Comparative Evaluation of Nano Inorganic Metal Oxides as Intracanal Medicaments for Cytotoxicity and Antimicrobial Activity in the Root Canal System.

Aim and objective: To evaluate and compare the cytotoxicity and antimicrobial activity of various inorganic metal oxide nanoparticles along with vehicles when used as intracanal medicaments in the root canal system. Materials and methods: The study included triplicates (n = 36 times) that were subjected to n calcium oxide (CaO), n zinc oxide (ZnO), n magnesium oxide (MgO), and metapaste as intracanal medicaments. The efficacy of novel intracanal medicaments was evaluated for biocompatibility assay using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) reagent following antimicrobial efficacy against Enterococcus faecalis (E. faecalis) was evaluated using zone of inhibition (ZOI) and minimum inhibitory concentration (MIC). The statistical analysis Kruskal-Wallis test, student t-test, and analysis of variance (ANOVA) using Statistical Package for the Social Sciences (SPSS) software (v.20.0). Results: The order of proliferative activity of experimental groups on L929 mouse fibroblast cells using MTT assay was: metapaste > nCaO > nMgO > nZnO). After evaluation of antimicrobial efficacy, group I: nCaO showed maximum ZOI and MIC against E. faecalis, which showed high statistically significant differences between all four groups after ANOVA (p < 0.0001*). Conclusion: n calcium oxide (CaO) mixed with propylene glycol (PPG) 400 has a potential role as an intracanal medicament with minimum cytotoxic effect and maximum antimicrobial activity against endodontic pathogens. Clinical significance: Nanoparticles-based intracanal medicament can provide a promising future in reducing endodontic flareups when used as intracanal medicament. How to cite this article: Barge P, Gugawad S, Devendrappa SN, et al. Comparative Evaluation of Nano Inorganic Metal Oxides as Intracanal Medicaments for Cytotoxicity and Antimicrobial Activity in the Root Canal System. Int J Clin Pediatr Dent 2023;16(S-2):S168-S175.

Comparative Evaluation of the Microleakage and Shear Bond Strength of Three Filled Pit and Fissure Sealants Using Subpressure and Adhesive System: An Experimental Analysis.

Introduction: Pit and fissure caries account for about 90% of caries in children and adolescents. Sealant application may be a preventive conservative approach. But it's still challenging to bolster the retention of the filled sealant and to chop back the microleakage. Aim: Aim is to evaluate and compare the microleakage and shear bond strength (SBS) of three filled pit and fissure sealants (PFS) using a subpressure and adhesive system: an experimental analysis. Materials and methods: A total of 90 orthodontically extracted premolars were prepared for microleakage and SBS and divided according to materials and subgroups. Group I: resin-based filled PFS, group II: resin-modified glass ionomer-based filled PFS, and group III: giomer-based filled PFS. Subgroup 1: only sealant application, subgroup 2: subpressure application, and subgroup 3: adhesive system + subpressure application. Samples were subjected to thermocycling. Microleakage was assessed with a dye penetration method under a stereomicroscope, and SBS was assessed with a universal testing machine. Statistical analysis and results: Unpaired t-test and one-way analysis of variance (ANOVA) test were used for analysis. Significant when p < 0.05. The SBS showed significant results for subpressure application and giomer-based filled PFS with p < 0.05. The microleakages score differed significantly for the subpressure application group with p < 0.05. Giomer-based filled PFS showed the least microleakage score. Conclusion: This study concluded that giomer-based filled PFS showed statistically significant results. The subpressure technique significantly reduces microleakage and increases SBS. How to cite this article: Waghmode SK, Devendrappa SN, Hadakar SG, et al. Comparative Evaluation of the Microleakage and Shear Bond Strength of Three Filled Pit and Fissure Sealants Using Subpressure and Adhesive System: An Experimental Analysis. Int J Clin Pediatr Dent 2023;16(S-1):S97-S100.

Effect of non-thermal atmospheric pressure plasma and ErCr:YSGG LASER activation of three fluoride varnishes on surface re-mineralization of enamel: A SEM-EDX analysis.

Background: Dental remineralization is the process of transporting minerals from the surrounding environment (i.e., saliva and biofilm) into partially demineralized tooth structures. Remineralization can be induced by professional therapies such as fluoride-based treatments that have the highest level of supporting evidence. High-intensity LASER and nonthermal atmospheric pressure plasma therapy have been known to increase the resistance of enamel to demineralization by surface modification. Aim: The aim of the study was to evaluate and compare the surface remineralization of enamel using ErCr:YSGG LASER and nonthermal atmospheric pressure plasma (NTP) activation with three different fluoride varnishes. Methodology: Sixty-eight extracted premolars were used which were sectioned mesiodistally to obtain 135 specimens and artificial caries were induced on the experimental surface. They were then randomly divided into three groups (n = 45): MI Varnish (GC Japan), Vanish Varnish (3M ESPE), and Embrace Varnish (Pulpdent). After varnish application, these groups were further divided into three subgroups based on the activation therapy used. Fifteen samples from each group were treated with ErCr:YSGG LASER, 15 samples with NTP, and 15 samples were the control that did not undergo activation. After 9 days of pH cycling, the mean ion concentration of the surface calcium and phosphate ions was recorded using FEG-SEM and EDX analysis. The data were statistically analyzed. Results: One-way ANOVA and post hoc Tukey test accepting P < 0.05 were performed for comparisons between all analyses groups. Vanish Varnish showed a higher Ca/P ratio in LASER, NTP, and control subgroups, followed by MI Varnish and Embrace Varnish. ErCr:YSGG LASER therapy showed an improved Ca/P ratio in all varnishes than NTP therapy and control. Conclusion: ErCr:YSGG LASER therapy showed positive effects toward improving the Ca/P, followed by NTP therapy as compared to control in all three varnishes indicating their role in enhancing the effects of remineralization. Vanish Varnish showed a higher Ca/P ratio indicating better remineralization post activation.

Sturge-Weber Syndrome: Roots to a Cure a Nightmare in Pediatric Dentistry.

AIM AND OBJECTIVE: This article aims to report a case of Sturge-Weber syndrome (SWS) in a pediatric patient and its systematic dental management to add to the existing literature. BACKGROUND: Sturge-Weber syndrome is one of the vascular disorders, known for its stupendous scope of clinical manifestations and life-threatening complications. The substantial prevalence of oral manifestations in SWS makes it crucial to have a comprehensive knowledge of this rare congenital disorder. CASE DESCRIPTION: This case report represents a case of SWS in an 11-year-old boy with oral, ocular, and neurological features who reported due to pain, unilateral gingival enlargement associated with spontaneous bleeding in the mandibular left region. A multidisciplinary team approach having comprehensive knowledge regarding such rare congenital disorder is a must to prevent its life-threatening complications. CONCLUSION: Sturge-Weber syndrome often affects the oral cavity through vascular lesions. Hence, deep knowledge is immensely important to provide an appropriate dental treatment without complications. CLINICAL SIGNIFICANCE: Port-wine stains should not be considered as just birthmarks and should be further investigated for its systemic involvement to arrive at a confirmatory diagnosis and treated accordingly with special precautions. HOW TO CITE THIS ARTICLE: Mapara PN, Taur SM, Hadakar SG, et al. Sturge-Weber Syndrome: Roots to a Cure a Nightmare in Pediatric Dentistry. Int J Clin Pediatr Dent 2021;14(1):145-148.

Comparative evaluation of antibacterial efficacy different bioactive smart composites: An in vitro study.

BACKGROUND: Composites are the widely used restorative materials, and over the year, newer restorative composites have been introduced to eliminate the drawbacks of previous ones. The recent advance in restorative dentistry is bioactive restorative materials. However, bacterial plaque formation on these restorations is the primary reason for secondary caries. AIMS AND OBJECTIVES: The purpose of this study was to do the comparative evaluation of bioactive restorative composites (Beautifil Flow Plus, Activa BioACTIVE, and Filtek Z250 XT as control) for their antibacterial efficacy under in vitro conditions. MATERIALS AND METHOD: Thirty material blocks were used for this evaluation. Antibacterial efficacy was checked against Streptococcus mutans and observed under confocal laser scanning microscopy. RESULTS: The results showed that Activa BioACTIVE shows maximum number of dead bacteria on the material surface compared to other groups. CONCLUSION: It can be concluded as it has maximum antibacterial efficacy among tested materials.

Comparative evaluation of calcium release of the apical plugs formed by mineral trioxide aggregate, Biodentine, and EndoSequence root repair material with and without 2% triple antibiotic powder: An in vitro study.

BACKGROUND: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. AIM: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. METHODS: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. RESULTS: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. CONCLUSION: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.

A simple novel technique for the management of a dentoalveolar fracture in a pediatric patient using a vacuum-formed splint.

This paper reports a novel, minimally invasive, simple technique for the treatment of a displaced dentoalveolar fracture using a vacuum-formed splint in a 12-year-old pediatric patient. Vacuum formed splints have been reliable treatment options with limited morbidity and discomfort compared to other traditionally used procedures.

Evaluation of Change in Microhardness by Application of MI Varnish on Primary Tooth Enamel, Affected by Use of Frequently Prescribed Paediatric Syrups: An In Vitro Study.

Introduction Dental erosion is considered as an irreversible progressive loss of tooth structure due to chemical dissolution by acids not of bacterial origin. Frequent intake of syrups can be an effective factor in tooth erosion when prescribed for illnesses. In the acidic environment, MI Varnish releases calcium, phosphate and fluoride from the covering layer and the teeth can be prevented from such acidic attacks from the erosive content of the syrups. Aim  To evaluate change in microhardness by application of MI Varnish on primary tooth enamel, affected by use of frequently prescribed paediatric syrups. Method  The effects of three paediatric syrups (Ibugesic Plus, Novamox, Becozinc H) and distilled water (control group) with different ingredients on primary tooth enamel were evaluated. Immersion cycles were applied three times a day for one minute. The measurements of the samples prepared were taken on 0 (baseline), third, fifthand seventh day. Microhardness was measured using a Vickers hardness tester. Then, those samples were coated with MI Varnish, and changes in microhardness were evaluated using the Vickers hardness tester after one week (14th day). The pH, titratable acidity and buffer capacity of the syrups were also evaluated. Results  There was a significant decrease in microhardness in all the syrups (p < 0.001) on days 3, 5, 7 and 14. Novamox syrup and distilled water (control group) were the least erosive on the primary tooth enamel and Becozinc H syrup being the most erosive on primary tooth enamel was seen. MI Varnish remineralized the enamel but not with any significant difference. Conclusion  In our findings, Novamox syrup showed the least erosion on primary tooth enamel compare to other syrups. Enamel microhardness was significantly reduced on all days after immersion in all syrups. Application of MI Varnish to enamel resisted erosion but was not significant. Paedodontists should be aware of the erosive potential of all the frequently prescribed syrups and stress on compliance with oral hygiene measures and application of varnishes releasing fluoride, calcium and phosphate on the tooth.

Management of Multiple Mandibular Fractures in a Child with Osteogenesis Imperfecta Using Arch Bar Retained Thermoformed Splints: A Novel Technique.

Osteogenesis Imperfecta (OI) is a heterogeneous group of autosomal dominant and recessive inherited disorders of type I collagen metabolism. Clinical features of OI include multiple bone fractures, muscle weakness, joint laxity, skeletal deformities, blue sclerae, hearing loss, and dentinogenesis imperfecta. This report presents a challenging case of multiple mandibular fractures in a five years old child with OI, which was successfully treated with a new, minimally invasive technique of closed reduction with arch bar retained thermoformed splint.

Implementation of Oral Health Education to Orphan Children.

OBJECTIVE: To determine the knowledge and oral hygiene status of orphanage children in Pune and changes in them after health education. STUDY DESIGN: Interventional study. PLACE AND DURATION OF STUDY: Centers for Orphan Children in Pune, India, from April to June 2014. METHODOLOGY: A specially designed questionnaire was used to assess the dental problems and existing oral hygiene maintenance practice among children between 5 - 12 years of age (n=100) in an orphanage center. Pre- and postinterventional intra-oral examination was carried out to check their oral hygiene status which included DMFS [Decayed Missing Filled Tooth Surfaces index (for permanent teeth)], OHIS (Simplified Oral Hygiene Index) and gingival indices. Intervention was in the form of oral health education, demonstration of correct brushing technique, diet counselling and maintenance of overall oral hygiene. RESULTS: Present study shows that the orphans had multiple dental problems along with improper oral hygiene practices and careless attitude towards oral health. Pre- and post-interventional DMFS was compared using Wilcoxon sign rank test, which was not significant; while OHIS and gingival indices were compared by using repeat measures ANOVA(p < 0.001) which was significant for each, respectively. CONCLUSION: There was considerable improvement in the oral hygiene status of orphans due to educational intervention. Oral health education at right age can help to cultivate healthy oral hygiene practices in orphans which will benefit them for lifelong. Caretakers should be educated and trained about oral hygiene practices so that they can implement it and supervise the orphan children.

Attitude of general dental practitioners toward root canal treatment procedures in India.

OBJECTIVE: The percentage of general dental practitioners is very common in India, so the purpose of this study was to assess attitude of general dental practitioners toward root canal treatment (RCT) procedures. MATERIALS AND METHODS: In a cross-sectional study, 178 dentists (96 males and 82 females) were surveyed using a selfadministered, structured questionnaire pretested through a pilot survey. The questionnaire collected information regarding RCT procedures among participants. Data were analyzed using SPSS version 15. Frequency and percentage distributions were calculated. RESULTS: In the present study most of the participants, i.e. 86.4% reported that they perform (RCT) procedures in posterior teeth. Isolation is mainly done with cotton rolls only (74.6%) and very few are using rubber dam in their practice (3.2%). Radiographs were not taken after every step in most of the cases. Rotary instruments were used in less number of cases and K-files were the most popular instruments (66.2%). Also single sitting RCT was not commonly seen. CLINICAL SIGNIFICANCE: This study indicates that most of the general dental practitioners' do not comply with quality standards guidelines such as use of rubber dam as isolation. So dentist should update their knowledge and practices with current techniques and materials through CDE programs.

Comparison of Antibacterial Efficacy of Calcium Hydroxide Paste, 2% Chlorhexidine Gel and Turmeric Extract as an Intracanal Medicament and their Effect on Microhardness of Root Dentin: An in vitro Study.

AIM: To evaluate and compare the antibacterial efficacy of turmeric extract as an intracanal medicament against E. faecalis and its effect on the microhardness of root dentin in comparison with calcium hydroxide and 2% chlorhexidine gel. MATERIALS AND METHODS: One hundred and fourty dentin blocks were prepared from 70 extracted human single-rooted teeth and standardized. For antibacterial assessment, 120 blocks were infected for 21 days with E. faecalis (n = 24/group). Dentin blocks were treated with group I (Ca(OH)2), group II (2% chlorhexidine gel), group III (turmeric extract), group IV (saline) and group V (negative control). Dentin shavings were obtained in TSB at depth of 400 µm and plated to count CFUs at 24 hours, 3 and 7 days (n = 8/day). For microhardness assessment, eight samples of 2 mm thickness were prepared form four dentin blocks (n = 8/group). Following treatment with medicaments, microhardness test was performed at 24 hours, 3 and 7 days using Vickers hardness indentation machine at 400 µm from canal lumen. RESULTS: Complete inhibition of E. faecalis was observed with group II, followed by 64% with group I and 54% with group III which was statistically highly significant (p < 0.001). Highest effect on microhardness of root dentin was shown by group I, followed by group II and no effect was seen with group III which was statistically highly significant (p < 0.001). CONCLUSION: Turmeric extract has substantial antibacterial activity with no effect on microhardness of root dentine and hence has a potential to be used as intracanal medicament if its antibacterial activity could be enhanced. How to cite this article: Prabhakar AR, Swapnil T, Savita H, Sugandhan S. Comparison of Antibacterial Efficacy of Calcium Hydroxide Paste, 2% Chlorhexidine Gel and Turmeric Extract as an Intracanal Medicament and their Effect on Microhardness of Root Dentin: An in vitro Study. Int J Clin Pediatr Dent 2013;6(2):171-177.