Iontophoresis-Infused Deep Topical Anesthesia and Injectable Local Anesthesia for Dental Procedures Among Pediatric Patients: Performances and Consequences.

INTRODUCTION: Exploring routes of needle-free anesthesia has drawn particular attention to the iontophoretic technique. Iontophoresis has a wide range of applications in dentistry, treating hypersensitivity, oral ulcers, non-invasive procedures of deep topical anesthesia, etc. Hence, this research was performed for a comparative assessment of topical anesthesia spray infused via iontophoresis and local anesthesia (LA) infiltration for dental procedures among 5-12-year-old patients. MATERIALS AND METHODS: A split-mouth, randomized clinical trial was undertaken over two years among study subjects aged 5 to 12 years. They were randomly assigned to one of two groups: the first (Group A - iontophoresis group) received topical anesthesia spray (Lidayn®; Pyrax Polymers, Roorkee, India) applied by iontophoresis, and the second (Group B - LA infiltration group) received local infiltration of 2% lignocaine solution (LignoTer®; Lusture Pharma, Ahmedabad, India), where primary teeth extraction or pulpectomy was performed. The Wong-Baker Facial Pain Rating Scale (WBFPRS) was used for a subjective assessment immediately following anesthesia. RESULTS: The mean value of current intensity for the extraction procedure was 9.43±0.95 mA, and the duration of application was 1.85±0.80 minutes. The mean value of current intensity for pulpectomy was 9.07±1.34 mA, and the time was 2.40±0.74 minutes. In inter-group comparison, WBFPRS scores were lower in Group A (1.96±1.64) compared to Group B (3.62±1.11), which was statistically significant with p=0.001. CONCLUSION: Compared to local infiltration, iontophoresis as a non-invasive approach for topical anesthesia was more well-received by pediatric patients.

Comparative evaluation of zinc oxide-eugenol and zinc oxide with Neem oil in root canal treatment of primary teeth: Split-mouth study with 12 months follow-up.

Background: Various root canal filling materials are used to preserve pulp tissue involved carious the primary tooth. A single material that fulfills all the requirements of an ideal root canal filling material for primary teeth is yet unavailable. Hence, this study was initiated to evaluate clinically and radiographically, the efficacy of two obturating materials - zinc oxide eugenol (ZOE) and zinc oxide mixed with Neem oil (ZON) for 12 months. Aims: To assess the success rate of a mixture of zinc oxide and neem oil in comparison to zinc oxide-eugenol paste, as an obturating material in primary molars. To compare the efficacy of ZON as an obturating material at the various time interval of 3, 6, 9, and 12 months postoperatively. Materials and methods: This split-mouth, double-blind study was performed on 24 children aged 5-7 years, who presented with bilaterally infected primary molars. Total 48 infected primary molars were divided into two groups for pulpectomy followed by obturation with ZOE and ZON, respectively. Randomization with the chit-pick method, for the control and experimental drug, was performed. A follow-up for 12 months was performed. The Chi-square test was used for inter-group comparison and the Z test was used for the analysis of data over a period of time. Results: Overall clinical findings in this study revealed 91.7% results in ZOE compared with 100% results in the ZON group. The radiographical findings revealed 91.7% results in ZOE compared with 100% success in the ZON group. Conclusion: ZON demonstrated excellent effectiveness as an obturating material in the 12-month follow-up period as compared to ZOE in primary teeth. The efficacy elicited in this study could be a basis to recommend ZON as herbal alternative obturation material.

Hookah addiction among adolescents of five major cities in Central India.

INTRODUCTION: Hookah use among the Indian adolescents is on the rise without them being aware of its tobacco content. This prevalence study highlights the issues associated with hookah use among high school students of five cities of Central India. METHODS: A study among 3500 students of high schools was undertaken to estimate the prevalence of hookah users and its associated factors including initiation/cessation, patterns, perceptions and behavior. Responses were received from 225 hookah users. RESULTS: The prevalence of hookah users in the present study was found to be 6.4% (225). Most of the subjects first learned about hookah use from friends (64.5%) and smoked hookah in hookah lounges (90.7%). Generally, the adolescents were aware of various lounges in their locality. CONCLUSION: This study suggests that the use of hookahs is attracting adolescents at a very early age and is attributed to the presence of hookah lounges in various cities of Central India. Hence, the legality of hookah lounges in India should be reconsidered.

Dentition Status, Treatment Needs and Risk Predictors for Dental Caries among Institutionalised Disabled Individuals in Central India.

INTRODUCTION: Children and adolescents with disabilities appear to have poorer oral health than their non-disabled counterparts. Individuals with disabilities or illnesses receive less oral care than the normal population. OBJECTIVE: To determine the dentition status, treatment needs and risk predictors for dental caries of the institutionalized disabled individuals. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted with pre-tested questionnaire among 330 institutionalised disabled individuals in the age range from 3 to 22 years. The Dentition status and treatment needs were assessed by using WHO Oral health Proforma 1997. ANOVA test, chi-square test and backward conditional logistic regression analysis were performed. RESULTS: The mean DMFT for all the groups was 1.26 and the mean deft was 0.59. Backward conditional logistic regression revealed that only age categories and disability types were significantly associated with dental caries. Individuals who were mentally retarded (OR=1.36) and in the age group of 13-17 y (OR=1.91) were more likely to develop dental caries. CONCLUSION: The findings of the present study showed that overall caries experience was low but the treatment need was high among these institutionalized disabled individuals.

Management of sublingual ulceration in a 12-month-old child.

The case of sublingual ulceration associated with erupted primary mandibular incisors in a 1-year-old child is presented. Sublingual ulceration is termed as Riga-Fede disease if the patient is less than 2 years old. Generally, the treatment methods for Riga-Fede's disease are discing and extraction of the traumatised teeth. Here, the child was treated with photo-polymerised composite resin coverage of the incisal edges of erupted mandibular incisors. The photo-polymerised resin coverage proved to help in the rapid healing of the ulcerations.

Management of an infant having natal teeth.

Eruption of teeth at or immediately after birth is a relatively rare phenomenon. These teeth are known as 'natal' teeth if present at birth and 'neonatal' teeth if they erupt during the first 30 days of life. Natal teeth might resemble normal primary dentition in size and shape; however, the teeth are often smaller, conical and yellowish and have hypoplastic enamel and dentin with poor or absent root formation. Complications include difficulty and discomfort during suckling, sublingual ulceration, laceration of the mother's breasts and aspiration of the teeth. These situations would warrant extraction. If the tooth does not interfere with breast feeding and is otherwise asymptomatic, no treatment is necessary. Negative cultural attitudes towards natal teeth demand good parental counselling and vigilant management in relation to child protection. Both general practice dentists and paediatric dental specialists may be involved in the supervision or treatment of patients with natal and neonatal teeth.

Taurodontism in deciduous molars.

Taurodont teeth are characterised by large pulp chambers at the expense of roots. An enlarged pulp chamber, apical displacement of the pulpal floor and no constriction at the level of the cement-enamel junction are the characteristic features of taurodont tooth. It appears more frequently as an isolated anomaly but its association with syndromes and other abnormalities have also been reported. Permanent dentition is more commonly affected than deciduous dentition. This paper presents a case report of taurodontism in relation to mandibular deciduous second molars.

Management of unusual case of Crocker and Hartzell's disease in a young patient with a 1 year follow-up.

Soft tissue enlargements of the oral cavity often present a diagnostic challenge because a diverse group of pathological processes can produce such lesions. Crocker and Hartzell's disease is one of the most common entities responsible for causing soft tissue enlargements. It is a relatively common benign mucocutaneous lesion. Crocker and Hartzell's disease has been referred to by other names such as pregnancy tumour, pyogenic granuloma, granuloma pediculatum benignum, benign vascular tumour and vascular epulis. The incidence is 26.8-32% of all reactive lesions. It is seen mostly in second or third decade of life and commonly seen in women. The most frequently involved site is the maxillary gingiva; other sites are lip, tongue, buccal mucosa and palate. This paper presents a rare case of Crocker and Hartzell's disease found on mandibular anterior gingiva of an 8-year-old male patient.