Nanosilver fluoride as a caries arresting agent in children: A systematic review and meta- analysis.

Background: Dental caries is one of the most common concerns in oral health of children. Arresting these lesions is a treatment which is gaining momentum as against conventional restorative approaches. Aim: The aim is to evaluate the efficacy of nanosilver fluoride (NSF) as a caries arresting agent in primary teeth or first permanent molars in children. Design: The protocol for the systematic review has been registered with PROSPERO database (CRD42020162386). Several databases, such as PubMed®/MEDLINE, Web of Science™, Scopus®, Google Scholar, LILACS, Cochrane Library, ProQuest, and BBO, were searched for randomized controlled trials (RCTs) which evaluated the arrestment of caries, in primary teeth and first permanent molars in children, with a minimum follow-up of 6 months. The Risk of Bias tool by Cochrane reviews system software, Revman 5.4.1, was used for quality assessment of the included RCTs. The quality evaluation was done using the GRADE approach. Heterogeneity was assessed using Cochrane's Q and I2 statistics. Results: Five studies were included for qualitative and quantitative analysis. The Risk Ratio for NSF versus active control group was assessed to be 1.09 (0.93-1.28) with 95% Confidence Interval and for placebo control was 0.49 (0.35-0.67). Conclusion: NSF shows promise as a caries arrestment agent when applied in primary teeth. PROSPERO Registration: This review was registered with the PROSPERO database (CRD42020162386).

Management of internal and external root resorption in primary teeth of a 3-year-old with myelomeningocele: A case report.

BACKGROUND: Myelomeningocele (MMC) is a severe manifestation of spina bifida. Children with MMC have motor disability, hydrocephalus, skeletal abnormalities, and mental retardation. These individuals are more susceptible to caries due to poor oral hygiene, carbohydrate-rich diet, prolonged use of sugar-containing medications and limited motor abilities. Latex allergy is an important factor to be considered during the dental rehabilitation of such patients. CASE REPORT: A 3-year-old girl visited the dental clinic with the chief complaint of multiple carious teeth and H/o neural tube defect (NTD) which had been operated on at the age of 6 weeks. On dental examination, multiple dental abscesses and severe early childhood caries were noted. Radiographic evaluation revealed internal root resorption of tooth "K" and external root resorption of tooth "T." The two teeth were treated with ledermix paste followed by obturation with Vitapex® (Diadent Group International Inc., Burnaby, BC, Canada) along with triple antibiotic paste and placement of stainless steel crown (SSC). A latex-free environment was maintained during the entire treatment to prevent allergic reaction. A follow up after 42 months indicated clinical and radiographical success. CONCLUSION: The paper reports succesfull management of internal and external root resorption as well as latex allergy in a dental operatory. The dental perspective while dealing with patients having NTD is limited. Explaining the particulars of the treatment plan will aid in management of such cases .

Dental Caries and Dental Anomalies in Children Undergoing Chemotherapy for Malignant Diseases.

Purpose: The study aims to evaluate the prevalence of dental caries and anomalies in pediatric patients undergoing chemotherapy or those who have completed chemotherapy. Methods: A total of 250 pediatric patients within the age group of 6 months to 17 years, either admitted to hospitals for chemotherapy or on follow-up, were included as a part of the study. Complete oral examination inclusive of the diet history, oral hygiene methods, past dental history, the decayed, missing, and filled teeth (DMFT), def score, and any dental anomaly was diagnosed clinically and radiographically using an orthopantomogram. The samples were further categorized under type of malignancies and duration of chemotherapeutic drug usage groups (from 6 months to 10 years and more than 10 years) to establish a correlation of these variables with the prevalence of dental caries and dental anomalies. Results: Among all patients, 108 (43.2%) had completed the treatment (chemotherapy), while 142 (56.8%) were undergoing the treatment. Forty-three (17.2%) patients showed positive findings for dental anomalies. Conclusion: The present study confirms the strong positive correlation between long-term exposure to chemotherapeutic agents and the prevalence of dental anomalies and dental caries in children. How to cite this article: Talekar AL, Musale PK, Kothare SS. Dental Caries and Dental Anomalies in Children Undergoing Chemotherapy for Malignant Diseases. Int J Clin Pediatr Dent 2022;15(4):428-432.

An 18-Month Prospective Randomized Clinical Trial Comparing Zirconia Crowns with Glass-reinforced Fiber Composite Crowns in Primary Molar Teeth.

Purpose: The purpose of this clinical trial was to assess the clinical performance of primary molar zirconia crowns with a glass fiber-reinforced composite crown (GFRC) in primary molar teeth. Methods: This trial was designed as a prospective, randomized, bilateral split-mouth study. A total of 66 crowns were placed in 30 children, ages four to nine years, from October 2018 until January 2019. Assessment of the clinical performance was done at one week and at three, six, 12, and 18 months. Several criteria, such as color match, time taken for the clinical procedure, resistance to dislodgement prior to cementation, crown retention, occlusal wear, staining, gingival health, plaque retention, and parental satisfaction, were evaluated. Result: At 18 months, 58 crowns were analyzed: 30 ZR crowns and 28 GFRC crowns. There was a statistically significant difference (P<0.05) between staining, occlusal wear, gingival health, plaque retention, and parental satisfaction between groups at 18 months, with the zirconia crowns outperforming the GFRC crowns in all those categories. The only areas where GFRC crowns performed better than ZR crowns were the time required to place them and the resistance to dislodgement before cementation. Conclusion: This study demonstrated that primary molar zirconia crowns had highly acceptable and significantly better clinical performance than glass fiber-reinforced composite crowns after 18 months.

Ex Vivo Assessment of Natural Teeth Wear against Zirconia and Novel Glass-Fiber-Reinforced Composite Crowns in Primary Teeth by a Three-Dimensional Assessment Method.

OBJECTIVES: The main purpose of the study was to assess the material wear, antagonistic natural primary teeth wear, and microhardness of zirconia (ZR), a recently launched novel glass-fiber-reinforced composite crown (GFRC). The research question was, are these aesthetic crowns resulting in antagonistic natural primary tooth wear and the crown material itself? METHODS: Forty-five primary canines were divided into three groups (15 per group) and mounted against Zr (Group A), GFRC (Group B), and natural teeth as control (Group C) in the wear test machine. All samples were assessed for surface wear with pre- and post-3-dimensional scanning. In addition, microhardness was assessed for all three groups. RESULTS: The mean microhardness value for the Zr disc was 1157 ± 7 HV; for the GFRC disc, it was 29.35 ± 2 HV; while with natural teeth, it was 105 ± 4 HV. There was a statistically significant difference in teeth wear in the prescan and postscan in the natural tooth (p < 0.05) group, highly significant difference (p < 0.001) in the ZR group, and no significant difference in the GFRC group. CONCLUSION: There is more significant wear loss of glass-fiber-reinforced composite discs as compared to zirconia. In addition, the wear of the antagonistic tooth with zirconia and natural teeth is more remarkable than with GFRC. There is a vast difference of microhardness between natural teeth and zirconia (almost 10 times higher) which suggests further scope of study. Clinical Relevance. Pediatric dentistry deals with the transition of dentition from primary to permanent through mixed dentition. Selection of restorative material needs to be done cautiously when we are dealing with primary teeth and young permanent teeth as antagonistic teeth. Wear of the crown material itself and opposing natural teeth are essential factors that should be considered in selecting crowns in clinical practice. The present study results can be extrapolated to clinical practice, and the practitioner can consider various factors in selecting full-coverage crowns for primary teeth. The vast difference in aesthetic crowns and natural teeth microhardness indicates a further need for research. Additionally, there is no literature published for the recently launched GFRCs.

Oral Health-related Quality of Life in HIV: A Systematic Review.

AIM: To systematically evaluate the literature evidence related to oral health and quality of life (QoL) among HIV-positive adults. BACKGROUND: The oral health-related quality of life (OHRQoL) is an essential entity to be measured for understanding the domains affected due to oral health problems. HIV comes with an array of complexities in the oral cavity and is also reflection of the systemic illness of the oral cavity. Hence, it is essential to know the area affected and also the lesions that contribute the most to decrease the QoL in this aspect. A systematic review was carried out in relation to studies across PubMed and Google Scholar regarding HIV and OHRQoL from January 1970 to May 2019. Of the 1,374 articles screened, 11 studies were filtered for the final review. REVIEW RESULTS: The physical domain followed by the psychological domain is the most affected in the HIV-positive patients. The maximum effect is due to dental caries and periodontitis. No studies report about oral substance abuse and its effect. CONCLUSION: Studies are further needed on a larger sample size and on similar scales and parameters to ensure greater evidence for intervention related to areas that should be focused upon for improving the QoL of HIV-positive patients. CLINICAL SIGNIFICANCE: There is a greater need to include quality-based assessment while treating HIV-positive people. Also not just physical indicators like pain or dental caries, even social indicators like mental and social dimensions of a patient's life should be included while deciding the treatment approach.