Comparative Evaluation of the Mechanical and Physical Properties of Mineral Trioxide Aggregate vs. Bacterial Cellulose Nanocrystal-Reinforced Mineral Trioxide Aggregate: An In Vitro Study.

AIM: This study aims to compare and assess the compression strength, microhardness, and surface texture of two sets of materials: mineral trioxide aggregate (MTA) PlusTM and bacterial cellulose nanocrystal (BCNC)-reinforced MTA PlusTM. MATERIALS AND METHODS: According to the ASTM E384 standard, the cylindrical molds made of plexiglass with an internal diameter of 6 mm and a height of 4 mm were fabricated using computer numerical control laser cutting. A total of 20 samples (n=10) in each group were considered in this experimental study: Group I (control group) MTA PlusTM (Prevest DenPro Limited, India) and Group II (experimental group) BCNC (Vedayukt India Private Limited, India)-reinforced MTA PlusTM. After preparation, the molds were incubated at 37°C in a fully saturated condition for about 24 hours, and then the compression strength, microhardness, and scanning electron microscopy analyses were performed at different magnifications. The obtained data were then statistically analyzed. RESULTS: Quantitative analysis revealed that there is a statistically significant difference between MTA PlusTM and BCNC-reinforced MTA PlusTM  (p<0.002). The Wilcoxon signed-rank test and Mann-Whitney U-test revealed that BCNC-reinforced MTA PlusTM  showed significantly higher compression strength (33.80±3.83 MPa, p=0.00) and surface microhardness (642.85±24.00 µm, p=0.00) than the control group. CONCLUSION: Based on our findings, it was concluded that there is a statistically significant difference between both study groups. Thus, incorporating BCNC into the MTA PlusTM  significantly increased the compression strength and surface microhardness of the MTA PlusTM cement. CLINICAL SIGNIFICANCE: Numerous dental applications have been investigated for bacterial cellulose. Many benefits of bacterial cellulose are available, which include its effects on moldability, low cost, high water retention capacity, biocompatibility, and biodegradability. Furthermore, the addition of BCNC to MTA PlusTM  accelerates the material's hardening process and decreases its setting time, which in turn shortens clinical chairside procedural timing and thereby improves patient satisfaction.

Evaluation of the Genotoxic Effects of Grape Seed Extract and Marine Collagen Peptide on the Fibroblast Cell Line: An In Vitro Study.

Introduction Collagen plays a vital role in maintaining the structural integrity of dentin, and its modification with bioactive compounds can enhance its mechanical properties and bonding capabilities. Aim This study aimed to evaluate the genotoxic effects of grape seed extract (GSE) and marine collagen peptide (MCP) on dental pulp-derived primary cells. Methodology Human dental pulp stem cells were isolated, cultivated, and then treated with GSE and marine collagen peptides. DNA fragmentation was assessed using DAPI (4',6-diamidino-2-phenylindole) staining. Statistical analysis was performed using SPSS version 20 (IBM Corp., Armonk, NY, USA). Results The results showed that GSE exhibited a minimum level of cell death compared to marine collagen peptides. The viable cell count increased steadily over three days in all groups, with the control group showing the highest number of viable cells. The differences in viable cell count among the groups were statistically significant. Conclusion This study suggests that GSE and marine collagen peptides are highly biocompatible with dental pulp cells and could be considered for further clinical studies.

Comparative Evaluation of the Remineralizing Potential of Flaxseed Paste, Chicken Eggshell Paste, and Fluoride Toothpaste on the Enamel of Primary Teeth Using Scanning Electron Microscopy-Energy Dispersive X-ray Analysis: An In-Vitro Study.

INTRODUCTION: Dental caries in primary teeth remains a critical public health challenge globally. Although fluoride toothpaste is the standard care for remineralization, its efficacy is limited by the requirement for bioavailable calcium and phosphate ions and its diminished performance on irregular dental surfaces. This study evaluates natural alternatives for dental care, focusing on their mineralizing potential compared to fluoride. AIM: This study aims to assess and compare the efficacy of remineralization by flaxseed paste and chicken eggshell paste to that of standard fluoride toothpaste on artificially demineralized primary teeth. MATERIALS AND METHODS: We utilized an in vitro model, creating standardized white spot lesions on extracted primary teeth to simulate early carious lesions. The teeth were treated with preparations of flaxseed paste, chicken eggshell paste, and fluoride toothpaste. Remineralization was quantitatively analyzed using scanning electron microscopy-energy dispersive x-ray analysis (SEM-EDX) conducted with a high-resolution scanning electron microscope (HRSEM) from Thermoscientific Apreo S at Sir C V Raman Research Park, SRM Institute of Science & Technology, Kattankulathur, Chennai, Tamil Nadu. RESULTS: Quantitative analysis revealed that both flaxseed and chicken eggshell pastes not only met but, in some cases, exceeded the remineralization performance of fluoride toothpaste. Significant differences were observed in the deposition of calcium and phosphate ions on the lesion surfaces. CONCLUSION: The study conducted at the Department of Pediatric and Preventive Dentistry at SRM Dental College, Kattankulathur, confirms the potential of flaxseed and chicken eggshell pastes as viable, cost-effective, and accessible alternatives to fluoride toothpaste for the remineralization of enamel in primary teeth. These findings support the inclusion of these natural agents in oral hygiene regimens and underscore the importance of further research into holistic approaches for the prevention and treatment of dental caries in children.

Effectiveness of Preoperative Alpha Wave Entrainment in Pediatric Dental Patients: A Randomized Controlled Trial.

Background Pediatric dental anxiety is a significant barrier to effective dental care, necessitating non-pharmacological interventions. Alpha wave entrainment has shown promise in adult studies for reducing procedural anxiety and pain perception, but its effectiveness in pediatric dental settings remains underexplored. Objective This study aims to evaluate the effectiveness of preoperative alpha wave entrainment in alleviating anxiety in gender-specific participants to the interventions. Methods We conducted a randomized controlled trial involving 252 pediatric patients (aged 7-12) with cooperative dispositions. Participants were randomly assigned to either an experimental group receiving alpha wave entrainment or a control group receiving conventional behavior management techniques. The experimental intervention involved 10-minute sessions of binaural beats with visual stimulation designed to induce alpha-wave synchronization. Anxiety levels were assessed using physiological measures (heart rate and blood pressure), both pre- and post-interventions. Results The intervention group demonstrated a significant reduction in heart rate and systolic blood pressure post-intervention compared to the control group. These changes indicate a decrease in anxiety levels, with no significant gender differences in the response to the intervention. Conclusion Alpha wave entrainment effectively reduces dental anxiety in pediatric patients, with similar efficacy observed across genders. This study supports the incorporation of alpha wave entrainment into pediatric dental practices as a viable alternative to traditional anxiety management techniques.

Non-pharmacological Behavior Management Techniques in Pediatric Dentistry: A Bibliometric Analysis.

As an emerging trend, non-pharmacological behavior management has gained immense research interest. By utilizing a bibliometric approach, this investigation aims to review the state of the non-pharmacological behavior management techniques research in pediatric dentistry. A Scopus search was done on non-pharmacological behavior management in pediatric dentistry, including literature from 1900 to 2022, using "Cited Reference Search" on 4/2/2022. After being screened, the articles were ranked according to the number of citations they had, and the publication year, authorship, contributing institutions, countries, article topic, study design, H index, and keywords were extracted. Out of the 1431 articles found during the literature search, the top 50 cited articles were used for analysis. The citation counts of the 50 selected articles varied from 163 to one, and their highest publications were in the years 2017 and 2019 (n = 7). Most studies were published in the United Kingdom (n = 10). The studies done in Australia and USA have the highest mean citation with the most significant contributions from the Department of Dental Medicine, Children's Hospital, Regional Medical Center, USA. The systematic review was the most frequent study design (n = 19). Among 110 unique keywords, dental anxiety (n = 11) was the most frequently used. This bibliometric analysis offers valuable details on the top 50 publications cited between 2006 and 2022. Although these methods have been employed for many years, only recently have they been the subject of significant scientific publications. It is hoped that this study will enable aspiring and seasoned researchers to envision and create potential future scenarios for interdisciplinary research collaborations on the use of non-pharmacological behavior management techniques in pediatric dentistry.

Changing Trends in Conscious Sedation at Pediatric Dental Offices: A Bibliometric Analysis.

The uncooperative behavior of children in the dental office has increased the demand for pharmacological behavior management techniques. Moderate sedation is more effective by providing analgesia and anxiolysis, thereby aiding in carrying out the most comfortable, efficient, and high-quality dental services. There is a need to understand the various aspects such as the choice of drug, method of drug administration, safety, and efficacy. Bibliometrics can reveal significant shifts in research and publication trends. Therefore, this study aimed to perform a bibliometric analysis of the literature on evolving trends in conscious sedation at pediatric dental offices. The bibliometric research used RStudio 2021.09.0+351 for Windows (RStudio, Boston, MA), package "bibliometrix," and VOS viewer software (Centre for Science and Technology Studies, Leiden University, The Netherlands. https://www.vosviewer.com). Elsevier's Scopus database (www.scopus.com) provided the literary data for this study, which were exported in BibTex format. The articles were independently categorized according to the following aspects: (a) annual scholarly output; (b) leading countries or regions; (c) leading journals; (d) productive authors; (e) citations; (f) study design; and (g) distribution of topics. The findings considered 1996 through 2022 and used journals, books, articles, and other sources, totaling 1064 papers, with an average of 10.7 per year. According to the findings, the United States, the United Kingdom, and India were principally leading the field of conscious sedation research. In total, 2433 authors were found through the search. The study identified the nations that are currently researching the topics such as midazolam and nitrous-oxide; this paves the way for future partnerships to strengthen the evidence generated in other topic areas using novel sedatives and exploring the different routes of drug administration, thereby benefiting the scientific community by identifying knowledge gaps and experts in this area of research.

Evaluation of Remineralization Potential of Natural Substances on Artificially Induced Carious Lesions in Primary Teeth: An In Vitro Study.

Aim: To evaluate the remineralizing potential of natural substances on artificially induced caries lesions in primary teeth. Materials and methods: A total of 50 primary molar teeth were selected and subjected to a demineralization process. Then samples were randomly divided into five groups for the remineralization process. Group I-colophony, group II-5% sodium fluoride (NaF) + colophony, group III-grape seed extract (GSE) + colophony, group IV-5% NaF + colophony + 10% peptide, and group V- GSE + colophony + 10% peptide. All the groups were subjected to remineralization using a brushing stimulator for 3,000 cycles. Assessment was done using Vickers hardness testing machine for evaluating the enamel surface microhardness (SMH) and scanning electron microscopy-energy dispersive X-ray analysis (SEM-EDX) for evaluating the surface morphology and mineral content, before and after demineralization and after remineralization, the obtained data was analyzed statistically using IBM Statistical Package for the Social Sciences (SPSS) software version 25. Results: The enamel microhardness results of this study revealed that remineralization of enamel was highest in group V (212.83 ± 64.416) and least in group II (137.83 ± 26.324) p-value of 0.038. SEM-EDX analysis revealed high calcium (Ca) and fluoride (F) content in groups II and IV, which was significant (p-value of 0.001) from other groups. Surface morphology evaluated with SEM revealed spherical globular agglomerates and scaffolding deposits on the enamel surface in groups III and V resembling the remineralization process. Conclusion: Grape seed extract (GSE) with colophony and peptide is a superior natural alternative to NaF. Colophony also exhibited remineralizing potential in primary enamel. Clinical significance: Natural remineralizing agents like GSE, colophony, and its combination serves as a potential alternative to overcome the toxic effect on long-term usage of F. These natural substances can be applicable in clinical conditions by incorporating toothpaste and varnish, which can be used as an alternative or adjuvant to the topical application of F. How to cite this article: Pooja V Ravi, Rajakumar S, Kavitha Ramar. Evaluation of Remineralization Potential of Natural Substances on Artificially Induced Carious Lesions in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(2):244-250.

Biocompatibility of Chitosan Nanoparticle in Root Canal Sealant with Vero Cell Line.

Root canal sealants placed in primary tooth are unique in various characteristics. Chitosan nanoparticles have gained an important milestone in research area due to its biodegradable and its bioavailability nature. Chitosan nanoparticles synthesized by ionic gelation method and studied for its physical characteristics when added with root canal sealant provides a promising result. In this study, biocompatibility nature of Chitosan nanoparticles with Vero cell line was being investigated. Several solution parameters of Chitosan nanoparticles and root canal sealants were investigated to optimize diameter of nanoparticles after being characterized to XRD, SEM, and FTIR. The Chitosan nanoparticles were found to be biocompatible to fibroblasts and on a dose-dependent manner, these can be used in combination with the root canal sealant in primary teeth. How to cite this article: Ramar K, N V. Biocompatibility of Chitosan Nanoparticle in Root Canal Sealant with Vero Cell Line. Int J Clin Pediatr Dent 2022;15(S-1):S57-S62.

Apexification and Repair of Root Fracture with Mineral Trioxide Aggregate - A Case Report with 5-Year Follow-up.

Young patients are most susceptible to trauma which involves teeth and their supporting structures. Severity can vary from simple enamel fracture to complete tooth avulsion. The treatment modality ranges from a noninvasive procedure to surgical intervention. The present case report describes the unique management, 5-year follow-up, and prognosis of a 10-year-old child diagnosed with lateral luxation and horizontal apical root fracture of maxillary central incisor with open apex.

Effect of Audioanalgesia in 6- to 12-year-old Children during Dental Treatment Procedure.

INTRODUCTION: To evaluate the effect of audioanalgesia in 6- to 12-year-old children during dental treatment procedure. MATERIALS AND METHODS: A total of 40 children were selected and divided into two groups, study group - with audioanalgesia and control group - without audioanalgesia. The value of their pain was evaluated using Venham's pain rating scale. Data were compared using one-sample t-test using Statistical Package for the Social Sciences (SPSS) (Inc.; Chicago, IL, USA), version 17.0. RESULTS: The difference in the control group and study group was statistically significant (p < 0.05). CONCLUSION: The method of distraction using audioanalgesia instills better positive dental attitude in children and decreases their pain perception. CLINICAL SIGNIFICANCE: Playing or hearing music during dental procedure significantly alters the perception of pain in 6- to 12-year-old children.

Root canal treatment of mandibular second premolar with three separate roots and canals using spiral computed tomographic.

Anatomic and internal morphology of a root canal system is more complex and differs for each individual tooth of which mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate foramina in mandibular second premolars is very rare. A wider knowledge on both clinical and radiological anatomy especially spiral computed tomographic is absolutely essential for the success of endodontic treatment. These teeth may require skillful and special root canal special shaping and obturating techniques. This paper reports an unusual case of a mandibular second premolar with atypical canal pattern that was successfully treated endodontically.

Oral manifestation of autosomal recessive congenital ichthyosis in a 2-year-old patient.

Ichthyosis is a heterogeneous family of hereditary keratinisation disorders mostly characterized by variable erythema of the whole body and different scaling patterns. Although these disorders affect tissues of epidermal origin, there is little evidence regarding the oral and dental manifestations of Lamellar Ichthyosis. A case report of early childhood caries in lamellar ichthyosis is presented and the dental consideration and management is discussed in this paper.