Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial.

AIM: The aim of this study was to compare the effectiveness of 2% articaine and 2% lignocaine in achieving adequate anesthesia in children between the age group of 6-13 years using inferior alveolar nerve block. METHODS: A triple blinded randomized controlled trial was conducted in 180 participants (90 patients- 2% articaine, 90 patients-2% lignocaine). Effectiveness of the anesthetic agent was determined at 3 points determined by subjective evaluation of pain using pain scales (FPS-R). Paired sample t-test and chi square test were performed for statistical significance. RESULT: Anesthetic success for 2% articaine were 64.4%, 42.2% and 81.8% respectively. The anesthetic success of 2% lignocaine was 66.7%, 48.9% and 85.7% at point one, point two and point three respectively (p > 0.05). CONCLUSION: This study concludes that 2% articaine in 1:2,00,000 did not demonstrate superior clinical effectiveness in comparison to 2% lignocaine. CLINICAL SIGNIFICANCE: Lignocaine has always been considered the gold standard. With its unique chemical structure and increased potency, Articaine has been gaining popularity. Its efficacy in 2% concentration had not been compared to 2% lignocaine. 2% articaine did not show clinical superiority but its comparable effectiveness with lignocaine can encourage further research in using articaine in reduced concentrations to improve effectiveness.

Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial.

Background: Pulpectomy has gained popularity in the pediatric dental practice for preserving the primary teeth in its position until exfoliation. There has been a paradigm shift from using manual instrumentation to rotary instrumentation for canal preparation in primary teeth. While studies show that there is a reduction in the instrumentation time with the use of rotary instruments which in turn influences the behavior of the child, its direct effect on the behavior of the children has not been evaluated. Aim: To compare the behavior of the children during manual and rotary instrumentation for pulpectomy in the primary molars. Materials and methods: A single-blinded randomized clinical trial was conducted in 88 children in any one of the mandibular primary molars indicated for pulpectomy. The canal preparation was done using manual K files and rotary ProTaper (44 children in each group). The influence of these instrumentation techniques on the children was assessed with three different scales- Frankl Behavior Rating Scale; Venham Interval Rating Scale; Wong Baker FACES Pain Scale for evaluating the behavior, anxiety, and the pain experienced by the children, respectively during canal preparation. Results: A total of 88 participants, comprising 50 females and 38 males, participated in the study. An equal distribution of the participants with respect to age (p = 0.064), gender (p = 0.389), and teeth (p = 0.877) was observed between the groups. More cooperative behavior (p < 0.001); lesser anxiety levels (p < 0.001); lower intensity of pain (p < 0.001) were recorded in the children instrumented using Rotary files. Conclusion: The present study concludes that it is preferable to use rotary instrumentation for primary canal preparation in pediatric practice as it has a more positive influence on the behavior of the children, which eventually determines the success of the treatment. Clinical significance: With rise in the use of rotary files for pulpectomy in primary teeth, the present paper demonstrates the influence of rotary instrumentation technique for canal preparation during pulpectomy on the behavior of the children in a dental chair. This paper throws light for the pedodontists to effectively perform pulpectomy in children with ease without leaving a psychological impact on the children. How to cite this article: Govindaraju L, Subramanian EMG, Jeevanandan G. Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(S-2):S179-S185.

Assessing quality of obturation and instrumentation time using Kedo-SG blue, Kedo-SH, and reciprocating hand K-files in primary mandibular molars: A double-blinded randomized controlled trial.

BACKGROUND: Pulpectomy is the treatment of choice for severely infected primary molars. The aim of the study is to evaluate the instrumentation time and obturation quality using Kedo SG blue, Kedo SH, and reciprocating hand K files in primary mandibular molars. To evaluate the instrumentation time and obturation quality using Kedo-SG blue, Kedo-SH, and reciprocating hand K-files in primary mandibular molars. MATERIALS AND METHODS: A double-blinded randomized controlled trial was conducted on 45 mandibular molars and were randomly assigned to three experimental groups (n = 15). Group I was instrumented using Kedo-SG blue pediatric rotary files, Group II with Kedo-SH pediatric hand files, and Group III with reciprocating hand K-files. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation were done using ANOVA and Chi-square test with the level of significance set at 5%. P < 0.05 was considered statistically significant. RESULTS: No significant differences were noted with regard to the quality of obturation between the three groups (P < 0.14). However, a statistically significant difference was noted in the instrumentation time between the three groups (P = 0.000). Kedo-SG blue rotary file had significantly lesser instrumentation time when compared to that of Kedo-SH hand files and reciprocating hand K-files. CONCLUSION: On comparative evaluation,Kedo-SG blue pediatric rotary file showed a marked reduction in instrumentation time, followed by Kedo-SH pediatric hand files and reciprocating hand K-files.

Evaluation of Postoperative Pain after Pulpectomy using Different File Systems in Primary Teeth: A Systematic Review.

OBJECTIVE: The purpose of this systematic review was to compare the incidence and intensity of postoperative pain after pulpectomy using different instrumentations in primary teeth. MATERIALS AND METHODS: An extensive literature search in PubMed, Cochrane Library, Science Direct, LILAC, SIGLE, and Google Scholar was performed to identify English language articles with human subjects that evaluated the effects of different instruments on postoperative pain after pulpectomy. RESULTS: The search retrieved 187 references. After screening of the abstracts and articles, based on the inclusion and exclusion criteria, a total of three articles were included in the systematic review. Of the three included studies, two of them had a moderate risk of bias and one showed a high risk of bias. CONCLUSION: The use of rotary instruments contributed to a lower incidence and intensity of postoperative pain than did the hand instruments in all the three studies. More high-quality randomized clinical trials are needed in this field in future studies to support the evidence.

Comparison of the Sedative Effect of Inhaled Nitrous Oxide and Intranasal Midazolam in Behavior Management and Pain Perception of Pediatric Patients: A Split-mouth Randomized Controlled Clinical Trial.

Background: Management of children has always been a challenging task in the dental office, as many children exhibit extreme fear, apprehension, and anxiety toward dental procedures. Pharmacological means of behavior management such as sedation are now at the forefront. Midazolam and nitrous oxide are the commonly employed pharmacological agents for sedation in pediatric dentistry. Though each route has its advantages and disadvantages, we compared the effect of atomized intranasal midazolam (dosage 0.3 mg/kg body weight) and nitrous oxide oxygen sedation in evaluating the behavior of child, pain experienced during local anesthesia administration, sedation level, and patient's acceptance. Materials and methods: A total of 35 (n = 35) anxious pediatric patients aged 4-7 years with negative and definitely negative behavioral rating were randomized to receive intranasal midazolam and inhalational nitrous oxide through mask. The overall behavior, alertness, and cry were recorded using Houpt rating scale while pain and sedation were assessed by face, legs, activity, cry, and consolability (FLACC) and Ellis sedation scores, respectively. Results: The children who received intranasal midazolam sedation were calm, had less adverse effects, and had better acceptance of the drug. Both the techniques of sedation were found to be equally effective in terms overall behavior rating. Conclusion: Intranasal midazolam was found to be as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. It can also be an effective alternative for anxious patients who are unable to maintain the nitrous oxide mask throughout the dental procedure. How to cite this article: Srinivasan NK, Karunagaran P, Panchal V, et al. Comparison of the Sedative Effect of Inhaled Nitrous Oxide and Intranasal Midazolam in Behavior Management and Pain Perception of Pediatric Patients: A Split-mouth Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2021;14(S-2):S111-S116.

Comparison of Shear Bond Strength of Three Commercially Available Esthetic Restorative Composite Materials: An In Vitro Study.

INTRODUCTION: Dental caries remains to be one of the most prevalent diseases encountered in the field of dentistry. Several restorative materials have been introduced with variable properties and among them, composite restorative materials are most widely used nowadays because of their superior esthetic property as well as minimal hard tissue removal. Shear bond strength of a restorative material plays a key role in deciding the restoration's longevity. Hence, for a better selection of the composite material, shear bond strength needs to be evaluated. AIM: The study aim was to analyze the shear bond strength of three commercially available esthetic restorative composite materials-Dentsply Ceram X, 3M ESPE™ Filtek™ Z350 XT, and GC Solare Sculpt to the tooth surface. MATERIALS AND METHODS: Thirty extracted human mandibular permanent molars that were caries-free were selected and erected in acrylic blocks. The uniform dentinal surface was exposed by cutting with a diamond disk. These were then randomly divided into three groups-groups I, II, and III based on the restorative material which was used, i.e., Ceram X, 3M ESPE™ Filtek™ Z350 XT, and Solare Sculpt, respectively. The restorative materials were applied on the dentinal surface of the prepared tooth specimens with the help of plastic molds, followed up by storing them in distilled water until they were subjected to shear bond strength testing. The collected data were examined by applying a one-way analysis of variance (ANOVA) and Turkey's post hoc test. RESULTS: The Ceram X (21.6155 ± 2.20717) and Solare Sculpt (19.8747 ± 3.99732) were comparable in terms of shear bond strength values; however, they depicted significantly higher bond strength compared to 3M ESPE™ Filtek™ Z350 XT (12.8068 ± 3.99732). CONCLUSION: Among the three materials compared in this study, Ceram X produced higher shear bond strength to tooth surface when compared to Solare Sculpt and 3M ESPE™ Filtek™ Z350 XT. CLINICAL SIGNIFICANCE: Restoration failure continues to be a major problem taking a toll on the dentists' time and patient satisfaction. Thus, the demand for restorative materials with better shear bond strength as well as excellent esthetics is on the rise. Thus, this particular study compares the shear bond strength of three commercial esthetic nanocomposites. HOW TO CITE THIS ARTICLE: Preethy NA, Jeevanandan G, Govindaraju L, e t a l. Comparison of Shear Bond Strength of Three Commercially Available Esthetic Restorative Composite Materials : An In Vitro Study. Int J Clin Pediatr Dent 2020;13(6):635-639.

Comparison of instrumentation time and obturation quality between hand K-file, H-files, and rotary Kedo-S in root canal treatment of primary teeth: A randomized controlled trial.

INTRODUCTION: Pulpectomy has been a treatment of choice in all necrotic primary teeth. Advancing technology has brought the rotary system to reduce the manual dexterity and improve the quality of treatment for pulpectomy. Advancing technology in pediatric dentistry should be used for the better treatment protocol. AIM: The aim of this study is to compare the obturation quality and instrumentation time after root canal instrumentation with rotary Kedo-S files, hand K-files, and H-files in primary molars. MATERIALS AND METHODS: A randomized control trial where pulpectomy was performed on 75 primary molars equally distributed for instrumentation with K-file, H-files rotary Kedo-S files, respectively. The instrumentation time and obturation quality were noted. RESULTS: Kedo-S files showed the least instrumentation time with better obturation quality as compared to other two groups (P < 0.001). CONCLUSION: Pediatric rotary files Kedo-S has better obturation quality in minimum instrumentation time.

Clinical Evaluation of Quality of Obturation and Instrumentation Time using Two Modified Rotary File Systems with Manual Instrumentation in Primary Teeth.

INTRODUCTION: Pulp therapy in primary teeth has been performed using various instrumentation techniques. However, the conventional instrumentation technique used for root canal preparation in primary teeth is hand instrumentation. Various Nickel-Titanium (Ni-Ti) instruments are available to perform efficient root canal preparation in primary teeth. These Ni-Ti instruments has been designed to aid in better root canal preparation in permanent teeth but are rarely used in primary teeth. It is necessary to assess the feasibility of using these adult rotary files with a modified sequence in primary teeth. AIM: To compare the quality of obturation and instrumentation time during root canal preparation using hand files and modified rotary file systems in primary molars. MATERIALS AND METHODS: Forty-five primary mandibular molars were randomly assigned to three experimental groups (n=15). Group I was instrumented using k-hand files, Group II with S2 ProTaper universal file and Group III with 0.25 tip 4% taper K3 rotary file. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS Software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation was done using ANOVA and Chi-square test with the level of significance set at 0.05. RESULTS: No significant differences were noted with regard to the quality of obturation (p=0.791). However, a statistically significant difference was noted in the instrumentation time between the three groups (p<0.05). ProTaper rotary system had significantly lesser instrumentation time when compared to that of K3 rotary system and hand file system. CONCLUSION: The hand files, S2 ProTaper Universal and K3 0.25 tip 4% taper files systems performed similarly with respect to the quality of obturation. There was a significant difference in instrumentation time with manual instrumentation compared to the modified rotary file systems in primary teeth.

Effect of Mechanical and Chemical Root Surface Treatment on the Shear Bond Strength of Intracanal Post in Primary Anterior Teeth: An In vitro Study.

INTRODUCTION: Aesthetic restoration of severely mutilated primary anterior teeth still remains as a special challenge to paediatric dentist. Due to increased parent's concern for aesthetic rehabilitation for their children, paediatric dentist are in a state to improve technique sensitive restorative procedure to improve aesthetic rehabilitation in children. AIM: The purpose of the study was to evaluate the effect of different root surface treatment on the shear bond strength of glass fibre reinforced post in primary anterior teeth using Universal Testing Machine (UTM). MATERIALS AND METHODS: Twenty single rooted primary anterior teeth were selected. Coronal portions of the teeth were sectioned transversally 2 mm above the Cemento-Enamel Junction (CEJ) and specimens were treated endodontically and obturated using metapex. Then the specimens were randomly divided into four groups. Group 1: Control group; Group 2: Chemical surface treatment of the root with 2% chlorhexidine; Group 3: Mechanical surface treatment with mushroom-shaped undercut; Group 4: Combination of mechanical and chemical surface treatments. Samples were tested for shear bond strength. ANOVA and Post-hoc Tukey test were used for statistical analysis using SPSS version 20.0. RESULTS: Combination of mechanical and chemical surface treatments exhibited higher mean shear bond strength (8.41 MPa), followed by mechanical surface treatment (4.68 MPa), chemical surface treatment (3.92 MPa) and control group (2.76 MPa). CONCLUSION: Mechanical and chemical surface treatments together led to a improved shear bond strength and increased the retention of the post to the root surface.

Comparative evaluation of post-operative pain after pulpectomy with K-files, Kedo-S files and MTwo files in deciduous molars -a randomized clinical trial / Avaliação comparativa da dor pós-operatória após pulpectomia com limas k, Kedo-S e MTwo em molares decíduos - um ensaio clínico randomizado

Objective: Despite the tortuous course of primary root canal system, a paradigm shift occurred from conventional hand files to rotary system, which lead to faster, cost-effective, uniform and predictable fillings. One of the many advantages being, reduction in post-operative pain with the use of rotary system. Many rotary file systems were introduced, with the recent one, the Kedo-S. So the present study aimed to compare and evaluate the post ­ operative pain after pulpectomy using K-files, MTwo files and Kedo-S files in deciduous molars. Material and Methods: 75 teeth were randomly divided into three groups (group A ­ K-files, group B - Kedo-S files and group C - MTwo files) for pulpectomy of primary molars. Post ­ operative pain was assessed every 6,12,24,48 and 72 hours using facial pain scale. Results: 44% of volunteers in K-file group had moderate pain followed by Kedo-S group (8%) and then MTwo files (4%). Conclusion: The least post-operative pain was found in Mtwo group followed by Kedo-S group and K-file group. (AU)

Objetivo: Apesar do curso tortuoso do sistema de canais radiculares de dentes molares decíduos, uma mudança de paradigma ocorreu das limas manuais convencionais para o sistema rotatporio, o que leva a obturações mais rápidas, econômicas, uniformes e previsíveis. Uma das muitas vantagens é a redução da dor pós-operatória com o uso do sistema rotatório. Muitos sistemas de limas rotátórias foram introduzidas, como o recente Kedo-S. Assim, o presente estudo objetivou comparar e avaliar a dor pós-operatória após pulpectomia utilizando limas K, MTwo e Kedo - S em molares decíduos. Material e Métodos: Setenta e cinco dentes foram divididos aleatoriamente em três grupos (grupo A - limas K, grupo B - limas Kedo-S e grupo C - limas MTwo) para pulpectomia de molares decíduos. A dor pós - operatória foi avaliada a cada 6,12,24,48 e 72 horas, utilizando a escala de dor facial. Resultados: 44% dos voluntários do grupo K apresentaram dor moderada, seguidos pelo grupo Kedo-S, com 8%, e MTwo, com 4%. Conclusão: A menor dor pósoperatória foi encontrada no grupo Mtwo, seguido pelo grupo Kedo-S e pelo grupo K-file. (AU)

Single-rooted primary first molars.

Knowledge regarding the morphological variations in roots and root canals aids in successful dental treatment. However, literature regarding dysmorphology of roots in primary dentition is sparse. The purpose of this article is to present a case of bilateral primary mandibular first molars with an unusual morphology of single root. Review of literature regarding variations in root number in primary dentition has been discussed in this article. The etiology for occurrence of such variations has also been briefly reviewed.