A Comparison of Antimicrobial Efficacy of Silver-based Preventive Restorations (Silver Nitrate, Silver Diamine Fluoride, and Silver Nanoparticles) against Streptococcus mutans Monospecies Biofilm Model.

Aim: The ability of the Streptococcus mutans (S. mutans) to form biofilms is not only crucial in the initiation of early childhood caries (ECC) but is also a challenge to its treatment. The current management protocols focus on remineralization and use of antimicrobial formulations which penetrate biofilms, control their formation, and decrease the incidence of caries in children. The paradigm shift toward preventive protocols and increasing antibiotic resistance rekindled the use of silver as a promising antibacterial agent. To gain further insight into the therapeutic potential, aim of the present study was to compare the antibacterial efficacy of silver-based preventive restorations [silver nitrate (AgNO3), silver diamine fluoride (SDF), and silver nanoparticles (AgNPs)] against S. mutans species. Materials and methods: Using an ex vivo monospecies biofilm model of S. mutans; the antimicrobial efficacy of three treatment groups (SDF, AgNO3, and AgNPs) was evaluated. Results: There was a significant difference between the negative control and three treatment groups (SDF, AgNO3, and AgNPs). The results showed that the mean diameter of inhibition zones obtained in biofilms treated with AgNPs was 40.3 ± 0.25 mm which was greater than both SDF (37.7 ± 0.18 mm) and AgNO3 (36.26 ± 0.18 mm). Conclusion: The study concluded that the number of viable bacteria was significantly reduced by all three medicaments (p < 0.05). However, AgNPs showed the highest antimicrobial activity in comparison to SDF and AgNO3 against S. mutans biofilm. Clinical significance: The present study thus supports that AgNPs are a promising preventive anticaries agent due to their better antibacterial activity in comparison to other silver-based preventive restorations and can be effectively used as an alternative to SDF or AgNO3 for the noninvasive treatment of ECC in the young. How to cite this article: Sharma P, Dhawan P, Rajpal SK, et al. A Comparison of Antimicrobial Efficacy of Silver-based Preventive Restorations (Silver Nitrate, Silver Diamine Fluoride, and Silver Nanoparticles) against Streptococcus mutans Monospecies Biofilm Model. Int J Clin Pediatr Dent 2023;16(S-1):S13-S19.

Evaluation and Comparison of Physical Properties of Cention N with Other Restorative Materials in Artificial Saliva: An In Vitro Study.

Objective: The objective of the study was to determine and compare flexural strength and microhardness of Cention N with Glass ionomer cement (GIC) (GC Gold Label Type IX Extra) and Zirconomer improved at a distinctive time period in artificial saliva. Materials and methods: Cention N, GC Gold Label Type IX Extra, Zirconomer improved for the fabrication of samples. To determine the physical properties such as flexural strength and microhardness, test samples (n-30) of dimensions 12 mm (length)*4 mm (breadth)*2 mm (thickness) were made and divided into three groups. Every sample was dipped for 28 days in a plastic tube containing 5 mL of artificial saliva. Statistical analysis was done using one-way ANOVA with a post hoc test, intergroup and intragroup analyses were carried out. Results: In an intergroup analysis, flexural strength and microhardness of Cention N were substantially higher than Zirconomer improved and GIC (GC Gold Label Type IX Extra), respectively. In intragroup analysis found that there was a significant decrease (p < 0.001) in the level of flexural strength as well as microhardness after samples were immersed in artificial saliva of group A (Cention N), group B (GC Gold Label Type IX Extra), and group C (Zirconomer improved) from 1st day to 28th day in artificial saliva. Conclusion: It can be concluded that Cention N had the highest flexural strength and microhardness of the three materials tested. Zirconomer improved can be used as a basic filling material in various restorative procedures due to good comparable mechanical properties and is economical for patients. How to cite this article: Adsul PS, Dhawan P, Tuli A, et al. Evaluation and Comparison of Physical Properties of Cention N with Other Restorative Materials in Artificial Saliva: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(3):350-355.

Evaluation of Effect of Silver Diamine Fluoride in Arresting Dental Caries Using International Caries Classification and Management System (ICCMS): An In Vivo Study.

Background: In terms of maintaining esthetics and function, reducing pain, and encouraging wellness, primary dentition care is just as important as permanent tooth care. The purpose of this research was to see how efficient silver diamine fluoride is at preventing tooth decay. Materials and method: The 3- month clinical experiment included a sample size of 30 children (both males and females) aged 4-8 years by applying silver diamine fluoride on the carious tooth to evaluate the efficacy of silver dimaine fluoride in arresting the caries. The children were kept on follow-up and IOPA's were taken to check the arrest of caries at baseline, 1 month and after 3 months. To assess the progression of caries radiographic interpretation of IOPA X-rays was done using ICCMS scores at baseline, 1 month and 3 months. Results and conclusion: The current study found that topical 38% silver diamine fluoride arrest tooth decay and was effective for treating dental caries in school-aged children in the short term. How to cite this article: Sharma M, Tuli A, Dhawan P, et al. Evaluation of Effect of Silver Diamine Fluoride in Arresting Dental Caries Using International Caries Classification and Management System (ICCMS): An In Vivo Study. Int J Clin Pediatr Dent 2022;15(S-2):S172-S175.

Comparative Evaluation of Antimicrobial Efficacy of Diode Laser (Continuous Mode), Diode Laser (Pulse Mode), and 5.25% of Sodium Hypochlorite in Disinfection of Root Canal: A Short Study.

Introduction: The success of endodontic treatment is achieved by the complete elimination of pulpal infection and protection from future invasion of microorganisms. Due to the complex structure of the root canal, complete eradication of microorganisms is not possible and is a major challenge for successful endodontic treatment. Therefore, microbiological studies are needed to explore the effect of various disinfection methods. Aim and objective: The aim of this study is to compare the effectiveness of root canal disinfection by using a diode laser (in pulse and continuous modes) and sodium hypochlorite by microbiological assessment. Materials and methods: Forty-five patients were selected and randomly divided into three groups. After gaining patency to the root canal the first sample from the root canal was taken using a sterile absorbent paper point and transferred to a sterile tube containing a normal saline medium. Biomechanical preparation was performed with Dentsply Protaper hand files of each corresponding group and was disinfected with group I (diode light amplification by stimulated emission of radiation (LASER) 980 nm with 3 W in continuous mode for 20 seconds), group II (diode LASER 980 nm with 3 W in pulse mode for 20 seconds), group III (irrigated with 5.25% of sodium hypochlorite for 5 minutes). Pre- and post-samples of each group were inoculated on sheep blood agar and examined for any bacterial growth. After the microbial evaluation of the total microbial count of pre- and post-samples, the data obtained were tabulated and statistically analyzed. Results: The data were evaluated and analyzed using analysis of variance (ANOVA) on Statistical Package for the Social Sciences (SPSS) software. Groups I, II, and III all three groups showed significant differences (p < 0.01) and an overall reduction in the microbial count at postbiomechanical preparation (BMP) as compared to pre-BMP with the highest being in laser in continuous mode (group I) (91.9%), followed by 5.25% sodium hypochlorite (group III) (86.5%) and LASER in pulse mode (group II) (72.0%) the least. Conclusion: The study concluded that the diode laser in continuous mode is more efficacious than the diode laser in pulse mode and 5.2% sodium hypochlorite, respectively. How to cite this article: Mishra A, Koul M, Abdullah A, et al. Comparative Evaluation of Antimicrobial Efficacy of Diode Laser (Continuous Mode), Diode Laser (Pulse Mode), and 5.25% of Sodium Hypochlorite in Disinfection of Root Canal: A Short Study. Int J Clin Pediatr Dent 2022;15(5):579-583.

Knowledge, Attitudes, and Perception of Parents toward Dental Treatment of Children during the COVID-19 Outbreak.

This study aimed to evaluate the knowledge of parents regarding the coronavirus outbreak and to assess the change in attitude and perception toward dental treatment during the coronavirus (COVID-19) pandemic. A structured questionnaire (on google format) containing 13 questions was used, and each question had 2 or 3 possible answers. The parents/guardians of children (aged 3-14 years) who were school-going were eligible to participate in this study. A total of 800 parents/guardians were interviewed on google reporting format from June to December 2020. A simple random sampling technique was used to select 800 parents/guardians of children, aged 3-14 years, studying in different schools in Chandigarh. According to the survey, a total of 86% of respondents said that they paid high attention to COVID-19 and explained it to their children; 97% reported that they emphasized the importance of hand hygiene and sanitation during the outbreak; 72% admitted that the outbreak has made them more conscious of the importance of maintaining good oral health and hygiene, to avoid visiting the dentist and 84% felt that the routine dental check-ups and appointments should be avoided during the COVID-19 outbreak; almost half of the respondents (47%) thought that the dental environment was a potential source of infection to their kids; 37% felt getting treatment at a dental setup may expose their child to risks of COVID-19; 71% said they would take their child to a dental department if he/she had a severe toothache. Approximately 46% of the respondents expressed confidence about the preventive measures taken in the dental department to ensure safe treatment for their children. In conclusion, all respondents were concerned about COVID-19 and most of them had talked about it with their children often. In addition, a considerable percentage of them showed apprehensions about the preventive measures being taken at the dental operatory and thought that the dental environment could be more dangerous than other environments. HOW TO CITE THIS ARTICLE: Sharma P, Dhawan P, Rajpal S, et al. Knowledge, Attitudes and Perception of Parents toward Dental Treatment of Children during the COVID-19 Outbreak. Int J Clin Pediatr Dent 2021;14(5):693-699.

QLF-D: A Contemporary Plaque Control Tool in Children.

BACKGROUND AND OBJECTIVES: The main causative factors for maximum periodontal diseases are dental plaque and oral biofilms. This study was done to check the impact of quantitative light-induced fluorescence-digital (QLF-D) as a motivational tool for plaque control among children from various schools situated in Dehradun district along with education using audiovisual aids. MATERIALS AND METHODS: A total sample of 800 school-going children including both males and females aged 6 to 12 years from various schools situated in Dehradun district of Uttarakhand were surveyed. A pro forma was prepared and the demographics of the students were noted. All the students were first examined for the Oral Hygiene Index-Simplified (OHI-S) and then the random division was done into two groups, group A (Q-scan) and group B (basic diagnostic aids) for examination of plaque index. RESULTS: The results of the study revealed that good OHI-S scores increased significantly from 1st visit to 3rd visit. The plaque scores for the control group, when examined with basic diagnostic aids of all three visits, were significantly good which increased subsequently from 1st visit to 3rd visit. Good plaque index score increased significantly for the test group from 1st to 3rd visit when examined with QLF-D. CONCLUSION: We found in our study that QLF technology is of paramount importance in epidemiological surveys and plays a pivotal role in evaluating masses in maintaining oral health care. HOW TO CITE THIS ARTICLE: Solanki R, Tuli A, Dhawan P, et al. QLF-D: A Contemporary Plaque Control Tool in Children. Int J Clin Pediatr Dent 2021;14(4):502-505.

Oral Health & Quality of Life in preadolescents with hearing impairment in Uttarakhand, India.

BACKGROUND: "Better teeth better health" is a guiding dictum for the 21st century that has been well adopted by WHO and emulated world over by numerous health care agencies. Hence its of paramount importance to assess the impact of oral health on the quality of life. Keeping this in mind the present study was done to gauge the impact of prevalence of dental diseases amongst 9-15 year old institutionalized hearing impaired children in districts of Uttarakhand, India. MATERIALS & METHODOLOGY: 250 hearing impaired institutionalized 9-15 year old children were examined using WHO type III clinical examination for DMFT/dmft, Traumatic dental injuries using TDI index and dentofacial anomalies using Angle's classification of malocclusion. The Hindi version of the C-OIDP questionnaire was used in this study. RESULTS: There was a high dental caries prevalence of 56% with significant male predilection. TDI index was 40.8% and the most common molar relation was class I with 90.4%. With 49.6% crowding was the most common dentofacial anomaly. Deformity of face or mouth has maximum impact on the daily life of these children. The overall oral health related quality of life was less favorable in this group. CONCLUSION: Oral health has a significant impact on daily life of these children with hearing impairment and those children having dental diseases showed unfavorable OHRQoL.

Ionic vs Manual Toothbrushes: Effect on Plaque and Oral Hygiene Status in Children.

INTRODUCTION: The foundation for healthy permanent teeth in children and teenagers is laid during the first few years of life. Toothbrushing should be presented as a habit. A wide array of toothbrushes is available in the market, which differ in size, design, length, hardness, arrangement of bristles. This present clinical study is undertaken to evaluate the effectiveness of ionic toothbrush on oral hygiene status and plaque removal. MATERIALS AND METHODS: A total of 30 children aged 6 years to 12 years were selected in this study. The children were divided into two groups, 15 children were given HyG ionic toothbrush, were instructed how to use product according to manufacturer's instructions, 15 children were assigned to use manual toothbrush, instructed to brush their teeth in usual manner. All subjects used the same commercially available dentifrice throughout the study. RESULTS: The results were evaluated at each visit day 0, day 15 and day 30 following 12-18 hours of no oral hygiene. The subjects brushed their teeth twice daily for 1 minute under supervision. The result showed that there was significant difference in all the mean values in all the parameters. It may be concluded from the present study that though the ionic toothbrush was insignificantly superior to the manual toothbrush, both the toothbrushes are clinically effective in removing plaque and improving the gingival conditions. HOW TO CITE THIS ARTICLE: Chandra S, Jain N, Garg R, et al. Ionic vs Manual Toothbrushes: Effect on Plaque and Oral Hygiene Status in Children. Int J Clin Pediatr Dent 2019;12(5):375-378.

A New Home for a Streetless Occupant: A Case Report.

This is a case report of a 14-year-old female patient in whom a premolar from a donor was used as an allotransplant to replace her missing lower premolar. The treatment results over 6 months showed successful periodontal healing and functioning of the allotransplanted tooth. The aim of this paper is to report a procedure, allotransplantation of tooth, which is followed from ages but less preferred and documented and is surrounded by variable prognosis and also highlight the use of a intentionally extracted tooth for orthodontic purpose, which otherwise goes as a waste and moreover the use of this technique can supplement the need of an implant for the time being in the young patient without compromising her alveolar bone height, functioning, and esthetics. HOW TO CITE THIS ARTICLE: Pokhriyal A, Dhawan P, Chandra S, et al. A New Home for a Streetless Occupant: A Case Report. Int J Clin Pediatr Dent 2019;12(6):587-589.

Psychometric properties of Hindi version of child oral impact on daily performances (C-OIDP) index amongst school children in North India.

AIM: To assess validity and reliability of Hindi version of Child Oral impact on daily performances (C-OIDP) index among school children in North India. MATERIAL AND METHODOLOGY: Descriptive cross sectional study was conducted amongst 250, 11-12 year old school children in primary schools of Rishikesh, Uttarakhand, India. The study was done in two phases: first phase included assessment of Psychometric and linguistic properties of hindi version of C-OIDP index which was then pilot tested on study subjects. Phase two comprised of the actual main study which included the re-assessment of Hindi C-OIDP index on the entire study population. The pilot study comprised of 40 school children while the main study was conducted on 250 school children. RESULTS: The inter-item correlation coefficient ranged from 0.1 to 0.786 while corrected item total correlation coefficient ranged from 0.176 (smiling) to 0.843 ((cleaning). The standardised Cronbach's Alpha coefficient was 0.88. Moreover, the alpha coefficients didn't increase upon deleting any of the items. Weighted kappa was 0.85 & ICC was 0.9. Children with higher scores were less satisfied with their mouth (p- 0.001) in case of concurrent validity. CONCLUSION: Hindi Child Oral Impact on Daily Performances index can be used as a valid and reliable instrument in measuring OHRQoL. of Paediatric North Indian population.

Assessment of oral health-related quality of life in 9-15 year old children with visual impairment in Uttarakhand, India.

BACKGROUND: To assess the prevalence of dental diseases among 9-15-year-old visually impaired children and find out its impact on their daily activities using the Child-Oral Impact on Daily Performance (C-OIDP) questionnaire in districts of Uttarakhand, India. MATERIALS AND METHODS: A total of 423 visually impaired institutionalized children between the age group of 9-15 years were included in the study. Stratified random sampling technique was used to obtain the study population. Dental caries was recorded using dmft for primary dentition and DMFT for permanent dentition, traumatic dental injuries were assessed using traumatic dental injury index, and dentofacial anomalies were recorded using Angle's classification of malocclusion. The Hindi braille version of C-OIDP questionnaire was used to gather information regarding oral health-related quality of life (OHRQoL). RESULTS: There was a high dental caries prevalence of 57.7% in visually impaired children. The prevalence of traumatic dental injuries was 50.6%. Crowding (61.5%) was the most commonly seen dentofacial anomaly and the most commonly perceived oral health problem was toothache. There was less favorable OHRQoL in males as compared to females. CONCLUSION: There was a high prevalence of dental diseases in this group and higher C-OIDP scores suggestive of unfavorable OHRQoL.

The doppelganger tooth: A diagnostic conundrum!

Abnormalities in tooth morphology and number are not uncommon. However, an exact clone of a normal tooth is a recondite clinical finding. Presence of supplementary teeth is mostly noticed in maxillary anterior, molar or premolar region, followed by mandibular premolar region in descending order of its site of occurrence. Supplemental tooth in mandibular anterior has a low prevalence of 0.01%. This paper reports one such rare case of nonsyndromic incisive jumeaux in mandibular anterior region during mixed dentition period.

Preclinical models of nicotinamide phosphoribosyltransferase inhibitor-mediated hematotoxicity and mitigation by co-treatment with nicotinic acid.

Nicotinamide adenine dinucleotide (NAD) is an essential co-factor in glycolysis and is a key molecule involved in maintaining cellular energy metabolism. Nicotinamide phosphoribosyltransferase (NAMPT) catalyzes the rate-limiting step of an important salvage pathway in which nicotinamide is recycled into NAD. NAMPT is up-regulated in many types of cancer and NAMPT inhibitors (NAMPTi) have potential therapeutic benefit in cancer by impairing tumor metabolism. Clinical trials with NAMPTi APO-866 and GMX-1778, however, failed to reach projected efficacious exposures due to dose-limiting thrombocytopenia. We evaluated preclinical models for thrombocytopenia that could be used in candidate drug selection and risk mitigation strategies for NAMPTi-related toxicity. Rats treated with a suite of structurally diverse and potent NAMPTi at maximum tolerated doses had decreased reticulocyte and lymphocyte counts, but no thrombocytopenia. We therefore evaluated and qualified a human colony forming unit-megakaryocyte (CFU-MK) as in vitro predictive model of NAMPTi-induced MK toxicity and thrombocytopenia. We further demonstrate that the MK toxicity is on-target based on the evidence that nicotinic acid (NA), which is converted to NAD via a NAMPT-independent pathway, can mitigate NAMPTi toxicity to human CFU-MK in vitro and was also protective for the hematotoxicity in rats in vivo. Finally, assessment of CFU-MK and human platelet bioenergetics and function show that NAMPTi was toxic to MK and not platelets, which is consistent with the clinically observed time-course of thrombocytopenia.

Retinal toxicity, in vivo and in vitro, associated with inhibition of nicotinamide phosphoribosyltransferase.

Nicotinamide phosphoribosyltransferase (NAMPT) is a pleiotropic protein with intra- and extra-cellular functions as an enzyme, cytokine, growth factor, and hormone. NAMPT is of interest for oncology, because it catalyzes the rate-limiting step in the salvage pathway to generate nicotinamide adenine dinucleotide (NAD), which is considered a universal energy- and signal-carrying molecule involved in cellular energy metabolism and many homeostatic functions. This manuscript describes NAMPT inhibitor-induced retinal toxicity that was identified in rodent safety studies. This toxicity had a rapid onset and progression and initially targeted the photoreceptor and outer nuclear layers. Using in vivo safety and efficacy rodent studies, human and mouse cell line potency data, human and rat retinal pigmented epithelial cell in vitro systems, and rat mRNA expression data of NAMPT, nicotinic acid phosphoribosyltransferase, and nicotinamide mononucleotide adenylyltransferease (NMNAT) in several tissues from rat including retina, we demonstrate that the retinal toxicity is on-target and likely human relevant. We demonstrate that this toxicity is not mitigated by coadministration of nicotinic acid (NA), which can enable NAD production through the NAMPT-independent pathway. Further, modifying the physiochemical properties of NAMPT inhibitors could not sufficiently reduce retinal exposure. Our work highlights opportunities to leverage appropriately designed efficacy studies to identify known and measurable safety findings to screen compounds more rapidly and reduce animal use. It also demonstrates that in vitro systems with the appropriate cell composition and relevant biology and toxicity endpoints can provide tools to investigate mechanism of toxicity and the human translation of nonclinical safety concerns.

Eating everything except food (PICA): A rare case report and review.

PICA is an act or habit of eating non-food items such as stone, bricks, chalk, soap, paper, soil etc., It occurs in children who actually start seeing the world through the oral cavity. There are many theories behind it such as iron and zinc deficiency etc., We as dentists should be able to diagnose and treat such conditions, as they may cause ill-effects to the developing dentition. This case report attempt to highlights the importance of proper diagnosis and treatment of pica.

Phosphorous dysregulation induced by MEK small molecule inhibitors in the rat involves blockade of FGF-23 signaling in the kidney.

MEK, a kinase downstream of Ras and Raf oncogenes, constitutes a high priority target in oncology research. MEK small molecule inhibitors cause soft tissue mineralization in rats secondary to serum inorganic phosphorus (iP) elevation, but the molecular mechanism for this toxicity remains undetermined. We performed investigative studies with structurally distinct MEK inhibitors GEN-A and PD325901 (PD-901) in Sprague-Dawley rats. Our data support a mechanism that involves FGF-23 signal blockade in the rat kidney, causing transcriptional upregulation of 25-hydroxyvitamin D(3) 1-alpha-hydroxylase (Cyp27b1), the rate-limiting enzyme in vitamin D activation, and downregulation of 1,25-dihydroxyvitamin D(3) 24-hydroxylase (Cyp24a1), the enzyme that initiates the degradation of the active form of vitamin D. These transcriptional changes increase serum vitamin D levels, which in turn drive the increase in serum iP, leading to soft tissue mineralization in the rat.

Eruption cysts: A series of two cases.

Eruption cysts are benign cysts that appear on the mucosa of a tooth shortly before its eruption. They may disappear by themselves but if they hurt, bleed or are infected they may require surgical treatment to expose the tooth and drain the contents. Here we present 2 case reports of eruption cysts presenting with different chief complaint. The treatment included incising the eruption cyst and draining the contents of the cyst.