Effect of Preemptive Analgesia on Pain Perception in Children: A Randomized Controlled Trial.

Background: Efforts have been made to minimize pain, prevent the development of needle fear, and promote positive experiences for children. The present study is designed to evaluate the effect of premedication with Ibugesic Plus before the administration of local anesthesia and extraction in children. Aim: The aim of the study is to assess the efficacy of preemptive analgesia on pain perception during local anesthesia administration and extraction in pediatric patients. Materials and methods: A total of 104 patients aged 7-10 years were selected who needed primary molar extraction. Group -Ibugesic Plus syrup was given 30 minutes prior to extraction. Group II-Placebo solution (B-Folcin syrup) was given 30 minutes prior to extraction. Pain level, pulse rate, and SpO2 were assessed using the Wong-Baker Faces Pain Rating Scale (WBFS) and pulse oximeter after injection, after extraction, and postoperatively. Results: The highest scores of pain were recorded after the time of injection and extraction. The patients who received preemptive analgesics (group I) reported significantly less pain than the placebo group (group II) at the time immediately after injection, after extraction, and 2 hours after extraction. Conclusion: The present study showed that preemptive analgesic administration may be considered a routine and rational pain management strategy in primary tooth extraction procedures in children. Clinical significance: Preemptive analgesia can be given to patients prior to dental procedures to reduce postoperative pain. How to cite this article: Virda M, Panda A, Kataria K. Effect of Preemptive Analgesia on Pain Perception in Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(8):913-917.

Implementation of a hybrid neural network control technique to a cascaded MLI based SAPF.

This paper presents a naïve back propagation (NBP) based i cos ∅ technique implemented to a cascaded multilevel inverter (MLI) based shunt active power filter (SAPF). The recommended control algorithm is applied to extract the fundamental component of load current and to decide the compensating current reference for harmonic elimination. The performance of the SAPF using the proposed NBP-based i cos ∅ technique is compared with another two classical control techniques, such as, i d - i q technique and i cos ∅ technique. The accuracy of the proposed control technique depends on the tuned estimation of active and reactive weights. The performance study of the proposed SAPF with the proposed control technique is investigated under non-linear conditions, with balanced and unbalanced loading conditions. The results reveal that the recommended SAPF is efficient enough to reduce the harmonics from the source current with smooth variation in DC link voltage. The effectiveness of the proposed method is validated by simulation using MATLAB Simulink, and the real-time results are also validated by the experimental setup.

Design and implementation of optimized virtual oscillatory controllers for grid-forming inverters.

The percentage of renewable power in conventional power generation is gradually growing due to developments in power electronic converters (PECs). Renewable energy sources (RESs) can be integrated into the main grid through PECs, which are the most prevalent method to accomplish this. Virtual oscillator control (VOC) is a well-known time-domain method to regulate grid-forming inverters. VOC objective is to model the nonlinear dynamics of deadzone oscillator in a system of voltage source inverters to give a steady AC microgrid (MG). VOC is a self-synchronizing control method that just involves the current feedback signal. In contrast, classical droop and virtual synchronous machine (VSM) controllers both require the use of low pass filters to calculate real and reactive powers. The selection of control parameters in deadzone VOC is difficult and time-consuming. The VOC parameters are designed using different optimization techniques such as Particle Swarm Optimization (PSO), Sine Cosine Algorithm (SCA), modified Sine Cosine Algorithm (mSCA), African Vulture Optimization Algorithm (AVOA), and Artificial Jellyfish Search Optimization (AJSO). MATLAB and a real-time digital simulator (Opal RT-OP5142) were used to examine the system's performance with aforesaid controllers (droop, VSM, conventional VOC, VOC-PSO, VOC-SCA, VOC-mSCA, VOC-AVOA, and VOC-AJSO). In comparison to all control methods, the proposed VOC-AJSO provides faster synchronization. The effectiveness of the suggested VOC-AJSO control approach is proved by the hardware results.

Comparative evaluation of the effectiveness of two innovative methods in the management of anxiety in a dental office: a randomized controlled trial.

Background: The first dental experience is vital in molding a child's attitude towards dentistry and dental outcomes. The cooperation of a child during dental treatment is essential to render successful and high-quality treatment. Dental anxiety is common in children undergoing dental treatment. The success of pediatric dental treatments and patient comfort depends on controlling the levels of patient anxiety in clinical settings. This study aimed to compare the effectiveness of the recorded maternal voice and virtual cognitive tool (Roogies application) in the management of pediatric dental patients. Methods: The study was carried out with children aged of 4-7 years [n = 80, (40 male and 40 female)], without any past dental history, and were randomly allocated into two groups. After informed consent was obtained, the entire procedure was explained to the parents. Anxiety was assessed pre-, during, and post-treatment by measuring pulse rate, and recording Venham Picture Test (VPT) scores. Group A [n = 40; 20 boys and 20 girls)] was provided with a headphone that played a recorded maternal voice. Group B [n = 40; 20 boys and 20 girls)] was administered the virtual cognitive tool. After conditioning the children, oral prophylaxis was performed for both groups. A comparative evaluation was conducted for each treatment session. Results: The intra-group comparison of VPT scores and heart rate for patients assigned to the recorded maternal voice showed a statistically significant difference in dental anxiety (P-value ≤ 0.001). Conclusion: This study demonstrated that a reduction in dental anxiety with the help of recorded maternal voice forms an important component of non-pharmacological behavior management. Alternatively, the use of a virtual cognitive tool as an anxiety-reducing technique can also be advocated.

Evaluation of microcrack formation during root canal preparation using hand, rotary files and self-adjusting file in primary teeth: An in vitro study.

Background. Pediatric endodontics is a field with constant evolution, resulting in the shifting of paradigms from the use of conventional hand files to rotary files for biomechanical preparation in primary teeth. Biomechanical preparation plays a crucial role in the success of root canal treatment. Primary teeth need special attention since they differ from permanent teeth in root canal morphology. Cleaning and shaping of the canals damage the root dentin, leading to dentinal cracks. Newer techniques for root canal preparation, including Ni-Ti rotary files and SAF system, have been developed for use in pediatric endodontics to overcome the drawbacks of conventional methods. The present study compared dentinal defects formed by rotary systems in primary teeth. Methods. Eighty primary teeth were included. The teeth were decoronated with a diamond disc. All the roots were inspected for any pre-existing cracks or craze lines under transmitted light under a stereomicroscope. The specimens were then divided into four groups (n=20): group 1: control, group 2: hand files (HF), group 3: ProTaper files, and group IV: SAF files. The samples were instrumented according to the group they were assigned to. Results. The HF and SAF groups exhibited fewer microcracks. Dentinal microcracks were observed in roots prepared with rotary ProTaper files. There were significant differences between HF/SAF and rotary files (P <0.05). Conclusion. Stainless steel hand K-files and SAF instruments resulted in fewer dentinal damage than the ProTaper Universal files. SAF exhibited satisfactory results with minimal or no crack formation.

Pediatric Dental Appointments No-show: Rates and Reasons.

AIM: To determine the frequency and reasons of missed and canceled pediatric dental appointments and identifying the factors associated with it among the patients visiting the pediatric dental clinic of the dental college in Navi Mumbai, Maharashtra, India. To assess the parents' perception regarding the treatment of their children and to explore the merit of different management strategies regarding the missed appointments. MATERIALS AND METHODS: Self-administered questionnaires were handed over to the parents in the waiting area, whose children were undergoing treatment in the pediatric dental clinic. Questionnaire included questions pertaining to the sociodemo-graphic characteristics, methods of remembering appointments, and satisfaction with the overall past clinic experience. RESULTS: Of the 294 surveyed sample, 52.0% stated that they have missed an appointment. Highest percentage of the patients had missed due to parents' forgetfulness and patient's exams; 52.0% relied on their memory to remember their appointments, and 44.5% used their diaries and mobiles as a means of reminders. For canceling an appointment, most of them stated that patient was unwell and parents' commitments toward other work led to an increase in rates of no-shows. Socioeconomic status and the methods of remembering the appointment date were found to be significantly correlated with missing an appointment among the surveyed sample (p < 0.05); 48.3% said that they would want a call from the dentist a day prior to their appointment as a reminder. CONCLUSION: Around one half of the patients attending the pediatric dental clinic missed their appointments. Patients most likely to fail to keep an appointment was the one who was young, remembered appointment via memory, came from a high socioeconomic class, most of them were males, and had previously broken appointments, while patients preferred receiving a call from the dentist as a reminder aide. CLINICAL SIGNIFICANCE: Missing appointment creates a series of problems. Firstly, it deprives another patient the opportunity of getting treated. Secondly, it contributes to the development of long waiting list for dental services. Thirdly, it affects the patient's treatment time and may cause increase in the dental emergencies leading to a disruption in the doctor-patient relationship and behavioral management problems.How to cite this article: Bhatia R, Vora EC, Panda A. Pediatric Dental Appointments No-show: Rates and Reasons. Int J Clin Pediatr Dent 2018;11(3):171-176.

A nonlinear control scheme based on dynamic evolution path theory for improved dynamic performance of boost PFC converter working on nonlinear features.

This paper is concerned to performance improvement of boost PFC converter under large random load fluctuation, ensuring unity power factor (UPF) at source end and regulated voltage at load side. To obtain such performance, a nonlinear controller based on dynamic evolution path theory is designed and its robustness is examined under both heavy and light loading condition. In this paper, %THD and zero-cross-over dead-zone of input current is significantly reduced. Also, very less response time of input current and output voltage to that of load and reference variation is remarked. A simulation model of proposed system is designed and it is realized using dSPACE 1104 signal processor for a 390VDC, 500W prototype. The relevant experimental and simulation waveforms are presented.

Effect of Hypnosis During Administration of Local Anesthesia in Six- to 16-year-old Children.

PURPOSE: Hypnosis is a tool that can help pediatric dentists allay fear or increase patient cooperation while administering local anesthesia. The purpose of this study was to determine whether hypnosis altered a patient's physical and/or verbal resistance and oxygen saturation or heart rate during administration of local anesthesia. METHODS: Two hundred six- to 16-year-olds were randomly allocated to either a control group or an experimental group that received hypnotic induction prior to the delivery of local anesthesia. Subjects were monitored for signs of physical or verbal resistance and changes in pulse rate and oxygen saturation at baseline and upon administration of local anesthetic. RESULTS: Children under hypnosis exhibited significantly less resistance to administration of local anesthesia (P<0.05). A bi-serial correlation for age and resistance showed a significant positive correlation (0.337) in the experimental group, indicating that resistance in children increases with age, but none was shown between gender and hypnotic suggestibility. There was a significant difference in pulse rate, attributable to the hypnotic condition (P=.000), but not in oxygen saturation level. CONCLUSION: Using hypnosis may increase patient cooperation, decrease resistance during painful procedures, and lead to a lower heart rate.

Dental knowledge and awareness among grandparents.

AIM: To investigate grandparent's knowledge and awareness about the oral health of their grandchildren. METHODS: Grandparents accompanying patients aged 4-8 years, who were living with their grandchildren and caring for them for a major part of the day, when both their parents were at work were included in the study. A 20-item questionnaire covering socio-demographic characteristics, dietary and oral hygiene practices was distributed to them. The sample comprised of 200 grandparents (59 males, 141 females). χ(2) analysis and Gamma test of symmetrical measures were applied to assess responses across respondent gender and level of education. RESULTS: Oral health related awareness was found to be low among grandparents. In most questions asked, grandparents with a higher level of education exhibited a better knowledge about children's oral health. Level of awareness was not related to their gender. CONCLUSION: Oral hygiene and dietary habits are established during childhood. There is a great need for dental education of grandparents as they serve as role models for young children.

Type-2 fuzzy logic control based MRAS speed estimator for speed sensorless direct torque and flux control of an induction motor drive.

In this research study, a model reference adaptive system (MRAS) speed estimator for speed sensorless direct torque and flux control (DTFC) of an induction motor drive (IMD) using two adaptation mechanism schemes are proposed to replace the conventional proportional integral controller (PIC). The first adaptation mechanism scheme is based on Type-1 fuzzy logic controller (T1FLC), which is used to achieve high performance sensorless drive in both transient as well as steady state conditions. However, the Type-1 fuzzy sets are certain and unable to work effectively when higher degree of uncertainties presents in the system which can be caused by sudden change in speed or different load disturbances, process noise etc. Therefore, a new Type-2 fuzzy logic controller (T2FLC) based adaptation mechanism scheme is proposed to better handle the higher degree of uncertainties and improves the performance and also robust to various load torque and sudden change in speed conditions, respectively. The detailed performances of various adaptation mechanism schemes are carried out in a MATLAB/Simulink environment with a speed sensor and speed sensorless modes of operation when an IMD is operating under different operating conditions, such as, no-load, load and sudden change in speed, respectively. To validate the different control approaches, the system also implemented on real-time system and adequate results are reported for its validation.

Children's perspective on the dentist's attire.

BACKGROUND: Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and get the child patient to accept the treatment readily. The manner in which the dentist presents himself plays an important role in cementing a friendly relation with the child. AIM: To assess school children's perceptions and preferences towards dentist's attire so as to understand their psych and promote a successful relationship with the patient. DESIGN: A questionnaire designed to evaluate children's attitudes and preferences towards dentists was distributed in public schools and was completed by 619 children (322 males, 297 females) aged between 6-14 years. RESULTS: The study found that majority of children preferred dental professionals to wear traditional formal attire with a white coat and name badge. They preferred the use of plain masks and white gloves but disliked protective eyewear or headcaps. Most children liked dentists with closed shoes and no jewellery but preferred the use of a wrist watch. CONCLUSIONS: The results obtained from this study can help dentists decide what is appropriate to wear when dealing with children so as to minimise their anxiety and improve delivery of health care.

Prevalence of malocclusion among 12 to 15 years age group orphan children using dental aesthetic index.

OBJECTIVE: The study was done to determine the prevalence of malocclusion and orthodontic treatment among orphan children. MATERIALS AND METHODS: The sample consisted of 165 orphan children aged between 12 and 15 years. A clinical examination was used to determine the orthodontic treatment need according to the Dental Aesthetic Index (DAI). The statistical software namely SPSS version 15.0 was used for the analysis different parameters as gender and age. RESULTS: The prevalence of definite, severe and very severe malocclusion was more among males than females and it increased with age. 16.4% subjects needed orthodontic treatment ranging from slight to mandatory form. CLINICAL SIGNIFICANCE: The prevalence and severity of malocclusion was more among orphan children as they are deprived of healthy lifestyle. So, they should be identified and corrective measures instituted at the earliest to prevent a widespread impact on their psychological development.

Comparative evaluation of guided tissue regeneration with use of collagen-based barrier freeze-dried dura mater allograft for mandibular class 2 furcation defects (a comparative controlled clinical study).

AIM: The aim of periodontal surgery is complete regeneration. The present study was designed to evaluate and compare clinically soft tissue changes in form of probing pocket depth, gingival shrinkage, attachment level and hard tissue changes in form of horizontal and vertical bone level using resorbable membranes. MATERIALS AND METHODS: Twelve subjects with bilateral class 2 furcation defects were selected. After initial phase one treatment, open debridement was performed in control site while freezedried dura mater allograft was used in experimental site. Soft and hard tissue parameters were registered intrasurgically. Nine months reentry ensured better understanding and evaluation of the final outcome of the study. RESULTS: Guided tissue regeneration is a predictable treatment modality for class 2 furcation defect. There was statistically significant reduction in pocket depth as compared to control (p < 0.01). There is statistically significant increase in periodontal attachment level within control and experimental sites showed better results (p < 0.01). For hard tissue parameter, significant defect fill resulted in experimental group, while in control group, less significant defect fill was found in horizontal direction and nonsignificant defect fill was found in vertical direction. CONCLUSION: The results showed statistically significant improvement in soft and hard tissue parameters and less gingival shrinkage in experimental sites compared to control site. CLINICAL SIGNIFICANCE: The use of FDDMA in furcation defects helps us to achieve predictable results. This cross-linked collagen membrane has better handling properties and ease of procurement as well as economic viability making it a logical material to be used in regenerative surgeries.