Evaluation of Aloevera Gel as a Storage Medium in Maintaining the Viability of Periodontal Ligament Cells - An in Vitro Study.

OBJECTIVE: To investigate the effectiveness of aloevera gel as a new storage medium in maintaining the viability of periodontal ligament cells. STUDY DESIGN: Premolars extracted for orthodontic reason were obtained. Confluent monolayers of fibroblasts were grown by cell culture method from the PDL cells isolated from the extracted teeth. One ml of this cell suspension was transferred to wells of culture plates, incubated for 24 hrs, followed by exposure to the three experimental media, Hank's balanced salt solution (HBSS), aloevera gel, and packaged drinking water. These plates were then assessed for viable cells using trypan blue dye exclusion test with haemocytometer after 15, 30, 60, 90 and 120 mins. The results obtained were statistically analysed using one-way analysis of variance (ANOVA). RESULTS: At 15 min, HBSS presented maximum mean percentage of viable PDL cells (89%), followed by aloevera at 81% and packaged drinking water at 10%. Aloevera demonstrated 71%, 59%, 57% viable cells at 30, 60, 90 mins respectively. At 120 min, HBSS presented 57% viable cells followed by aloevera gel (45%) and packaged drinking water (3%). No statistical significant difference was observed between HBSS and aloevera gel. CONCLUSIONS: Within the parameters of this study, both aloevera gel and HBSS were effective in maintaining the viability of PDL cells. Hence, aloevera gel could be used as a storage media for avulsed tooth in situations where availability of HBSS is in question.

Assessment of safe zone in maxillary molar region for miniscrew placement in the mixed dentition period--a digital volumetric tomographic (DVT) study.

Assessment of bone thickness in maxillary frst molar region for miniscrew placement during the mixed dentition period with reference to the following variables a) mesio-distal bone width b) buccal cortical plate thickness c) palatal cortical plate thickness d) bucco-palatal bone depth. DVT images of fifteen healthy patients aged 8-10 years with early exfoliated maxillary second deciduous molar were obtained using the Kodak 9000 extra-oral imaging system. The scanned images were analyzed using Kodak dental imaging software [3DmoduleV2.2] and the bone thickness measurements were obtained at six mm and eight mm apical to the cemento-enamel junction. The mean and standard deviation for the measurements was calculated and data was statistically analysed using paired 't' test. The Method error calculations were performed using the Dahlberg formula. The mean values for the mesiodistal width, buccopalatal depth, buccal and palatal cortical bone thickness were found to be sufficient for miniscrew placement up to 1.2mm diameter and 10mm length. The bone thickness measurement and assessment of safe zone in maxillary posterior region from the present study showed potential for miniscrew placement in pediatric age group. Miniscrews can be considered as a promising aid in pediatric space management; so also, they can be used for molar distalization and space regaining in early mixed dentition period.

Evaluation and Comparison of Facial Appearance Using the Golden Ratio: An Anthropometric Study in Preschool and School-Going Children of Santhal Tribe in West Bengal.

Introduction Golden ratio and beauty are two inseparable sides of the same coin and have been studied for centuries by the Greeks. This divine ratio is defined as an invincible parameter in aesthetic dentistry to measure looks, symmetry, and balance. Being beautiful and handsome also boosts confidence in today's children and therefore is a top priority for young growing kids. However, there is no study done to define facial measurements based on the golden ratio in preschool and school-going children that can succor aesthetics in formative years. The purpose of this research was to evaluate facial proportions in the vertical dimension, quantify them in reference to the golden ratio, and analyze the association with gender among preschool and school-going children of the Santhal tribe in the Bankura district. Materials and methods A total of 399 subjects, 198 children of 3-5 years with primary teeth and 201 children of 6-12 years with mixed dentition, were selected from schools in villages of Bankura district, West Bengal, India. The subjects were made to relax in a sitting position and a digital vernier caliper was used to record the following vertical facial parameters: total facial height (TFH), trichion-gnathion distance (Tr-Gn), and subnasale-gnathion distance (Sn-Gn). The total facial height was correlated with sexual dimorphism and dentition. The ratio of Tr-Sn/Sn-Gn was calculated and compared with the golden ratio. The ratio was classified as normal (if it was between 1.6 and 1.699, i.e., normal to the golden ratio value), long (if it was more than 1.699, i.e., more than the golden ratio value), or short (if it was below 1.6, i.e., less than the golden ratio value). This facial analysis based on the golden ratio was correlated to sexual dimorphism and dentition. The data were recorded, compared with gender, and statistically analyzed using the unpaired t-test and Chi-square test. Results The total facial height was larger in males than females in both primary and mixed dentition; however, the value was highly significant in primary dentition. Tr-Sn/Sn-Gn ratios were lower in the long facial category in both males and females in both preschool and school-going children. The values were statistically significant in these ratios for both dentitions. Conclusion The majority of children in the Santhal tribe of Bankura in West Bengal did not conform to the golden ratio and showed long faces. There was a significant association of facial features with sexual dimorphism. Clinical significance The early prediction of facial features in children and its confirmation with the established golden ratio can be considered an imperative parameter to comprehend facial aesthetics and symmetry.

Diode Laser-Assisted Pulp Polyp Excision and Canal Disinfection in a Primary Molar: A Case Report.

This case report presents the successful application of diode laser technology in the management of a pulp polyp in a primary molar, showcasing its efficacy in both excision of the proliferative tissue and subsequent canal disinfection. An eight-year-old patient with a symptomatic primary molar exhibiting a pulp polyp was selected for this intervention. The diode laser, with its specific wavelength and precise tissue interaction, allowed for a minimally invasive and efficient removal of the pulp polyp. Additionally, the laser was utilized for thorough disinfection of the root canals, targeting bacterial pathogens while preserving surrounding healthy tissue. The case was monitored over a three-month follow-up period, demonstrating favorable clinical and radiographic outcomes. This report emphasizes the potential of diode laser technology as a feasible adjunct in the treatment of pulp polyps in primary molars, showcasing its benefits in terms of reduced invasiveness, enhanced precision, and effective canal disinfection in pediatric endodontics.

Self-Directed Learning Versus Traditional Teaching in Learning Gross Anatomy Among First-Year Medical Students: A Comparative Study.

INTRODUCTION: Gross anatomy is the first subject to be grasped by budding medicos before learning a long series of skills and competencies required to bloom as a physician or surgeon. In recent years, the teaching time for anatomy has been reduced. The number of anatomy teachers is much less in comparison to the increasing number of students. There is also a paradigm shift in medical education; it has become competency-based, learner-centric, and technology-based. So, anatomical education is also shifting to adopt blended learning strategies. Now, the onus of learning lies more with the students, which can be promoted through self-directed learning (SDL). Many first-year medical students are unprepared for SDL and need assistance understanding SDL. Structured SDL can successfully instill the habit of SDL in young medical students, who are supposed to be lifelong learners in their professional careers. The concept of structured SDL under the supervision of teachers is comparatively new in India. Very few studies are there to compare the effectiveness of SDL with those of traditional teaching methods. The present study aimed to evaluate the effectiveness of SDL in learning the gross anatomy of an important viscus, viz., the liver, and to compare it with the effectiveness of the traditional method of teaching by demonstration/prosection. METHODS:  This interventional comparative study was carried out at the department of anatomy of a government medical college in Kolkata, India. Sixty willing first-year undergraduate medical students were included in the study. The students were divided into two batches (Batch A and Batch B) of 30 each. Students of Batch A were taught the viscus (liver) by the traditional method of teaching by demonstration/prosection for one and a half hours. Validated pre-test and post-test questionnaires were administered to evaluate learning outcomes. Students of Batch B had a structured self-directed learning (SDL) session under the supervision of teachers on the same topic, viz., viscus (liver), for one and a half hours. The pre-test and post-test questionnaires were given before and after the SDL sessions to evaluate learning outcomes. The results were statistically analyzed. RESULTS: It was observed that the mean post-test score after traditional teaching improved significantly compared to the mean pre-test score. Also, the mean post-test score after the SDL session improved significantly compared to the mean pre-test score. It was found that the mean post-test score after exposure to traditional teaching methods was slightly better than the mean post-test scores after exposure to SDL, but this difference was not statistically significant. CONCLUSION: It can be inferred that structured SDL under the supervision of teachers was almost as good as the traditional teaching method by demonstration/prosection in learning the gross anatomy of an important viscus, viz., liver. In the context of the reduced number of anatomy teachers and an increasing number of students, this may open up an option of teaching some portion of gross anatomy, like a few viscera, by SDL. However, a more robust study with a larger sample size can be more conclusive.

Passive Root Coverage Through Creeping Attachment of the Gingiva Before and After Scaling and Root Planning Therapy in the Mandibular Anterior Teeth: A Clinical Study.

Introduction Root coverage is one of the most imperative procedures in periodontal therapy. The demands from patients for aesthetics and sensitivity are some of the complaints in root exposure cases. Creeping attachment is a passive apical migration of the marginal gingiva and can be proposed as a noteworthy root coverage technique. The purpose of this study was to evaluate the position of the marginal gingiva and quantify the creeping attachment before and after the scaling and root planning (SRP) procedure. Materials and methods The present study was based on a single-centre clinical trial in which 30 sites from 10 patients were selected. Patients with Miller's class I gingival recession were selected. The plaque index, gingival biotype, and gingival margin position were measured at baseline and then at 10 and 21 days after SRP. The gingival biotype was measured with an endodontic file with a stopper and a digital vernier calliper. The gingival margin position was measured from the incisal surface of the tooth to the marginal gingiva with the help of a University of North Carolina (UNC) 15 periodontal probe. After recording the clinical parameters, a thorough SRP was performed using an ultrasonic scaler and manual instruments. Results The results were compared clinically at baseline and after 10 days and 21 days postoperatively. Statistical analysis was conducted for pre-SRP and post-SRP findings using the IBM SPSS Statistics for Windows, Version 19 (Released 2010; IBM Corp., Armonk, New York) software. A statistically significant improvement was seen in all the clinical parameters at baseline, at 10 days, and at 21 days postoperatively after the procedure (P < 0.01). Conclusion The position of the gingival margin was shifted towards the crown, and the creeping attachment was significantly observed from baseline to 10 and 21 days. Clinical significance Creeping attachment after the SRP procedure can be considered a significant root coverage technique. The genetic memory of the gingiva may play an important role in achieving root coverage. Once local irritants are removed, the gingiva attempts to regain its original position. In addition, the gingival phenotype plays an important role in gingival marginal positioning after basic therapy and root coverage procedures.

Dental Management of a Child With Sickle Cell Anemia: A Case Report.

Sickle cell disease (SCD) has been identified as one of the most prevalent genetic conditions. It alters the shape and function of red blood cells. This brief case report presents a case of a five-year-old male with sickle cell disease who complained of pain in the left mandibular region due to deep proximal caries. Before dental management, a complete fitness evaluation was performed with the help of a pediatrician, followed by informed consent. Dental management includes pulpectomy followed by stainless steel crown placement and Glass ionomer cement (GIC) restoration for superficial caries. Other oral manifestations were observed, including a smooth tongue and mucosal pallor. It was concluded that dentists and health professionals should be knowledgeable of the general and oral anomalies that can be present in individuals with sickle cell anemia in order to take preventive action and implement effective management.

Clear Aligners in Pediatric Dentistry: A Scoping Review.

Today not just adults but also children are affected by their looks and appearance. Their facial and dental appearance primarily influence how they present themselves in the outside world. Poor esthetic appearance at any age, especially when it comes to children, affects their psychological status. In earlier times, correction of dentition used to be done with crude methods, after which came the concept of braces, which were fixed on the labial surfaces. Even with these, the patients are equally concerned with their looks throughout the treatment, and thus neither adults nor children are eager to use the standard metallic-looking orthodontic gear. To tackle this problem, researchers have developed several solutions, and clear aligners are the modern and aesthetic answer. For effective tooth movement into the desired position, thin, transparent, plastic aligners known as invisible aligners are used, which are created using the computer-aided design/computer-aided manufacturing (CAD-CAM) technology. These aligners are analogous to the splints that cover the clinical crowns as well as the marginal gingiva. The treatment requires proper patient motivation as there can be poor compliance by patients. However, it can offer greater dental hygiene, comfort, and an excellent aesthetic experience during treatment. This review highlights the history of fabrication of clear aligners, examining the efficacy, advantages, and disadvantages of transparent aligners for pediatric patients and also dentists. It weighs aspects like aesthetic appeal, comfort, oral hygiene, treatment predictability, and practice efficiency when comparing transparent aligners, like Invisalign, to conventional orthodontic treatments. It also ascertains the applicability and worth of clear aligners in contemporary orthodontic practice, while examining patient happiness, compliance, and overall treatment results.

Dental Management of an Uncooperative Child with Hearing Impairment and Mutism Under General Anesthesia.

Oral health is a vital part of overall health, particularly for children with special healthcare requirements. The terms "dumb" and "mute" are frequently linked with the term "deaf" due to the connection between hearing loss and speech impairment. A hearing and speech-impaired child may be unable to express completely because of the communication barriers. It is important to treat special children with utmost care and safety. This case report describes the dental management of an 8-year-old special child reported with multiple carious lesions under general anesthesia as she was not well acquainted with sign language. In a hospital setting under general anesthesia (GA), all necessary treatments are carried out in a single appointment. Since it is monitored by a multi-disciplinary team it can safely provide effective care to a child with hearing impairment and mutism.

Successful Replantation of an Anterior Tooth in an 11-Year-Old Child: A Case Report.

Avulsion occurs when the tooth is completely knocked out of its alveolar socket. The maxillary central incisors are more vulnerable to avulsion due to their prominent position in the dental arch. This case report describes a successful permanent maxillary incisor replantation in an 11-year-old child. The replanted tooth was stabilized in the socket using orthodontic wire, followed by root canal treatment and composite restoration within a two-week interval. Clinical and radiographic follow-up was done at one and six months. Successful management of an avulsed tooth requires educating the patient about different storage mediums and emergency management after an avulsion. This case report concluded that the avulsed tooth result is highly dependent on the patient's understanding of avulsion and how to approach it.

Treating a Dentoalveolar Fracture in a Four-Year-Old Girl With a Functional Removable Partial Denture.

In children and young adults, traumatic dental injuries are common. Children's tooth loss is mostly caused by dentoalveolar trauma. Owing to anatomical variations and developmental phases, treating such injuries is difficult. Trauma to deciduous teeth might harm the permanent tooth beneath; however, trauma to permanent teeth can worsen their long-term outlook. An alveolar segment trauma may result in the irreversible loss of dental tissues, malalignment, and deformity. The periodontium and pulpal tissues suffer significant harm as a result of this. In the current case, there was a segmental cortical fracture in the mandible of a four-year-old girl child.

Managing the Lower Lip-Sucking Habit With a Lip Bumper Appliance: A Pediatric Case Study.

Oral habits in children are of prime concern to a pediatric dentist as the child is in an active growth phase, and it may alter the development of the orofacial area. One of the major etiological factors in the development of malocclusion and other adverse effects on orofacial structures is oral habits during and after preschool age. The habit of sucking one's lower lip is rarely examined; it appears that practitioners tend to associate it with less adverse clinical consequences. It is important to identify harmful oral habits and eliminate them as early as possible. This case report focuses on the diagnosis of the lip-sucking habit, understanding its etiology, and creating a treatment plan that will prevent unfavorable consequences. A lip bumper is an easy-to-fabricate, easy-to-place, and easily tolerated intra-oral appliance. The successful use of lip bumper in this case adds to the evidence that when used as an early intervention the habit can be intercepted appropriately.

Generalized Non-syndromic Hypertaurodontism With Delayed Eruption: A Case Report.

Taurodontism is a rare dental anomaly defined by a change in tooth shape due to Hertwig's epithelial sheath not folding inward at the right horizontal level. It has a larger pulp chamber and a pulpal floor that is shifted apically, and the cementoenamel junction (CEJ) is not constricted. This condition is more frequently observed in permanent teeth than in primary teeth and can occur in a bilateral or unilateral manner, affecting any quadrant or group of teeth. This brief case report discusses a 14-year-old female patient who presented with complaints of decayed teeth in the lower right and left posterior regions of the jaw. Radiographic examination revealed the presence of non-syndromic taurodontism in both the deciduous teeth and their permanent successors. Dental management included oral prophylaxis, application of pit and fissure sealants, indirect pulp capping, and restoration with glass ionomer cement for the affected teeth.

Comparative Evaluation of Horizontal Lip Position With Ricketts Esthetic Plane in Preschool and School-Going Children of Bankura, West Bengal: A Craniofacial Anthropometric Study.

Introduction The horizontal lip position and esthetic plane are two important parameters to define facial beauty, and these factors are always given importance in children undergoing fixed orthodontic therapy. The purpose of this study was to evaluate horizontal lip position in primary and mixed dentition children with class I occlusion and to analyze its association with gender among preschool and schoolchildren of villages in the Bankura district in West Bengal. Materials and methods Researchers screened 437 children for the study and selected those who met the inclusion criteria. A total of 407 children were segregated: 201 children aged three to five years with the flush terminal plane and mesial step in primary teeth and 206 children aged seven to eleven years with class I occlusion in mixed dentition were selected from schools in villages in Bankura district, West Bengal, India. The subjects were instructed to hold the head in the natural head position by looking straight, and points were marked on the nose and chin tip, respectively. A metallic ruler was placed from nose to chin, representing Rickett's esthetic line. The horizontal lip distance to the esthetic plane of both upper and lower lips was measured as a linear distance from the most anterior part of the lip to the metallic ruler. The data were recorded, compared with gender, and statistically analyzed using the Chi-square test using the Statistical Package of Social Sciences software (SPSS version 19.0, 2015, IBM Corp., Armonk, NY). Results The most prevalent horizontal lip distance for both upper and lower lips to the esthetic line for primary and mixed dentition in the Bankura region of West Bengal was category I, where the lip is seen beyond the E plane, followed by category II, where lips are at a horizontal distance in the range of 0-1.5 mm from the esthetic line. A significant correlation of lip position with Rickets aesthetic plane was also illustrious with gender in primary dentition, but a non-significant association with gender was noted in mixed dentition. Conclusion Children with class I occlusion from the Bankura district of West Bengal showed a higher percentage of lip position beyond the esthetic plane in both primary and mixed dentition, which is not in line with the inference of Ricketts's studies on the Caucasian population. There is a definite association between gender and horizontal lip distance in Ricketts esthetic plane. Protrusive upper lips were seen more in males, and retrusive lips were seen more in females. Clinical significance  The horizontal lip position with reference to Ricketts esthetic plane has been documented in the literature for adults and teens undergoing fixed orthodontic treatment. However, there is no study done to define these measurements in preschool and school-going children, which can assist in determining future esthetic profiles and in preparing a protocol for early age interceptive orthodontics along with aesthetic rehabilitation of the anterior area of the mouth.

Evaluation of Antibacterial Activity of Madhuca longifolia (Mahua) Stem Extract Against Streptococcus mutans: An In Vitro Study.

Introduction Madhuca longifolia is one of the important folklore medicinal plants with a plethora of established pharmaceutical properties. Its twigs are used as chewing sticks (toothbrushes), and it is believed that if a person uses it daily, it will make their gum healthy and strong. No study has ever been conducted to evaluate the antibacterial effect of M. longifolia extracts against oral microorganisms. Materials and methods Fresh stem twigs (Madkam Kaarkad) of M. longifolia were collected and dried. The dried stem was cut into small pieces, 5 g of which was mixed with 50 ml distilled water (in the ratio 1:10) and kept for two days for maceration. After two days, the liquid was filtered and the final filtrate was obtained, from which dry pellets were made and stored in the refrigerator at 4°C. Brain heart infusion agar was used as a medium to grow the lyophilized bacteria. Pure strains of Streptococcus mutans 890 were obtained from the Microbial Type Culture Collection (MTCC) and MTCC-suggested protocol was followed for the revival of lyophilized bacteria. The agar well diffusion method was used to determine the zone of inhibition. The extract of stems with different concentrations (10%, 7.5%, 5.0%, and 2.5%) and at different volumes (100 µl, 150 µl, 200 µl, and 250 µl) was transferred to the agar plates. Chlorhexidine 0.2% was used as a control and it was also transferred to agar plates, which were incubated aerobically at 37°C for 24 hours. Antibacterial activity was interpreted from the size of the diameter of zones of inhibition measured in millimeters using a measuring scale in all the agar plates. Results The minimum zone of inhibition of 11 mm at 2.5% concentration and 100 µl volume of M. longifolia extract and the maximum zone of inhibition of 20 mm at 10% concentration and 250 µl volume was notified. While for chlorhexidine at 0.2% concentration, the zone of inhibition obtained was 9.5 mm at 40 µl volume. The minimum inhibitory concentration (MIC) value of M. longifolia was found to be 35 mg/ml. Conclusion M. longifolia showed marked antibacterial activity against S. mutans and has a high MIC value. Therefore, this plant can be considered an effective agent against oral diseases like dental caries.

Conservative Management of Maxillary and Mandibular Fractures in a Pediatric Patient With a Modified Open Cap Splint: A Case Report.

Pediatric maxillofacial fractures, which are not very prevalent, account for around 5% of all face injuries. Children under the age of 13 are more susceptible to craniofacial injuries because they have a larger cerebral mass-to-body ratio than adults. The fracture pattern in children does not resemble that of adults, due to which the treatment of pediatric fractures differs from that of adults and can pose substantial difficulties to the pediatric dentist due to many factors, including the complex anatomy of the developing jaw. In this case report, a 5-year-old male patient presented with an injury to the upper and lower jaw. A case was managed with a conservative approach by using a modified open cap splint. A radiographic investigation, including CT brain and face, was done, which revealed the mandibular symphyseal fracture, bilateral condyle, and right Lefort II fracture. A modified open cap splint was fabricated and fixed with circummandibular and circumzygomatic wiring under general anesthesia. After two months, the fractured site showed good healing on orthopantomography (OPG), and satisfactory occlusion was achieved. The patient was kept on monthly follow-ups for up to five months. Treatment guidelines for pediatric maxillary and mandibular fractures are different from those for adults in that most pediatric cases are managed by a conservative approach. Cap splints are a versatile treatment option for juvenile mandibular fractures because they can be used to restore function and aesthetics with minimal morbidity, do not impede jaw growth or the development of dentition, and can be applied to patients of a wider range of ages.

Conservative Management of a Non-vital, Young, Permanent Tooth in a Pediatric Patient: A Case Report.

A fracture due to trauma in children is one of the most common traumas treated by dentists. Pain, swelling, and aesthetics are some of the most common chief complaints patients report to dental clinics after trauma. The anterior teeth play a significant role in the aesthetics of the patient's smile thus affecting the patient's psychological well-being. In addition, they are also important for mastication and speech. Treatment of fractured teeth, especially in the anterior region, has always been a major concern of aesthetics for the patient and the dentist. The most commonly observed fracture, i.e., Ellis class IV fracture includes endodontic treatment due to exposure of the pulp during trauma. This brief case report presents a case of an 11-year-old female with the chief complaint of a fractured tooth in the maxillary front teeth region. The treatment plan included the preventive procedures followed by root canal treatment and composite restoration with the right permanent maxillary lateral incisor. The benefit of this is directly linked to the professional's dexterity, skill, and technical mastery, as well as the achievement of desirable outcomes.

Effective Management of a Tooth Eruption Bulge: A Comprehensive Case Report.

An eruption bulge is a swelling or an enlargement below the gumline due to the eruption of a tooth. Radiographic images would also illustrate the fact that there may be the presence of a successor tooth (unerupted or unimpacted) under the bulge of the gingiva. Teething refers to the sequence of growth and appearance of the primary as well as permanent teeth within the oral region that varies according to age. A tooth eruption bulge is a lump that occurs due to the eruption of the teeth in the gum tissue. The appearance of the bulge varies according to the amount of fluid or blood present in this engorged organ. It is important to focus on the fact that the dentist will always be able to notice any changes and solve the issue when it comes to the check-ups, which should take place on a regular basis. Parents need to be aware of the possible adverse effects of trauma on primary incisors on the eruption as well as the health of its permanent successors. They need to watch and tell about any oral changes or conditions their child may have, like pain, color change, and swelling as this may tell of something negative to their dentition. Such a condition can only be managed using a multi-disciplinary team that includes a pedodontist, an orthodontist, and in severe cases an oral surgeon who will have to deal with the long-term sequelae of dental trauma. This is why it is necessary to educate them on these matters because then they can be proactive.

Prosthetic Management of Congenital Palatal Defect in a Neonate: A Case Report on Obturator Efficacy.

Neonates with cleft palate exhibit a malformed maxillary arch since birth. Newborns with various types of clefts exhibit multiple issues, primarily associated with their feeding habits. Feeding these children is crucial, as evidence indicates that newborns with this congenital deformity exhibit a slower growth rate compared to those without this condition. To mitigate these challenges, the conventional line of treatment for these children is obturator therapy to facilitate sucking or feeding followed by various surgical procedures. The following case report describes a 2-day-old girl, who reported with her parents to the Department of Pediatric Dentistry, to seek treatment for congenital cleft present in her palate as it was interfering with her feeding habits. A feeding appliance was made with a direct technique to help the parents improve feeding habits. It also regulates milk flow by sealing the area separating the oral and nasal cavities. This feeding appliance is placed over the child's hard palate, creating a contact point that facilitates milk expression from the mother's mammary gland and making it easier for the neonate to compress the nipple. It shortens the time needed for feeding, eases feeding, and lessens nasal regurgitation.

The Impact of Rubber Dam Association With Physiological Stress Parameters on Children of 7-10 Years Undergoing Pit and Fissure Sealant Treatment: An In-Vivo Study.

Introduction Anxiety is an emotion representing apprehension towards an unknown stimulus or situation. Rubber dam application during dental procedures in children makes the treatment more comfortable and acceptable as it gives them a psychological feeling that treatment is being carried out outside the oral cavity. The prime objective of this study was to evaluate and compare physiological parameters, which include pulse rate, arterial oxygen saturation level, blood pressure, and respiratory rate before and after rubber dam isolation. Material and methods The study consisted of 30 children patients of 7-10 years, comprised of 14 females and 16 males with a mean age of 8.15 ± 0.93 years. The study was a 'split mouth' clinical design study, where 60 sites in 30 patients (two sites in each patient) were used. The selected sites were divided into two groups by a convenience sampling method and were categorized as Group-I (control group - 30 sites were treated with pit and fissure sealants under cotton roll and saliva ejectors on mandibular right permanent first molar) and Group-II (study group - 30 sites were treated with pit and fissure sealants underrubber dam isolation on mandibular left permanent first molar). Results Rubber dam application reduced different physiological parameters of stress such as pulse rate, systolic and diastolic blood pressure, and respiratory rate at different intervals from the baseline values. Rubber dam and cotton roll applications have no significant effects on oxygen saturation levels at different intervals in healthy individuals. From statistical analysis, it was evident that a statistically significant difference was evident between the control and experimental groups (P value < 0.005). Conclusion It is confirmed in this study that rubber dam reduces different physiologic parameters of stress. After the application of the rubber dam, children's pulse rate, systolic and diastolic blood pressure, and respiratory rate were reduced. Clinical significance The study highlights the imperative role of rubber dam isolation in improving dental and medical effectiveness. In addendum to this, our research promotes the clinical use of rubber dams in pediatric dentistry.