Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation.

Aim: To evaluate the change in microflora in children suffering from severe early childhood caries (ECC) after full mouth rehabilitation. Materials and methods: A total of 60 children, aged 3-5 years suffering from severe ECC who fulfilled the inclusion and exclusion criteria were included in the study. Pooled plaque samples were taken and subjected to quantitative reverse transcriptase polymerase chain reaction (PCR) to obtain baseline mean values of Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Candida albicans (C. albicans), and Candida dubliniensis (C. dubliniensis) before full mouth rehabilitation was done under general anesthesia. Posttreatment samples were collected at 6, 12, and 18 months. Wilcoxon signed-rank test was used to compare the mean values of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis before and after full mouth rehabilitation. Results: A total of 60 patients recruited for the study were present at the follow-up at 6 and 12 months. At 18 months, 55 patients returned, and five were lost due to follow-up. A statistically significant reduction was seen in all microorganisms at 6, 12, and 18 months compared to baseline values. At 18 months a slight increase in S. mutans, S. sobrinus, and C. albicans was seen. C. dubliniensis was not detected in any cases after full mouth rehabilitation. Caries recurrence was seen in four patients at 18 months. Conclusion: Significant reduction of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis was seen at 6, 12, and 18 months. A complete reduction of only C. dubliniensis was seen. A significant but not permanent reduction of S. mutans, S. sobrinus, and C. albicans. Caries recurrence was seen in 7.27% of patients at 18 months. How to cite this article: Mathew MG, Jeevanandan G, Rathod NN. Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation. Int J Clin Pediatr Dent 2024;17(1):21-25.

Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia.

AIM: To evaluate the risk factors associated with caries development after full-mouth rehabilitation for early childhood caries (ECC) under general anesthesia. MATERIALS AND METHODS: A total of 100 children diagnosed with ECC requiring full-mouth rehabilitation under general anesthesia were recruited for the study. At baseline, caries status, plaque index, Streptococcus mutans count, and Lactobacillus count were evaluated. The risk assessment for caries was evaluated using a cariogram. Children were recalled after 12 months for evaluation. All children returned for the recall and data was recorded at the recall visit. Children were grouped into caries-free or caries recurrent based on the absence or presence of caries. Chi-square tests and student's t-test were used for statistical analysis using the statistical package for the social sciences (SPSS), version 23. RESULTS: All 100 children returned for follow-up. 76% of the children developed new carious lesions in a period of 1 year. A statistically significant association between caries recurrence and S. mutans count and caries risk assessment (CRA) score was found (p < 0.001). No significant associations were seen between parental education levels and the oral health practices of the child. CONCLUSION: Children treated under full-mouth rehabilitation for ECC under general anesthesia are at risk for developing new carious lesions after treatment. New carious lesions are strongly correlated with the presence of S. mutans, and high cariographic risk scores serve as an indication of future caries. Early childhood caries may be avoided if children are more diligent in practicing good dental hygiene. CLINICAL SIGNIFICANCE: Relapse of caries after full-mouth rehabilitation under general anesthesia can affect the quality of life of children. Preventive measures should be initiated and reinforced to prevent the occurrence of new carious lesions after full-mouth rehabilitation. How to cite this article: Mathew MG, Jeevanandan G, Maganur PC, et al. Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia. J Contemp Dent Pract 2024;25(1):85-91.

The Evaluation of Postoperative Complications and Oral Health-Related Quality of Life Following Dental General Anesthesia for Early Childhood Caries.

Aim The study aims to evaluate the postoperative complications and oral health-related quality of life (OHRQoL) following dental general anesthesia for early childhood caries (ECC). Materials and methods Two hundred children aged between three and six requiring full-mouth rehabilitation for general anesthesia were recruited for the study. Demographic data and oral health-related quality of life using the Early Childhood Oral Health Impact Scale (ECOHIS) were collected before the surgery. Postoperative complications and oral health-related quality of life were evaluated after 24 hours and at a one-week follow-up appointment. Results All 200 children returned for the follow-up appointment after one week. Pain was found to be the most common postoperative complication after 24 hours (52%) and one week (6%). The oral health-related quality of life showed a significant improvement after one week (P < 0.001) Conclusion Children may experience a postoperative complication after full-mouth rehabilitation, which resolves within a week. Dental pain was the most common operative complication in the present study. Oral health-related quality of life showed significant improvement after full-mouth rehabilitation.

Perceived Outcomes, Parental Satisfaction, and Oral Health-Related Quality of Life After Full Mouth Rehabilitation Under General Anesthesia for Early Childhood Caries.

AIM: The aim of this article is to evaluate the perceived outcomes, parental satisfaction, and oral health-related quality of life after full mouth rehabilitation under general anesthesia for children with early childhood caries. MATERIALS AND METHODS: A total of 200 children requiring full-mouth rehabilitation under general anesthesia for the management of early childhood caries were recruited for the study. Perceived outcomes, oral health-related quality of life, and parental satisfaction were evaluated at the follow-up visit after six months. RESULTS: All participants reported back for the follow-up visit after six months. Oral health-related quality of life after full-mouth rehabilitation showed statistically significant improvement at follow-up (P <0.001); 97.5% of the parents were satisfied with the treatment. Perceived outcomes were found to be satisfactory, and a significant improvement (P <0.001) was seen after treatment. CONCLUSION: The perceived outcomes of participating parents were met. Significant improvement in oral health was seen after full-mouth rehabilitation under general anesthesia. Parental satisfaction was found to be high at the follow-up visit after six months. Parents found the improvement in the oral and general health of their child to be significant.

Evaluation of Factors Affecting Clinical Outcomes of Full Mouth Rehabilitation Under General Anaesthesia for Children With Early Childhood Caries: A Prospective Cohort Study.

AIM: This study was designed to evaluate the factors affecting the clinical outcomes of full mouth rehabilitation under general anaesthesia for children with early childhood caries (ECCs). MATERIALS AND METHODS: A prospective cohort of 200 children with early childhood caries and requiring dental rehabilitation under general anaesthesia was evaluated and treated. Children were recalled at six-month intervals for a period of two years and evaluated for the recurrence of caries and the need for repeat treatment of failed cases. RESULTS: 86.5% of the patients adhered to the six-month recall visits for 24 months. An overall caries recurrence rate of 14.5% was seen. Children who did not adhere to the follow-up plan and visited ad hoc had the highest caries recurrence rate (88%). CONCLUSION: Good compliance with postoperative instructions after full mouth rehabilitation resulted in good oral hygiene and a limited recurrence of caries. Patients with poor compliance with recall visits and postoperative instructions had high rates of caries recurrence. Rehabilitation under general anaesthesia can be considered a viable treatment option for children diagnosed with early childhood caries.

Comparison of distraction techniques using salivary biomarkers during local anaesthesia administration in children aged 3-5 years: A clinical study.

Aim: In paediatric dentistry, pain is adversely influenced by a child's level of anxiety. Ironically, the most common form of pain control used in dentistry, local anaesthesia, can itself produce anxiety. One of the techniques to overcome a child's anxiety is using distraction. The aim of the present study was to evaluate the effectiveness of distraction techniques, i.e. audio distraction (AD) and audio-visual distraction (AVD) by measuring salivary stress biomarker (salivary cortisol and salivary alpha-amylase) levels in 3-5 year-old children. Materials and Methods: Forty children aged 3-5 years were divided randomly into two groups; (Group I = AD, Group II = AVD). Cotton pellets were placed in the lingual vestibule to collect a sample of saliva. Children were then asked to wear overhead phones in the AD group, connected to a phone, and rhymes were played. In AVD, a cartoon movie was shown to the children using AV glasses. Simultaneously, local anaesthesia was administrated to children, after which another saliva sample was collected. Biomarker estimation was done using ELISA. Fisher's exact test was used for statistical analysis. Results: Statistically significant results were seen with Group II compared to Group I (cortisol-P = 0.009; salivary alpha-amylase-P = 0.03). Conclusion: Both distraction techniques are effective in reducing stress but compared to AD, AVD is more efficacious.

Comparison of Total Salivary Antioxidant Capacity of Children with and without Severe Early Childhood Caries before and after Complete Dental Rehabilitation.

Introduction: Early childhood caries (ECC) is the most chronic disease affecting children all over the world. Children often complain of pain and need complete rehabilitation, which is often done under general anesthesia due to extensive treatment and behavioral problems that are often encountered. The present study was undertaken to evaluate the total salivary antioxidant capacity of children with severe ECC (S-ECC) before and after complete dental rehabilitation and compare it with caries-free children. Materials and methods: Salivary samples were obtained from 30 children aged 3-5 years and diagnosed with S-ECC, along with 30 age and sex-matched controls. Complete dental rehabilitation under general anesthesia was performed on the children with S-ECC, and follow-up salivary samples were obtained after 3 and 6 months postoperatively. Total salivary antioxidant capacity was measured using a commercially available Oxygen Radical Absorbance Antioxidant Assay measurement kit. At baseline, children with S-ECC had higher total antioxidant capacity (TAC) compared to the controls. Results: A significant difference in total salivary antioxidant capacity between both groups was seen at baseline. At 3 months following, the total salivary antioxidant capacity of children treated for S-ECC was slightly higher than controls but had significantly reduced compared to baseline. At 6 months, there was no significant difference between both groups. Conclusion: Within the limitations of our study, it can be concluded that the total salivary antioxidant capacity associated with children suffering from S-ECC is reduced after complete rehabilitation. How to cite this article: Mathew MG, Jeevanandan G. Comparison of Total Salivary Antioxidant Capacity of Children with and without Severe Early Childhood Caries before and after Complete Dental Rehabilitation. Int J Clin Pediatr Dent 2023;16(3):474-477.

Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries.

AIM: To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries. MATERIALS AND METHODS: About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up. RESULTS: All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment. CONCLUSION: Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries. CLINICAL SIGNIFICANCE: Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.

Comparison of Three Luting Cements for Prefabricated Zirconia Crowns in Primary Molar Teeth: a 36-month Randomized Clinical Trial.

PURPOSE: The purpose of this study was to evaluate and compare the long-term clinical retention and gingival health of prefabricated zirconia crowns (PZCs) in primary molar teeth cemented using three luting cements. METHODS: Primary molar teeth restored with PZCs (n equals 30 per group) were cemented using glass ionomer cement (GIC), resin-modified GIC (BioCem™), or adhesive resin cement (APC technique: air- particle abrasion, zirconia primer, composite resin). Crown retention, plaque accumulation, and gingival status were evaluated over three years; cumulative crown survival was assessed using Kalpan-Meier analysis. Plaque gingival scores were analyzed for within and between groups using repeated measures one-way analysis of variance. RESULTS: The survival of PZCs cemented using GIC was 76.7 percent, 70 percent for APC, and 50 percent for BioCem™ after three years. The mean survival for PZC in the GIC group (35.5 months) was significantly higher than for APC (34.7 months), and BioCem™ (33 months; P=0.019). Plaque accumulation around GIC-luted crowns was significantly lower (P<0.001; three-year follow-up); gingival outcomes were uniformly favorable between groups. No crown fracture was observed throughout the study period. CONCLUSIONS: Prefabricated zirconia crowns cemented using traditional glass ionomer cement have superior retention and lower plaque accumulation compared to BioCem™ and APC after three years. PZCs provided long-term favorable gingival health outcomes irrespective of the cement used for luting the crowns.

Evaluation of Clinical Success, Caries Recurrence, and Oral Health-Related Quality of Life of Children Undergoing Full Mouth Rehabilitation for Early Childhood Caries: A Prospective Cohort Study.

AIM: This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management. METHODOLOGY: The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance. RESULTS: 272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment. CONCLUSION: Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.

Mandibular talon cusp: a rare dental anomaly.

Talon cusp is a rare dental anomaly which consists of a supernumerary projection from the cingulum towards the incisal edge of the tooth. The cusp is made up of enamel and dentin but pulpal tissue may or may not be present. The occurrence of mandibular talon cusp is a rare entity with only 58 cases reported until now. This article reports a case of talon cusp on a mandibular central incisor along with a literature review of all mandibular talon cusp reported in history.

Parental and Child Outlook on the Impact of ECC on Oral Health-related Quality of Life: A Prospective Interventional Study.

AIM: To evaluate the perspectives of parents and children on the impact of early childhood caries (ECC) on the oral health-related quality of life (OHQoF). MATERIALS AND METHODS: About 400 children aged 3-5 years were recruited for the study. About 200 children who were caries-free were the controls for the study. The remaining 200 consisted of children who were diagnosed with ECC and required dental rehabilitation under general anesthesia. Oral health-related quality of life was recorded at baseline and 6 months after intervention using the Michigan oral health-related quality of life scale. Data were analyzed and evaluated using Statistical Package for Social Sciences (SPSS) Version 25.0. RESULTS: Children with ECC were found to have a significantly lower oral health-related quality of life compared with caries-free children, and a statistically significant difference was seen between both groups. The main concern for both parents and children at baseline was pain at the first visit when the evaluation was done. After the intervention, a significant improvement in the oral health-related quality of life was seen. CONCLUSION: Early childhood caries was found to have detrimental effects on the oral health-related quality of life. Full-mouth rehabilitation under general anesthesia was found to bring a significant improvement in the oral health-related quality of life. The perspectives of both parents and children were found to be similar. CLINICAL SIGNIFICANCE: Early childhood caries has an impact on the lives of children and their parents. Oral health-related quality of life was low with children suffering from ECC. Full-mouth rehabilitation under general anesthesia can significantly improve the OHRQoL of children. Continuous monitoring of the children with regular follow-ups and parental education should be enforced to prevent the relapse of ECC.

Evaluation of Factors Influencing the Oral Health-related Quality of Life among Children with Early Childhood Caries: A Cross-sectional Study.

AIM: To evaluate the factors that affect the oral health-related quality of life (OHRQoL) among children with early childhood caries (ECC). MATERIALS AND METHODS: A total of 340 children aged between 3 and 6 who were diagnosed with ECC were enrolled in the study. Parents accompanying the children completed a questionnaire on the sociodemographic status and filled out the Early Childhood Oral Health Impact Scale (ECOHIS) for the evaluation of OHRQoL. Data were recorded, tabulated, and statistically analyzed. RESULTS: The study population consisted of 189 (55.6%) boys and 151 girls (44.4%). A total of 96.4% had cavitated lesions; 31.2% of the children had pain at the time of evaluation. A significant association was seen between the Decayed Missing Filled Teeth (DMFT) score of the child (p < 0.001). Pain at the time of evaluation and DMFT status had a significant association with the ECOHIS (p < 0.001). CONCLUSION: Early childhood caries was found to impact the OHRQoL. Pain, visible dental plaque, family income, and parental education were found to be determinants that affect the OHRQoL. CLINICAL SIGNIFICANCE: Early childhood caries significantly reduces the OHRQoL of children and their families. Pain, visible dental plaque, family income, and parental education were found to influence the OHRQoL. Teaching parents the importance of oral health and preventive treatment will help prevent the occurrence of ECC.

Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial.

AIM AND OBJECTIVE: To estimate the obturation quality and instrumentation time on comparing traditional hand files and two rotary file types during root canal instrumentation in deciduous molars. MATERIALS AND METHODS: Forty-five deciduous mandibular molars were taken and randomly allotted to three groups (n = 15). Group I: K-hand files, group II: ProTaper Gold rotary file, and group III: Kedo-SG Blue rotary files. Before and after root canal instrumentation, standardized digital radiography was taken and the instrumentation time was also noted. The recorded data were then subjected to statistical analysis utilizing SPSS Software version 22.0. To compare the instrumentation time and quality of obturation between the groups, a Chi-square test and ANOVA with the level of significance at 0.05 were employed. RESULTS: There was no significant difference recorded with reference to the quality of obturation (p > 0.05). However, the difference was noticed to be statistically significant when the instrumentation time between the two rotary groups and the manual instrumentation groups was taken into account (p < 0.05). The rotary systems ProTaper Gold and Kedo-SG Blue exhibited a significantly less instrumentation time on comparing with that of the hand files. CONCLUSION: Concerning the quality of obturation, all three file groups demonstrated almost a similar performance. However, there was a significant difference noticed in the instrumentation time with the use of manual instrumentation in comparison to rotary instrumentation in deciduous teeth. HOW TO CITE THIS ARTICLE: Preethy NA, Jeevanandan G, Mathew MG, et al. Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(4):471-474.

Pediatric dental emergency management and parental treatment preferences during COVID-19 pandemic as compared to 2019.

Pediatric dental emergency management were temporarily suspended during the COVID-19 pandemic, which worsened urgent dental needs. This retrospective study investigated the management of pediatric emergencies during COVID-19 lockdown and the trends in parental preferences from March to July in 2019 and 2020. Pediatric dental emergencies managed during pandemic was collated, procedures were categorized (emergency, restorative, preventive, elective) and trends in parental treatment preference was compared from March-July 2019/2020. Bivariate analysis was performed using fisher-exact test and statistical significance was set at 5%. Total 1081 children were treated during COVID-19 lockdown, and 1509 procedures were performed, of which 20.8% were emergency, 42% restorative, 24.4% preventive, 12.6% elective. In 2019, 7462 children were treated; and except for emergency (10.6%), other procedures were comparable to 2020. Extractions (267) predominated in 2020 followed by sealants (195); but in 2019, pulectomy (1268), scaling (1251) were predominant. None of the residents who performed aerosol procedures got infected with COVID-19 during the lockdown. Emergency dental needs among pediatric patients were very high during the COVID-19 pandemic in South India, and there was not much change in the trend in parental treatment preference in 2019 and 2020. Further, aerosol procedures did not increase the risk of COVID-19 during the pandemic provided proper universal precautions were followed.

Association of severe early childhood caries with salivary ferritin.

AIM: To evaluate salivary ferritin levels in children with severe early childhood caries (ECC). MATERIALS AND METHODS: One hundred twenty participants were split into a study group that consisted of 60 children with severe ECC (dmft ≥5) and a control group that was free of caries. Both groups were age and gender-matched. Saliva was collected from both groups. Salivary ferritin was assessed using chemiluminescence microparticle immunoassay. The data obtained were statistically analyzed. RESULTS: Salivary ferritin levels were higher in children with severe ECC (159.53 ± 18.65 µg/dl) compared to children with no caries (92.16 ± 12.91 µg/dl) and a highly significant statistical difference was seen (P < 0.001). CONCLUSIONS: Salivary ferritin levels were high with children having severe ECC.

Ten-cusped primary molar tooth: A rare entity with literature review.

Teeth arise by complex and progressive interactions between the ectoderm, oral epithelium and underlying mesenchyme. However, it may show variations and changes in morphological structure. A 6-year-old female child patient came for the treatment of her carious tooth. Intraoral examination revealed supernumerary cusp on occlusal surface of the maxillary right second primary molar. Incidence of supernumerary cusp is a rare condition formed by abnormal proliferation and folding of inner enamel epithelium during morphodifferentiation stage of the tooth development. Conservative cavity preparation and restorative treatment protocol were carried out to treat this case. Early diagnosis, management and timely recall of these rare anomalies will help to avoid potential complications, resulting from faster carious progression in these teeth due to the presence of many fissures and early pulpal extensions into the cuspal area.