In Vitro Evaluation of the Efficacy of Three Different Remineralizing Agents on Artificial Enamel Lesions in Primary Teeth: A Comparative Study.

AIM: The aim of the present study was to assess the effectiveness of three various remineralizing agents on artificial enamel lesions in deciduous teeth. MATERIALS AND METHODS: Eighty primary teeth that were implicated for extraction were taken from patients of 4 to 14 years of age. Every specimen was subjected to air drying followed by the creation of 3 × 3 mm window positioned on the central surface of the coronal portion of the tooth to restrict the area of investigation. A digital pH meter was utilized to formulate a demineralizing solution by checking the pH before and following formulation of the solution. A total of 80 specimens (20 in every group) were allocated to three of the following experimental groups and one control group: group I: control, group II: tricalcium phosphate, group III: casein phosphopeptide-amorphous calcium phosphatefluoride (CPP-ACPF), and group IV: calcium sucrose phosphate (CaSP). Specimens in every group were subjected to treatment with the assigned remineralizing substance once in 24 hours for 14 days. Confocal laser scanning microscopic (CLSM) evaluation of the samples was performed to assess the baseline and posttreatment remineralization as well as demineralization. RESULTS: CPP-ACPF group (110.73 ± 0.11) displayed the greatest mean remineralization depth, in pursuit by the calcium orthophosphate complex (CaSP) group (122.19 ± 0.28), tricalcium phosphate group (126.87 ± 0.15) as well as the control group (158.46 ± 0.07). These differences amid the investigational groups for remineralization were significant. The greatest depth µ area of remineralization was seen in the CPP-ACPF group (50.29 ± 0.06) in pursuit by the CaSP group (36.70 ± 0.17) as well as the tricalcium phosphate group (33.29 ± 0.06). This difference amid the remineralizing agents was statistically significant. CONCLUSION: Amid the confines of the limitations of the current research, it may be concluded that the three remineralizing agents studied, exhibited a remineralization capability on the artificially induced lesions in enamel. CPP-ACPF exhibited the greatest remineralization capability in comparison with the CaSP and tricalcium phosphate groups. CLINICAL SIGNIFICANCE: Dental caries is an unalterable course that leads to everlasting loss of dental hard tissues with eventual formation of a cavity. Off late, numerous techniques have centered on applying remineralizing substances to early lesions due to dental caries, aiming at arresting demineralization while encouraging remineralization. Such remineralizing substances form an atmosphere that is superconcentrated with calcium and phosphate, thereby forcing these ions to diffuse into the unoccupied areas, thereby avoiding further loss of minerals.

Assessment of Microleakage Using Dye Penetration Method in Primary Teeth Restored with Tooth-colored Materials: An In Vitro Study.

AIM: The present study aimed to assess the microleakage in primary teeth restored with tooth-colored materials using the dye penetration method. MATERIALS AND METHODS: A total of 60 healthy primary molar teeth were included in this study and standardized class II mesio-occlusal cavities were prepared on the samples. Consequently, these teeth were randomly divided into three experimental groups (n = 20 each group) such as group I: nano-filled resin-modified glass-ionomer, group II: nanocomposite resin, and group III: Cention N. After completing all the restorations, the restored teeth were subjected to 100 cycles of thermocycling. Next, all the surfaces of the tooth, except the restoration and a 1-mm zone adjacent to the restoration's margins, were covered with two coats of nail varnish. The coated teeth were then submerged in a 0.5% basic fuchsin dye solution. The teeth were then sectioned along the center of each restoration mesiodistally. Each part was visualized under a stereomicroscope at ×40 magnifications to assess microleakage. RESULTS: Out of all the included restorative materials, the least microleakage was demonstrated by teeth restored by the nano-filled resin-modified glass-ionomer (RMGI) group (1.05 ± 0.21) followed by the Cention N group (1.84 ± 0.14) and the nanocomposite resin group (3.10 ± 0.03). A statistical method involving the analysis of variance revealed a statistically significant difference among the different restorative materials. Multiple comparisons among the restorative materials showed a statistically significant difference between groups I and II and groups II and III restorative materials (p < 0.05). The dye penetration score 1 was more [11(55%)] for the nano-filled RMGI group, score 3 was more [12(60%)] for the nanocomposite resin group, and score 2 was more [9(45%)] for the Cention N group. CONCLUSION: The present study showed significantly less microleakage associated with the nano-filled resin-modified glass ionomer group than nanocomposite resin and Cention N groups. CLINICAL SIGNIFICANCE: Since many years, dentists have encountered a challenging problem with cervical lesions. Thus, an interdisciplinary treatment approach is the appropriate option in the management of carious teeth that involve gingival recession and cervical extension.

Effectiveness of Different Bristle Designs of Toothbrushes and Periodontal Status among Fixed Orthodontic Patients: A Double-blind Crossover Design.

AIM: The aim of the present study was to evaluate the effectiveness of different bristle designs of toothbrushes and the periodontal status among patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: This randomized controlled trial (RCT) consisted of 45 adolescents (comprising 20 males and 25 females) undergoing fixed orthodontic treatment. The study participants were randomly allocated to three groups, each group being assigned a locally available toothbrush with a particular design of toothbrush bristle. In the first test phase, group I study participants were allocated to toothbrush with flat bristles, group II study subjects were allocated to toothbrush with zigzag bristles, and group III study participants were allocated to toothbrush with crisscross bristles. The study participants were recalled after 4 weeks to check the effectiveness of the allocated toothbrushes. A washout period of 1 week was maintained to ensure that there was no carryover effect of the different bristle designs. In the second test phase, each patient used the opposite toothbrush bristle design (group I: toothbrush with zigzag bristles, group II: toothbrush with crisscross bristles, and group III: toothbrush with flat bristles). Plaque scores were measured using Turesky-Gilmore-Glickman modification of Quigley-Hein plaque index (PI). RESULTS: In both phase 1 and 2 of this RCT, toothbrush with crisscross bristles exhibited maximum plaque reduction among the three different bristle design toothbrushes following 30 days (p = 0.312 ± 0.102 and 0.280 ± 0.110, respectively), which was statistically significant. CONCLUSION: It was concluded that all the three designs of toothbrushes were effective in removing plaque in patients with fixed orthodontic appliances. But among the three different toothbrushes, toothbrush with crisscross bristles showed the highest mean plaque reduction. CLINICAL SIGNIFICANCE: Plaque accumulation around the orthodontic brackets and gingival margins is quite common among the fixed orthodontic patients, who encounter difficulty in maintaining good oral hygiene. Specially designed toothbrushes are very essential for effective plaque removal among the patients undergoing fixed orthodontic treatment.

Evaluation of Intracanal Calcium Hydroxide Removal with Different Techniques: A Scanning Electron Microscope Study.

AIM: This study aimed to evaluate the efficacy of Intracanal calcium hydroxide removal with different techniques. MATERIALS AND METHODS: Seventy-five freshly extracted, non-carious, single canalled lower first premolars, having anatomic characteristics similar to each other, extracted for the orthodontic purpose were collected. After the root canal preparation, Calcium hydroxide was placed into the working length using lentulo spiral instrument till the medicament was visible at the apex. The specimens were segregated into three groups; Group 1: Rotary Files, Group 2: EndoVac system and Group 3: Ultrasonics. The evaluation was done with SEM in the coronal and apical third of the roots with a magnification of 1000x. The statistical analysis was done using statistical packages for social sciences (SPSS) software, version 20.0 for Windows (SPSS Inc., Chicago, IL). A p-value of less than 0.05 was considered significant statistically. RESULTS: Maximum removal of Ca(OH)2 was analyzed in the EndoVac system (2.90 ± 0.12) followed by the rotary files (1.76 ± 0.26) and least was seen with Ultrasonics (1.32 ± 0.14). The p-value of 0.001 was seen between the coronal and apical third with the EndoVac system which is statistically significant. The significant difference statistically was observed between Rotary Files vs. Ultrasonics at apical third and with the EndoVac system vs. Ultrasonics at coronal third as well as at the apical third with p-value 0.001. CONCLUSION: It can be concluded that the EndoVac technique was effective in removing Ca(OH)2 medicament from the coronal and apical third of the root canal significantly. CLINICAL SIGNIFICANCE: Calcium hydroxide removal before the obturation was of priority as the Ca(OH)2 remnants have a negative impact of the ability for sealing the obturation material. Therefore, having a complete knowledge regarding the effective technique is much important.

Assessment of Enamel Surface Microhardness with different Fluoride Varnishes-An In Vitro Study.

AIM: This study aimed to assess the microhardness of the enamel surface after fluoride varnish application. MATERIALS AND METHODS: Thymol of 0.1% in distilled water was used to store the collected healthy sixty teeth. The samples were divided into three groups randomly as per the different applica -tion of fluoride varnish. Group A: Fluor protector varnish (FIV) application, group B: Duraphat varnish application and group C: Bifluorid 10 varnish application. The present study followed the pH cycling protocol. Microhardness tester was used to test the microhardness of enamel surface and was expressed as micro-hardness measurements of Vickers hardness number (VHN) which was performed at baseline, on the 3rd day andon 7th day. RESULTS: At baseline, group A samples mean SMH value was 230.64 ± 12.32 which was slightly more than group B with 229.45 ± 10.22 and group C with 230.10 ± 11.45. There was no significant difference showed with the analysis of variance between the groups. On the 3rd day, there was a slight increase in the mean SMH in group A with 235.39 ± 6.44 and no significant difference between the groups was seen statistically. On the 7th day, the group A showed high SMH value of 262.20 ± 4.89 compared to other groups which didn't show a significantly high statistical difference. CONCLUSION: On conclusion, post-application of fluorprotector varnish showed higher enamel surface microhardness compared to Duraphat and Bifluorid 10 varnishes. CLINICAL SIGNIFICANCE: In young children, fluoride varnishes are effectively used as a noninvasive, anti-caries agent in the treatment of initial caries. Therefore, in routine dental practice, the knowledge about different fluoride varnishes is of importance.

A Rare Case of Calcified Radicular Cyst in Deciduous Tooth.

Radicular cysts (RCs) are one of the most common odontogenic cystic lesions of inflammatory origin. It originates mostly from epithelial residues in periodontal ligaments secondary to inflammation. The pathogenesis involves the activation of epithelial cell rests of Malaseez after physical, chemical, or bacterial injury. Radiographically, it is seen as a well-defined unilocular lesion of size >1.5 cm. RCs are considered rare in the primary dentition, comprising only 0.5-3.3% of the total number of RCs in both primary and permanent dentitions. This is the first case to be reported of a radicular cyst in primary teeth, with dystrophic calcification. How to cite this article: Sunny R, Rag B, Punathil S, et al. A Rare Case of Calcified Radicular Cyst in Deciduous Tooth. Int J Clin Pediatr Dent 2024;17(1):86-88.

Comparison of Antibacterial Effect of Calcium Hydroxide Combined With Chlorhexidine and Povidone-Iodine Against Enterococcus faecalis in Dentinal Tubules of Human Incisors: An In Vitro Comparative Study.

BACKGROUND AND OBJECTIVES: It has been found that the microorganism behind the failure of root-filled teeth is Enterococcus faecalis, which shows resistance to most of the intra-canal medicaments. Therefore, the purpose of this study was to evaluate the antibacterial efficacy of three intra-canal medications-calcium hydroxide with saline, combinations of calcium hydroxide with 2% chlorhexidine (CHX), and calcium hydroxide with 5% povidone-iodine-against E. faecalis in dentinal tubules of human incisors. MATERIALS AND METHODS: Forty permanent maxillary central incisors were made into standardized segments and infected with E. faecalis. They were treated with a paste made of calcium hydroxide and 2% CHX, calcium hydroxide and 5% povidone-iodine, and calcium hydroxide and saline for 1 week. Dentinal shavings collected from the canal were suspended in thioglycollate broth solution and spread on brain heart infusion agar. Colony-forming units (CFUs) were enumerated and the CFU per milligram of dentin was calculated. The pH of the medicaments used was measured with the help of pH meter. RESULTS: The results showed that the paste made from calcium hydroxide and 2% CHX was significantly more effective than that made from calcium hydroxide and povidone-iodine, and calcium hydroxide and saline. The addition of CHX or povidone-iodine did not affect the alkalinity of calcium hydroxide. CONCLUSION: This study concludes that Ca(OH)2 + 2% CHX are effective against E. faecalis. Combinations of calcium hydroxide and 5% povidone-iodine showed better antibacterial effect than calcium hydroxide and saline. Ca(OH)2 + saline was ineffective against E. faecalis.

An Ex Vivo Evaluation of Antimicrobial Efficacy of Root Canal Preparation With Hand K-Files, Hand Pro Taper, and Pro Taper Rotary Files.

BACKGROUND: Microorganisms are considered to be the primary cause behind persistent pulpoperiapical pathologies as well as endodontic failures. It has been found that Enterococcus faecalis is one of the most commonly isolated organisms in failed endodontic treatment. Proper and appropriate mechanical instrumentation is necessary to eradicate these microorganisms. AIMS AND OBJECTIVES: The aim of this study was to compare antimicrobial efficacy of various root canal instrumentation techniques. This study was designed to compare antimicrobial efficacy of root canal preparation using hand K-files, hand Pro Taper files, and Pro Taper rotary files. MATERIALS AND METHODS: Forty intact maxillary premolars extracted for orthodontic reasons were used. After extirpation of pulp, teeth are decoronated and autoclaved. Then the root canals were infected with E. faecalis suspension and the teeth were incubated at 37°C for 24 h. Thereafter the teeth were divided into five groups and were prepared using the following instruments: group 1 (hand K-files), group 2 (hand Pro Taper files), group 3 (Pro Taper rotary files), group 4 (Control I; treatment consists of irrigation with 1 mL of sterile physiological saline with no instrumentation), and group 5 (Control II; teeth received no treatment at all). Before and after treatments, samples were taken from the root canals for culture and were transferred to physiological saline. Results were evaluated after 24-h incubation in selective culture medium. RESULTS: The results showed that the teeth prepared with Pro Taper rotary files showed significant reduction in number of bacteria from the root canals.

Comparison of Efficacy of Lycopene and Lycopene-Hyaluronidase Combination in the Treatment of Oral Submucous Fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic progressively scarring disease of the oral cavity. Lycopene is a powerful antioxidant obtained from tomatoes and has the highest singlet oxygen quenching capacity and a high capacity of quenching other free radicals in vitro among dietary carotenoids. Hyaluronidase is a substance prepared from the testes and semen of mammals that modifies the permeability of connective tissue through the hydrolysis of hyaluronic acid. OBJECTIVE: To evaluate the efficacy of lycopene and lycopene-hyaluronidase combination, and to compare the efficacy of lycopene and lycopene-hyaluronidase combination in the treatment of OSMF. STUDY DESIGN: The study consisted of 45 patients with OSMF divided into three equal groups. Patients in Group A were given Lycored 16 mg daily in two equally divided doses for 3 months. Patients in Group B were given LycoRed along with hyaluronidase intralesional injection of 1500 IU twice weekly for 3 months. Patients in Group C were given placebo capsules. Patients were evaluated after 3 months. The following parameters were recorded: mouth opening, visual inspection, palpatory findings, and burning sensation. RESULTS: There was statistically significant change in mouth opening and burning sensation for lycopene and lycopene-hyaluronidase combination than in the placebo group in the treatment of OSMF, but the lycopene-hyaluronidase combination did not show any statistically significant change when compared with lycopene alone. CONCLUSION: Lycopene appears to be a very promising antioxidant in the management of oral submucous fibrosis, both in clinical and symptomatic improvement.

Caries Risk Assessment of 12-13-year-old Government and Private School Going Children of Mysore City Using Cariogram: A Comparative Study.

AIM: The aim of this study is to assess the caries risk assessment of 12-13-year-old government and private school going children of Mysore city using Cariogram. MATERIALS AND METHODS: A cross-sectional examination was carried out on a total of 104 government and private schoolchildren aged 12-13 years. Ten factors from the Cariogram software(D Bratthall, Computer software, Malmo, Sweden) were included from study participant's records to complete the Cariogram. The percentage of "chances of avoiding new lesions" (caries risk) among government and private school study participants were obtained from Cariogram, and the participants were classified into five risk groups. Statistical analysis was performed using the software program Statistical Package of Social Science (version 17.0, SPSS Inc., Chicago IL, USA). RESULTS: Findings revealed that there is slight difference in caries risk among government and private schoolchildren, where 48% caries risk development and 52% chance to avoid dental caries were showed in government schoolchildren, and 51% caries risk development and 49% chance to avoid dental caries were showed in private schoolchildren, according to Cariogram. Decayed, missing, and filled teeth component, mutans streptococci, and Lactobacillus counts were slightly higher in private schoolchildren compared with government schoolchildren. CONCLUSION: The private schoolchildren had less favorable values than government schoolchildren for most of the caries-related factors. Cariogram can be the most modest and reliable tool for caries prediction, thus aiding in identifying different risk groups in a community so that appropriate preventive strategies can be provided to overcome new carious lesion formation.

Evaluation of the Oral Health Knowledge, Attitude and Behavior of the Preclinical and Clinical Dental Students.

BACKGROUND: Dentists play very important role in the oral health education of the community. Thus it is important to know the status of knowledge, attitude, and behavior toward the maintenance of oral health at the student level. The aim of the present study was to evaluate the oral health knowledge, attitude, and behavior among preclinical and clinical dental students. MATERIALS AND METHODS: A cross-sectional study was conducted on 147 dental students from 1(st) to 4(th) year of Malabar Dental College, Kerala, in the year of March-June 2010 and was carried out with the help of 30 questionnaires. Age, gender and academic year data were recorded. Statistical analysis was performed with the help of SPSS version 20 using the Student's t-test and one-way ANOVA tests. RESULTS: The difference in scores of oral health knowledge, attitude and behavior between preclinical and clinical dental students was found statistically highly significant (Student's t-test, P < 0.001). The variation of scores of knowledge, attitude, and behavior also showed highly significant increase with the year of study (one-way ANOVA, P < 0.001). While the difference in scores between males and females showed that females have better oral health knowledge than males, but the difference was not statistically significant (Student's t-test, P > 0.01). The present study thus showed improvement of knowledge, attitude and behavior with the academic years and there was no bias of gender with reference to oral health. CONCLUSIONS: Although oral health knowledge, attitude and behavior showed improved results from 1(st) to 4(th) year dental students, it should be improved in order to serve better for the community in the future.