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.

Comparison of antimicrobial substantivity of root canal irrigants in instrumented root canals up to 72 h: an in vitro study.

Disinfection of the root canal system is one of the primary aims of root canal treatment. This can be achieved through the use of various antimicrobial agents in the form of irrigants and medicaments. The antimicrobial substantivity of 2% chlorhexidine gluconate, 1% povidone iodine, 2.5% hydrogen peroxide followed by 2% sodium hypochlorite, and 2% sodium hypochlorite alone as irrigants was assessed in instrumented root canals. 2% chlorhexidine showed antimicrobial substantivity lasting up to 72 h, followed by 1% povidone iodine, and 2% sodium hypochlorite. Thus 2% chlorhexidine should be used as a final rinse irrigant in endodontic treatment protocols.

Microleakage and SEM analysis of flowable resin used as a sealant following three fissure preparation techniques--an in vitro study.

OBJECTIVE: Preventive procedures using pit and fissure sealants are one of the important aspects of pediatric dental practice. The objectives of this in vitro study were to comparatively evaluate microleakage and resin tag penetration of a flowable resin used as a sealant on molars after preparation with Conventional, Enameloplasty and Fissurotomy techniques. METHOD: A total of 48 teeth were divided into 3 groups (n-16). Group A (CST), Group B (EST), and Group C (FT). Following the fissure preparation sealant was applied as per manufacturer's instructions. 8 samples in each group were used for Microleakage and Resin tag analysis. Microleakage analysis was done under Stereomicroscope after Methylene blue dye immersion by using scoring system. The resin tag analysis was done by measuring the length of resin tags on scanning electron microscope (SEM) images consisting of 10 microm scale taken under optical zoom of 2000 X. RESULTS: Significantly lesser microleakage score (P < 0.01) and longer resin tag penetration (P < 0.001) observed in EST (mean score 0.5 +/- 0.53) & (12.19 +/- 1.93 microm) when compared to CST (mean score 1.75 +/- 0.89) & (5.96 +/- 1.84 microm) and FT (mean score 1.5 +/- 0.53) & (6.76 +/- 1.82 microm) which showed more microleakage and short resin tags. No statistical significance between CST and FT was found. CONCLUSION: EST has proven to be an excellent method for preparation of pits and fissures when Flowable composite is used as a sealant because of its lesser microleakage and longer resin tag penetration.

Comparative evaluation of microleakage of two self-etching dentin bonding agents on primary and permanent teeth. An in vitro study.

AIM: Conservative procedures using dentin bonding agents are one of the important aspects of paediatric dental practice. The objective of this in vitro study was to comparatively evaluate the microleakage of two self etching adhesives in primary and permanent teeth. MATERIALS AND METHODS: Sixty-four human anterior teeth (thirty-two primary and thirty-two permanent) were divided into four groups: primary teeth bonded using a 6th generation (Contax) bonding agent; permanent teeth bonded using a 6(th) generation (Contax) bonding agent; primary teeth bonded using a 7(th) generation (Clearfil S3) bonding agent; permanent teeth bonded using a 7(th) generation (Clearfil S3) bonding agent. A Class V cavity was prepared on all samples and were restored with composite resin as per manufacturers' instruction. After thermocycling, the teeth were stained with methylene blue, sectioned, and measured for microleakage. RESULTS: It was found a statistically significant difference in microleakage between incisal and gingival margins in each of the study group. CONCLUSION: Clearfil S3 (7(th) generation) bonding agent could be of greater advantage in paediatric dentistry than Contax (6(th) generation) because of its fewer steps and lesser microleakage in both primary and permanent teeth.

Dentin comparison in primary and permanent molars under transmitted and polarised light microscopy: an in vitro study.

UNLABELLED: Dentin is the fundamental substrate of restorative dentistry and its properties and characteristics are key determinants of nearly all restorative, preventive and disease processes of the teeth. The intrinsic permeability of dentin is responsible for permitting bacterial or chemical substances to diffuse across the dentin and irritate the pulpal and periradicular tissues. Improved understanding of the dentin structure and nature will have important consequences for today's dental procedures. The aims of the study were to observe the direction of dentinal tubules, interglobular dentin, incremental lines of dentin and the dead tracts. MATERIALS AND METHODS: A total of 30 teeth (15 primary and 15 permanent molars), unrestored, noncarious, hypoplastic extracted molars were used. Longitudinal ground sections of teeth were obtained using hard tissue microtome. RESULTS: Examination of ground sections of the primary teeth dentin showed "s"-shaped curvature in four (26.7%) specimens and a straight course of dentinal tubules in 11 (73.3%) specimens out of 15 teeth examined whereas in permanent teeth, all 15 (100%) specimens showed an "s"-shaped curvature. These results are statistically highly significant (P < 0.001). CONCLUSION: Dentinal tubules followed an "s"-shaped course in all the 15 (100%) permanent molars and in four (26.7%) primary molars. There was no significant difference in the occurrence of interglobular dentin of primary and permanent molars. But, they were at angles in the primary teeth.

Comparison of antibacterial efficacy of intracanal medicaments in multiple visit pulpectomies in primary molars-an in vivo study.

Antibacterial efficacy of formocresol, 2% gluteraldehyde and iodine-potassium iodide was assessed by obtaining cultures at consecutive appointments in multiple visit pulpectomies in primary molars. Formocresol and 2% gluteraldehyde were more effective as intracanal medicaments and caused significant reduction in the counts of aerobic and anaerobic microorganisms, thereby supporting the need for placing intracanal medicaments with antibacterial properties, in multiple visit pulpectomies in primary molars.

Biodegradation of nickel and chromium from space maintainers: an in vitro study.

Band materials are often used in the practice of pediatric dentistry. Nickel and Chromium are the main ingredients of these materials. The potential health hazards of nickel and chromium and their compounds have been the focus of attention for more than 100 years. It has established that these metals could cause hypersensitivity. The study was undertaken to analyze in vitro biodegradation of space maintainers made out of stainless steel band materials from manufacturers Dentaurum and Unitek. The leaching effect simulating the use of one, two, three, and four space maintainers in clinical practice was studied by keeping the respective number of space maintainers in the artificial saliva incubating at 37 degrees C and analyzing for nickel and chromium release after 1,7,14,21 and 28 days using atomic absorption spectrophotometer. Results showed that there was measurable release of both nickel and chromium which reached maximum level at the end of 7 days which was statistically significant (P < 0.05) and was very much below the dietary average intake even for four bands used and was not capable of causing any toxicity.

A comparative study of retentive strengths of zinc phosphate, polycarboxylate and glass ionomer cements with stainless steel crowns - an in vitro study.

An in vitro study was conducted to compare the retentive strengths of zinc phosphate, polycarboxylate and glass ionomer cements using Instron universal testing machine. Thirty preformed and pretrimmed stainless steel crowns were used for cementation on 30 extracted human primary molars which were divided into three groups of 10 teeth in each group. Then the teeth were stored in artificial saliva and incubated at 37°C for 24 h. A load was applied on to the crown and was gradually increased till the crown showed dislodgement, and then the readings were recorded using Instron recorder and analyzed for statistical significance. The surface area of crown was measured by graphical method. The retentive strength was expressed in terms of kg/cm 2 , which was calculated by the equation load divided by area. Retentive strengths of zinc phosphate (ranged from a minimum of 16.93 to amaximum of 28.13 kg/cm 2 with mean of 21.28 kg/cm 2 ) and glass ionomer cement (minimum of 13.69 - 28.15 kg/cm 2 with mean of 20.69 kg/cm 2 ) were greater than that of polycarboxylate cement (minimum of 13.26 - 22.69 kg/cm 2 with mean of 16.79 kg/cm 2 ). Negligible difference (0.59 kg/cm 2 ) of retentive strength was observed between zinc phosphate (21.28 kg/cm 2 ) and glass ionomer cements (20.69 kg/cm 2 ). Glass ionomer cements can be recommended for cementation of stainless steel crowns because of its advantages and the retentive strength was almost similar to that of zinc phosphate cement.

Flowable resin used as a sealant in molars using conventional, enameloplasty and fissurotomy techniques: an in vitro study.

BACKGROUND AND OBJECTIVE: Preventive procedures using pit and fissure sealants are one of the most important aspects of pediatric dental practice. The objectives of this in vitro study were to comparatively evaluate microleakage of a flowable resin used as a sealant on molars after preparation with conventional, enameloplasty and fissurotomy techniques. MATERIALS AND METHODS: A total of 24 teeth were divided into three groups of eight samples each. Pits and fissures were prepared with conventional sealant technique (CST) (Group A), enameloplasty sealant technique (EST) (Group B) and fissurotomy technique (FT) (Group C). Following sealant placement, thermocycling and sectioning of samples of Groups A, B and C were performed and microleakage was assessed under a stereomicroscope after methylene blue dye immersion. RESULTS: There was significantly lesser microleakage in EST when compared with CST and FT, which showed more microleakage. No statistical significance between CST and FT was found. INTERPRETATION AND CONCLUSION: EST has proven to be an excellent method of preparation of pits and fissures when flowable composite is used as a sealant because of its lesser microleakage.

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

Comparative evaluation of shear bond strength of two self-etching adhesives (sixth and seventh generation) on dentin of primary and permanent teeth: an in vitro study.

AIM: The present study was undertaken to compare and evaluate shear bond strength of two self-etching adhesives (sixth and seventh generation) on dentin of primary and permanent teeth. MATERIALS AND METHODS: Flat dentin surface of 64 human anterior teeth (32 primary and 32 permanent) divided into four groups of 16 each. Groups A and C were treated with Contax (sixth generation), while groups B and D were treated with Clearfil S3 (seventh generation). A teflon mold was used to build the composite (Filtek Z-350) cylinders on the dentinal surface of all the specimens. Shear bond strength was tested for all the specimens with an Instron Universal Testing Machine. Data were statistically analyzed using one-way ANOVA for multiple group comparison, followed by student's unpaired 't' test for group-wise comparison. RESULTS: There was no statistically significant difference in shear bond strength among the study groups except that primary teeth bonded with Contax exhibited significantly lesser shear bond strength than permanent teeth bonded with Clearfil S3. CONCLUSION: This study revealed that Clearfil S3 could be of greater advantage in pediatric dentistry than Contax because of its fewer steps and better shear bond strength in dentin of both primary and permanent teeth.

An analysis of concentration of sucrose, endogenous pH, and alteration in the plaque pH on consumption of commonly used liquid pediatric medicines.

BACKGROUND: Many parents are often unaware of the hidden, added sugars in many foods and drinks including pediatric liquid medicines; thus, hidden sugar in the form of pediatric medications has not been focused upon as cariogenic agents. OBJECTIVE: (i) assess concentration of sucrose in six pediatric drugs, (ii) determine endogenous pH of these drugs, and (iii) estimate drop in the plaque pH in the oral cavity in first 30 minutes after consumption of the drugs. MATERIALS AND METHODS: Ten adult volunteers with mean age of 22 years were double blinded for the study. Concentration of sucrose was assessed by volumetric method at Department of Chemical Branch of Engineering. Endogenous pH and drop in the plaque pH after consumption of the drugs were assessed using digital pH meter. STATISTICAL ANALYSIS: SPSS software was used to assess the pH level at different time intervals and expressed as mean +/- SD. Changes in pH were assessed by one-way ANOVA followed by Wilcoxons signed rank test. P-value was set at 0.05. RESULT: There were varying amounts of fermentable sucrose detected in the drugs; all the drugs were acidic. There is a significant drop of plaque pH after consumption of the drug. CONCLUSION: These sweeteners along with their low endogenic pH form a high cariogenic formulation. Thus, nonsucrose (noncariogenic) or sugar-free medications are needed to be prescribed along with proper oral hygiene care to the children under medication.

Prevalence of malocclusion and orthodontic treatment needs among middle and high school children of Davangere city, India by using Dental Aesthetic Index.

BACKGROUND: Malocclusion has large impact on individual and society in term of discomfort, Quality of Life [QoL]. AIMS AND OBJECTIVES: To assess prevalence of malocclusion and orthodontic treatment needs among middle and high school children of Davangere city, India by using Dental Aesthetic Index [DAI]. MATERIALS AND METHODS: A Descriptive cross sectional study was conducted among 1000, in the age group 12 to 15 year old school children studying in middle and high schools of Davangere city, India. 10 schools were selected by simple random sampling procedure and 100 study subjects were selected proportionately for males and females by using systematic random sampling procedures in each school. Data recorded using proforma consisted DAI components. The collected data was subjected to statistical analysis. STATISTICAL ANALYSIS: The Chi-square test [x(2)] was used for comparison of severity of malocclusion. Analysis of Variance [ANOVA] test was used for comparison of mean DAI scores between the age groups and in DAI scores. 'Z' test was used for comparing the mean DAI scores between sex group. RESULTS: Of the 1000 children examined, 518[ 51.8%] were males and 482[ 48.2%] were females. 80.1% school children had < or = 25 DAI scores with no or minor malocclusion requiring no or little treatment, 15.7% had 26-30 DAI scores with definite malocclusion requiring elective treatment, 3.7% had 31-35 DAI scores with severe malocclusion requiring highly desirable treatment and 0.5% had > or = 36 DAI scores with handicapping malocclusion requiring mandatory treatment. CONCLUSIONS: 80.1% school children had no or minor malocclusion which required no or slight treatment, 19.9% had definite/handicapping malocclusion requiring definite/mandatory orthodontic treatment.

Prevalence and severity of dental fluorosis among 13- to 15-year-old school children of an area known for endemic fluorosis: Nalgonda district of Andhra Pradesh.

OBJECTIVES: The present study was conducted to assess dental fluorosis and to compare fluorosis in incisor teeth among 13- to 15-year-old school children of Nalgonda district, Andhra Pradesh. METHODS: Cross-sectional analytical study was conducted. A total of 1000 school children aged 13 to 15 years were selected by stratified cluster sampling from 4 different areas with different levels of naturally occurring fluoride in drinking water. Fluorosis was recorded using TF index (TFI). RESULTS: Prevalence of fluorosis (TFI score, > or = 1) was 100% at all the 4 different fluoride levels. The prevalence and severity increased with increased fluoride levels in drinking water. Prevalence and severity of fluorosis did not show any significant variation between maxillary and mandibular incisor teeth. CONCLUSION: There is a high prevalence of mild-to-moderate fluorosis in Nalgonda district, even in areas with optimal fluoride levels in water.

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.

Comparison of antibacterial activity of three fluorides- and zinc-releasing commercial glass ionomer cements on strains of mutans streptococci: an in vitro study.

The purpose of present study was to investigate the antibacterial activity of three commercially available fluoride- and zinc-releasing glass ionomer cements on strains of mutans streptococci. Three glass ionomers (Fuji II Conventional, Fuji II Light Cure, and Fuji IX) were used. The antibacterial effect of glass ionomer cements were estimated by anaerobically growing mutans streptococci on a selective medium by inoculating human saliva and measuring the inhibition zones around the glass ionomer discs on the medium. Fluoride and zinc release were measured and compared with the antibacterial activity. The results, when statistically analyzed, showed a direct correlation between fluoride release and antibacterial activity, but there was no correlation between zinc release and antibacterial activity.

Chocolate mouth rinse: Effect on plaque accumulation and mutans streptococci counts when used by children.

BACKGROUND: Glucosyltransferases (GTF) play an important role in the adherence of bacteria to acquired pellicle. Cocoa bean husk extract (CBHE) has been shown to possess anti-glucosyltransferase and antibacterial activity. AIM: This study aimed to evaluate the effect of CBHE on plaque accumulation and mutans streptococcus count when used as a mouth rinse by children. MATERIALS AND METHODS: Scaling of the teeth of the selected children was done and the children were instructed to refrain from their routine oral hygiene practices till the morning of the fourth day; they were instead given a placebo mouth rinse for use during this period. On the fourth day, saliva was collected from each subject for microbiological analysis and plaque was disclosed and scored using the modified Quigley and Hein plaque index; later, the teeth were cleaned. After 1 week, scaling of the subjects was done and they were given CBHE mouth rinse to rinse their mouth, following the above protocol. The data was statistically analyzed using Wilcoxon's signed rank test. RESULTS: There was a 20.9% decrease in mutans streptococci counts and a 49.6% decrease in plaque scores in the CBHE group as compared to the placebo group, which was highly significant (P value Conclusion: CBHE is highly effective in reducing mutans streptococci counts and plaque deposition when used as a mouth rinse by children.

Papillon-Lefevre syndrome: Report of two cases in the same family.

Papillon-Lefevre syndrome is a very rare syndrome of autosomal recessive inheritance characterized by palmar-plantar hyperkeratosis and early onset of a severe destructive periodontitis, leading to premature loss of both primary and permanent dentitions. Various etiopathogenic factors are associated with the syndrome but a recent report has suggested that the condition is linked to mutations of the cathepsin C gene. Two cases of Papillon-Lefevre syndrome in the same family, having all of the characteristic features, are presented. An 11-year-old girl and a 9-year-old boy presented with the complaints of loose teeth. Both expressed hyperkeratosis of palms, soles, and knees. Severe generalized periodontal destruction, with mobility of teeth, was evident on intraoral examination; orthopantomograph examination showed severe generalized loss of alveolar bone in both the patients.

Orthodontic uprighting of impacted mandibular permanent second molar: a case report.

The mandibular second molars can become impacted beneath the crown of the first molars due to various causes and fail to erupt normally. Presented herewith is a case report of orthodontic uprighting of a mesioangular impacted mandibular right permanent second molar. Though various treatment options were available, an uprighting push spring appliance was used as it is easy to fabricate and produces distal tipping and uprighting of the impacted tooth without the necessity of surgical assistance, bone removal, or splinting. The uprighting of the mandibular second molar was achieved within two months.