Karnataka, India. MATERIALS AND METHODS: A cross-sectional survey was conducted where children aged 11-16 years were selected (both girls and boys) and type III clinical examination was done. They were checked for the following features - Carabelli's cusp, 3-cusped maxillary 2(nd) molar, 5-cusped maxillary 1(st) molar, 4-cusped mandibular 1(st) molar, 5-cusped mandibular 2(nd) molar, cusp 6 present in mandibular 1(st) molar, and 7-cusped mandibular 1(st) molar. STATISTICAL ANALYSIS USED: The Chi-square test was used to analyze the categorical data. P value of 0.05 or less was considered for statistical significance. RESULTS: Around 99.3% of the school children examined had at least one of the dental variations that were examined in relation to the shape of teeth. CONCLUSIONS: This study definitely provides us with baseline data, but further epidemiological studies are required to determine the prevalence of the above mentioned dental anomalies.

In vitro Evaluation of Stainless Steel Crowns cemented with Resin-modified Glass Ionomer and Two New Self-adhesive Resin Cements.

AIMS: To assess and compare the retentive strength of two dual-polymerized self-adhesive resin cements (RelyX U200, 3M ESPE & SmartCem2, Dentsply Caulk) and a resin-modified glass ionomer cement (RMGIC; RelyX Luting 2, 3M ESPE) on stainless steel crown (SSC). MATERIALS AND METHODS: Thirty extracted teeth were mounted on cold cured acrylic resin blocks exposing the crown till the cemento-enamel junction. Pretrimmed, precontoured SSC was selected for a particular tooth. Standardized tooth preparation for SSC was performed by single operator. The crowns were then luted with either RelyX U200 or SmartCem2 or RelyX Luting 2 cement. Retentive strength was tested using Instron universal testing machine. The retentive strength values were recorded and calculated by the formula: Load/Area. STATISTICAL ANALYSIS: One-way analysis of variance was used for multiple comparisons followed by post hoc Tukey's test for groupwise comparisons. Unpaired t-test was used for intergroup comparisons. RESULTS: RelyX U200 showed significantly higher retentive strength than rest of the two cements (p < 0.001). No significant difference was found between the retentive strength of SmartCem2 and RelyX Luting 2 (p > 0.05). CONCLUSION: The retentive strength of dual-polymerized self-adhesive resin cements was better than RMGIC, and RelyX U200 significantly improved crown retention when compared with SmartCem2 and RelyX Luting 2. HOW TO CITE THIS ARTICLE: Pathak S, Shashibhushan KK, Poornima P, Reddy VVS. In vitro Evaluation of Stainless Steel Crowns cemented with Resin-modified Glass Ionomer and Two New Self-adhesive Resin Cements. Int J Clin Pediatr Dent 2016;9(3):197-200.

Dental health in children with congenital bleeding disorders in and around Davangere: A case-control study.

AIM: The present study was carried out to investigate the dental and some other aspects of oral health status of young patients with congenital bleeding disorders (CBDs) and compared with controls. MATERIALS AND METHODS: Decayed, missed, filled tooth surfaces (DMFS-dmfs) in permanent and primary teeth scores, simplified oral hygiene index, occlusion, occurrence of hypoplasia, fluorosis other hard tissue and soft tissue findings of 50 CBD patients at the age range of 4-15 years and 50 of other children as control were compared. Data were analyzed by Chi-square and Student's unpaired t-test. RESULTS: Patients were significantly more caries-free with less decayed teeth in primary-permanent dentition (P < 0.05) and with lower scores for overall hygiene. CONCLUSION: By this, it can be concluded that children with CBD have a significantly lower prevalence of dental caries and better oral hygiene compared with matched, healthy controls.

Comparative Evaluation of Longevity of Fluoride Release From three Different Fluoride Varnishes - An Invitro Study.

INTRODUCTION: Fluoride varnishes play a pivotal role in inhibition of dental caries by increasing remineralization. AIM: To determine the longevity of fluoride release from 3 different fluoride varnishes over a period of time through salivary fluoride estimation. MATERIALS AND METHODS: Twenty four extracted human deciduous anterior teeth were divided into four groups, i.e., ClinproTM XT, Flouritop SR, Flourprotector and Control group. Fluoride varnishes were applied on 3mm x 3mm window on labial surface of the teeth and then the teeth were immersed and stored in artificial saliva. The concentration of fluoride in ppm was measured after 1 week, 1 month, 3 months and 6 months. Fluoride release at each time interval for different groups was statistically analyzed using ANOVA and Post Hoc Tukey's test. RESULTS: Although all the fluoride varnishes released fluoride, with greatest release observed during 1(st) week by Fluoritop SR (66.92±16.30ppm), ClinproTM XT Varnish released consistently and substantially more fluoride than Fluoritop SR and Fluorprotector during 6 months analysis (p<0.05). Fluorprotector showed the lowest rate of F release among all the groups compared. CONCLUSION: Over a period of 6 months ClinproTM XT Varnish released consistently and substantially more fluoride than other tested products.

Effect of newer antioxidants on the bond strength of composite on bleached enamel.

AIM: The study aims to evaluate the effect of the application of two antioxidants on the bond strength of composite resin to bleached enamel. MATERIALS AND METHODS: Eighty enamel surfaces were obtained from forty human extracted premolars. Specimens were randomly divided into four groups (n = 20). Group 1: No bleaching (control); Group 2a: Bleaching with 15% carbamide peroxide gel; Group 2b: Bleaching, followed by application of 10% sodium ascorbate gel; Group 2c: Bleaching, followed by application of 5% proanthocyanidin agent. Surfaces were etched followed by application of total etch bonding system, and composite resin cylinders were bonded. Specimens were tested for shear bond strength. STATISTICAL ANALYSIS USED: One-way analysis of variance was used for multiple group comparison and post hoc Tukey's test for individual group-wise comparison. RESULTS: Significantly higher shear bond strength values were observed in Group 2c and 2b as compared with Group 1 and 2a (P < 0.05). Among the antioxidants, Group 2c showed significantly higher shear bond strength values than Group 2b (P < 0.05). CONCLUSION: It can be concluded that the use of antioxidant before bonding procedures on bleached enamel completely neutralizes the deleterious effects of bleaching and increases the bond strength significantly.