Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study.

Introduction: With the paradigm shift in the management of dental caries, the focus is now laid on remineralization therapies that can arrest the progression of the disease and remineralize the subsurface lesions. Objectives: The purpose of this study was to determine and compare the remineralizing potential of silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish (FV) on enamel surfaces in primary and permanent teeth. Materials and methods: A total of 120 primary anterior teeth and 120 premolars were used to prepare enamel blocks in acrylic resin. The mean baseline surface microhardness (SMH) for each sample was determined using a microvickers hardness testing machine. Thereafter, the samples were randomly and equally distributed into groups and subgroups based on the materials used, that is, SDF, CPP-ACP, FV, and distilled water (control). After subjecting the samples to a pH cycling regime, SMH was determined again and the percentage change in SMH was calculated. Results: The data were tabulated and subjected to statistical analysis using an independent t-test and one-way analysis of variance (ANOVA). In primary teeth, the least mean percentage reduction in SMH was observed after the application of FV followed by SDF, CPP-ACP, and control. In permanent teeth, both SDF and FV showed the least percentage reduction of enamel SMH followed by CPP-ACP and control. Conclusion: Silver diamine fluoride (SDF), FV, and CPP-ACP showed remineralizing potential in both primary and permanent teeth. How to cite this article: Kaur S, Bhola M, Bajaj N, et al. Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S91-S96.

Comparative Evaluation of Smear Layer Removal Efficacy of Neem Leaf Extract, Propolis, and Orange Oil when used as Endodontic Irrigants: An in vitro Scanning Electron Microscopic Study.

Introduction: In root canal treatment, chemical debridement of the root canal with the help of irrigants is important due to the complex internal anatomy of the teeth. Biomechanical root canal preparation produces a smear layer. It covers the dentinal tubules, which may interfere with the penetration of various irrigants and intracanal medicaments, so the smear layer has to be removed. The potential side effects and certain limitations of chemical irrigants for smear layer removal have led to a shift toward herbal alternatives. Objective: The aim of the present study was to evaluate and compare the smear layer removal efficacy of Neem leaf extract, Propolis, and Orange oil as endodontic irrigants using the scanning electron microscope. Materials and Methods: Ninety samples were taken and then randomly (simple random sampling method) divided into three experimental groups (n = 30) depending upon different endodontic irrigants used: Group 1-Neem leaf extract, Group 2-Orange oil and Group 3-Propolis and smear layer removal evaluation was done under the scanning electron microscope Scanning Electron Microscope (SEM) at all the levels, i.e., coronal, middle, and apical. Results: The collected data were analyzed using the Chi-square test. Group 1 (Neem leaf extract) showed the highest smear layer removal efficacy, which was followed by Group 2 (Orange oil) and the least efficacy of smear layer removal was shown by Group 3 (Propolis) at coronal, middle, and apical levels. Conclusion: Group 1 (Neem leaf extract) performed significantly better in removing the smear layer at coronal, middle, and apical levels as compared to the other two groups.

Comparative Evaluation of Changes in Salivary pH and Streptococcus mutans Count in Saliva by Natural Sugar Substitutes: An In Vivo Study.

Aim: The purpose of this study was to compare the effect of natural sugar substitutes-stevia, jaggery, and honey on salivary pH and Streptococcus mutans (S. mutans) count in saliva. Materials and methods: Children aged between 7 and 12 years with no active carious lesion were selected. A total of 80 subjects were randomly selected and divided into three experimental groups and one control group, with 20 subjects in each group. Prior to rinsing with the respective solutions, the baseline pH and S. mutans count were evaluated for each individual. All solutions were freshly prepared whenever required. After rinsing with the respective solutions, saliva samples were collected to evaluate pH and S. mutans count. The pH was analyzed at different time intervals, that is, 0 (immediately after rinsing), 15, and 30 minutes. The S. mutans count was analyzed after 30 minutes of rinsing with the respective solutions. Results: The results were tabulated and statistically analyzed using one-way analysis of variance (ANOVA) and post hoc tests. The results depicted that group I (stevia) showed a maximum increase in salivary pH, followed by group III (honey) and group III (jaggery) at different time intervals (0, 15, and 30 minutes). The maximum number of subjects who had shown a decrease in S. mutans count were from group III (honey), followed by group I (stevia), and group II (jaggery) after 30 minutes of rinsing with the respective solutions when compared to baseline S. mutans count. Clinical significance: It is a universally known fact that dental caries is a multifactorial disease process, one of the key factors of which is the consumption of sugar. Of all the fermentable carbohydrates, sucrose is considered the archcriminal in the carious process. Hence, this advocates the need for developing suitable sugar substitutes that help in controlling dental caries. An ideal sugar substitute should not only minimize the risk of dental caries but also should have nutritional benefits. Conclusion: Natural sugar substitutes (stevia, jaggery, and honey) have the ability to reduce caries risk in children. How to cite this article: Sharma W, Bhola M, Bajaj N, et al. Comparative Evaluation of Changes in Salivary pH and Streptococcus mutans Count in Saliva by Natural Sugar Substitutes: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(5):728-733.

Fracture resistance of lab composite versus all-ceramic restorations in class II inlay cavity preparations: An in vitro study.

Aim: The aim of this study was to evaluate and compare the fracture resistance of inlay preparations restored with indirect lab composite, conventional and translucent monolithic zirconia-based ceramics. Materials and Methods: Fifty freshly extracted human maxillary premolars were selected for the study. Standardized inlay cavities were prepared and restored with indirect lab composite, conventional monolithic zirconia-based ceramic and translucent monolithic zirconia-based ceramic. After restoration each sample was subjected to axial compressive load with Universal testing machine. The force required to induce fracture was recorded in Newton (N). Statistical Analysis Used: The data were analyzed using the one-way ANOVA test and Post hoc Bonferroni multiple comparison test. Results: Results revealed that fracture resistance of prepared inlay cavities restored with conventional monolithic zirconia-based ceramics was found to be best followed by other groups. Group I > Group IV > Group V > Group III > Group II. Conclusion: The fracture resistance of conventional monolithic zirconia-based ceramic inlays and translucent monolithic zirconia-based ceramic inlays were comparable with intact teeth but, indirect lab composite inlays showed lower fracture resistance than all.

Comparative evaluation of push-out bond strength of root-end filling materials in root-end cavities prepared by laser or ultrasonic technique: An in vitro study.

CONTEXT: The use of mineral trioxide aggregate (MTA) and Biodentine as a root-end filling materials used in the root-end cavities prepared by laser or ultrasonic technique is a current topic in the branch of dentistry and push-out bond strength is used to measure the adhesiveness provided by the root-end filling materials. AIM: The aim of this study is to evaluate the push-out bond strength of MTA and Biodentine in root-end cavities prepared by erbium:yttrium-aluminium-garne (Er:YAG) laser and ultrasonic retrotip. MATERIALS AND METHODS: A total of 40 extracted maxillary central incisors and canines were selected. Chemomechanical preparation and obturation were done. Root-end resections were performed followed by the root-end cavity preparation and root-end filling. Specimens were divided into four groups. Root-end cavities prepared by Er:YAG laser and filled with MTA, root-end cavities prepared by Er:YAG laser and filled with Biodentine, root-end cavities prepared by ultrasonic retrotip and filled with MTA and root-end cavities prepared by ultrasonic retrotip and filled with Biodentine, respectively. The apical end was again sectioned perpendicular to the long axis. The push-out bond strength was evaluated using a universal testing machine. STATISTICAL ANALYSIS USED: The data were analyzed using the analysis of variance and post hoc Tukey test. RESULTS: Difference between push-out bond strength of root-end filling materials to root-end cavity walls prepared by laser and ultrasonic retrotips was statistically nonsignificant. Push-out bond strength of MTA and Biodentine did not differ significantly. CONCLUSION: Difference between push-out bond strength of MTA and Biodentine to root-end cavity walls prepared by Er:YAG Laser or ultrasonic retrotip were statistically nonsignificant.

Clinical Evaluation of Root Resorption and its Correlation with Obturation Quality in Pulpectomized Deciduous Teeth with Different Obturating Materials: An In vivo Study.

AIMS AND OBJECTIVES: The aim was to evaluate the root resorption in pulpectomized deciduous teeth and its correlation with obturation quality using zinc oxide and eugenol (ZOE), Metapex and Endoflas at the interval of 6 and 12 months. MATERIALS AND METHODS: A total of 150 infected primary mandibular molars were randomly and equally divided into three subgroups (n = 50 each): Group 1 (ZoE), Group 2 (Metapex), and Group 3 (Endoflas) based on the obturation material preferred. The teeth were clinically and radiographically evaluated at 6 and 12 months' postoperatively by another investigator who was blinded to the type of filling material that was used in each tooth. Kruskal-Wallis test, Mann-Whitney Test, and Wilcoxon Signed-Rank Test was used for statistical analysis. RESULTS: When the obturation quality was assessed, the optimal filling was found in 78% of the cases while the rest have underfilling (9%) and overfilling (13%). The incidence of overfilling was higher in the cases with some root resorption. After 12 months, Group 2 showed maximum variation with the highest incidence (70%) of extensive resorption both interradicular and intraradicular (Grade 3 score) followed by Group 1 (26%) and Group 3 (16%), respectively. CONCLUSION: Among all the materials, Endoflas showed the highest success rate with least incidence of resorption both outside and within the root canal (hollow tube effect) whereas least success rate was observed with Metapex having the hollow tube effect in majority of the cases (70%) after the follow-up of 12 months.

Assessment of consistency in the dimension of gutta-percha cones of ProTaper Next and WaveOne with their corresponding number files.

OBJECTIVES: To compare the dimensions of gutta-percha (GP) cones of ProTaper Next (25/0.06) and WaveOne (25/0.08) in relation to their corresponding instruments of the same dimension, respectively. MATERIALS AND METHODS: Two groups of GP cones were made with 25 cones in each group. Group 1 consisted of 25 GP cones # 25/0.06 (ProTaper Next). Group 2 consisted of 25 GP cones # 25/0.08 (WaveOne). Measurements were done at D1 (1 mm short of the tip), D3 (3 mm short of the tip), and D11 (11 mm short of the tip) for GP cones of both groups and were compared with their corresponding instruments. RESULTS: Group 1 (ProTaper) 25/.06 GP points showed greater diameters than those of the corresponding instrument, which was statistically significant. Group 2 (WaveOne) 25/0.08 GP points showed greater diameters than those of the corresponding instrument which was statistically significant whereas it was nonsignificant at level D1. CONCLUSION: Diameters of both ProTaper Next and WaveOne GP cones were greater than their corresponding instruments. Hence, there are chances of under obturation with both systems.

Comparison of incidence of dentinal defects after root canal preparation with continuous rotation and reciprocating instrumentation.

Biomechanical preparation is one of the most important steps in endodontic therapy. Rotary instrumentation has facilitated this step. Nowadays the market is flooded with different types of rotary instruments. The present study compared the root dentinal crack formation with continuous rotating versus reciprocating root canal preparation methods. One hundred and fifty freshly extracted teeth were used for the study. They were divided into 5 groups with 30 teeth in each group. Thirty teeth were kept under control group A and no root canal preparation was done for this group. Another 30 teeth were prepared with hand files which were kept under control group B. In the experimental groups (sample size, n=30 each) root canals were prepared with ProTaper, K3XF rotary system and WaveOne. Sectioning of these teeth was done at 3, 6 and 9mm from the apex and were evaluated for the presence of any defects. Root dentinal cracks were produced with each type of rotary instruments. Statistical analysis showed no significant difference in root dentinal crack formation between control groups and WaveOne system. There was statistically significant difference in root dentinal crack formation when the canals were prepared with ProTaper and K3XF rotary system. So it was concluded, that continuous rotating instruments could produce dentinal crack formation. Root canal instruments with reciprocating movement appear to be a better option than continuous rotation movement.

Association of physical properties and maintenance of sterility of primary teeth in human tooth bank.

BACKGROUND: This study was carried out to evaluate the sterility and structural integrity of stored primary teeth in artificial saliva over a storage period of 12 weeks (3 months) in human tooth bank (HTB). MATERIALS AND METHODS: A total of 80 freshly extracted teeth were taken and were categorized into four groups of 20 each. The samples were stored at 4°C for 12 weeks (3 months) in the refrigerator. During their storage time of 3 months, they were repetitively evaluated for their sterility, enamel hardness, calcium and phosphate solubility and color stability at regular intervals of 3 weeks. OBSERVATIONS AND RESULTS: That teeth stored in artificial saliva maintained their sterility throughout the storage time of 12 weeks, but changes in their physical and chemical properties occurred with an increase in storage time. CONCLUSION: Storage time not more than 9 weeks is recommended for deciduous teeth to be stored in artificial saliva in a HTB.

Congenital epidermal nevus.

Epidermal nevi are hamartomas that are characterized by hyperplasia of the epidermis and adnexal structures, and may be associated with serious disfiguration. Germline mutations in the FGFR3 gene have found to be the etiology of epidermal nevus. Patients often seek treatment from dermatologic surgeons but even an alert dentist can help to diagnose the lesion from its clinical appearance. Various treatment modalities are available and it is the clinician's choice to choose depending upon the patient's condition. How to cite this article: Arora B, Khinda VIS, Bajaj N, Brar GS. Congenital Epidermal Nevus. Int J Clin Pediatr Dent 2014;7(1): 43-46.