Comparative Evaluation of Myristica fragrans Essential Oil-Zinc Oxide Mixture with Zinc Oxide Eugenol in Root Canal Filling of Primary Teeth: An In Vivo Study.

Background: This is a preliminary investigation to assess the efficacy of Myristica fragrans (M. fragrans) as pulpectomy obturation material. Objective: To assess the clinical and radiographic efficacy of M. fragrans as pulpectomy obturating material and compare it with zinc oxide eugenol, the gold standard in the obturation of primary teeth. Materials and methods: This is a triple-blind, randomized, and controlled clinical trial performed on children aged between 4-8 years with primary molars requiring pulpotomy. A total of 50 teeth were randomly assigned into two groups-group I received M. fragrans with zinc oxide eugenol, and group II zinc oxide eugenol. Teeth were then filled with glass ionomer cement and were restored using stainless steel crowns. Clinical and radiographic evaluation was done by a blinded calibrated evaluator at 3, 6, and 12-month follow-up periods. The data obtained were subjected to statistical analysis. Results: Clinical and radiographic success in both groups was 100% throughout the follow-up period. Extruded material in the M. fragrans group showed resorption during the follow-up period. Conclusion: Myristica fragrans (M. fragrans) can be suggested as a pulpectomy obturating material for primary teeth. However, further clinical studies with long-term follow-ups are needed to give more affirmative results. How to cite this article: Setty JV, Srinivasan I, Sathiesh RT. Comparative Evaluation of Myristica fragrans Essential Oil-Zinc Oxide Mixture with Zinc Oxide Eugenol in Root Canal filling of Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(2):237-243.

Characterization of Cocoa Bean Husk Extract Particles and its Comparison as a Mouthrinse with Different Vehicles in Children aged 7-12 Years.

Aim: Assessing the efficacy of cocoa bean husk extract (CBHE) particles with different vehicles as a mouthrinse in children aged 7-12 years in comparison to chlorhexidine (CHX) and sodium fluoride (NaF) mouthrinse. Materials and methods: A total of 80 children aged 7-12 years residing at a residential school/orphanage in Bengaluru city were selected and randomly allocated into five groups-group I: 0.1% CBHE with distilled water (DW); group II: 0.1% CBHE with Ringer's lactate (RL); group III: 0.12% CHX; group IV: 0.1% CBHE with normal saline (NS); and group V: 0.05% NaF. A Simplified Oral Hygiene Index (OHI-S) was recorded, salivary pH was assessed, and unstimulated saliva samples were collected at baseline (BL) after 30 minutes of rinsing on day 7 and day 14. These saliva samples were subjected to microbiological analysis, and all the data from five groups at four different time intervals was tabulated and statistically evaluated. Results: Nearly 0.1% CBHE with NS as vehicle showed maximum antibacterial properties among all the groups at all time intervals. The addition of RL to CBHE provided better anti-plaque efficacy than 0.1% CBHE with DW and 0.12% CHX mouthwash. All three combinations of 0.1% CBHE and 0.12% CHX mouthwash proved to be better anti-plaque agents than 0.05% NaF. Improving the preparation of CBHE mouthwash by using NS, RL, and with the addition of saccharin sodium also improved the patient's compliance. Conclusion: Thus, preparing chocolate/CBHE mouthwash with NS or RL instead of plain DW increased the salivary pH, anti-plaque efficacy, and antibacterial property by reducing Streptococcus mutans growth. Clinical significance: Cocoa bean husk extract (CBHE) mouthwash is a better anticariogenic and nonalcoholic mouthwash compared to CHX and NaF, which can be safely used in children as a routine oral rinse and also for those with gingivitis and high-risk of caries. How to cite this article: Kibriya S, Srinivasan I, Setty JV, et al. Characterization of Cocoa Bean Husk Extract Particles and its Comparison as a Mouthrinse with Different Vehicles in Children aged 7-12 Years. Int J Clin Pediatr Dent 2023;16(1):54-59.

Low-level Laser Therapy to Alleviate Pain of Local Anesthesia Injection in Children: A Randomized Control Trial.

Aim: The aim of our study was to evaluate and compare pain perception following photobiomodulation (PBM), topical anesthesia, precooling of the injection site, and vibration during administration of local anesthesia injection in pediatric patients aged 6-13 years. Materials and methods: In this split-mouth study, a total of 120 patients between the age group of 6 and 13 years were selected and randomly divided into three equal groups with 40 subjects in each. Pain was assessed using visual analog scale (VAS) and the Wong-Baker Faces Pain Rating Scale after the administration of local anesthesia. Behavior during the procedure was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale filled by the operator. Pulse rate was recorded before and during the administration of local anesthesia using pulse oximeter. After the procedure, patient compliance was also recorded using validated questionnaire. The level of significance was set at p < 0.05. Results: The study showed PBM exhibited the lowest mean scores of anxiety/pain using VAS, Wong-Baker Faces Pain Rating Scale, FLACC scale and pulse rate as compared to precooling, vibration, and topical anesthesia. The differences in pain scores recorded were found to be statistically significant. Children were not anxious about the PBM method and exhibited good compliance (p < 0.001). Conclusion: Photobiomodulation (PBM) was found to be effective means of reducing injection pain, demonstrating much better efficacy than other tested methods. Clinical significance: Photobiomodulation (PBM) can be used effectively to better manage procedures that patients frequently find painful without the need for prescription drugs, which frequently have several side effects. How to cite this article: Khan BS, Setty JV, Srinivasan I, et al. Low-level Laser Therapy to Alleviate Pain of Local Anesthesia Injection in Children: A Randomized Control Trial. Int J Clin Pediatr Dent 2023;16(S-3):S283-S287.

Assessment of anxiety levels in children aged 4-9 years about the pediatric dentists donning a personal protective equipment during treatment in the COVID-19 pandemic.

Background: Managing anxiety in children during the pandemic will be a concern for many pediatric dentists. Aim: The aim of this study was to assess the anxiety levels in children aged between 4 and 9 years about the pediatric dentists donning a personal protective equipment (PPE) for dental treatment during the COVID-19 pandemic era in Bengaluru. Methods: The study was done in two parts with a sample size of 100 each. The first part was a questionnaire-based survey addressed to the pediatric dentists practicing in Bengaluru. The second part of the study was clinical assessment of dental anxiety at three time intervals (T1, T2, and T3) using the animated emoji scale. Results: The study revealed that 87% use preprocedural behavior management post-COVID. Majority of the dentists donned the PPE before conditioning the child (59%) and 41% wore the PPE after conditioning the child. The mean anxiety level in the study children showed an increase in anxiety level at T2 of 3.58 (P < 0.001 ± 1.32) in children aged 4-6 years when compared to T1 and T3 of 3.27 (P < 0.001 ± 1.64) and 3.07 (P < 0.001 ± 1.32), respectively. Conclusion: Children aged between 4 and 6 years showed increased levels of anxiety compared to the 7-9-year age group to the pediatric dentists donning a PPE during treatment in the COVID-19 pandemic. Pediatric dentists also showed a satisfactory knowledge regarding disinfection and fumigation procedures.

Restoration of Proximal Contacts in Decayed Primary Molars Using Three Different Matrix Systems in Children Aged 5-9 Years: An In Vivo Study.

AIMS AND OBJECTIVES: Proximal contacts and their interdigitation through occlusal contact with opposing teeth play a major role in children, for the eruption of permanent teeth into normal position. Determining the ideal matrix band system for proximal restorations helps in the construction of contacts and contours. This study is designed to determine the most suitable matrix band system for proximal restorations. MATERIALS AND METHODS: A total of 96 proximal cavities were selected among patients aged 5-9 years and were equally divided into three groups. Group I: T-band, group II: ProMatrix, and group III: FenderMate. Pre- and postoperative radiographs were taken to evaluate carious lesions and restorations. Class II cavity was prepared and glass ionomer restorations were done using matrix systems. The efficacy of matrix bands was evaluated through the operator's questionnaire and postoperative radiographs. RESULTS: No statistical significance was found between the three matrix bands but FenderMate showed few clinical drawbacks that were statistically significant (p < 0.005). INTERPRETATION AND CONCLUSION: Matrix systems used in this study showed good results in restoring proximal contacts and contours. FenderMate showed few drawbacks when compared with the other two matrix systems. None of the matrix systems used in the present study were able to create 100% accurate proximal contacts and contours. HOW TO CITE THIS ARTICLE: Dindukurthi MK, Setty JV, Srinivasan I, et al. Restoration of Proximal Contacts in Decayed Primary Molars Using Three Different Matrix Systems in Children Aged 5-9 Years: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(1):70-74.

Pyknodysostosis: Report of a Rare Case and its Dental Management.

AIM: This is a case report of a 16-year-old girl visiting MR Ambedkar Dental College and Hospital (Department of Pedodontics and Preventive Dentistry) for dental treatment. BACKGROUND: Osteopetrosis acroosteolytica or Toulouse-Lautrec syndrome or pyknodysostosis is a rare autosomal recessive bone dysplasia, characterized by osteosclerosis, and short stature. Montanari described a patient with an unusual variation of achondroplasia, which in retrospect was the first case of pyknodysostosis to be reported.1. CASE DESCRIPTION: A 16-year-old girl reported to the Department of Pediatric and Preventive Dentistry with a chief complaint of pain in the lower left back region of the jaw since past 2 weeks. CONCLUSION: Pyknodysostosis is a rare condition that is diagnosed basically on its clinical and radiographic features. CLINICAL SIGNIFICANCE: It is important to recognize these features so that correct diagnosis can be made. This allows the treatment and prevention of future complications and ensures a better quality of life to the patient. HOW TO CITE THIS ARTICLE: Jawa A, Setty JV, Vijayshankar LV, et al. Pyknodysostosis: Report of a Rare Case and its Dental Management. Int J Clin Pediatr Dent 2020;13(2):192-195.

In vitro evaluation of antimicrobial effect of Myristica fragrans on common endodontic pathogens.

BACKGROUND: Complete elimination of microorganisms from the root canals is the important key for the successful endodontic treatment. Constant emergence of resistant strains and adverse effects of synthetic drugs has led to the search of effective herbal alternatives. Nutmeg (Myristica fragrans) is one such spice used for its various medicinal activities. AIMS: To evaluate the antimicrobial effect of M. fragrans on common endodontic pathogens of primary tooth. MATERIALS AND METHODS: Essential oil of nutmeg was extracted by hydrodistillation method, and its phytoconstituents were determined by thin-layer chromatography (TLC), high-performance TLC, and gas chromatography-mass spectrometry analysis. Minimum inhibitory concentration of essential oil against standard strains of common endodontic pathogens (Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Streptococcus mutans, Candida albicans, Lactobacillus casei, Actinomyces viscosus, Prevotella intermedia, and Porphyromonas gingivalis) was determined by serial tube dilution method. RESULTS: Essential oil of M. fragrans was effective against all tested endodontic microorganisms. DISCUSSION: The active components of essential oil of nutmeg such as myristicin, myristic acid, trimyristin, elemicin, and safrole have good antimicrobial activity and are effective against endodontic microorganisms. CONCLUSION: M. fragrans can be used as an effective medicament in the treatment of endodontic infections.

Rugoscopy as a Gender Determination Tool and its Appositeness in Malocclusion among Adolescents Aged 13-18 Years.

AIM: The aim of the study was to determine the relationship between malocclusion and palatal rugae patterns and its reliability in gender determination of adolescents aged 13-18 years. MATERIALS AND METHODS: A total of 90 children with 30 in each of skeletal class I, II and III groups respectively were included in the study. The lateral cephalograms of the study samples were analyzed cephalometrically using ANB angle, WITS appraisal and beta angle and categorized as skeletal class I, class II or class III sagittal skeletal jaw relation. Sassouni's Archial analysis was used to reconfirm skeletal jaw relation and also to assess treatment needs. Palatal rugae of each sample were recorded to study the patterns. Thomas and Kotze classification was followed for rugae pattern analysis. RESULTS: No definite rugae print pattern could be associated with any particular sagittal skeletal jaw relation in the present study. Female population of class II skeletal malocclusion showed a significant difference for number of rugae on the right and left sides of mid palatine raphe. Discriminant function analysis showed no significance when the number of rugae were compared among males and females for gender determination. CONCLUSION: As rugoscopy was neither found to provide absolute conclusive evidence in identification of any particular jaw relationship nor gender determination, combination with more reliable forensic methods would help in better personal identification. CLINICAL SIGNIFICANCE: Palatal rugae and craniofacial skeleton develop at the same embryonic period. Developmental factors that cause malocclusions should also reflect in the palatal rugae patterns. There exists a deficiency in studies in samples of younger age group and hence the need of the study. HOW TO CITE THIS ARTICLE: Lalitya D, Srinivasan I, et al. Rugoscopy as a Gender Determination Tool and its Appositeness in Malocclusion among Adolescents Aged 13-18 Years. Int J Clin Pediatr Dent 2019;12(4):307-311.

Use of an animated emoji scale as a novel tool for anxiety assessment in children.

BACKGROUND: Dental anxiety in children is a major barrier in patient management. If dental anxiety in pediatric patients is assessed during the first visit, it will not only aid in management but also help to identify patients who are in need of special care to deal with their fear. Nowadays, children and adults are highly interested in multimedia and are closely associated with them. Children usually prefer motion pictures on electronic devices than still cartoons on paper. Therefore, this study was conducted to evaluate a newly designed scale, the animated emoji scale (AES), which uses motion emoticons/animojis to assess dental anxiety in children during their first dental visit, and compare it with the Venham picture test (VPT) and facial image scale (FIS). METHODS: The study included 102 healthy children aged 4-14 years, whose dental anxiety was measured using AES, VPT, and FIS during their first dental visit, and their scale preference was recorded. RESULTS: The mean anxiety scores measured using AES, FIS, and VPT, represented as mean ± SD, were 1.78 ± 1.19, 1.93 ± 1.23, and 1.51 ± 1.84, respectively. There was significant difference in the mean anxiety scores between the three scales (Friedman test, P < 0.001). The Pearson's correlation test showed a very strong correlation (0.73) between AES and VPT, and a strong correlation between AES and FIS (0.88), and FIS and VPT (0.69), indicating good validity of AES. Maximum number of children (74.5%) preferred AES. CONCLUSION: The findings of this study suggest that the AES is a novel and child-friendly tool for assessing dental anxiety in children.

Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: A crossover split-mouth study.

BACKGROUND: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. METHODS: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. RESULTS: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. CONCLUSION: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.

Comparison of three behavior modification techniques for management of anxious children aged 4-8 years.

BACKGROUND: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. METHODS: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. RESULTS: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. CONCLUSION: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.

Comparison between Rotary (Mtwo) and Manual (H-Files) Techniques for Instrumentation of Primary Teeth Root Canals.

BACKGROUND: The aim of the study is to compare instrumentation time between manual (H-files) and rotary (Mtwo) files along with patient and operator compliance in primary lower molars. MATERIALS AND METHODS: 30 primary teeth were selected and divided into two groups of 15 in each group instrumented with H-files and Mtwo files respectively. Time taken for instrumentation was calculated using stop watch. Patient and operator compliance was recorded through questionnaire. STATISTICAL ANALYSIS USED: Chi Square test was used to compare the distribution of teeth and number of canals. Independent Student t test was used to compare the mean time taken for instrumentation with both techniques in different canals and the mean overall time for instrumentation where P value is less than 0.001. Chi Square Goodness of Fit test was used to compare the patient's and operator's perspective regarding instrumentation techniques. RESULTS: The instrumentation time recorded with Mtwo files is less when compared with H-files. 66.7% children preferred H-files over Mtwo, 60% children reported pain while using H-files, 60% of children were scared on sight of Mtwo rotary system. Operator could manage 80% of children easily while using H-files, but it was found that operator ease of comfort was more with Mtwo rotary system. CONCLUSION: Time taken for instrumentation with Mtwo files was less as compared to H-files. It was convenient for the operator to manage the child using H-files but with the use of Mtwo files, marked reduction in the instrumentation time was appreciated.

Determination of Relationship between Lip Prints and Skeletal Malocclusion in Children of Age 9-14 Years.

AIM: To determine the relationship between lip prints and sagittal skeletal jaw relation in children of age 9-14 years. MATERIALS AND METHODS: The lateral cephalograms of a total of 90 children were analyzed cephalometrically to categorize as skeletal class I, II, or III jaw relation groups. Each group had 30 patients. Lip prints of each sample were recorded and analyzed. STATISTICAL ANALYSIS: The data obtained were statistically analyzed (Z test) to compare lip print patterns among patients of different sagittal skeletal jaw relations. RESULTS: (1) Type IV lip print pattern was significantly higher (p < 0.05) in occurrence on lower lip of class III group males when compared to males of class I group; (2) The proportion of type I lip print pattern on lower lip was significantly higher (p < 0.05) in overall subjects having class II jaw relation; (3) Type II lip print pattern on upper lip and type I lip print pattern on lower lip were significantly higher (p < 0.05) in females of class II group as compared to class III group; (4) Type III upper lip print pattern was significantly higher (p < 0.05) in females of class III group as compared to class II group. CONCLUSION: In the present study, type I lip print pattern on lower lip was significantly higher (p < 0.05) in overall subjects having class II jaw relation; some interrelations between lip print patterns and malocclusions were found especially in skeletal class II and III jaw relation groups. No definite lip print pattern could be associated with any particular sagittal skeletal jaw relation. CLINICAL SIGNIFICANCE: Lips prints and craniofacial skeleton develop at the same embryonic period. Developmental factors that cause malocclusions might also reflect in the lip print patterns. HOW TO CITE THIS ARTICLE: Allani S, Setty JV, Srinivasan I, et al. Determination of Relationship between Lip Prints and Skeletal Malocclusion in Children of Age 9-14 Years. Int J Clin Pediatr Dent 2019;12(6):494-499.

A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6-11-year-old children during local anesthesia administration-a novel approach.

BACKGROUND: The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6-11-year-old children during local anesthesia administration. METHODS: The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6-8 years while group 2 consisted of 15 children aged 9-11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. RESULTS: The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. CONCLUSIONS: The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

Knowledge and Awareness of Primary Teeth and Their Importance among Parents in Bengaluru City, India.

INTRODUCTION: Often people responsible for the oral care of children feel or believe that since primary teeth will eventually shed, it is not worthwhile to spend time/money on providing good oral health to children. Parents are the ones who take care of their children and make decisions for them. Hence, they should have knowledge about primary teeth, their health and caring in order to build confidence in their children through tiny teeth. AIM: To assess the knowledge of primary teeth and their importance among parents with children below 12 years. MATERIALS AND METHODS: A total of 1,000 questionnaires containing questions written both in English and in the local language (Kannada) were prepared for data collection and were personally distributed to parents visiting dental clinics for their children's dental treatment. STATISTICAL ANALYSIS: Both descriptive statistics and Chi-square test were used. RESULTS: Complaints related to dental caries constituted 82% of children visiting dental clinics among children in Bengaluru city. Only 39% of respondents were aware of all functions of primary teeth. CONCLUSION: The present study revealed that the parents of Bengaluru city had superficial or partial knowledge of primary teeth and that there is a need to improve this awareness. How to cite this article: Setty JV, Srinivasan I. Knowledge and Awareness of Primary Teeth and Their Importance among Parents in Bengaluru City, India. Int J Clin Pediatr Dent 2016;9(1):56-61.

Comparative clinical evaluation of transcutaneous electrical nerve stimulator over conventional local anesthesia in children seeking dental procedures: A clinical study.

AIM: The aim of this study to evaluate the effectiveness of pain control by employing transcutaneous electrical nerve stimulator (TENS) over conventional injectable local anesthesia for children requiring restorative procedures under rubber dam. MATERIALS AND METHODS: The study design considered was the split mouth design, in experiment (right) side, dental procedures under rubber dam was performed under TENS and in control (left) side, dental procedures under rubber dam was performed under conventional injectable local anesthetic (LA). The level of comfort and discomfort experienced during TENS and conventional LA was determined using visual analog scale (VAS) and heart rate. RESULT: Increase in mean heart rate associated with TENS (0.78%) was significantly less compared to increase in heart rate with administration of conventional local anesthesia (11.78%). In VAS, the mean values for pain indicate that minimum pain was felt with TENS, which was closely followed by LA. CONCLUSION: TENS can offer many safer and psychological advantages and is a valuable alternative to conventional LA for children.

Autism Disorder (AD): An Updated Review for Paediatric Dentists.

Over the past two decades, there has been an explosion of interest in Autism Disorder (AD). Knowledge and awareness on the condition has grown exponentially at all levels among the general public, parents, health professionals, the research community and more recently, at parliamentary level. The world has begun to recognize the scope of this problem and act internationally and locally to improve the lives of the growing number of individuals and families affected by this devastating disorder. This article reviews the dental literature since 1969 and it summarizes characteristics of patients with AD, oral health status and dental management of patients with AD.

Management of symphysis fracture in a 3-year-old child with prefabricated acrylic splint and circum-mandibular wiring.

Pediatric mandibular fractures are often the sequelae of facial skeletal injuries in patients with trauma and frequently require hospitalization. Due to the retrusive mid-face position relative to the calvarial prominence, facial fractures are rare in children younger than 5 years of age. Although rare, they most often occur as a result of motor vehicle accidents. The purpose of this report is to describe the management of a mandibular symphysis fracture in a 3-year-old boy with displacement between the primary mandibular left central and lateral incisors. The fracture was reduced and the fractured segment was stabilized under general anesthesia with a prefabricated acrylic splint with circum-mandibular wiring. Children have greater osteogenic potential and faster healing rates than adults; therefore, anatomic reduction in children is best accomplished earlier.

Miniplate for osteosynthesis in a 9-year-old with symphysis fracture: clinical report.

Osteosynthesis using minimum material in pediatric mandibular fractures is the key, due to the limited space available in the mandible, especially in the mental foramen and apical region. There is an important role of open reduction and rigid internal fixation in re-establishing facial height, width and projection. During the early years of growth and development, there is a high osteogenic potential of the bones. The thick periosteum allows for rapid consolidation and remodeling at the site of fracture. Primary teeth have short, bulbous crowns which compromise stable maxillomandibular fixation during fracture reduction and stabilization using traditional methods. Further, stability of the fractured segments may be hampered because of the displaced or mobile permanent anterior teeth in the mixed dentition along the line of fracture. This clinical report outlines the use of miniplate with monocortical screws in a 9-year-old boy with symphysis fracture. How to cite this article: Srinivasan I, Kumar N, Jaganathan U, Bhandari A. Miniplate for Osteosynthesis in a 9-Year-Old with Symphysis Fracture: Clinical Report. Int J Clin Pediatr Dent 2013;6(3):213-216.

Bilateral three-rooted primary lower molars.

The dental literature contains a small number of reports of primary multi-rooted anomalies. Among these reports the majority are regarding three-rooted primary mandibular second molar anomalies. The presence of bilateral three-rooted primary mandibular first and second molars is uncommon. There have been no reports of three-rooted primary molars from India. Here, we present a case of an 8-year-old boy with bilateral three-rooted primary mandibular first and second molars.