Salivary Proteinase 3 as a Biomarker for Caries Severity in Children: A Cross-sectional Study.

AIM: This study aims to evaluate the relation between salivary proteinase 3 (PR3) concentration and caries severity in children. MATERIALS AND METHODS: Six-to-eight-year age group children, from the Outpatient Department of Pediatric and Preventive dentistry at PMS Dental College were selected for the study. From these children, three groups each consisting of 28 children were selected according to the dental caries severity. Three groups were: (1) No Dental Caries group, (2) Low Dental Caries group with DMFT/DEFT score of 1-4, and (3) High Dental Caries group with DMFT/DEFT score of 5-15. Thus, a total of 84 children who satisfied the inclusion criteria were selected. The concentration of PR3 in saliva of the donors were analyzed using an ELISA kit. One way ANOVA was used for finding the relation of salivary PR3 concentration with caries severity. Pairwise comparison of PR3 concentration and caries severity were analyzed using post hoc Tukey test. RESULTS: Severity of caries and concentration of salivary PR3 showed an inverse relation. As the caries severity increases there was a decrease in PR3 concentration and vice versa. CONCLUSION: The children with high caries severity showed lower concentration of PR3 in their saliva compared with those with lower caries severity which indicates that PR3 can be used as a biomarker for assessing caries severity and also paves way to use PR3 as a caries vaccine in future. Nowadays, interest toward noninvasive and personalized dentistry has been increased. Molecular assays using salivary biomarkers can be an effective tool in detecting the caries in earlier stages and assessing a patient's caries risk. CLINICAL SIGNIFICANCE: Salivary PR3 can be used as prognostic biomarker for assessing caries severity and after treatment the value of PR3 can be used as a assessment tool to confirm its relation with caries. How to cite this article: Karthika S, George S, Soman A, et al. Salivary Proteinase 3 as a Biomarker for Caries Severity in Children: A Cross-sectional Study. J Contemp Dent Pract 2024;25(3):236-240.

Knowledge, attitude, and practice regarding different domains of pediatric obstructive sleep apnea among pediatric dentists from Kerala: A cross-sectional study.

Background: Pediatric dentists should play an essential role in obstructive sleep apnea (OSA) screening, referral, and management of their child patients. However, few studies have investigated pediatric dentists' knowledge, attitude, and practice aspects regarding different domains of pediatric OSA. Aim of the Study: This cross-sectional survey aimed to assess the knowledge, attitude, and practice aspects of different domains of pediatric OSA among pediatric dentists from Kerala. Methods: This cross-sectional study was conducted in Kerala. The sample frame consisted of 163 dentists, and the minimum required was 115. Ethical approval was obtained before starting the study. Settings and Design: An invitation E-mail explaining the purpose of the study with a survey link was sent to the pediatric dentists from Kerala (n = 163). Nonrespondents were contacted at timely intervals. Statistical Analysis: Categorical and quantitative variables were expressed as frequency (percentage) and mean ± standard deviation, respectively. Chi-square test was used to find an association between categorical variables. Statistical analysis was performed using a statistical software package, SPSS, version 20.0. Results and Conclusion: This cross-sectional study showed that pediatric dentists in Kerala have a moderate-to-good level of knowledge, along with a positive attitude toward different domains of pediatric OSA, but lag behind in the practice aspects. Hence, they are required to direct themselves toward continuing dental education programs in order to boost their routine practice. For this, steps must be taken to ensure proper networking of the practitioners and amendments in the dental billing system similar to the medical counterpart.

Early Prediction of Dental Caries using Hormonal Fingerprint in 6-12 Years Old Children: A Cross-sectional Study.

Background: The ratio between second and fourth digit lengths (2D:4D ratio) is termed as hormonal fingerprint. Second and fourth digit lengths ratio is used as a biological marker for predicting and diagnosis of many metabolic disorders mainly coronary heart disease and autism, whereas, in dentistry, this method is still in blooming stage. The aim of the study was to assess the relationship between the new biological marker-hormonal fingerprints in the early detection of caries in children. Methodology: A total of 250 children were randomly selected from both sexes of the age group 6-16 years. Caries assessment was done using standard mouth mirrors and community periodontal index probes. Caries status (deft and DMFT) was recorded and subjects with a total DMFT/deft score of >5 were considered to have a high caries rate. The hormonal fingerprint was made by measuring the length ratio of the index and ring finger with the help of vernier caliper. The entire study population was divided into children with 2D:4D ratio less than 1 and ≥1 based on the calculations of 2D:4D. Results: The results showed that 79.67% males and 29.92% females have 2D:4D ratio <1 and 70.07% females and 20.32% males have 2D:4D ≥1. There is negative correlation between caries incidence and 2D:4D ratio. Children with low 2D:4D ratio have high caries index (54.4%) and high 2D:4D ratio have low caries index (45.6%), which is statistically significant. Conclusion: The study confirms a positive correlation between low 2D:4D ratio and high caries, which could be used as an early biological predictor of dental caries. How to cite this article: Beegum F, Khan N, George S, et al. Early Prediction of Dental Caries using Hormonal Fingerprint in 6-12 Years Old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(3):247-250.

Comparative Evaluation of Antimicrobial Efficacies of 0.2% Chlorhexidine and 4% Tulsi Extract in the Decontamination of Child Toothbrushes: An Observational Analytical Study.

Aims: The aim of this study was to evaluate the efficacy of 0.2% chlorhexidine and 4% tulsi extract as toothbrush decontaminants. Materials and Methods: Of 100 children, who attended the outpatient unit of Department of Pediatric dentistry, 81 children, who satisfied all the inclusion criteria were subjected to systematic sampling, after arranging them in the alphabetical order and were grouped into three. The first child came under Group I, second under Group II, third under Group III, fourth one again under Group I, and so on till the 81st child. In the baseline phase, the children were provided precoded toothbrushes and toothpastes and instructed to place those brushes to be put after use, in single-use glasses. After obtaining the baseline value of Streptococcus mutans colony count, the participants of Group I was given 0.2% chlorhexidine, Group II was given 4% tulsi extract, and distilled water for Group III, to be used as toothbrush decontaminants for 5 days. The toothbrushes were then collected back, and were subjected to microbial analysis. Statistical analysis was performed by using Kruskal-Wallis one-way analysis of variance (ANOVA) and Mann-Whitney U test with P < 0.05. Results: All test solutions, 0.2% chlorhexidine and 4% tulsi extract, except for distilled water, showed a statistically significant reduction of S. mutans count. There was no statistical difference between the efficacies of 4% tulsi extract and 0.2% chlorhexidine, although the latter showed a better reduction. Conclusion: Tulsi extract may well be a perfect replacement to chlorhexidine for reducing the S. mutans count in the child toothbrushes.

Comparative evaluation of diffused calcium and hydroxyl ion release from three different Indirect pulp capping agents in permanent teeth - An in vitro study.

BACKGROUND: Indirect pulp capping therapy has gained increased popularity in paediatric dentistry since it is less invasive, and is of low cost. The aim of the present study was to evaluate and to compare the diffusion of calcium (Ca2+) and hydroxyl (OH-) ions through coronal dentin into pulp after indirect pulp capping in vitro using TheraCal LC, ProRoot MTA and Calcimol LC. MATERIALS AND METHODS: Total of 60 human caries-free maxillary first premolars were selected for the study. Samples were divided into 4 groups with 15 in each group: Group 1 TheraCal LC; Group 2 ProRoot MTA; Group 3 Calcimol LC; Group 4 Control Group. Indirect pulpcapping on the coronal RDT (remaining dentine thickness) system was performed using pulp-capping materials, such as TheraCal LC, ProRoot MTA and Calcimol LC, on the respective samples. The control group was completely filled with composite. Ca2+ ions (ppm) and OH- ions (pH) were analysed in deionized water using a multimeter connected to a calcium probe (calcium ion electrode) and pH metre connected to a temperature-compensated pH probe after 3 h, 24 h, 7 days, 14 days, 28 days and 60 days. RESULTS: Calcium release was significantly higher (P < 0.05) in the TheraCal LC group than in the other groups. Slightly alkaline pH values were observed in all the groups except for the control. CONCLUSION: TheraCal is a new light-curable pulp capping material that initially releases high Ca2+ ions and creates an environmental pH close to physiological pH after 60 days.

Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study.

Objectives and methods: Children, in the age-group of 6 to 8 years, with moderate level of anxiety, (measured with M-DAS), requiring inferior alveolar nerve block (IANB) for mandibular tooth extraction were selected. Informed consent was obtained from parents. Selected children were allocated randomly into 3 groups virtual reality (VR) distraction group, audio distraction group and Tell-show-do (TSD) group. Pre- and post- distraction anxiety level of children was measured subjectively with facial image scale and objectively with pulse rate and oxygen saturation (measured with pulse oxymeter). Results: There was a statistically significant decrease in pulse rate after distraction (with a p < 0.01) in all the three groups. Postdistraction pulse rate was lowest in the VR distraction group when compared to other groups. While comparing postdistraction pulse rate values in the three groups, the difference in pulse rate between TSD and VR distraction group was significant. But while comparing the pulse rate between audio distraction and TSD group (p = 0.06), and audio distraction and VR distraction group (p = 0.24) was not statistically significant. Oxygen saturation increased in all the three groups which was statistically significant (p < 0.01). There was a statistically significant difference in the postdistraction oxygen (O2) saturation levels between TSD and audio distraction groups (p < 0.05) with more O2 saturation in audio distraction group. But while comparing the audio distraction with VR group and TSD with VR group, the difference was not significant. Facial image scale (FIS) scores decreased in all the three groups (p < 0.01). Conclusion: The overall results revealed by all the parameters indicate that children were most relaxed in VR group, followed by audio group and were least relaxed in TSD group during dental visits. Hence VR distraction can be considered as a useful technique for behavior management of pediatric patients during a conventional dental treatment. How to cite this article: SG G, George S, S A, et al. Comparative Evaluation of the Efficacy of Virtual Reality Distraction, Audio Distraction and Tell-show-do Techniques in Reducing the Anxiety Level of Pediatric Dental Patients: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(S-2):S173-S178.

Evaluation of the Association of Oral Stereognosis with Malocclusion in Children.

AIM AND OBJECTIVE: To evaluate the association between oral stereognosis with malocclusion in children. MATERIALS AND METHODS: Stereognostic investigation was made with a set of seven different geometric configurations (circle, square, triangle, star, clover, diamond, and heart shapes) cut out from fresh, raw carrots using preformed iron molds. Any five of the seven geometric forms were randomly placed inside the mouth on the dorsum of the tongue by the investigator with the subject's eyes closed. A minimum of three shapes correctly identified out of the five offered to each child was considered as an indicator of the adequate stereognostic ability of that particular child. RESULTS: Among the children under Index of Orthodontic Treatment Needs (IOTN) grade I group, 82.4% of children came under the positive response group. Among IOTN grades II, III, and IV, the percentages of children with positive responses were 72.1%, 58.1%, and 18.8%, respectively. There is a statistically significant (p < 0.001) decrease in positive response with increasing IOTN grades. CONCLUSION: The observations from the present study show that there is altered oral sensory perception in children graded as with malocclusion according to the index used and belonging to the age group selected in the study. CLINICAL SIGNIFICANCE: Sensory and motor components of the orofacial region, like any other part of the human body, are inseparable in their structure and function, the association between orofacial growth and development and sensory maturation cannot be overlooked. HOW TO CITE THIS ARTICLE: Janardhanan R, Soman A, George S, et al. Evaluation of the Association of Oral Stereognosis with Malocclusion in Children. Int J Clin Pediatr Dent 2021;14(S-1):S18-S21.

Lesion Sterilization and Tissue Repair-Current Concepts and Practices.

A deciduous tooth affected by dental caries involving the pulp tissue with subsequent periradicular pathosis at times makes the conventional endodontic procedures a dilemma for a variety of reasons. In this situation, lesion sterilization and tissue repair (LSTR) stands out as the only option by which dentists could increase the longevity of the deciduous teeth of a young child. This therapy aims to eliminate bacteria from the root canals by sterilizing the lesion and promoting tissue repair and regeneration by the host's natural tissue responses. This article reviews the rationale, indications, contraindications and the procedure in detail. How to cite this article: Sain S, Reshmi J, Anandaraj S, George S, Issac JS, John SA. Lesion Sterilization and Tissue Repair-Current Concepts and Practices, Int J Clin Pediatr Dent. 2018;11(5):446-450.

Efficacy of Four Remineralizing Agents on Primary Teeth: In Vitro Evaluation Using Microhardness Testing and Quantitative Light-induced Fluorescence.

PURPOSE: This study's purpose was to evaluate the remineralization of primary enamel using GC Tooth Mousse, Clinpro Tooth Crème, SHY-NM, and Pronamel by employing microhardness testing and quantitative light-induced fluorescence (QLF) values. METHODS: An in vitro study was performed with 100 intact primary anterior teeth. After specimen preparation, they were subjected to baseline microhardness and QLF testing. The specimens were immersed in demineralizing solution, subjected again to microhardness and QLF testing, and divided randomly into five groups of 20 teeth: group one-control group (artificial saliva); group two-GC Tooth Mousse; group three-ClinPro tooth crème; group four-SHY-NM; and group five-Pronamel. The pastes were respectively applied for the specific group specimens for 15 consecutive days. The samples were subjected to microhardness and QLF testing. RESULTS: The results were analyzed using analysis of variance testing. A post-hoc comparison was done using a paired t test. There were mean increases in microhardness and QLF values with all remineralizing agents. Group two showed a statistically significant increase (P<0.05) in microhardness and QLF values. Group four showed a significant increase only in microhardness values. (P<0.05). CONCLUSION: GC Tooth Mousse and SHY-NM are promising materials for remineralizing incipient lesions in primary teeth.

Rotary endodontics in primary teeth - A review.

Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the "gold-standard" over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel-titanium (Ni-Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel-titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.

Childhood Oral Lichen Planus: Report of Two Cases.

Lichen planus (LP) is a chronic mucocutaneous disease widely recognized in adults, but uncommon in children. The purpose of this paper is to report two cases of LP in children. The diagnosis was made based on clinical and histopathological findings. The treatment consisted of antifungal and multivitamin therapy. Regression of lesions was observed. The patients are still under follow-up. Although LP is uncommon in children, it is necessary to have adequate knowledge about this condition for proper diagnosis and treatment.

Delayed reimplantation: a case report.

A 12-year-old boy reported to the clinic with a history of trauma, whereas playing 1 day before. On examination it was noted that the patient had an avulsed tooth in relation to 11, Class III fracture in relation to 12 and Class II fracture in relation to 21. The avulsed tooth was brought by the patient wrapped in a newspaper. Although the tooth was in highly unfavorable storage condition, it was decided to reimplant the teeth since the patient was young and to relieve him from psychological, cosmetic and functional trauma. Now after 24 months, the tooth is, functional, firm and free of symptoms with minimal signs of resorption. Even though the long-term prognosis is uncertain, this treatment technique has proven to be an advantage for the patient in this growing period by maintaining the esthetics, by maintaining the height of alveolar bone and making the provision of an aesthetically acceptable permanent restoration at a later age if prognosis becomes poor.

Biologic restoration of a traumatized maxillary central incisor in a toddler: a case report.

Trauma to the anterior teeth is relatively common in young children and teenagers. Traumatized anterior teeth require quick functional and aesthetic repair, and poses a challenge to the dental practitioner owing to the lack of co-operation ceded and the longer time invested. Reattachment of tooth fragment should be the first choice to restoring teeth when a usable fragment is available, since it gives a psychological and aesthetic advantage over the conventional technique. With the vast improvement in adhesive technology, reattachment is definitely a predictable treatment option for very young children. This paper describes the treatment of a 2½ year old female child who sustained crown-root fracture, extending subgingivally, in primary upper central incisor.