Distribution of TGFBI variants in patients with early onset glaucoma.

Purpose: To describe a novel association of TGFBI variants with congenital glaucoma in a family with GAPO (growth retardation, alopecia, pseudoanodontia, and progressive optic atrophy) syndrome, as well as among other unrelated cases of juvenile onset open-angle glaucoma (JOAG) and primary congenital glaucoma (PCG). Methods: This study of one family of GAPO with congenital glaucoma and three unrelated patients with JOAG analyzed a common link to glaucoma pathogenesis. Three girls with GAPO syndrome born to consanguineous parents in a multi-generation consanguineous family were identified. Two of the girls had congenital glaucoma in both eyes, while the elder sibling (a 10-year-old female) had features of GAPO syndrome without glaucoma. Results: A genetic evaluation using whole exome sequencing revealed a novel homozygous ANTXR1 mutation in all three affected siblings with GAPO. No other mutations were detected in the genes associated with glaucoma. A rare missense variant in the TGFBI gene was shared in the two siblings with congenital glaucoma and GAPO syndrome. We found three other unrelated patients with JOAG and one patient with primary congenital glaucoma with no known glaucoma causing gene mutations, but having four different missense variants in the TGFBI gene. One of these patients with JOAG had familial granular corneal dystrophy. Molecular dynamic simulations of TGFBI and 3-D structural models of three of its variants showed significant alterations that could influence TGFBI protein function. Conclusions: The possibility that variations in the TGFBI gene could have a possible role in the pathogenesis of congenital and juvenile onset open-angle glaucomas needs further evaluation.

Efficacy of lignocaine in gel and spray form during buccal infiltration anesthesia in children: a randomized clinical trial.

AIM: To compare the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic, in reducing pain, during buccal infiltration in children. MATERIALS AND METHODS: Forty-two patients aged between 7 and 12 years requiring restorative procedures/extraction/pulp therapy of primary/ permanent teeth in the maxillary arch, under buccal infiltration anesthesia were selected for the study. The participants were randomly allocated into 2 groups of 21 each. In group A, 8% lignocaine gel and in group B, 15% lignocaine spray was applied prior to buccal infiltration. Pain was assessed using Wong-Baker faces pain rating scale (WBFPRS) and faces legs activity cry and consolability (FLACC) painscale. RESULTS: Pearson's chi-square test revealed that there was no significant difference in the FLACC scores of the two groups (p = 0.54). Independent t-test demonstrated that there was no significant difference in Wong-Bakers faces pain score between the two agents (p = 0.07). CONCLUSION: There is no significant difference in the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic in controlling pain during buccal infiltration anesthesia, in children.

Evaluation of Indirect Pulp Capping Using MTA, Light-cured Calcium Silicate, and Propolis in Primary Teeth: A Clinical and Radiographic Study Using VistaScan.

Aims: Clinical and radiographic evaluation of mineral trioxide aggregate (MTA), TheraCal LC, and propolis when used as an indirect pulp capping agent in primary teeth over a period of 6 months. Materials and methods: A total of 42 primary molar teeth from children aged 4-10 years were chosen for the study. The teeth were divided equally into three groups (group I: MTA, group II: light cured calcium silicate, and group III: propolis). The teeth were followed up clinically and radiographically at 3 and 6 months. The teeth that showed successful treatment outcomes clinically and radiographically were evaluated for the amount of dentin bridge formed at the end of 3 and 6 months, which was measured using CorelDRAW software. The data obtained was analyzed statistically using Statistical Package for the Social Sciences (SPSS) version 21. Results: The mean change in dentin thickness from baseline to 3 months in group II was found to be the highest, followed by groups I and III. The mean change in dentin thickness from 3 months to 6 months was highest in group I, followed by groups III and II. The mean change in dentin thickness from baseline to 6 months in group II was found to be significantly higher than that of group I, followed by group III. Conclusion: Clinically and radiographically, all three materials showed favorable outcomes when used as an indirect pulp capping material with significant reparative dentin formation. The highest amount of dentin deposition was recorded with light-cured calcium silicate, followed by MTA and propolis, respectively. How to cite this article: Saikia D, Yadav G, Saha S, et al. Evaluation of Indirect Pulp Capping Using MTA, Light-cured Calcium Silicate, and Propolis in Primary Teeth: A Clinical and Radiographic Study Using VistaScan. Int J Clin Pediatr Dent 2023;16(5):686-691.

Development and characterization of self emulsifying drug delivery system of a poorly water soluble drug using natural oil.

Objective of present study involves preparation and evaluation of self emulsifying drug delivery system (SEDDS) of ibuprofen using peanut oil. SEDDS were composed of varying concentrations of peanut oil (solvent), tween 80 (surfactant) and span 20 (co-surfactant). Influence of concentration of surfactant/co-surfactant and globule size on dissolution rate was investigated. Dissolution rate was studied in phosphate buffer pH 6.8 using dissolution apparatus II. The dissolution rate of self emulsifying capsule was found to be significantly faster than that from conventional tablet. The optimized SEDDS released approximately above 85% of ibuprofen within 30 min, while conventional ibuprofen tablet could released only 36% in 30 min. Therefore, these SEDDS could be a better alternative to conventional drug delivery system of ibuprofen.

Chlorhexidine: An effective anticovid mouth rinse.

CONTEXT: Dentists across the globe are witnessing a completely unforeseen and uncertain professional situation during these times of COVID-19 pandemic. There is conflicting evidence regarding the effectiveness of routinely used mouthwashes and especially Chlorhexidine, to reduce the viral load in oral cavity and the aerosols during oral procedures. AIMS: Comparative evaluation of the effectiveness of the current 'gold standard' chlorhexidine and povidone iodine as a control agent, through an in-vitro analysis. SETTINGS AND DESIGN: In-vitro laboratory analysis. METHODS AND MATERIAL: All the experiments for analysis of antiviral efficacy of chlorhexidine digluconate (2%)and povidone iodine(1%), against SARS-CoV-2 virus were performed in the BSL3 facility at the Council of Scientific and Industrial Research-Institute of Microbial Technology, using the VeroE6 cell lines. The analysis of the virus inactivation was based on quantification of viral RNA (Cycle threshold (Ct) profile) present in the culture supernatant using Real-Time Quantitative Reverse Transcription PCR (qRT-PCR). STATISTICAL ANALYSIS USED: Descriptive analysis (Statistical package for social sciences (SPSS Inc., Chicago, IL, version 15.0 for Windows). RESULTS: Chlorhexidine digluconate in 0.2% concentration inactivated more than 99.9% of SARS CoV 2 virus, in minimal contact time of 30 seconds, which was considered better efficacy than povidone-iodine utilized for 30 and 60 seconds. Subtle differences were observed in the activity of both the compounds in terms of percent inactivation of virus, though a greater relative change in Ct values was observed for chlorhexidine. CONCLUSIONS: Within the limitations of the present study, it can be concluded that Chlorhexidine digluconate in 0.2% concentration inactivated SARS CoV 2 in minimal contact time i.e 30 secs, however both compounds tested i.e Chlorhexidine and povidone-iodine were found to have antiviral activity against SARS CoV2 virus.

Little Color, Little Flavor of Different kinds of Commercially Available Flavored Milk and their Consumption Effect on Salivary pH Value in Children: An In Vivo Study.

AIM: This study aimed to compare the effect of different flavored kinds of milk on salivary pH value in 6 to 14 years old children. MATERIALS AND METHODS: The impact of these different kinds of flavored milk on the salivary pH is evaluated between two groups of children, caries-active group (n = 35) constituted children who had decayed missing filled tooth (DMFT) ≥2, and the caries-free group (n = 35) constituted children who had DMFT = 0. Four different flavors of milk are taken for the study, and plain sweetened milk is chosen as the control baseline. The endogenous pH of the salivary samples is measured at baseline and after consumption of the flavored milk immediately and then at 5-, 10-, 15-, and 30-minute intervals. The results are statistically analyzed by using the paired t-test and analysis of variance (ANOVA). RESULTS: It is shown in the present study that caries-active group subjects had a more evident salivary pH fall than the caries-free group subjects which was statistically significant. For caries-active group, subject's salivary pH value took a longer duration to return to baseline pH as compared to caries-free subjects. However, salivary pH value is restored to standard/baseline value after 30 minutes for all the flavored milk taken in both groups; hence, their intake can be regarded safe for the oral environment. CONCLUSION: It is concluded from the current study that the consumption of flavored milk can be considered as non-cariogenic for children. CLINICAL SIGNIFICANCE: In the present study, the salivary pH fall in both caries-active and caries-free subjects was found above the critical pH level. Hence, all these flavored milk used in the study did not cause a threat to oral environment health as there was no significant decrease in salivary pH value so their consumption can be regarded as safe for children. HOW TO CITE THIS ARTICLE: Navit S, Agarwal S, Khan SA, et al. Little Color, Little Flavor of Different kinds of Commercially Available Flavored Milk and their Consumption Effect on Salivary pH Value in Children: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(S-1):S87-S91.

Comparison of Pain and Anxiety Level Induced by Laser vs Rotary Cavity Preparation: An In Vivo Study.

AIM: To evaluate and compare the pain perception, anxiety level, and acceptance of Er,Cr:YSGG laser (2780 nm) with a conventional rotary method during cavity preparation in children. MATERIALS AND METHODS: In a randomized controlled trial, using split-mouth design thirty 6- to 12-year-old children with 60 carious molars were examined. In one quadrant, cavity was prepared conventionally by airotor while, in the other quadrant, Er,Cr:YSGG laser was used. Anxiety was assessed by measuring pulse rate using a fingertip pulse oximeter, while the pain was measured on the Wong-Baker Faces Pain Rating Scale. After the cavity preparation by both the methods, the child was asked about the preference for future treatment of a carious lesion. RESULTS: Pulse rate was found significantly higher in the airotor group but no significant difference in pulse rate was found in the laser group when compared to the baseline pulse rate. The mean value of pain in the airotor group was slightly higher than the laser group. Fifty-seven percent of children preferred Er,Cr:YSGG laser for cavity preparation in the future. CONCLUSION: During cavity preparation, Er,Cr:YSGG laser comes out to be more effective and acceptable, as it is less anxiety-provoking and may cause less pain when compared with the airotor. CLINICAL SIGNIFICANCE: Er,Cr:YSGG laser helps the children to remain calm during the cavity preparation. HOW TO CITE THIS ARTICLE: Alia S, Khan SA, Navit S, et al. Comparison of Pain and Anxiety Level Induced by Laser vs Rotary Cavity Preparation: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(6):590-594.

Effect of Diode Laser Office Bleaching on Mineral Content and Surface Topography of Enamel Surface: An SEM Study.

AIM: To assess the effects of different bleaching procedures on the mineral component and surface topography of the enamel using scanning electron microscope (SEM) and energy-dispersive X-ray spectrometry (EDX). MATERIALS AND METHODS: Forty samples of approximately 3 × 3 mm size from the coronal portion of 20 extracted human anterior teeth were obtained. The samples were divided into two control groups and three experimental groups. In group I or positive control (n = 5), no bleaching or phosphoric acid treatment to the enamel surface was done. Group II samples or negative controls (n = 5) were treated with 37% phosphoric acid. In group III (n = 10), the tooth was treated with 35% hydrogen peroxide (HP) without any activation. Group IV (n = 10) was treated with 37.5% HP with LED light activation and group V (n = 10) was treated with 45% HP with diode laser activation. The calcium (Ca) and phosphorus (P) levels of each sample were measured using an EDX system prior to bleaching treatments. All the samples were again subjected to the EDX analysis after the bleaching treatment and two samples (after EDX analysis) from each group were subjected to the SEM analysis. RESULT: No significant difference was seen in phosphorus levels before and after the bleaching. However, significant increase in calcium levels was observed after bleaching activated with LASER and LED light. The SEM observations revealed maximum surface alterations on the enamel after chemically activated bleaching. CONCLUSION: The LASER-activated bleaching agent seems to be more surface-friendly and less time-consuming as compared to other bleaching systems. HOW TO CITE THIS ARTICLE: Suresh S, Navit S, Khan SA, et al. Effect of Diode Laser Office Bleaching on Mineral Content and Surface Topography of Enamel Surface: An SEM Study. Int J Clin Pediatr Dent 2020;13(5):481-485.

Nature's Benefaction as a Life Saver for an Avulsed Tooth: An In vitro Study.

INTRODUCTION: Dentoalveolar trauma is a very common and avulsion is the most frequent injury. Treatment of choice following avulsion is immediate reimplantation. However, in cases where this might not be possible the prognosis of reimplanted teeth can be improved by the selection of an appropriate storage media. Prevention of ankylosis and replacement resorption depends more on the potential of storage media to maintain cell viability rather than the extraalveolar time period. AIM: To compare and evaluate the efficacy of different storage media in maintaining the viability of Periodontal Ligament (PDL) cells in an avulsed tooth. MATERIALS AND METHODS: A total of 58 freshly extracted human premolar teeth were divided into four experimental groups and two control groups. The positive and negative controls corresponded to 0 minute and an eight hours dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of the four media: Hank's Balanced Salt Solution (HBSS), coconut water, aloe vera and saline for 45 minutes. The teeth were then treated with Collagenase Type II and Dispase for 30 minutes. The number of viable PDL cells were counted with a haemocytometer and analysed. The statistical analysis was done using SPSS version 15.0. The Analysis of Variance (ANOVA) and Post-hoc tests (Tukey-HSD) were performed to reveal the statistical significance. The values were represented in number (%) and mean±SD. RESULTS: Statistical analysis demonstrated that among the experimental groups maximum percentage of viable cells were seen in HBSS (87.33%) followed by coconut water (79.87%), aloe vera (70.59%) and saline (50.56%). CONCLUSION: Within the parameters of this study, it can be concluded that the HBSS is the most effective storage media in maintaining the viability of PDL cells. However, in Indian scenario where availability of HBSS is questionable, coconut water can be considered as the best natural storage media for an avulsed tooth followed by aloe vera.

Effects of Structural Variations on the Cellular Response and Mechanical Properties of Biocompatible, Biodegradable, and Porous Smectic Liquid Crystal Elastomers.

The authors report on series of side-chain smectic liquid crystal elastomer (LCE) cell scaffolds based on star block-copolymers featuring 3-arm, 4-arm, and 6-arm central nodes. A particular focus of these studies is placed on the mechanical properties of these LCEs and their impact on cell response. The introduction of diverse central nodes allows to alter and custom-modify the mechanical properties of LCE scaffolds to values on the same order of magnitude of various tissues of interest. In addition, it is continued to vary the position of the LC pendant group. The central node and the position of cholesterol pendants in the backbone of ε-CL blocks (alpha and gamma series) affect the mechanical properties as well as cell proliferation and particularly cell alignment. Cell directionality tests are presented demonstrating that several LCE scaffolds show cell attachment, proliferation, narrow orientational dispersion of cells, and highly anisotropic cell growth on the as-synthesized LCE materials.

Antimicrobial Efficacy of Contemporary Obturating Materials used in Primary Teeth- An In-vitro Study.

INTRODUCTION: Preservation of primary tooth with non-vital pulp has been a major problem for pediatric dentist. In such cases, the preferred treatment modality is pulpectomy. The objective of pulpectomy is complete removal of necrotic and irreversibly infected pulp of an affected tooth but, in spite of chemomechanical preparation and copious irrigation of canal, there are chances of failure of pulp therapy due to the entrapped micro organisms in the canal space owing to the tortuous and complex nature of the root canal system and change in their morphology with root resorption. Thus, for optimal success of endodontic treatment, obturating material with antimicrobial properties is advocated in deciduous teeth. AIM: The aim of the study was to assess the antimicrobial efficacy of different obturating materials used in pediatric dentistry. MATERIALS AND METHODS: In the present study, antimicrobial efficacy of endoflas, Zinc Oxide Eugenol (ZOE), calcium hydroxide with chlorhexidine, calcium hydroxide with iodoform and distilled water, metapex and saline as control were assessed and compared with each other. The antimicrobial efficacy of obturating materials was evaluated against E. faecalis (ATCC 29212) by agar diffusion method. The statistical analysis was done using SPSS Version 15.0. The Analysis of Variance (ANOVA) and Post-Hoc Tests (Tukey-HSD) were performed to reveal the statistical significance. RESULTS: Intergroup comparison at 24 hours (Tukey's test) revealed significant difference amongst all the groups. Endoflas had significantly higher zone of inhibition as compared to all the other groups except group treated with ZOE (p-value <0.001). CONCLUSION: The antimicrobial activity of obturating materials according to results obtained from the present study can be summarized as follows: Endoflas > ZOE >Calcium hydroxide + Chlorhexidine > Calcium hydroxide + Iodoform +Distilled water ~ Metapex > Saline.

Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study.

BACKGROUND: Fluoridation of drinking water, despite being regarded as one of the top ten public health achievements of the twentieth century, has remained a much debated concept. Various studies on animals and aborted human fetuses have confirmed that excessive fluoride intake during infancy and early childhood, causes a number of irreversible structural and functional changes in the CNS leading to memory, learning and intellectual deficits. AIM: To compare the IQ levels of school children of two different locations, having different fluoride levels in water, and to establish a relationship between fluoride levels, prevalence of fluorosis and its effect on IQ levels. MATERIALS AND METHODS: A cross-sectional study was conducted among 429 children aged 6 - 12 years, selected by stratified random sampling from two different areas with different levels of fluoride in drinking water in and around Lucknow district. Dental fluorosis was measured using Dean's Fluorosis Index. Intelligence Quotient was measured using Raven's Coloured Progressive Matrices (1998 edition). RESULTS: Majority of the fluorosis free children (76.3%) had an IQ grade 2 (definitely above the average). Majority of the children suffering from very mild and mild dental fluorosis were found to have IQ grade 3 (Intellectually average). Children with moderate cases of dental fluorosis were found to have IQ grade 4 (Definitely below average). Only 5 children with severe fluorosis were included in the study and they all were found to have an IQ grade 5. Hence, a trend of increase in the IQ grade (decrease in intellectual capacity) was observed indicating a strong correlation between fluorosis grade and IQ grade. CONCLUSION: Findings of this study suggest that the overall IQ of the children exposed to high fluoride levels in drinking water and hence suffering from dental fluorosis were significantly lower than those of the low fluoride area.

Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients.

BACKGROUND: Dental anxiety is a widespread phenomenon and a concern for paediatric dentistry. The inability of children to deal with threatening dental stimuli often manifests as behaviour management problems. Nowadays, the use of non-aversive behaviour management techniques is more advocated, which are more acceptable to parents, patients and practitioners. Therefore, this present study was conducted to find out which audio aid was the most effective in the managing anxious children. AIMS AND OBJECTIVES: The aim of the present study was to compare the efficacy of audio-distraction aids in reducing the anxiety of paediatric patients while undergoing various stressful and invasive dental procedures. The objectives were to ascertain whether audio distraction is an effective means of anxiety management and which type of audio aid is the most effective. MATERIALS AND METHODS: A total number of 150 children, aged between 6 to 12 years, randomly selected amongst the patients who came for their first dental check-up, were placed in five groups of 30 each. These groups were the control group, the instrumental music group, the musical nursery rhymes group, the movie songs group and the audio stories group. The control group was treated under normal set-up & audio group listened to various audio presentations during treatment. Each child had four visits. In each visit, after the procedures was completed, the anxiety levels of the children were measured by the Venham's Picture Test (VPT), Venham's Clinical Rating Scale (VCRS) and pulse rate measurement with the help of pulse oximeter. RESULTS: A significant difference was seen between all the groups for the mean pulse rate, with an increase in subsequent visit. However, no significant difference was seen in the VPT & VCRS scores between all the groups. Audio aids in general reduced anxiety in comparison to the control group, and the most significant reduction in anxiety level was observed in the audio stories group. CONCLUSION: The conclusion derived from the present study was that audio distraction was effective in reducing anxiety and audio-stories were the most effective.

Biocompatible, biodegradable and porous liquid crystal elastomer scaffolds for spatial cell cultures.

Here we report on the modular synthesis and characterization of biodegradable, controlled porous, liquid crystal elastomers (LCE) and their use as three-dimensional cell culture scaffolds. The elastomers were prepared by cross-linking of star block-co-polymers with pendant cholesterol units resulting in the formation of smectic-A LCEs as determined by polarized optical microscopy, DSC, and X-ray diffraction. Scanning electron microscopy revealed the porosity of the as-prepared biocompatible LCEs, making them suitable as 3D cell culture scaffolds. Biodegradability studies in physiological buffers at varying pH show that these scaffolds are intact for about 11 weeks after which degradation sets in at an exponential rate. Initial results from cell culture studies indicate that these smectic LCEs are compatible with growth, survival, and expansion of cultured neuroblastomas and myoblasts when grown on the LCEs for extended time periods (about a month). These preliminary cell studies focused on characterizing the elastomer-based scaffolds' biocompatibility and the successful 3D incorporation as well as growth of cells in 60 to 150-µm thick elastomer sheets.