Ortho-Endo Management of Traumatically Intruded Immature Incisors: A Case Report of Novel Interventional Approach With 20 Months Follow-Up.

The case report describes the successful interdisciplinary management of a nine-year-old girl who suffered from traumatic intrusion and rotation of her immature teeth with 12 mm apical displacement of teeth 11 and 21 and 10 mm of teeth 12 and 22. It emphasizes the importance of a comprehensive and contemporary approach, which includes orthodontic intervention and regenerative endodontic procedures (REP). The report follows the CARE (case report) guidelines. The patient was initially observed for four weeks to see if there was potential for spontaneous re-eruption. After eight weeks of orthodontic intervention, the rotation was corrected. However, negative pulp sensitivity and external inflammatory (infection-related) resorption (EIR) occurred, which led to REP using injectable platelet-rich fibrin (i-PRF). Follow-ups over 20 months showed the favorable outcomes of the treatment. A long-term perspective is essential in understanding the outcomes and potential complications associated with traumatic dental injuries (TDI) in children. The case report highlights the importance of collaboration between orthodontists and pediatric dentists, among other specialists. It provides valuable insights into the complexities of managing TDI in children and highlights contemporary regenerative strategies as viable solutions.

Clinical evaluation of periodontal status in subjects with multibracket appliances and the role of age and gender during initial months of fixed orthodontic treatment.

Background: During fixed orthodontic treatment, the presence of various fixed appliances like brackets in the oral cavity for a long period leads to various changes in the oral microflora, ultimately affecting the periodontal health of the teeth. Hence, the current study was performed to clinically assess the periodontal status of the subjects undergoing fixed orthodontic treatment and to evaluate the role of age and gender during the first 6 months of treatment. Materials and Methods: Forty-one subjects (26 females and 15 males) in the age range of 12-28 years scheduled for fixed orthodontic treatment were included in the study. Twenty-eight subjects were adolescents with a mean age of 13.96 years and 13 were adults with a mean age of 22.38 years. Plaque index (PI) and gingival index (GI) were recorded at the beginning and the end of 1, 2, 3, and 6 months of the treatment, and pocket probing depth (PPD) was evaluated at the start and after 6 months of fixed orthodontic treatment. Results: The study showed a statistically significant increase in the mean values of PI (1.10 ± 0.264) and GI (0.929 ± 0.220) over a period of 6 months when compared with the baseline mean values, i.e., 0.557 ± 0.224 and 0.423 ± 0.329, respectively (P < 0.001). The mean PPD values exhibited no significant change. Effect of orthodontic treatment on adolescents/adults and between genders did not statistically differ. Conclusions: Fixed orthodontic treatment with multibracket appliances significantly increases plaque accumulation leading to significant inflammatory changes in the gingival tissues without any significant changes in the clinical probing depths of the pockets regardless of age and gender.

A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability.

AIM: The present study aimed to evaluate and compare the applicability of Demirjian, Willems, and Haavikko methods of dental age estimation in southeastern (Dravidian ethnicity) and northwestern regions (Aryan ethnicity) of the Indian population. MATERIALS AND METHODS: The study includes the orthopantomographs (OPGs) of 303 individuals (173 males and 130 females) of age ranging from 5 to 14 years. The participants in the present research were evaluated under two study groups: group I: participants of the southeastern region and group II: participants of the northwestern region. Dental age was calculated using Demirjian, Willems, and Haavikko methods and compared with the chronologic age of each participant. The accuracy of dental age estimation methods was evaluated by mean absolute error. One-way analysis of variance (ANOVA) and Student's t tests were used to test the significant difference between the chronologic age and estimated dental ages. RESULTS: The Demirjian method showed overestimation, while Willems and Haavikko methods showed underestimation for boys and girls in both the ethnic groups of Indian population. The Willems method of dental age estimation showed comparatively more accurate and reliable results in both the ethnic groups of the Indian population. CONCLUSION: The dental age estimation by Demirjian, Willems, and Haavikko methods showed no significant variation between the different ethnicities of the Indian population. CLINICAL SIGNIFICANCE: The present research will be helpful in pedodontic, orthodontic, and forensic investigations for accurate and reliable dental age estimation in different parts of Indian population. HOW TO CITE THIS ARTICLE: Chaudhry K, Talwar M, Vanga NRV, et al. A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability. Int J Clin Pediatr Dent 2020;13(1):16-20.

Remineralization of Demineralized Enamel and Dentine Using 3 Dentifrices-An InVitro Study.

Objectives: To monitor the electrical resistance of artificially demineralized enamel and root dentine after exposure to different fluoridated dentifrices and, using transversal microradiography, to quantify remineralization. Materials and methods: This in-vitro blind investigation used 20 extracted teeth (four groups of five each). Each group was exposed to one test dentifrice [Colgate PreviDent (5000 ppm F), Colgate Winterfresh gel (1100 ppm F), Fluocaril Bi-Fluoré (2500 ppm F) and placebo (without fluoride)] three times daily for three minutes for 4 weeks. In between exposure to the test dentifrices, teeth were stored in a saliva storage solution. An Electrical Caries Monitor measured the electrical resistance at baseline and during the four-week test period at weekly intervals. The measurements were log transformed and Duncan's multiple range test applied. Remineralization was quantified using transversal microradiography. Results: Log mean (SD) electronic carries monitor (ECM) measurements in enamel at baseline and after 4 weeks of exposure to the test dentifrices were 4.07(1.53) and 3.87(0.90) (Placebo-Fluocaril), 4.11(1.86) and 4.64(1.43) (Colgate Winterfresh gel), 4.81(0.9) and 4.21(1.20) (Fluocaril Bi-Fluoré), and 4.60(0.88) and 3.76(0.9) (Colgate PreviDent). Corresponding measurements in dentine were 2.13(0.89) and 3.06(0.87) (Placebo-Fluocaril), 1.87(0.63) and 2.88(1.32) (Colgate Winterfresh gel), 2.47(1.20) and 1.65(0.60) (Fluocaril), and 2.16(0.00), and 2.34(1.07) for Colgate PreviDent. Lesion depth (µm) after microradiography in enamel was 100.1 (Placebo), 50.6 (Colgate Winterfresh gel), and 110.2 (Fluocaril, and 97.1 (Colgate PreviDent), and corresponding values in dentine were 169.7, 154.8, 183.7, and 153.5. The correlation of ECM and microradiographic parameters was negative (p < 0.05). Conclusion: Exposure of artificially demineralized enamel and root dentine to fluoridated dentifrices and saliva storage solution resulted in remineralization as follows: Colgate Winterfresh > Colgate PreviDent > Placebo-Fluocaril > Fluocaril Bi-Fluoré. Remineralization in teeth of the Placebo dentifrice group may be attributed to the presence of calcium and phosphate ions in the saliva storage solution.

Fluoride Concentration in Saliva following Professional Topical Application of 2% Sodium Fluoride Solution.

BACKGROUND: Topical fluoride application in moderate and high-risk individuals and in those living in low-fluoride communities has been a common practice by dental professionals. OBJECTIVES: The objective of this study was to assess fluoride concentration available in saliva after a professional 2% sodium fluoride solution application (9000 ppm), and the duration of its availability to have an evidence-based practice for application. MATERIALS AND METHODS: Two percent sodium fluoride application was carried out in 45 participants residing in a boarding school. The participants were non tea drinkers and nonfluoride users. Water fluoride of the area ranged from 0.34 ppm to 0.38 ppm. Whole mixed saliva samples were collected at baseline and various time intervals postapplication of 2% sodium fluoride solution. Fluoride in saliva was estimated using the fluoride combination electrode (Orion model 94-09, 96-09) coupled to an ionanalyzer. RESULTS: IBM SPSS statistics version 23.0 was used for the analysis. Normality of the data was assessed using the Kolmogorov-Smirnov test and box plot, and it was found to be nonnormal. Wilcoxon signed-rank test was used to compare all time intervals with baseline, and statistically significant differences were observed (P = 0.0001). Salivary fluoride according to this study showed a biphasic clearance pattern with a peak at 15 min and a rapid fall in 60 min followed by a slow, consistent decline over a 20-h period. The fluoride concentration in saliva remained elevated above baseline from 0.03 ppm to 0.076 ppm even 3 months after application. CONCLUSION: Findings of this study show that, in this population, the frequency of application should be between 2 and 3 months (four applications per year).

Intraosseous Leiomyoma of the Mandible: A Case Report of the Rare Entity and Review of Literature.

INTRODUCTION: Leiomyoma is a rare tumor of smooth muscle origin with a very low incidence in the maxillofacial region. Intraosseous occurrence of oral leiomyoma is even rare with involvement of mandible followed by maxilla. AIM: The purpose of this paper is to present a case of intraosseous leiomyoma of the left mandibular angle region with the review of literature describing this rare entity. The paper also highlights the need to include this entity in differential diagnoses of jaw lesions. MATERIAL AND METHOD: An extensive search of literature was carried out on the Medline-Pubmed and Google Scholar database using the keywords leiomyoma, maxilla, mandible, oral and palate to thoroughly search and collect all the reported cases of intraosseous leiomyoma. RESULT: To the best of our knowledge till date only 22 cases of intraosseous leiomyoma have been reported in the maxillomandibular region we represent the 23rd case of the intraosseous leiomyoma in a 36 year old male patient. CONCLUSION: Though uncommon but it is known to occur in the jaws therefore intraosseous leiomyoma should be included in the list of differential diagnoses of radiolucent lesion of mandible and maxilla.

Odontometric sex estimation from clinically extracted molar teeth in a North Indian population sample.

BACKGROUND: Different dental features have contributed significantly toward sex determination in the forensic anthropological contexts. Population-specific standards (discriminant functions or regression formulae) have been suggested for various population groups to identify the sex of an unknown individual from dental dimensions and other odontometric features. The main purpose of the present investigation was to examine the degree of sexual dimorphism exhibited by the human teeth of North Indians and identify importance as a forensic tool in sex determination. MATERIALS AND METHODS: The linear and diagonal dimensions were recorded at both crown and cementoenamel junction levels of 58 upper and 72 lower molars of 130 Northwest Indian subjects (73 males and 57 females). The measurements were subjected to appropriate statistical analyses to estimate the sex estimation accuracy from lower and upper molars separately. RESULTS: Univariate analyses revealed that molar teeth had greater dimensions in males than the females and the mesiodistal cervical diameter (MDCV) was found to be the most suitable variable for sex determination of the molars. The classification results were in agreement with the previously conducted studies. The index of sexual dimorphism (ISD) was calculated to be higher in lower molars than the upper molars, and the highest sex differences were observed for MDCV based on the ISD. The overall sex estimation accuracy obtained from multivariate discriminant function analysis and regression analysis of pooled data was 70.0% (74% males, 64.9% females) and 66.9% (78.1% males, 52.6% females), respectively. CONCLUSIONS: Odontometrics can play a significant role in establishing the biological identity of an unknown individual even from a single tooth in the absence of other sophisticated molecular or biochemical techniques used for this purpose.

A comparative assessment of fluoride concentration available in saliva using daily prescribed topical fluoride agents.

OBJECTIVE: To assess the availability of fluoride concentration in saliva following the use of fluoride mouthrinse and dentifrice. MATERIALS AND METHODS: The experiment was carried out in 7-15 year-old school children of Chandigarh (n = 90). The children were nonfluoride users. Baseline saliva samples were collected. The subjects were exposed to two test agents, i.e., fluoride mouthrinse (0.05%, 225 ppm F) and dentifrice (1000 ppm F) for 7 days and on the day 8, saliva samples were collected over a 20 hrs period. Wash out period of 3(1/2) months was there before the subjects were exposed to the second test agent. Fluoride in saliva was estimated using fluoride ion-specific electrode. Written informed consent was taken. STATISTICAL ANALYSIS: Kolmogorov-Smirnov test was applied to test the normality of the variables. Mann-Whitney U-test was used to compare the fluoride concentration available in saliva at respective time intervals subsequent to use of the two test agents. RESULTS: Fluoride concentration was elevated in saliva compared to baseline for both the test agents. Fluoride mouthrinse (0.05% sodium fluoride [NaF]) and dentifrice (1000 ppm monofluorophosphate [MFP]) showed a biphasic clearance. Peak in saliva occurred at 15 mins postuse. Night-time use resulted in higher concentration of fluoride in saliva compared to baseline. There was statistically significantly higher fluoride concentration available in saliva for the dentifrice at 5 hrs, 10 hrs, and 20 hrs postuse (P < 0.05). CONCLUSION: Subsequent to the use of NaF (0.05%) daily mouthrinse and MFP dentifrice (1000 ppm) the fluoride concentration in saliva remained elevated to a level of 0.12 ppm for mouthrinse and 0.14 ppm for dentifrice compared to baseline (0.03 ppm) up to 20 hrs postuse. The therapeutic window though not yet established but suggested is 0.1-1 ppm for prevention of demineralization, indicating that daily use of fluoride mouthrinse and dentifrice provides fluoride concentration in saliva for the prevention of demineralization.