Comparative Evaluation of Longevity of Fluoride Release from Three Different Fluoride Varnishes: An Observational Study.

Introduction: The cycles of demineralization and remineralization result in a dynamic process of caries development. Caries are prevented by the shift in the balance from demineralization to remineralization at the tooth-oral fluid interface with the help of salivary fluoride levels (in parts per million). The advantages of fluoride varnish application over other substitutes like dentifrices, mouthrinses, gels, or foams are that varnishes are well tolerated by infants, young children, or children with special healthcare needs and have prolonged therapeutic effects. This study was formulated to evaluate and compare the longevity of fluoride release from different fluoride varnishes, namely Fluor Protector, Enamelast, and Enamel Pro varnish. Aim: To evaluate and compare the longevity of fluoride release from three different fluoride varnishes. Materials and methods: The study samples comprised 72 healthy permanent maxillary anterior teeth. The teeth were divided into four groups, with eighteen teeth in each group. The surfaces of all teeth were then covered by different colored nail varnish according to the respective group, except for a 3 × 3 mm window on the facial (labial) surface of the crown, where the test materials were applied according to their respective group. In group I, Fluor Protector varnish; in group II, Enamelast varnish; and in group III, Enamel Pro varnish was applied. Group IV was the control group; hence, no test material was applied. All specimens were then stored in plastic containers with a pH of 7.2 in artificial saliva at room temperature. The specimens were transferred into new plastic containers after 1 day, containing fresh artificial saliva, and solutions from previous plastic containers were taken for fluoride analysis. This process was repeated sequentially to analyze the amount of fluoride released in ppm from the specimens at the end of 1, 3, and 6 months. Statistical analysis: Analysis was performed on Statistical Package for the Social Sciences (SPSS) software (Windows version 22.0). Results: Conventionally used 1.5% ammonium fluoride varnish, that is, Fluor Protector varnish, showed the least release of fluoride (0.03 ± 0.0 ppm), while resin carrier-based 5% sodium fluoride varnish, that is, Enamelast varnish showed a good amount of fluoride release for 6 months continuously, that is, (0.16 ± 0.06 ppm) at last follow-up. Enamel Pro varnish, which has 5% sodium fluoride with amorphous calcium phosphate (ACP) formula, was found to be the best varnish as it released the maximum amount of fluoride in ppm in artificial saliva for up to 3 months (0.32 ± 0.08) but less than Enamelast varnish only at 6 months follow-up that is 0.09 ± 0.03 ppm. Conclusion: The present study concludes that based on the amount of fluoride released for 6 months duration, Enamel Pro varnish, followed by Enamelast varnish and Fluor Protector varnish, are advisable to apply for caries prevention. How to cite this article: Singh V, Naik S, Vashisth P, et al. Comparative Evaluation of Longevity of Fluoride Release from Three Different Fluoride Varnishes: An Observational Study. Int J Clin Pediatr Dent 2024;17(3):341-345.

Relationship between attachment style of 4-7-year-old children and their behavior during dental visit.

Background: The general health and quality of life are directly correlated with oral health. Oral health is one of the unique health concerns that apply to all children. Pediatric dentistry is built on effective communication with children, which is also a requirement for providing pediatric dental care. Many pediatric dentists find it difficult to anticipate children's behavior and how they will respond to therapeutic procedures. The purpose of this study was to evaluate children's attachment types in order to forecast their behavior during a dentist appointment. Materials and Methods: The participants were 120 children between the ages of 4 and 7 who were reported to the Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Bareilly. The youngsters were evaluated by a dental graduate student. While they waited in the waiting area, the parents were asked to complete the Kinship Center Attachment Questionnaire regarding their kids. In the second visit, dental work was scheduled for the kids who had met the requirements for inclusion in the first visit. Another pediatric dentistry postgraduate student evaluated the children's conduct during the dental procedure using a predefined questionnaire and the Frankl scale. The Chi-squared test, t-test, Pearson's correlation coefficient, and linear regression were used to examine the data. Results: According to the findings, 55.8% of the total children were cooperative, among which 59.1% were female and 52.0% were males. The average age of the kids was 6.2 ± 0.95. Moreover, 21.3% of kids had insecure attachment styles and 78.7% of kids had secure attachment types. The child-dentist communication and the insecure ambivalent attachment pattern were significantly correlated. As a result, our study demonstrated that children's safe attachment styles varied with age. Our results showed that there is an inverse relationship between children's collaboration and age, with cooperation rising as age increases. Conclusions: According to the findings of this study and considering its limitations, in young ages, the attachment style of the mother plays an important role in behavior of children. The significant correlations existed between the insecure ambivalent attachment style and child-dentist communication, as well as the secure attachment type and mother-child separation.

Comparative evaluation of Hand, Rotary and Reciprocation motion on Dentin thickness and instrumentation time in Primary anterior teeth using CBCT: An observational study.

Background: Ultimate goal of BMP is to extirpate the pulp tissue completely, microorganisms, debris & shaping the canal which preserves the original course of the canal to receive an obturating material. Due to various morphological challenges present in deciduous root canal, there is high demand of an improved quality & design of file system with less working length to prevent undesirable complication & reduce treatment time. Aim: To evaluate & inter-compare the dentin thickness and instrumentation time in root dentin of deciduous teeth after BMP in Hand, Rotary & Reciprocation motion with single-file systems. Material and Methods: 60 extracted primary single rooted teeth with un-resorbed roots were included in the study. Teeth were divided into three groups consisting of 20 teeth in each group. In Group-1 Root canal preparation was done with pediatric Hand files, In Group-2 with pediatric Single-file system in rotary motion and in Group-3 with pediatric Single-file system in reciprocating motion. Teeth were scanned before & after preparation with CBCT. Segments were analyzed for dentin thickness at 3mm,5mm and 7mm respectively. Instrumentation time was recorded by an assistant. Results: Mean instrumentation time of Rotary was least as compared to Reciprocation & Hand respectively, instrumentation time taken by hand filing was significantly higher. Reciprocating filing helps in better dentin debridement at apical and the middle third and no difference was found at the coronal third among all three groups. Conclusions: Reciprocating filing helps in better dentin debridement and rotary instrumentation requires least time for canal preparation. Key words:Hand Files, Rotary Files, Reciprocating motion, CBCT.

Sex determination from mesiodens of Indian children by amelogenin gene.

CONTEXT: The identification of sex is the first and the foremost step in forensic science. Teeth consist of enamel which is the hardest tissue available in the body, protector of DNA presents in pulp tissue at the time of exposure of tooth to adverse conditions. Teeth can be stated as a sealed box of mystery as it contains various human and bacterial DNA for molecular utilization. AIM AND OBJECTIVE: The aim is to determine sex from mesiodens on the basis of gene identification by the polymerase chain reaction (PCR). SETTINGS AND DESIGN: Total number of sample was 8 human-extracted mesiodens. DNA was isolated and was subjected to PCR analysis with use of predesigned primers for amelogenin (AMEL) X and AMEL Y genes. RESULTS: Isolation of genomic and mitochondrial DNA from mesiodens was successful in six samples (75%). In samples, quantity of DNA present was also calculated. CONCLUSION: Mesiodens are a good source of DNA and are a very useful tool in identification of sex using PCR analysis which was simple and effective. Hence, the procedure presented in the present study can be applied for extraction of DNA and identification of sex for forensic purpose.

Bioactive Glass S53P4 versus Chlorhexidine Gluconate as Intracanal Medicament in Primary Teeth: An In-vivo Study Using Polymerase Chain Reaction Analysis.

BACKGROUND: Bacteria have long been recognized as the primary etiology for pulpal and periapical lesions, which necessitates the elimination of bacteria from the root canal system. In primary teeth, irrigation and debridement is the main protocol required to disinfect the canal. Biomechanical preparation cannot be vigorously done on the primary teeth due to anatomical barrier such as thin and flared roots. This calls for the use of an effective intracanal medication that will assist disinfection of root canal system. Aim of the study was to examine the in-vivo susceptibility of root canal bacteria to chlorhexidine (CHX) gluconate-1% gel and bioactive glass (BAG) S53P4 when used as intracanal medicaments using polymerase chain reaction (PCR). METHODOLOGY: PCR (analysis used oligonucleotide primers of Escherichia coli) was used to detect and compare the microbial load reduction after medication of 14 teeth for a week with either CHX gel - 1% or BAG S53P4. The pre and post microbial load was checked in the form of colony forming units. When analysis was done, a statistically significant difference was observed between the two groups. RESULTS: The study revealed that both medicaments caused a considerable amount of microbial load reduction. BAG S53P4 caused much more reduction than CHX 1% gel. Statistical analysis showed a significant difference between the two groups. CONCLUSION: BAG S53P4 has superior antibacterial property as compared to CHX 1% gel.

Comparative evaluation of root surface morphology after planing and root conditioning with tetracycline hydrochloride--an in vitro SEM study.

BACKGROUND AND OBJECTIVES: Tetracycline hydrochloride has been shown to produce changes on periodontally involved root surfaces that can potentially enhance periodontal regeneration. This in vitro study was carried out to compare the root surface changes after scaling and root planing alone, and scaling and root planing followed by application of 100 mg/ml tetracycline hydrochloride under the Scanning Electron Microscope. MATERIALS AND METHOD: Fifteen periodontally compromised freshly extracted single-rooted teeth were thoroughly cleaned. The teeth were then sectioned into thirty blocks and divided into two groups. Group I (control) consisted of teeth which received scaling and and root planing alone and Group II received scaling and root planing followed by application of 100 mg/ml tetracycline hydrochloride under the Scanning Electron Microscope. RESULTS: Tetracycline hydrochloride solution showed statistically highly significant removal of smear layer at 100 mg/ml solution (p < 0.001) and enlargement of dentinal tubule diameter (1.46 microm). CONCLUSION: It can be concluded that tetracycline hydrochloride at concentration 100 mg/ml effectively removes the smear layer and enlarges the dentinal tubules.

Bond strength and interfacial morphology of different dentin adhesives in primary teeth.

OBJECTIVE: To evaluate the interfacial morphology and the bond strength produced by the three-step, two-step and single-step bonding systems in primary teeth. MATERIALS AND METHODS: Occlusal surfaces of 72 extracted human deciduous teeth were ground to expose the dentin. The teeth were divided into four groups: (a) Scotchbond Multipurpose (3M, ESPE), (b) Adh Se (Vivadent), (d) OptiBond All-in-One (Kerr) and (e)Futurabond NR (VOCO, Cuxhaven, Germany). The adhesives were applied to each group following the manufacturer's instructions. Then, teeth from each group were divided into two groups: (A) For viewing interfacial morphology (32 teeth), with 8 teeth in each group, and (B) For measurement of bond strength (40 teeth), with 10 teeth in each group. All the samples were prepared for viewing under SEM. The statistical analysis was done using SPSS version 15.0 software. RESULTS: Observational measurement of tag length in different adhesives revealed that Scotchbond had the most widely spread values with a range from 12.20 to 89.10µm while OptiBond AIO had the narrowest range (0 to 22.50). The bond strength of Scotchbond Multipurpose was significantly higher (7.4744±1.88763) (p<0.001) as compared to Futurabond NR (3.8070±1.61345), Adhe SE (4.4478 ± 1.3820) and OptiBond-all-in-one (4.4856±1.07925). CONCLUSION: The three-step bonding system showed better results as compared to simplified studied bonding systems.

Combined endodontic therapy and periapical surgery with MTA and bone graft in treating palatogingival groove.

A 37-year-old male patient reported to our department with chief complaint of pain and pus discharge from the labial marginal gingiva in the maxillary right lateral incisor region since last 4 months. Clinically, the tooth was hypersensitive to percussion and palpation but failed to respond to pulp sensitivity testing. After periodontal probing, a palatal groove was observed which started at the cingulum and travelled apically and laterally, associated with a pocket depth of 8 mm. Occlusal radiograph showed circumscribed radiolucency measuring 5 mm×7 mm in diameter at the apex of the tooth. A clinical diagnosis of chronic apical abscess was established. The case was treated with a combination of mineral trioxide aggregate and bone graft. At the 6-month follow-up visit, the tooth showed progressive healing without sinus track and sulcular bleeding.

Multiple bilateral taurodontic teeth in primary dentition: a case report.

Taurodontism describes the tendency for the body of the tooth to enlarge at the expense of the roots. An enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cementoenamel junction are the characteristic features. These anatomic variations may hinder location of canal orifices, complete removal of pulp, proper instrumentation and obturation. Importance of radiographic interpretation for the diagnosis of this alteration cannot be overlooked. This article describes a case of multiple bilateral taurodontism involving all the deciduous molars in a 3½ year old female. The child reported with a chief complaint of multiple carious lesions. How to cite this article: Vashisth P, Dwivedi S, Arora S, Mayall S. Multiple Bilateral Taurodontic Teeth in Primary Dentition: A Case Report. Int J Clin Pediatr Dent 2013;6(2):132-133.

Comparative evaluation of the effect of different bonding agents on the ultramorphology of primary tooth dentin and the resin dentin interface.

AIM: To analyze and compare the changes in the ultramorphology of dentin in primary teeth using different bonding agents and to study the resin/dentin interface produced by them. MATERIALS AND METHODS: Occlusal surfaces of 50 extracted human deciduous teeth were grounded to expose the dentin. The teeth were divided into two groups (A) For viewing surface morphology- 18 teeth divided into four groups: (a) for viewing dentinal morphology (3 teeth), (b) Scotchbond multi-purpose (5 teeth), (c) Adhe SE (5 teeth), (d) Futurabond (5 teeth). (B) For viewing interfacial morphology- 32 teeth divided into four groups with 8 teeth each: (a) Scotch Bond Multipurpose (3M, ESPE),), (b) Adhe Se (Vivadent), (c) Optibond All-in-One (Kerr), (d) Futurabond NR (VOCO, Cuxhaven, Germany). The adhesives were applied to each group following the manufacturer's instruction. All the samples were then prepared for viewing under SEM. RESULTS: The photographs were graded using a four-step (0-3) scale method proposed by Ferrari et al. For Scotchbond, 12 (75%) were graded as 2 Grade 3 was observed in only 1 observation in the entire lot of materials. The results obtained for Adhe SE and Optibond AIO were similar, i.e. in 5 (31.25%) observations each the scores were 0 and in 11 (68.75%) observations each the scores were 1. In case of Futurabond, 3 (18.75%) observations were graded as 0 and 13 (81.25%) were graded as 1, thus showing a mean score of 0.81±0.40. CONCLUSION: Three- step bonding agent results in the complete removal of smear layer. While the self- etch approach is not efficient in removing the smear layer and opening of the dentinal tubules. The longest resin tags with lateral branches were seen in two groups- Scotch bond multipurpose and Optibond FL.

Butterfly rash with periodontitis: A diagnostic dilemma.

Rashes can occur in any part of the body. But rash which appears on face has got both psychological and cosmetic effect on the patient. Rashes on face can sometimes be very challenging to physicians and dermatologists and those associated with oral manifestations pose a challenge to dentists. Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE), but it can also include a plethora of conditions. The case presented here is of a female with butterfly rash along with typical bright red discoloration of gingiva. The clinical, histopathological and biochemical investigations suggested the presence of rosacea.

Early treatment outcomes of class II malocclusion with twin-block facial profile and cephalometric changes.

Esthetic improvement is highly valued by patients seeking orthodontic treatment. Subjects with a class II malocclusion are a good example of patients who seek treatment primarily for esthetic improvement. A young growing child with convex profile due to a small, retropositioned mandible, normal midface and lower tip trap is more suitable for functional appliance treatment. Functional appliances encourage adaptive skeletal growth by maintaining the mandible in a corrected forward position for a sufficient period of time to allow adaptive skeletal changes to occur in response to a functional stimulus. The aim of this article is to describe two cases of class II malocclusion in late mixed dentition period treated with twin-block. The cephalometric and facial profile changes have been discussed.