Conservative Vertical Groove Technique for Tooth Rehabilitation: 3-Year Follow-Up.

Reattachment of tooth fragment is a simple, conservative, and noninvasive procedure, and it is the most currently acceptable treatment option. This article presents management of two accidentally damaged maxillary incisors using direct composite resin restoration and fractured tooth fragment. With the advancements in adhesive dentistry, tooth fragment reattachment procedure has become simpler and clinically reliable. The present paper is a report of 3-year follow-up of coronally fractured tooth treated with a very conservative technique of tooth fragment reattachment using vertical groove preparation and reinforcement with fiber post.

Fracture resistance of reattached fragments using three different techniques with emphasis on vertical grooves and fiber-reinforced composite post: A novel technique.

BACKGROUND: The aim of this study was to evaluate and compare relatively less explored fragment reattachment methods following traumatic injury. MATERIALS AND METHODS: Eighty sound permanent maxillary incisors were selected and mounted in acrylic blocks. Teeth were sectioned using the diamond disc and randomly divided into 4 groups (n = 20), Group A, B, C, D. In Group A, after reattachment with composite, a 1 mm-depth circumferential chamfer was placed in the fracture line using a diamond disc bur and filled with composite. In Group B, two vertical grooves 1 mm deep, 1 mm wide, and 4 mm length were placed on the labial surface perpendicular to the fracture line and filled with two fiber-reinforced composite (FRC) posts and composite. In Group C, dentin is removed from the fragment and filled with composite. In Group D, the teeth were intact which served as control group. The force required to fracture the reattached teeth were recorded in Newton's using an onscreen calibration tool of the universal testing machine. RESULTS: Teeth in Groups A, B, C required lesser force to fracture when compared with the teeth of the Group D. When compared to Group D, Group A showed a fracture resistance of 36%, Group B 62%, and Group C 32%. CONCLUSION: This study proves that reattachment by vertical grooves with FRC posts showed highest fracture resistance and it is the most preferred method. So far no attempt has been made to reattach fractured fragment using vertical grooves and reinforcing with FRC posts.

Comparison of shear bond strength and micro-leakage of three commercially available seventh generation bonding agents in primary anterior teeth: an in vitro study.

PURPOSE: The study was conducted with the aim of comparing the shear bond strength (SBS) and microleakage of Tetric N-Bond, G-bond, and Xeno V (seventh generation dentin adhesives) in primary anterior teeth. MATERIALS AND METHODS: For the shear bond strength, 45 teeth were randomly divided in to three groups namely group A, B, C (n = 15). Samples were mounted horizontally on acrylic block exposing the facial surface and bonded with different adhesives according to manufacturer instructions. A split Teflon mold was used to build the composite resin cylinder and light cured. Shear bond strength was tested using a universal testing machine. The values were statistically analysed. For microleakage, another 45 teeth were similarly grouped. Two class V cavities were prepared on the labial surface and treated with different dentine bonding agents and restored with resin composite (Ivoclar vivadent) A2 shade. The restorations were subsequently thermally stressed for 200 cycles and were subjected to dye penetration test, followed by sectioning through the center of the restoration labiolingually. Each section was examined using stereomicroscope at × 40 magnification to asses dye penetration at the margins of the restoration. RESULTS: The SBS varied between 22.12-23.77 N/mm 2 (P-value = 0.231). The microleakage scores varied between 0.6-1.2 (P-value = 0.03; Post-hoc test A vs B (0.007)).There was a statistically higher degree of microleakage observed in group A when compared to group B. CONCLUSION: Among the three commercially available bonding agents, there were no statistically significant differences in SBS. G bond had higher microleakage when compared to the others.

Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study.

OBJECTIVES: The study is to evaluate changes in microhardness of enamel after exposure to acidic center filled chewing gum on primary and permanent teeth. METHODS: Thirty primary and 30 permanent molar extracted teeth were painted with acid resistant varnish except a small window over buccal surface. Teeth were divided into four groups according to type of teeth and type of chewing gum (Center fresh and Bubbaloo) (D1, P1, D2 and P2); each tooth was exposed to whole chewing gum mashed with 5 ml of artificial saliva for five minutes at room temperature twice a day for 5 days. After the exposure, teeth were stored in deionized water and submitted for microhardness tests. RESULTS: Paired t-test and independent sample t-test were used for statistical analysis. A significant reduction in microhardness was found between exposed and unexposed areas in all groups. There was no statistically significant difference in reduction of microhardness to chewing gums, and between primary and permanent enamel. CONCLUSION: There is a definite reduction in microhardness in all groups exposed to chewing gums. Both the chewing gums are equally erosive; both permanent and primary teeth were affected. How to cite this article: Mudumba VL, Muppa R, Srinivas NCH, Kumar DM. Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):24-29.

Comparison of anxiety levels associated with noise in the dental clinic among children of age group 6-15 years.

Fear or anxiety due to noise produced in the dental clinic is rated third among the reasons to avoid dental visits. The aim of the present study was to determine anxiety levels associated with noise in a dental clinic. The study was done using a survey questionnaire containing 10 questions and was divided into two parts. The first part included demographic information such as name, age, gender, and school; the second half included questions regarding patient's feelings toward noise in the dental clinic and its possible link to dental anxiety. Two-hundred and fifty children and adolescents of age group 6-15 years participated in the study. Results of the study showed that 50% of females, 29% males avoided a visit to the dentist because of anxiety and fear, 38% subjects of age group 6-11 years reported that sound of the drill makes them uncomfortable, followed by having to wait in the reception area. Gender gap was also observed with more females feeling annoyed than males on the 1-10 annoyance level scale. More than 60% felt "annoyed" to "extremely annoyed" by noise in the dental clinic. 45% of subjects preferred watching television to cope with such noise. This study concludes that the noise produced in dental clinic is anxiety provoking and significantly contributes to avoidance of dental treatment and the best way opted by the majority of subjects to overcome this anxiety was audiovisual distraction method.

Streptomycin-lidocaine injections for the treatment of postherpetic neuralgia: Report of three cases with literature review.

The sudden, stabbing, paroxysmal pain of neuralgia is the fiercest agony that a patient may experience in his life. Many varied medical treatments and surgical procedures have been suggested in the literature for neuralgic pain. Most of the patients fail to respond to medical treatments or succumb to complications of total anesthesia owing to surgical procedures. Herein, we tried a new treatment modality in patients suffering from postherpetic neuralgia with appreciable success in all the three cases that are presented in this paper. Streptomycin sulfate dissolved in 2% lidocaine solution was deposited at the peripheral branches on the involved nerves targeting the trigger zones, given weekly once for a maximum of 6 week period and continued once in 2 weeks if symptoms persisted. All patients were followed-up for 1 year and there was a marked improvement on follow-up.

Biological restoration in a young patient with a complicated crown root fracture with an autogenous tooth fragment.

Crown-root fractures are one of the most challenging trauma cases to treat. Reattachment of tooth fragment to a fractured tooth being a simple procedure conserves the tooth structure, maintains the natural esthetics value and is thus considered as a favorable treatment option. The reattachment procedure using composite resin should be considered if the subgingival fracture can be exposed to provide isolation after a careful evaluation of the biologic width involvement. This case report presents a complicated crown-root fracture of permanent maxillary left central incisor, involving the biologic width in an 11-year-old boy. The traumatized tooth was treated endodontically and reinforced by using glass fiber-post. Access to the subgingival margins was gained by electro surgery. The fractured fragment was reattached using bonding system and composite resin.

Non syndromic gingival fibromatosis in a mild mental retardation child.

Gingival fibromatosis is a benign oral condition characterized by enlargement of gingival tissues. It usually develops as an isolated disorder but can be one of the features of a syndrome. This case report is of a 5-year-old male with severe gingival hyperplasia and mild mental retardation which was complicated by open bite, abnormal occlusion, open lip posture, and disabilities associated with mastication and speech. Full mouth gingivectomy in single sitting under general anesthesia was done with electrocautery.

Facial talon cusp: A rarity, report of a case with one year follow up and flashback on reported cases.

Talon cusp is a relatively uncommon developmental anomaly characterized by cusp-like projections, usually presenting on palatal/lingual surface of the anterior teeth. This cusp resembles an eagle's talon, and hence the name. Normal enamel and dentin covers the cusp, which may or may not contain an extension of pulp. Presence of this anomalous cusp on the facial surface of an anterior tooth is a rare finding and very few cases have been reported in the literature. In most instances, such cusps are associated with clinical problems such as poor esthetics and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This case report presents a facial talon cusp on the maxillary left central incisor of a 10 year old boy, which was conservatively treated. Vitality of the affected tooth was maintained and followed up for a period of 1 year.

Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide.

Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation.

Hand, foot and mouth disease.

Hand, foot and mouth disease (HFMD) is an acute viral illness with a distinct clinical presentation of oral and characteristic distal extremity lesions. Knowledge of this is important for the dentists as the oral lesions are the first clinical signs and sometimes may be the only sign because the condition occasionally may regress even before the lesions appear on the extremities. This case describes a 5-year-old boy in whom low-grade fever of 38.7°C and oral lesions were the initial manifestations. Proper diagnosis was established later based on the typical location of the initial intraoral ulcers on the soft palate followed by cutaneous lesions on the hands and feet with vesicle formation surrounded by an erythematous halo. The recognition of HFMD is important for both pediatricians and pedodontists as oral manifestations are the first signs and may mimic many other conditions like acute herpetic gingivostomstomatitis, apthous stomatitis, chickenpox, erythema multiformae and misdiagnosis may involve an inappropriate prescription of medication.

Papillon-lefevre syndrome: a combined approach from the dermatologist and dentist - a clinical presentation.

Papillon-Lefevre syndrome (PLS) is a rare disease characterized by skin lesions, which includes palmar-plantar hyperkeratosis and hyperhidrosis with severe periodontal destruction involving both the primary and the permanent dentitions. It is transmitted as an autosomal-recessive condition, and consanguinity of parents is evident in about one-third of the cases. This paper describes a 13-year-old male patient who presented to the department of pedodontics, with rapidly progressing periodontitis. A general physical examination revealed scaling on the hands and feet, which had been medically diagnosed as PLS. The incidence of this rare entity is increasing in the recent times, which is associated with irreparable periodontal destruction at an early age, with not so prominent skin lesions in some cases. In such instances, the dentist has a more important role in diagnosing, treatment planning and preservation of the periodontal tissues and, at the same time, referring for the treatment of the skin lesions. This paper emphasizes the combined effort of the two specialities in order to maintain skin as well as dental conditions in health by early intervention and a synergistic treatment approach.

Multidisciplinary management of multiple maxillary anterior supernumerary teeth: a case report.

Supernumerary teeth are a relatively frequent disorder of odontogenesis. They may occur alone or in multiple; be unilateral or bilateral; and appear in the maxilla, mandible, or both. Mesiodens is a supernumerary tooth in the anterior maxilla between the two central incisors. This case report describes the treatment of maxillary central incisors displaced and impacted because of the presence of four mesiodens in a 12-year-old boy. After clinical and radiographic examination, surgical removal of the mesiodens and exposure of the maxillary right central incisor was performed. This resulted in a 14-mm space between the displaced central incisors. Successively, fixed orthodontic treatment was planned with cephalometric analysis. The central incisors were brought to the occlusal plane and aligned, and the space between the incisors was redistributed. Remaining minor spaces between the incisors were closed with composite resin buildup.