Case Report: Holistic dental care for a child with Hunter syndrome: Addressing dental ramifications, overcoming challenges, and enhancing quality of life.

Hunter syndrome (MPS II), an X-linked recessive lysosomal storage disorder, is a result of deficiency of the iduronate 2-sulfatase enzyme (IDS), leading to cognitive impairment, systemic organ involvement, and increased dental problems. This case report describes the management of a child with Hunter syndrome who was referred to the Department of Paediatric and Preventive Dentistry for pain in the upper front teeth. Intraoral examination revealed severe early childhood caries, prompting planning for full-mouth rehabilitation under general anaesthesia due to the child's uncooperative behaviour. In response to recommendations from the Department of Otolaryngology and the Department of Paediatric Surgery, a comprehensive treatment plan consolidated full-mouth rehabilitation in addition to adenoidectomy and inguinal and umbilical herniotomy procedures during a single session of general anaesthesia. Successful interventions were reflected in the uneventful one-month follow-up of the patient, highlighting the efficacy of the interdisciplinary approach. The key takeaway underscores the importance of collaborative interventions, emphasising singular intubation for patients requiring recurrent hospitalisations, providing both monetary relief and reducing post operative healing time. Designed to address global developmental delay in the child, a personalised home care plan was also implemented. Evaluation of plaque and gingival indices before and after the home care regimen demonstrated a notable improvement, indicating an enhanced oral quality of life.

Comparison of stem cells from human exfoliated deciduous posterior teeth with varying levels of root resorption.

BACKGROUND: Stem cells from human exfoliated deciduous teeth (SHED) are regarded as an attractive cell source for tissue regeneration. However, the effect of different levels of root resorption on the characteristics of SHED remains less understood. Thus, the tooth source that is most suitable for the isolation of SHEDs needs to be determined. To compare cellular and biological characteristics of stem cells from human exfoliated deciduous posterior teeth with varying levels of root resorption. METHODS: The pulp was obtained from the deciduous posterior teeth depending on the level of root resorption, and isolated SHEDs were grouped as follows: Teeth with 0 to 1/3rd root resorption as SHEDs (G1) and 1/3rd to 2/3rd root resorption as SHEDs (G2). Teeth were also collected from >2/3rd root resorption status, but failed to establish primary culture of SHED as the availability of pulp tissue was too less. Later, isolated SHEDs were compared on their morphology, viability, growth kinetics, colony-forming ability, expression of cell surface markers and in vitro differentiation into osteocytes and adipocytes. RESULTS: No major differences were observed in terms of cellular morphology, viability, proliferation rate, colony-forming ability, cell surface markers expression, and mesenchymal lineage differentiation of SHEDs isolated from posterior teeth with 0 to 1/3rd and 1/3rd to 2/3rd root resorption. However, SHED from teeth with 0 to 1/3rd root resorption (G1) displayed relatively higher proliferation capacity and expression of selected markers. CONCLUSIONS: Collectively, SHEDs (G1) and SHEDs (G2) showed comparable cellular and biological characteristics that enable their possible applications in regenerative therapies.

Augmentation of Narrow Anterior Alveolar Ridge Using Autogenous Block Onlay Graft in a Pediatric Patient: A Case Report.

Tooth loss due to trauma often triggers residual alveolar resorption to a greater degree in the sagittal direction leading to atrophy. However, in a pediatric patient, if this defect is left untreated, it can cause further atrophy leading to collapse of the arch. In the maxillary anterior area, this is also of esthetic concern. Hence, it is viable to reconstruct the alveolar defects and restore the alveolar anatomy with superior quality of bone while the patient is still in growing phase to avoid any structural and dental malformation, as well as to provide a more novel treatment like dental implant at a later stage when growth ceases. Modes for successfully augmenting the bone are diverse. Among these, barrier membrane with guided bone regeneration, distraction osteogenesis, and bone block graft is ubiquitous. The current case report deals with the management of horizontal atrophic anterior maxillary region using autologous block bone graft harvested from mandibular symphysis, to augment the alveolar ridge and aid in esthetic and functional restoration of alveolar anatomy by restoring the defect with the bone of superior quality as well as preparing the site for receiving implant prosthesis in future when growth ceases. How to cite this article: Bhandary M, Hegde AM, Shetty R, et al. Augmentation of Narrow Anterior Alveolar Ridge Using Autogenous Block Onlay Graft in a Pediatric Patient: A Case Report. Int J Clin Pediatr Dent 2021;14(2):311-314.

Impact of Music Distraction on Dental Anxiety in Children Having Intellectual Disability.

AIM AND OBJECTIVE: To analyze the impact of Indian instrumental music on children with intellectual disability (mild) exhibiting dental anxiety during dental procedures using electrical skin resistance measured by a biofeedback machine. MATERIALS AND METHODS: A total of 20 children of 6-14 years having an intellectual disability (mild) were randomly divided into two groups comprising of 10 each. The study was carried out in a cross-over design, with and without music distraction in two appointments spaced out at a gap of 1 month. The children were subjected to a dental examination, oral prophylaxis, and auditory operative stimuli in both appointments. The electrical skin resistance during each procedure was measured using a galvanic skin response (GSR) biofeedback machine and the values were statistically analyzed using paired and unpaired t-tests. RESULTS: A statistically significant increase in electrical resistance was observed during music distraction, which indicated an anxiety reduction when music distraction was employed. CONCLUSION: The increased electrical skin resistance due to low anxiety proves the positive impact of music distraction in intellectually disabled children. CLINICAL SIGNIFICANCE: Music can be employed as a distraction technique to reduce anxiety in intellectually disabled children. HOW TO CITE THIS ARTICLE: Gowdham G, Shetty AA, Hegde A, et al. Impact of Music Distraction on Dental Anxiety in Children Having Intellectual Disability. Int J Clin Pediatr Dent 2021;14(1):170-174.

Characterization of Stem Cells from Human Exfoliated Deciduous Anterior Teeth with Varying Levels of Root Resorption.

BACKGROUND: Deciduous teeth undergo the physiologic process of resorption, during which the remnant pulp undergoes activation. However, the quality of stem cells obtained at various stages of root resorption has not been documented. OBJECTIVE: To isolate and characterize stem cells from deciduous teeth with varying levels of root resorption. STUDY DESIGN: Healthy primary anterior teeth were extracted according to the treatment needs of the patient. The teeth were categorized into SHED(1/3)- teeth with 0 to 1/3rd root resorption, SHED(2/3)- teeth with 1/3rd to 2/3rd root resorption, and SHED(COMP)- teeth with more than 2/3rd root resorption. SHED were characterized based on their morphology, viability, proliferation rate, population doubling time, expression of cell surface markers, and in vitro differentiation potential into osteocytes and adipocytes. RESULTS: SHED from all three groups demonstrated largely similar morphological and cellular characteristics. However, SHED(2/3) showed relatively better characteristics in terms of growth kinetics and phenotypic marker expression. Also, the differentiation ability for osteogenic and adipogenic cell lineages was slightly higher in SHED(1/3) and SHED(2/3) compared with SHED(COMP). CONCLUSION: Based on the cellular, phenotypic and biological characteristics, it is suggested that SHED (2/3) could be a useful source for tissue regeneration, and warrants further investigations.

Efficacy of a Modified Audio-Tactile Performance Technique with Braille (ATPb) on the Oral Hygiene Status of Visually-Impaired Children.

OBJECTIVE: We assessed the effectiveness of a modified audio-tactile performance (ATP) technique with braille (ATPb) on the oral health statuses of visually-impaired children. STUDY DESIGN: Ninety visually-impaired institutionalized children received oral hygiene instructions using audio (AM), ATP or ATPb techniques. Plaque scores were assessed at baseline and after reinforcement and non-reinforcement periods. RESULTS: In the totally visually-impaired, mean reductions in plaque scores in the ATPb, ATP and AM groups during the reinforcement period were 1.119 ± 0.260, 0.654 ± 0.239 and 0.237 ± 0.255, respectively (p <0.001), worsening to 0.107 ± 0.160, 0.083 ± 0.193 and -0.208 ± 0.267 during the non-reinforcement period (p <0.001), before culminating at 6 months at 1.227 ± 0.261, 0.737 ± 0.317 and 0.029 ± 0.108 (p <0.001). In partially visually-impaired children, reductions during the reinforcement period were 0.934 ± 0.279, 0.762 ± 0.270 and 0.118 ± 0.237, respectively, dropping to 0.176 ± 0.166, 0.083 ± 0.169 and -0.128 ± 0.114 without reinforcement and culminating at 1.109 ± 0.258, 0.845 ± 0.292 and -0.010 ± 0.226 (p <0.001). There were significant inter-group differences during the three periods (p <0.001), except in the ATP and ATPb groups during the non-reinforcement period for totally impaired (p = 0.157) and during reinforcement (p = 0.155) and non-reinforcement (p = 0.051) periods for partially impaired children. CONCLUSIONS: All three techniques were successful when reinforced periodically. However, only ATP and ATPb were successful during periods without reinforcement. The modified audio-tactile performance technique with braille (ATPb) was most effective, allowing visually-impaired children to retain oral hygiene information without intervention.

Association of sleep disturbances and craniofacial characteristics in children with class ii malocclusion: An evaluative study.

BACKGROUND: Behaviour problems, poor academic performance and failure to thrive are some of the potential sequelae of sleep problems in children. Hence, there is a need to evaluate the prevalence of sleep problems and significant associations in children with skeletal class II malocclusion with mandibular retrognathism. AIMS: This study aimed to determine associations if any between sleep practices and problems and craniofacial characteristics in children with skeletal class II malocclusion with mandibular deficiency. SETTINGS AND DESIGN: A cross-sectional study was conducted among a group of children with skeletal class II malocclusion with mandibular retrognathism. MATERIALS AND METHODS: Fifty children aged 8-14 years with skeletal class II with mandibular retrognathism and who required myofunctional therapy were selected. A validated sleep questionnaire assessed the sleep practices and problems. A detailed clinical examination including tonsils and evaluation for mouth breathing was performed. A lateral cephalogram recorded specific linear, angular variables as well as upper and lower pharyngeal airway space. STATISTICAL ANALYSIS: Descriptive statistics, frequency, and percentages were calculated, and the Chi-square test was used. RESULTS: All children reported at least one sleep problem, with snoring reported by 76% of the children. Forty-two percent of the children showed a decreased upper airway, whereas 80% showed a decreased lower airway. Significant associations were seen between SN-MP and noisy breathing, upper airway, and snoring with a P value of 0.017. We also found significant associations between upper and lower airway and sleep positions with a P value of 0.021 and 0.005, respectively. CONCLUSION: All the children exhibited at least one sleep problem. There was a strong association of certain sleep practices and sleep problems with cephalometric variables.

Sex determination from the pulp tissue of deciduous teeth exposed to natural soil and wet clay - A PCR study.

CONTEXT: Dental tissue remains are the toughest, and chemically, the most stable tissue in the body. Its high resilience in the events of fire and bacterial decomposition makes them vital for DNA analysis by PCR method. AIMS: Determination of sex of children through molecular analysis of pulp tissue of exfoliated deciduous teeth stored in different media and analyzed after a different time period. SETTINGS AND DESIGN: Sixty samples of deciduous teeth were divided into three groups. Group IA and Group IIA were stored in natural soil and wet clay for 1 month, respectively. Group IB and Group IIB were stored in natural soil and wet clay for 6 months, respectively. Group III was analyzed immediately after extraction. METHODS AND MATERIAL: Sex determination was carried out in five steps: Pulp tissue removal, DNA isolation, DNA quantification, PCR amplification, Sex determination. X and Y specific chromosomes from each sample were amplified and compared. STATISTICAL ANALYSIS USED: Kruskal-Wallis test, Dunn's test, and Wilcoxon signed rank test. RESULTS: Group III revealed the highest amount of DNA quantified. Amount of DNA quantified after 6 months of storage in natural soil and wet clay decreased in both the groups with the samples stored in wet clay showing a maximum decrease. Results of the PCR analysis also showed 100% accuracy rate in the samples of Group III. CONCLUSIONS: Sex determination from pulp tissue depends a lot on the quality and quantity of DNA extracted. Sex could be effectively determined among the samples evaluated immediately after extraction. This ability decreases as the storage condition changes and the time period increases. Samples stored in wet clay were found to show the least sex identification ability than dry soil.

To Compare the Efficacy of Two Intravenous Combinations of Drugs Ketamine-Propofol vs Ketamine-Dexmedetomidine for Sedation in Children Undergoing Dental Treatment.

OBJECTIVE: To compare the efficacy of two intravenous combinations of drugs ketamine-propofol (KP) vs ketamine-dexmedetomidine (KD) for sedation in children undergoing dental treatment. STUDY DESIGN: Thirty patients were selected, evaluated according to the predetermined criteria and divided in equal numbers of 15 amongst 2 groups KP and KD. MATERIALS AND METHODS: Informed consent was taken, nil per oral (NPO) guidelines were followed and the study drug was administered. Dental procedure was performed. Heart rate (HR), blood pressure (BP) and oxygen saturation (SPO2) were monitored continuously throughout the procedure. The modified Ramsay sedation (MRS) score was recorded along with Houpt sedation score. Recovery status was accessed by modified Aldrete's recovery scale. STATISTICAL ANALYSIS: Student t test was used for comparing HR, BP and SPO2. Chi-square test was used to compare MRS, Houpt sedation score and modified Aldrete's recovery scale amongst the two groups KP and KD. RESULTS: The sedation achieved with both the groups was adequate. Both the drugs produce adequate hemodynamic stability. CONCLUSION: Ketamine-dexmedetomidine has a better efficacy over the other group, ketamine-propofol. HOW TO CITE THIS ARTICLE: Joshi AB, Shankaranarayan UR, Hegde A, et al. To Compare the Efficacy of Two Intravenous Combinations of Drugs Ketamine-Propofol vs Ketamine-Dexmedetomidine for Sedation in Children Undergoing Dental Treatment. Int J Clin Pediatr Dent 2020;13(5):529-535.

Acidogenic Potential of Packaged Fruit Juices and its Effect on Plaque and Salivary pH.

AIM: The aim of this study was to analyze the acidogenic potential of the various commercially available fruit juices and to evaluate the salivary and plaque pH changes before and after consumption of the fruit juices that were kept at various temperatures. MATERIALS AND METHODS: Baseline plaque and salivary pH were measured for 30 volunteers, and the test was conducted for 4 consecutive days on which juices with a known pH was consumed, which were kept at varying temperatures. The resulting changes in the plaque and salivary pH were measured after 1, 5, 15, and 30 minutes of the consumption of the fruit juices using a portable standard digital pH meter. RESULTS: Among the three juices compared, grape juice was found to be more acidic compared to the orange juice and pineapple juice. The pH fall was maximum after consumption of grape juice followed by orange and pineapple juice, respectively. The consumption of ice candy caused a greater fall in pH followed by the refrigerated juice and the juices that were kept at room temperature, respectively. CONCLUSION: Parents are unaware of the harmful effects of endogenous acids in the fruit juices and their effect on the teeth. We, as primary dental care providers, should take initiatives to provide adequate knowledge and information regarding this new trend of consuming frozen fruit juices and must strongly discourage this form of consumption as a frequent habit. CLINICAL SIGNIFICANCE: Though many presume that the readily available fruit juices are healthy, frequent consumption of these fruit juices causes acid dissolution of enamel as most of these juices have a pH below the critical level. Hence the present study was conducted to evaluate the erosive potential of the various commercial fruit juices. As with increased awareness by both the dentists and the parents, the problem of fruit-juice-induced tooth loss may be reduced. HOW TO CITE THIS ARTICLE: Mehta LK, Hegde A, et al. Acidogenic Potential of Packaged Fruit Juices and its Effect on Plaque and Salivary pH. Int J Clin Pediatr Dent 2019;12(4):312-317.

Revascularization of an Immature Permanent Central Incisor with Complicated Crown Root Fracture: A Case Report.

The treatment of complicated crown root fracture in children possesses a great challenge to pedodontists. A 10-year-old boy presented with trauma to the permanent maxillary left central incisor. Upon clinical and radiographic examination, revealed mobility of coronal fragment, open apex, and vertical fracture involving enamel dentin and pulp. Instead of the standard root canal treatment protocol, revascularization was performed after stabilizing the coronal fragment. The detachment of the coronal fragment occurred following a fall for the second time after 1 month of placement of mineral trioxide aggregate (MTA) over the blood clot. The coronal seal was intact; hence, the coronal fragment was reattached and the crown was placed. At 12-month follow-up, clinical and radiographic evaluation showed that the tooth was asymptomatic and functional. With increasing scope of clinical facts, patient, and practitioner favorable reception, regenerative techniques may be used as a standard technique in treating complicated crown root fracture in young permanent teeth. HOW TO CITE THIS ARTICLE: John A, Hegde AM, et al. Revascularization of an Immature Permanent Central Incisor with Complicated Crown Root Fracture: A Case Report. Int J Clin Pediatr Dent 2019;12(1):59-63.

Effect of Virtual Reality Distraction on Pain and Anxiety During Dental Treatment in 5 to 8 Year Old Children.

OBJECTIVE: This study was aimed at assessing the impact of Virtual Reality (VR) distraction technique on pain and anxiety in 5-8-year-old children, during short invasive dental procedures. STUDY DESIGN: 120 children, aged 5-8 years, scoring less than 25 on the SCARED questionnaire, scheduled to undergo short invasive dental procedures, were randomly divided into a control (without VR distraction) and study group (with VR distraction) of 60 each. State anxiety levels were assessed in the children from both groups using revised version of Modified Child Dental Anxiety Scale, before and after dental treatment. Pain perceived during treatment was assessed using Wong Baker Faces pain rating scale at the end of treatment. Salivary cortisol levels were also assessed before, during and after the dental procedure, in all children. RESULTS: We observed a significant reduction in pain perception and state anxiety in children, using VR distraction (p<0.001, p=0.002). The decrease in salivary cortisol levels was significantly greater in children using VR distraction (p<0.001). CONCLUSION: Virtual Reality distraction can be used as a successful behavior modification method in children undergoing short invasive dental treatments.

Effect of crude apple extract on the cariogenic factors of Streptococcus mutans: An in vitro study.

OBJECTIVE: The aim was to assess the effects of crude extract of whole apple on the cariogenic properties of Streptococcus mutans by evaluating (1) its growth, (2) its adherence property, and (3) changes caused by acid produced by S. mutans in the presence of sucrose (in vitro). STUDY DESIGN: Kashmiri Apples (sourced from the local market) were used for the study. Whole apple extracts including the skin were used to obtain undiluted crude apple extract. The growth of S. mutans in the presence of the crude apple extract was evaluated by agar diffusion test as well as direct contact inhibition test. The effects of the crude extract on the adherence of S. mutans was assessed by modified O'Toole method in which the viable cell counts of S. mutans which remained adherent on the microtitre plate were calculated. The effects of the test materials on pH changes caused by S. mutans in the presence of sucrose were assessed using pH meter. RESULTS: Crude extract of the whole apple showed no significant inhibitory effect on the growth of S. mutans while a significant inhibitory activity on the adherence of S. mutans was observed. Furthermore, the significant inhibitory effect on the pH drop was recorded, although pH remained below the critical value of 5.5 at all times. CONCLUSION: Crude whole apple extract has considerable anti-cariogenic effect on S. mutans and hence can be used as a natural alternative which can aid in the prevention of dental caries.

Development and evaluation of new clinical methods of age estimation in children based on the eruption status of primary teeth.

BACKGROUND: Age estimation methods in the permanent dentition are numerous in number and well established and evaluated. However, there exists a dearth of methods available for the estimation of age based on the eruption status of primary teeth, despite various studies displaying greater accuracy using such methods. AIM: The purpose of this study was to develop the methods of age estimation based on the eruption status of primary teeth and based on previous methods developed for permanent teeth and to assess the accuracy of the methods in a clinical situation. MATERIALS AND METHODS: A total of 50 children were randomly selected between the age group of 6 and 38 months for the assessment of primary tooth emergence in the oral cavity. New methods of age estimation (triangles and regression equations) were developed for used in the Indian population. RESULTS: Data were analyzed using receiver operating characteristics curve and intraclass correlation coefficient. Our results conducted in a validation sample of 30 children suggested high levels of accuracy using the new methods, with greater accuracy displayed using the regressive equation (0.928) as compared to the new triangle of age estimation (0.897). CONCLUSION: Such methods of age estimation will be of unparalleled importance in rural setups, which cannot afford the luxury of panoramic radiography.

Accuracy of clinical methods of age estimation based on permanent teeth present as erupted: A study on the coastal population of India.

INTRODUCTION: The role of age estimation in paediatric dentistry has been well documented with an onus being placed for the development of methods independent of radiographic analysis. The study was done to evaluate the accuracy of previously established clinical methods of age estimation in Indian children and to derive new methods for use in an Indian subpopulation. MATERIALS AND METHODS: Foti's clinical method of age estimation based on the eruption status of permanent teeth was tested for accuracy in a sample comprising 1000 children within the age group of 6-14 years encompassing five different southern states of India. A comparative evaluation of Foti's methods and new regressive models developed for an Indian subpopulation was conducted in a sample size comprising 100 children reporting to the department of pedodontics, A.B. Shetty Memorial Institute of Dental Sciences, Mangalore. RESULTS: Statistical analysis revealed greater correlation between chronological and estimated dental age using the newer formulae as compared to the original formulae. CONCLUSION: Hence it is derived that the new population specific methods can help ascertain an individual's age with relative accuracy, even in the absence of radiographs, and hence can be of considerable importance in a rural setup.

Digit Ratio and Dental Caries: A Sexually Dimorphic Trait.

Dental caries is the most common oral health disease affecting all age groups, races, and geographic locations. The need for the study was to determine the anatomical marker that could predict the taste perception and caries at an early stage. Aim of the study was to determine the correlation between digit ratio and caries experience in school-going children of south Canara region. An observational and cross-sectional pattern was adopted for the present study. The study was then evaluated to find out the correlation between the digit ratio that is thought to be predetermined with caries experience in children of age group 6 to 16 years. In the total sample of 2,037 children, the total population was divided into two categories, i.e., high digit ratio and low digit ratio. Of the total population, 1,112 had low digit ratio and 925 had high digit ratio. Caries experience was highest in low-risk group, followed by moderate, high risk, low risk, and very high risk groups. In all the categories, low digit ratio was affected more than high digit ratio. The study clearly states a positive correlation between digit ratio, taste, social behavior, and dental caries. How to cite this article: Verma P, Hegde AM. Digit Ratio and Dental Caries: A Sexually Dimorphic Trait. Int J Clin Pediatr Dent 2018;11(1):1-6.

Skeletal open-bite treatment with zygomatic anchorage for a child with mental retardation: A new modality.

Anterior open bite (AOB) is one of the most difficult malocclusions to treat and maintain in orthodontics. Malocclusion occurs more frequently in children with disabilities than in healthy children. Surgical correction of severe AOB often requires maxillary impaction to reduce the anterior facial height. The zygomatic buttress area could be a valuable anchorage site to achieve intrusion of maxillary posterior teeth. A 16-year-old boy with mental retardation showing signs of persistence of infantile behavior, decreased cognitive functioning, and psychomotor skill deficits (no identified syndrome) with an AOB was treated by intrusion of maxillary posterior teeth using I-shaped multipurpose titanium miniplate (SK Surgicals, India). A 7 mm AOB was corrected after 6 months of intrusion. The benefits of this treatment as an alternative to conventional orthodontic appliances are significant in subjects who lack the understanding or with manual dexterity to use an orthopedic appliance.

Environmental Arsenic Contamination and Its Effect on Intelligence Quotient of School Children in a Historic Gold Mining Area Hutti, North Karnataka, India: A Pilot Study.

CONTEXT: Arsenic is a rare crystal element that naturally occurs in all environmental media. A combination of regional and site-specific biogeochemical and hydrological factors governs its dispersion in the environment. It has far reaching consequences on human health. Exposure to arsenic in drinking water has been associated with a decline in intellectual function in children. AIM: The aim of this study is to assess the relationship between exposure to arsenic by drinking water and children's intelligence in Karnataka state, India. SETTINGS AND DESIGN: Twenty school children of age 10-14 years from Sandur, Bellary, Karnataka, and from Hutti, Raichur, Karnataka, were categorized as control and study group, respectively. SUBJECTS AND METHODS: Water samples were collected from both the villages for the analysis of arsenic and fluoride levels. Hair and nail samples were collected from the participants, and the arsenic levels were determined. Intelligence quotient (IQ) assessment was done using the Raven's Standard Progressive Matrices. STATISTICAL ANALYSIS USED: Chi-square test, Mann-Whitney U-test, and Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS: There was a significant increase in the arsenic content in the hair and nail samples of children in the study group. The mean IQ tests score in the control group and study group was 30.55 and 17.95, respectively, and this difference was statistically significant. CONCLUSION: Chronic arsenic exposure could be a possible cause for the reduced IQ scores seen in children residing in Hutti, Raichur District, North Karnataka.

A spectroscopic and surface microhardness study of enamel exposed to beverages supplemented with ferrous fumarate and ferrous sulfate. A randomized in vitro trial.

PURPOSE: To compare the efficacy between supplementing ferrous fumarate and ferrous sulfate to carbonated beverages by recording the in vitro mineral loss and surface microhardness (SMH) changes in human enamel. METHODS: 120 enamel blocks each (from primary and permanent teeth) were uniformly prepared and the initial SMH was recorded. These enamel specimens were equally divided (n = 60) for their respective beverage treatment in Group 1 (2 mmol/L ferrous sulfate) and Group 2 (2 mmol/L ferrous fumarate). Each group was further divided into three subgroups as Coca-Cola, Sprite and mineral water (n= 10). The specimens were subjected to three repetitive cycles of respective treatment for a 5-minute incubation period, equally interspaced by 5-minute storage in artificial saliva. The calcium and phosphate released after each cycle were analyzed spectrophotometrically and the final SMH recorded. RESULTS: The results were tested using student's t-test, one-way ANOVA and Wilcoxon signed rank test (P < 0.05). The spectrophotometric assessment of calcium and phosphate withdrawal found more loss with the supplementation of 2 mmol/L ferrous sulfate than ferrous fumarate (P < 0.005). Similarly, the mean surface microhardness reduction was less with the supplementation of 2 mmol/L ferrous fumarate than with ferrous sulfate (P < 0.005). Statistical comparisons revealed the maximum surface microhardness and mineral loss with primary enamel and the maximum loss produced in all groups by Coca-Cola (P < 0.005).

Repeated exposure of acidic beverages on esthetic restorative materials: An in-vitro surface microhardness study.

BACKGROUND: A manifold increase in the consumption of aerated beverages has witnessed a twin increase in tooth wear and raised demand for esthetic restorative materials. This study aimed to evaluate the surface microhardness changes of esthetic restorative materials following treatment with aerated beverages in an in-vitro situation. MATERIAL AND METHODS: The initial surface microhardness of the restorative materials GC Fuji II LC, GC Fuji IX, Nano Glass ionomer, Resin and Nano composite was recorded. These materials were studied under 3 groups that included those exposed to the acidic beverages daily, weekly once in a month and those that had no exposures at all. The final surface microhardness of the materials was recorded following experimentation and was subjected to statistical comparisons. RESULTS: The restorative materials were compared for their surface microhardness changes following respective treatments using the T-test and One-way ANOVA analysis. Inter-comparisons between the groups showed statistical significance (p<.05), when treated with both the beverages. The five restorative materials revealed surface microhardness loss; the maximum reduction noticed with the Nano glass ionomer cement tested (p<.0005). CONCLUSIONS: The surface microhardness of restorative materials markedly reduced upon repeated exposures with acidic beverages; the product with phosphoric acid producing the maximum surface microhardness loss. KEY WORDS: Restorative materials, acidic beverages, surface microhardness, resin composites, glass ionomers.