Comparative evaluation of antimicrobial efficacy of various intracanal medicament in young permanent teeth: An in vivo study.

INTRODUCTION: Bacteria and their byproducts are key contributors to the onset and perpetuation of pulpoperiapical pathosis. Intracanal medication is vital in achieving successful endodontic outcomes as it targets and eradicates remaining microorganisms following biomechanical preparation. AIM AND OBJECTIVE: The aim of the study was to compare and evaluate the antimicrobial efficacy of calcium hydroxide (CH) paste, triple antibiotic paste (TAP), and probiotics (PBs) as intracanal medicament in 12-17-year-old children undergoing root canal treatment for the management of infected pulpal tissues in young permanent teeth. MATERIALS AND METHODS: A total of 30 patients aged 12-17 years indicated for endodontic therapy in maxillary incisors and with no systemic complications were selected. They were randomly divided into three groups, i.e., Group I - CH group, Group II - TAP, and Group III - PB allocating 10 teeth in each group. After access opening, the first sample (S1) was collected by inserting a paper point into the root canal, the second sample (S2) was collected immediately after biomechanical preparation, and the third sample (S3) was collected after 7 days, i.e., postintracanal medication. Samples were sent for microbiological analysis to assess the microbial count, and statistical analysis was done for the obtained data. RESULTS: The three intracanal medicaments were successful in reducing the microbial counts of Enterococcus faecalis in the infected root canals. However, according to the results of the study, the PB group demonstrated greater effectiveness against E. faecalis compared to the CH group and displayed similar antimicrobial efficacy as the TAP group. CONCLUSION: PB exhibited antimicrobial efficacy comparable to TAP but greater than Ca (OH) 2 paste. Hence, PB can be utilized as an intracanal medicament in young permanent teeth.

Assessment of Interleukin-6 Levels and Lactobacillus casei Counts in Pediatric Stainless Steel and Zirconia Crowns: A Comparative Study.

Background: Pediatric dental crowns play an integral role as they maintain the form and function and prolong the life of the affected tooth. However, placing a crown in the oral cavity creates a new niche for the adhesion of microorganisms that can lead to plaque accumulation, gingival inflammation, and the development of secondary caries, which in the long term might determine the clinical success of the restored tooth. The present study allowed us to assess the changes caused by the full coverage restorations at a clinical, immunological, and microbiological level using enzyme-linked immunosorbent assay (ELISA) and microbial analysis. Materials and methods: The in vivo analysis consisted of a total of 26 children aged 3-10 years. They were divided into two groups, group I (n = 13) children receiving preformed zirconia crowns and group II receiving stainless steel crowns (SSCs). Plaque index (PI) scores, gingival index (GI) scores, and interleukin-6 (IL-6) levels were assessed at baseline and at 45 days of follow-up. The in vitro part of the study consisted of 13 preformed zirconia crowns and 13 SSCs which were immersed in artificial saliva containing strains of Lactobacillus casei which were then processed for their microbial analysis. Results: On mean comparison, preformed zirconia crowns performed superiorly both clinically and immunologically compared to SSCs. Microbial analysis using independent t-test revealed that the colony-forming units (CFU) per milliliter was statistically significantly higher for the SSCs, and the mean difference among the groups was statistically significant (p < 0.01). Conclusion: Preformed zirconia crowns can be a relative replacement for SSCs in primary teeth with the advantage of esthetics and superior periodontal health. How to cite this article: Saharia NP, Malik M, Jhingan P, et al. Assessment of Interleukin-6 Levels and Lactobacillus casei Counts in Pediatric Stainless Steel and Zirconia Crowns: A Comparative Study. Int J Clin Pediatr Dent 2024;17(4):395-403.

Intercomparison of Efficacy of Transcutaneous Electrical Nerve Stimulation and Precooling Vibration Device on Pain and Anxiety Management during Administration of Local Anesthesia Injection in 6-12-year-olds.

Aim: To compare and evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) and a vibrational precooling system in reducing pain and anxiety during the administration of local anesthesia in children aged 6-12 years old. Materials and methods: A total of 60 children aged 6-12 years old participated in this randomized controlled trial and were randomly allocated to three groups: the conventional method group, the vibrational precooling system group, and the TENS group. The Modified Dental Anxiety Scale (MDAS), pulse rate, and oxygen saturation were recorded to assess the preoperative anxiety of the participating children. Sound, motor, and eyes (SEM) and face, legs, activity, cry, and consolability (FLACC) scores were recorded during the procedure, along with pulse rate and oxygen saturation, to measure pain during the procedure. This was followed by a self-administered visual analog scale (VAS) to assess the discomfort felt by the child. Results: A statistically significant reduction in pain was observed with the usage of the vibration system and TENS, as measured by the FLACC scale, compared to the conventional method group. Similarly, statistically significant differences in SEM scores were noted between the vibrational precooling system group and the conventional method group, as well as between the TENS group and the conventional method group, with the highest scores observed in the conventional method group. The children reported the highest comfort levels with the usage of the vibration system, as indicated by the self-administered VAS. However, no statistically significant difference was observed within any group. Conclusion: The new vibrational precooling system as well as TENS can be effectively used to alleviate the pain experienced during the administration of local anesthesia. How to cite this article: Singh K, Jhingan P, Mathur S, et al. Intercomparison of Efficacy of Transcutaneous Electrical Nerve Stimulation and Precooling Vibration Device on Pain and Anxiety Management during Administration of Local Anesthesia Injection in 6-12-year-olds. Int J Clin Pediatr Dent 2024;17(3):297-302.

Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator.

Aim: To investigate the potential effectiveness of "medical clowns" on preoperative, intraoperative, and postoperative anxiety of children undergoing various dental treatments and also its effect on the operator's stress levels in a dental setup. Materials and methods: A total of 170 pediatric patients, aged 4-8 years, indicated for preventive therapy, extractions, restorative, and endodontics were included and divided into two groups [group I-audiovisual (A-V) aids; group II-medical clowns], group of 85 patients each after recording Modified yale preoperative scale. Both pre- and postoperatively, Frankl's behavior score was recorded for each patient. During treatment, the face, legs, activity, cry, consolability (FLACC) pain scale, and dental operator's stress level were recorded. Results: Intervention of medical clowns positively influenced children during dental treatment by increasing their pain threshold. The majority of children showed positive Frankl rating scales after dental treatment. Also, the operator's stress was significantly reduced, which led to enhanced treatment outcomes. Conclusion: Humor yields the power of healing, distracts pediatric patients, reduces their anxiety, and alleviates their pain, conferring the patients with a sense of laughter, creativity, and care.Therefore, medical clowns in pediatric dentistry can prove to be serviceable and valuable as a nonpharmacological approach to behavior management. How to cite this article: Aggarwal P, Mathur S, Chopra R. Assessment of Medical Clowning in Influencing the Anxiety and Behavior Scores of Children Undergoing Various Dental Treatments and the Stress Levels of the Operator. Int J Clin Pediatr Dent 2024;17(1):59-66.

Comparison of micromorphological changes in enamel using SEM analysis after conventional and erbium, chromium:yttrium, scandium, gallium, and garnet hard-tissue laser fissurotomy: An in vitro study.

Background: Well articulated by John Knowles - "Everything has to evolve or else it perishes." With the paradigm shift of emphasis toward the prevention of dental caries, it has been proven that laser irradiation protects against both caries initiation and caries progression. Aim: The aim of the study was to evaluate and compare the micromorphology of caries-free extracted premolars using a Scanning electron microscope (SEM) after fissurotomy by conventional fissurotomy bur and erbium, chromium: yttrium, scandium, gallium, and garnet (ER, CR: YSGG) hard-tissue laser. Methodology: Sixty caries-free premolars extracted atraumatically for orthodontic treatment were included in the study. The samples were divided into two groups randomly (Group 1: fissurotomy by bur, n = 30, and Group 2: fissurotomy by hard-tissue laser, n = 30). Each sample was further divided into halves from the occlusal surface wherein one-half of the occlusal surface received fissurotomy procedure and the other half was control. Samples were analyzed by scanning electron microscopy (SEM) for micromorphological changes. Results: Profile image of control samples revealed the disorganization of enamel surface at the junction of fissures forming a heterogeneous tissue and agglomeration of enamel with deep pit and fissure. On the contrary, the image of experimented samples (with laser fissurotomy) showed smooth enamel surface and homogeneous enamel subsurface with wider pit and fissure owing to self-cleansing ability. Conclusion: On the grounds of the present study results, it could be concluded that the intervention of ER, CR: YSGG hard-tissue laser possesses self-cleansable pit and fissures for caries prevention and has the potential to irradicate the smear layer entirely for superior attachment of remineralizing agents.

Assessment of changes in Streptococcus pyogenes levels using N-acetylgalactosamine-6-sulfatase marker and pharyngeal airway space with appliance therapy in mouth breathers - An ELISA-based study.

Background: The frequency of adenotonsillar hypertrophy in mouth-breathing children when compared to the average found in the general population is considered to be higher. Mouth breathing is considered as one of the causative factors for tonsillitis in children. Through continuous irritation on tonsillar wall, tonsils swell up and inflammation develops. Purpose: The purpose of the study is to evaluate Streptococcus pyogenes count using colony-forming units (CFUs) and N-acetylgalactosamine-6-sulfatase side chain marker on ELISA (enzyme linked immunosorbent assay) in mouth breathers and to establish its correlation with pharyngeal airway space pre- and post-oral screen appliance therapy. Materials and Methods: A total number of 24 (n) mouth breathers aged between 5 and 12 years were included in the study and given oral screen appliance therapy. The subjects were evaluated for the various parameters before the delivery of a habit-breaking appliance and then reevaluated for the same parameters (presence of S. pyogenes and its counts, size of tonsils, and pharyngeal airway space dimensions) after 6 months of appliance usage. Results: A statistically significant difference was seen in levels of S. pyogenes using ELISA and CFUs. Furthermore, statistically significant difference was observed in Friedman tonsil scoring and pharyngeal airway space and pre- and post-oral screen appliance therapy. Conclusion: Oral screen appliance therapy reduced the frequency of occurrence of tonsillitis in mouth breathers by decreasing the counts of S. pyogenes bacteria. Upper and lower pharyngeal airway space dimensions were increased after 6 months of appliance therapy in mouth breathers.

Statewide Assessment of the Hepatitis C Virus Care Cascade for Incarcerated Persons in Vermont.

OBJECTIVES: Incarcerated persons in the United States have a high burden of hepatitis C virus (HCV) infection. This study assessed the impact of a statewide effort in Vermont to treat HCV in this group. METHODS: We performed a retrospective, observational cohort study of all HCV-infected persons who were imprisoned in Vermont during the 19-month study period (December 2018-June 2020). The cascade of care comprised opt-out HCV screening, full access to direct-acting antiviral treatment (without hepatic fibrosis-based treatment restrictions), HCV specialist involvement, and medication-assisted treatment for patients with opioid use disorder. The primary outcome was sustained virologic response at 12 weeks after treatment completion (SVR12). RESULTS: The study included 217 HCV-infected patients; the median age was 35 years (range, 18-73 years), 89% were male, 76% had opioid use disorder, 67% had a psychiatric comorbidity, and 9% had cirrhosis. Of the 217 patients, 98% had a liver fibrosis assessment, 59% started direct-acting antiviral treatment, 55% completed direct-acting antiviral treatment, and 51% achieved documented SVR12. Of the 129 HCV-infected persons who started direct-acting antiviral treatment, 92% completed therapy and 86% achieved documented SVR12. Psychiatric comorbidity was not significantly associated with achieving SVR12 (odds ratio = 0.67; 95% CI, 0.27-1.65; P = .38), nor was receiving medication-assisted treatment for patients with opioid use disorder (odds ratio = 1.45; 95% CI, 0.62-2.56; P = .45). CONCLUSIONS: This study reports the highest SVR12 rate achieved in a state incarcerated population to date. HCV treatment in incarcerated populations is a practical and efficacious strategy that should serve a foundational role in HCV elimination.

Evaluation of different pre-treatment behaviour modification techniques in 4-7-year olds: A randomised controlled trial.

Purpose: The aim of this study is to evaluate and compare the effectiveness of five pre-treatment behaviour modification techniques in 4-7-year olds in reducing dental anxiety by evaluating pulse rate, partial pressure of oxygen, systolic blood pressure, diastolic blood pressure, salivary flow rate, salivary pH, and through modified facial anxiety scale. Material and Methods: Using simple random sampling technique (drawing of lots), 125 children were equally distributed into 5 groups of 25 each: Group 1: tell-show-do (control); Group 2: tell-show-play-doh; Group 3: Playmobil Dentist; Group 4: mobile dentist games; Group 5: role play as dentist. Samples in each group were treated in a single appointment after using the behaviour modification techniques. Class I or Class II cavities were prepared on carious primary molar and restored using glass ionomer cement. Patient's anxiety level was assessed by recording blood pressure, pulse rate, oxygen saturation, salivary pH, salivary flow rate, and facial anxiety scale at different time intervals, that is before the treatment, during the treatment, and after the treatment. Results: All the intervention Groups (Groups 2-5) showed reduced anxiety scores in both physiological and facial anxiety compared to the control group, that is tell, show do. The modified distraction techniques aid in better modification. Conclusion: Tell-show-play-doh, Playmobil dentist games, mobile dentist games and role play as dentist are effective distraction techniques as compared to conventional tell-show-do techniques which can be incorporated in day-to-day clinical practice to reduce dental anxiety in paediatric patients.

Correlation of caries occurrence in primary teeth using human leukocyte antigen typing and maternal and physiochemical factors.

Background: Dental caries being the leading health issue worldwide has no specific cure due to its multifactorial etiology and genetic susceptibility. Hence, this paper attempted to correlate the clinical and hereditary factors between mother and child, to predict the caries occurrence in child in future, and thereby implement early preventive measures. Aim: The aim of the study was to look for an association between maternal and child's human leukocyte antigen (HLA)-DR4 levels and relate it with other physiochemical factors to assess caries susceptibility in children. Methodology: Saliva samples were collected from children who were in the age group of 0-6 years and their mothers by spitting method and swab method. The clinical indicators such as Decayed, Missing, and Filled Teeth, decayed, extraction needed, and filled teeth, salivary flow rate, and pH were recorded by clinical evaluation. The Streptococcus mutans count was measured by culture plate followed by colony count method, and the HLA-DR4 factor was assessed using ELISA. Results: The results revealed a statistically significant correlation between the physiochemical factors of the mother and the child. The genetic factor in which the HLA-DR4 caries indicator was checked also has a strong association between the mother and the offspring. Thus, a strong caries prediction formula was derived through which probability of caries occurrence in the child could be determined prematurely. Conclusion: Thus, it can be concluded that using the clinical and genetic factors, the caries prediction can be done for the child and preventive protocol can be started before disease occurrence.

Effect of Stainless-Steel Crown and Preformed Zirconia Crown on the Periodontal Health of Endodontically Treated Primary Molars Correlating with IL-1ß: An In Vivo Study.

OBJECTIVE: The purpose of this study was to evaluate the effect of different crown materials on the interleukinone beta (IL-1ß) content of the gingival crevicular fluid and to study which crown material causes the highest inflammation on the marginal gingiva on a biochemical basis in pediatric patients. STUDY DESIGN: Twenty patients in the age group of 4-8 years with endodontically treated primary molars indicated for crown placement were selected for the study which was further divided into 3 groups for sample consideration: group 1-stainless steel crown, group 2-preformed zirconia crown, and group 3- control group (primary second molar). All assay procedures were carried out and the results of the collected samples were calculated using the ELISA-AID TM technique. RESULTS: On mean comparison among the groups using ANOVA oneway test, P-value turns out to be highly significant, on mean comparison using Tukey's HSD post-hoc test, The p-value was 0.000 ,0.000 ,0.193 on comparing group 1 with group 2, group 1 with group 3, group 2 with group 3 respectively. CONCLUSION: Preformed zirconia crown can be a relative replacement of SSC in primary molars as it causes comparatively less inflammation and with an advantage of esthetics.

Estimating the effectiveness of lollipops containing xylitol and erythritol on salivary pH in 3-6 years olds: A randomized controlled trial.

Background: Prevention of dental caries is important for nutrition and health of the child. Sucrose being considered an arch criminal, various substitutes are recommended. Xylitol is an artificial sweetener which cannot be metabolized by bacteria. Thus, it seems to be a promising method in prevention of dental caries. Materials and Methods: Fifty children between the age of 3-6 years were randomly divided into two groups; Group 1: Control group (without lollipops) and Group 2: Experimental group (with sugar substitute lollipops). The saliva sample was collected at four different time intervals, and pH of saliva was determined using universal pH indicator. Results: There was a significant drop in the pH after drinking sweetened beverages in both the groups, but there was a significant rise in pH after having xylitol + erythritol lollipops which almost returned to baseline after 15 min. Conclusion: Lollipops containing xylitol and erythritol can be used in small children and it has potential to increase salivary pH, thus not allowing the pH to fall below the critical value.

The impact of the modified frailty index on clinical outcomes for patients with stage IV non-small cell lung cancer receiving chemotherapy.

INTRODUCTION: Frailty impacts outcomes for patients with lung cancer, but no brief tools have been assessed in patients with metastatic disease. We evaluated the impact of the Modified Frailty Index (mFI) on clinical outcomes for patients with metastatic non-small cell lung cancer (NSCLC). METHODS: We conducted a retrospective cohort study of all patients with Stage IV NSCLC diagnosed in Manitoba between 2011 and 2016 who then received first-line cytotoxic chemotherapy. We assigned mFI scores based on documented comorbidities and collected data on toxicity, progression, and survival. Descriptive statistics characterized the cohort and toxicity experienced. Kaplan-Meier methods were used to evaluate progression-free survival (PFS) and overall survival (OS), followed by multivariable Cox proportional hazards models. RESULTS: Our cohort of 426 (mFI 0/1-2/3+ = 175/196/55) patients, showed no significant association between higher mFI score and incidence of overall chemotherapy toxicity. Patients with mFI 0 experienced more frequent thromboses (p=0.022) and a trend towards less nausea or vomiting (p = 0.059). There was no significant difference in PFS or OS among frailty groups. Poorer performance status, number of metastatic sites, and the absence of a driver mutation were independently associated with poorer PFS and OS. Male sex and not completing chemotherapy were also associated with worse OS. CONCLUSION: This study is the first to investigate the use of the mFI as a frailty tool in patients with metastatic NSCLC receiving cytotoxic chemotherapy. The mFI does not appear to be strongly associated with treatment-related toxicities, PFS, or OS in patients with metastatic NSCLC receiving first-line cytotoxic chemotherapy.

Effectiveness of cryotherapy, sucrose solution and a combination therapy for pain control during local anesthesia in children: a split mouth study.

BACKGROUND: Pain management in dentistry is inevitable without the use of local anesthesia. However, the agonizing experience of dental injections incorporates a fear of dentist in children. Therefore, the painless administration of local anesthetic agents is crucial in providing optimum dental care. AIM: To compare the effectiveness of four different techniques in minimizing the pain during administration of local anesthesia in 7-11 years old children. STUDY DESIGN: In this split mouth study design, 132 healthy and cooperative children of age 7-11 years, who needed bilateral extraction of primary molars were children were randomly allocated to four different groups: Group I (cryotherapy), Group II (30% sucrose solution), Group III (combination of cryotherapy + sucrose) and Group IV (topical anesthetic agent). The pain perception during administration of local anesthesia (IANB) was recorded before, during and after anesthesia using VAS (visual analogue scale), oxygen saturation (SpO2) and pulse rate (PR), SEM (sound, eye, body movement) and FLACC (face, legs, activity, cry, consolability) scale. RESULTS: The mean difference of scores of VAS scale showed a statistically significant difference (p < 0.05) in all the groups. The FLACC and SEM scores, pulse rate (PR) and SpO2 of Group I (popsicle) showed a statistically significant difference (p < 0.05) when compared to Group III (ice-cubes) and Group IV (topical anesthetic). CONCLUSION: Pain management using a combination of cryotherapy & sweet substance in pediatric patients can be a safe and effective alternative to the conventional topical anesthetic agents in minimizing pain as the sweet taste acts a reward and offers the advantage of providing a positive dental experience for the patient.

Two Cases of Sporadic Eosinophilic Solid and Cystic Renal Cell Carcinoma in Manitoba Population.

Two sporadic cases of eosinophilic solid and cystic renal cell carcinoma (ESC RCC), at our institution, are presented in this study to contribute to the growing literature on this novel renal neoplasm. The first patient was a 38-year-old female with two synchronous renal masses measuring 3.5 and 1.9 cm on preoperative imaging. The second patient was a 44-year-old female with an incidental renal mass measuring 4 cm. Both patients underwent uncomplicated radical nephrectomies. The 1.9 cm mass in the first patient was consistent with clear cell RCC. The dominant mass in the first patient and the tumor in the second patient had microscopic and macroscopic findings in keeping with ESC RCC including a tan appearance, abundant eosinophilic cytoplasm, and CK20+ and CK7- staining. Both patients had an uncomplicated course following surgery with no evidence of local recurrence or distant metastatic disease for 1 and 2 years for the first and second patient accordingly. These cases contribute to a growing body of literature regarding ESC RCC including, to our knowledge, the first reported case of synchronous ESC RCC and clear cell RCC. Further research about this novel renal neoplasm is needed.

Using nitrous oxide inhalation sedation for classical conditioning - An evaluative study.

PURPOSE: This study was undertaken to evaluate conscious sedation as a means of classical conditioning for managing paediatric dental patients. METHODS: A total of 20 healthy children (American Society of Anesthesiologists I) aged 5-9 years with positive and definitely positive Frankel behaviour rating scale were evaluated. In the first appointment (A1) non-invasive treatment under nitrous oxide inhalation sedation was performed and oxygen saturation and pulse rate at 10%, 30% and 50% were recorded. In subsequent appointment (A2") same treatment was executed under 100% oxygen and recordings were taken. Behaviour was assessed using comfort scale. RESULTS: No significant difference was observed in pulse rate, oxygen saturation and visual analogue scale whereas scores of comfort scale showed significant results. CONCLUSION: Once behaviour modification to dental treatment is achieved, subsequent visit can be undertaken even without sedation, giving oxygen as a placebo where patient is sensitized to nasal hood resulting in positive dental behaviour.

Inter-comparison of antimicrobial photodynamic therapy, LASER, and an antifungal agent as adjunct intracanal irrigation techniques to standard disinfection protocols in reducing Candida albicans counts in the root canals of primary teeth: A pilot study.

BACKGROUND: Despite endodontic infections being a common problem in the primary dentition, some of the infected primary teeth can remain functional until the exfoliation through endodontic treatment. The primary endodontic treatment goal must be to optimize root canal disinfection and to prevent reinfection. AIM: The aim of this study is to compare the antifungal efficacy of antimicrobial photodynamic therapy, LASER, and 1% clotrimazole as irrigants by reducing the colony-forming units (CFU) of Candida albicans in the infected root canals of primary teeth. MATERIALS AND METHODS: Pulp therapy was performed on deciduous mandibular second molars of 20 healthy children aged 5-8 years, which were divided into four groups of intracanal disinfection protocols: Group 1 (n = 5) - Sodium Hypochlorite, Group 2 (n = 5) - Photodynamic, Group 3 (n = 5) - Normal saline with LASER, and Group 4 - (n = 5) Antifungal. Disinfection potential was compared by collecting samples one just after access opening and the other after the experimental groups using paper points. The samples were cultured and incubated for 48 h to check change in CFU of the fungi. RESULTS: Data were analyzed statistically using the Shapiro-Wilk's test, Mann-Whitney U-test; Kruskal-Wallis test, and Wilcoxon signed-ranks test. No significant difference (P > 0.05) was found between the different groups. However, complete inhibition of C. albicans CFU was seen with Group 4. CONCLUSION: One percent Clotrimazole (antifungal) can be utilized as an adjunct in the endodontic irrigation protocol for better success of pulpectomy in children.

Variations in Physiological, Psychomotor, and Analgesic Parameters during Titration of Nitrous Oxide in 3-12 Years Old Children Managed with Inhalation Sedation.

BACKGROUND: The present study was designed to assess variations in physiological, psychomotor parameters, and analgesic effects at various levels of nitrous oxide-oxygen analgesia in 3-12 years old children. DESIGN: One hundred children aged 3-12 years were assessed for physiological, psychomotor, and analgesic parameters at various concentrations of N2O, i.e., baseline, 20, 40, 50, and 0% (100% O2). Physiological, psychomotor, and analgesic effects were assessed using a pulse oximeter, bender visual-motor Gestalt test, and response to electric pulp tester, respectively. RESULTS: Oxygen saturation (SpO2) showed a significant increase while heart rate (HR) showed a significant reduction at 50% N2O. No significant changes were observed in respiratory rate with a change in N2O levels. Significant reduction in the pain scores was found at the same level of stimulation by an electric pulp tester at 40 and 50% levels. The psychomotor changes were consistently higher at every concentration of nitrous oxide. However, no correlation could be found between various parameters tested. CONCLUSION: N2O caused a significant increase in SpO2 in both the age groups, a decrease in HR, a significant decrease in pain score at 40 and 50% concentration of N2O, and had a significant effect on the psychomotor ability of children. HOW TO CITE THIS ARTICLE: Sharma S, Chopra R, Mathur S, et al. Variations in Physiological, Psychomotor, and Analgesic Parameters during Titration of Nitrous Oxide in 3-12 Years Old Children Managed with Inhalation Sedation. Int J Clin Pediatr Dent 2020;13(6):650-655.

Evaluation of compressive strength, shear bond strength, and microhardness values of glass-ionomer cement Type IX and Cention N.

AIM: This study aimed to compare the compressive strength, shear bond strength, and microhardness of glass-ionomer cement (GIC) Type IX and Cention N. MATERIALS AND METHODS: Five samples each of GIC Type IX and Cention N were prepared for testing the shear bond strength, tensile strength, and microhardness. Cylinders of the samples measuring 1 cm diameter and 6 mm height were prepared for compressive strength and shear bond strength. For shear bond strength, these samples were embedded into acrylic blocks of dimensions 2 cm × 2 cm. Testing of shear bond strength and compressive strength was done by mounting the samples in a universal testing machine with a crosshead speed of 1 mm/min. The samples for microhardness were 1 cm diameter and 5 mm height. The samples were mounted on Vickers microhardness testing machine to test the microhardness. RESULTS: The values for shear bond strength of Cention N were statistically highly significant (P < 0.01) as compared to GIC Type IX, whereas the compressive strength and microhardness values of Cention N were statistically significant (P < 0.5) as compared to GIC Type IX. CONCLUSION: The results suggest significantly higher values for mechanical properties of Cention N as compared to GIC Type IX.

Evaluation of a mixture of zinc oxide-10% sodium fluoride as novel root canal filling material: A pilot study!!

BACKGROUND: To establish mixture of zinc oxide and 10% sodium fluoride as a novel root canal obturating material for primary teeth. AIM: This study aims to evaluate clinical and radiographic success of a mixture of zinc oxide and 10% sodium fluoride as root canal obturating material. SETTINGS AND DESIGN: This pilot study was conducted among 30 primary molars indicated for pulpectomy. METHODS: Thirty grossly decayed primary molars of children aged 4-9 years were selected with signs or symptoms of irreversibly inflamed or degenerative pulp tissue. Single sitting pulpectomy was carried out in all the teeth with a mixture of zinc oxide powder with 10% sodium fluoride, and they were subsequently restored with preformed crown. Teeth were assessed clinically and radiographically at 3-, 6-, 9-, and 12-month intervals. STATISTICAL ANALYSIS: Data were analyzed using SPSS Software Version 20.0 (IBM SPSS Statistics, Chicago, IL, USA) and statistical significance was determined by Chi-square test; level of significance was set at P < 0.05. RESULTS: Overall clinical and radiographic success rate of combination of zinc oxide and sodium fluoride was 92.9% and 85.7%, respectively, at the end of 12 months. Furthermore, resorption rate of material matched resorption of tooth root. Excess filling material was also observed to resorb at the end of 3 months. CONCLUSION: These results suggest that combination of zinc oxide and sodium fluoride can be considered as suitable alternative root canal obturating materials for primary teeth with low cost to achieve acceptable therapeutic results.

Evaluation of temperature rise and efficacy of cavity disinfection with diode laser: An in vivo study.

BACKGROUND: Management of caries using minimally invasive dentistry is prevalent in dentistry today. A newer technology is to disinfect/sterilize caries in depth of the dental tissue with diode laser. However, to have a bactericidal effect, increased energy density of light amplification by stimulated emission of radiation (LASER) may be required which in turn may lead to higher thermal load causing harmful effects on vital pulpal tissue. AIMS: The aim was to evaluate temperature rise and efficacy of cavity disinfection with diode laser. MATERIALS AND METHODS: Twenty permanent molar teeth with dentinal caries were randomly assigned into two groups on the basis of LASER irradiation: Group 1 - at 1 W, Group 2 - at 2 W. The elevation of subsurface temperature during irradiation was measured using thermocouples positioned in the center of a prepared cavity. Dentinal samples were collected before and after disinfection of the cavity. These samples were subjected to microbiological evaluation for Streptococcus mutans on Mutans-Sanguis agar and Lactobacilli on Rogosa agar. STATISTICAL ANALYSIS: Log transformed "t"-test and paired "t"-test were used for the statistical analysis. RESULTS: Although the reduction in microbial count revealed insignificant difference at two different wattages, the rise in temperature with 1 W was less than that with 2 W. CONCLUSION: Efficacy of 1 W and 2 W is similar, but 1 W causes less thermal changes, thus, 1 W is recommended over 2 W.