In Vitro Evaluation of Mechanical Properties of Cention N and Its Comparison with Resin Modified Glass Ionomer Cement (RMGIC) Restorative Material as Used in Primary Teeth.

Methods: 22 specimens prepared with Cention and RMGIC were embedded in primary teeth mounted in acrylic for analysing shear bond strength. Shear bond strength was analysed using a universal testing machine. The modes of failure in samples were observed under a stereomicroscope and scanning electron microscope. 22 customised samples of Cention N and RMGIC were prepared and categorised as group A and group B, respectively. The flexural and compressive strengths of these samples were evaluated using a universal testing machine. Results: The shear bond strength of RMGIC was higher than that of Cention N, whereas the compressive and flexural strengths of Cention N were significantly higher than those of RMGIC. The modes of failure were predominantly adhesive followed by mixed failures. Conclusion: The results of this study suggest that Cention N demonstrated superior mechanical properties compared with RMGIC and can therefore be recommended for restorations in primary posterior teeth. Cention N being a smart, esthetic, self-cured, or dual-cured material with better mechanical properties offers a wide range of applicability in primary teeth.

Paediatric condylar trauma - primary management considerations - A review.

Children are not simply ''small adults'', and the application of adult-type treatment can be inappropriate in many circumstances. Their craniomaxillofacial (CMF) structure changes dramatically as children grow and develop. This anatomical change also changes the location, pattern, and nature of CMF injury. Similarly, condylar architecture and anatomy also differ in children, due to which the management of paediatric condylar fractures is strikingly different from adult condylar fractures. In addition to this physiological, and behavioural differences pose an additional challenge to a surgeon. Paediatric condylar fracture also considers conservative/non-operative treatment as an effective treatment option. However, the decision between operative and non-operative management compromises paediatric facial growth, precise reduction, and rigid fixation. This decision is crucial and is guided by many factors. Improper treatment protocol can have a devastating effect on a child facial growth and development. It can lead to various deforming complications mainly ankylosis. Hence treatment of paediatric condylar fracture should be well planned and executed.

Effect of shape of titanium dioxide nanofillers on the properties of dental composites.

The main objective of the present study was to evaluate the effect of the morphology of titanium dioxide nanofillers on the flexural strength and shear bond strength of the dental composite. Spherical and rhombic-shaped nano titanium dioxide fillers were synthesized via solvothermal method and were characterized. Subsequently, these fillers were incorporated into a flowable composite (Filtek™ Z350 XT Flowable Restorative) at 0.5 wt.% and 1.5 wt.% and the prepared specimens were stored in water for 24 h. The specimens were then evaluated for flexural strength using a universal testing machine. Similarly, the shear bond strength of modified composites to the tooth was evaluated and bond failures were analyzed using stereomicroscope magnification. Incorporation of nanofillers significantly enhanced the flexural strength of flowable composite (p = 0.009) with a significant increase at 0.5wt.% of spherical (p = 0.015) and rhomboidal-shaped fillers (p = 0.010). However, no statistically significant difference in flexural strength was observed among the different shapes of nanofillers. The results of our study did not show a significant effect on the shear bond strength of the composites. Thus the reinforcing ability of titanium dioxide nanofillers on dental composite was confirmed in this study, although the effect of using nanofillers with different morphology was not significant.

Analysis of Erosive Nature of Fruit Beverages Fortified with Calcium Ions: An In Vitro Study Evaluating Dental Erosion in Primary Teeth.

Background: Since children frequently consume acidic fruit beverages, dental erosion is common in children. The erosive effects on primary teeth are more profound due to the lesser thickness of enamel and dentin. This study evaluated if calcium fortification of fruit beverages could reduce their erosive potential. Methodology. Tropicana Orange Delight was the fruit beverage chosen and fortified with calcium carbonate. Forty noncarious extracted primary teeth were equally distributed into four groups. Samples in group A were exposed to calcium-fortified fruit beverages and group B to nonfortified fruit beverages for 1, 2, and 3 min. The pH and calcium ion concentration of both the fruit beverages were evaluated from baseline through the test period. Samples in groups C and D were then exposed to fortified and nonfortified fruit beverages for 10, 20, and 30 min. The surface roughness and microhardness of these samples were analysed. Results: Due to fortification, the pH and calcium ion concentration of fortified beverages was higher compared to nonfortified beverages at baseline. The calcium ion concentration of fortified beverages decreased from baseline in contrast to an increase in the nonfortified beverage group. This indicates that fortified beverage is less erosive in nature. The surface roughness of samples in the fortified beverage group did not decrease significantly from baseline. In the nonfortified beverage group, surface roughness values at 20 and 30 min of exposure were higher than baseline, suggesting that significant erosive changes occur at the prolonged duration of exposure. The microhardness values of samples in the fortified beverage group increased from baseline through the test period, suggestive of resistance to erosion offered by calcium fortification. The microhardness values of samples in the nonfortified beverage group decreased through the test period, suggestive of erosion. Conclusion: Calcium fortification of this fruit beverage significantly reduces its erosive potential on primary teeth.

Hardware Removal in Maxillofacial Trauma: A Retrospective Study.

BACKGROUND: Miniplates are commonly used for the fixation of maxillofacial fracture segments. Removal of the hardware is controversial. A retrospective study of medical records was performed to observe the reasons for plate removal. MATERIALS AND METHODS: A 10-year retrospective study of medical records was performed. Demographics, type of fracture, location, type of miniplate used, the time gap between the insertion and removal, and causes of hardware removal were assessed. RESULTS: About 1472 patients had undergone internal fixation for the facial fractures. Stainless steel miniplate was used in 489 patients, and titanium was used in 983 patients. Out of the 42 cases, 22 cases involved the removal of titanium hardware and 20 patients involved the removal of stainless steel hardware. Infection/osteomyelitis was the main cause of hardware removal. The maximum amount of hardware failure was in the mandible. 78.6% of hardware removal was performed in males. CONCLUSION: Based on our study, routine removal of titanium miniplates can be performed in children to avoid growth disturbances, not indicated in adult patients unless symptomatic.

Comparison of shear bond strength of light cure mineral trioxide aggregate and light cure calcium hydroxide with nanofilled composite: A stereomicroscopic and scanning electron microscope analysis.

OBJECTIVE: The quest for ideal pulp capping materials has given rise to the development of newer materials such as light cure mineral trioxide aggregate (MTA). The bond strength of the pulp capping materials with overlying restoration is one among the several factors that are critical for the success of vital pulp therapy. Hence, we conducted this study to evaluate and compare the shear bond strength (SBS) of light cure MTA and light cure calcium hydroxide with nanofilled composite. MATERIALS AND METHODS: Thirty acrylic blocks each with a central hole were prepared to uniform dimensions and randomly distributed into two equal groups. In Group I, light cure MTA, and in Group II, light cure calcium hydroxide was used as pulp capping materials. After the application of adhesive system, nanofilled composites were applied onto the pulp capping material using a cylindrical plastic matrix. The SBS was tested on a universal testing machine (Instrom 3366, UK) at a crosshead speed of 0.5 mm/min. The samples were examined under stereomicroscope and scanning electron microscope to analyze different modes of failure. RESULTS: The results were statistically analyzed using independent sample t-test. Light cure MTA attained the mean SBS of 6.54 MPa and light cure calcium hydroxide attained the mean SBS of 6.56 MPa. There was no significant difference statistically in SBS of both the materials (P < 0.05). The modes of failure were predominantly mixed failure followed by cohesive failure within the restorative material in both Group I and II. CONCLUSION: The results of the study suggest that the SBS of light cure MTA and light cure calcium hydroxide is comparable. The modes of failure analyzed in both light cure MTA and light cure calcium hydroxide are not significantly different statistically. Hence, both materials can be successfully used as pulp capping material with nanofilled composite.

Survey of knowledge of school children towards the prevalence, severity, management of maxillofacial injuries, and rescue skills in the event of a dog bite.

BACKGROUND: Maxillofacial injuries are reported commonly in children encountering animal/dog attack. The level of knowledge of children on such events can form a sound basis for the prevention of maxillofacial injuries resulting from dog bites/attacks. AIM: This study aims to assess the knowledge of children on maxillofacial injuries resulting from dog bites, their management, and rescue skills to be used during the event of a dog attack. SETTINGS AND DESIGN: The study is a cross-sectional questionnaire survey. MATERIAL AND METHODS: Seven hundred children aged 7-12 years participated in the study. A questionnaire consisting of 21 questions assessed the common site and management of injury resulting from dog bites, the source of exposure, and the knowledge of children on rescue skills to be used in the event of dog attack. This was followed by an awareness program to educate the children on rescue skills and management of dog bite injuries. STATISTICAL ANALYSIS: Descriptive statistics were calculated for all the variables. RESULTS: A significant percentage of dog bite injuries occurred on the face and hands in children. Boys were more common victims. Familiar dogs inflicted injuries to the children commonly than stray dogs. The children lacked knowledge on the management of dog bite injuries; however, they were aware of rabies and its prevention. The children were not well aware of rescue skills to be used in the event of a dog attack. CONCLUSION: Children are innocent and behavior of dogs are unpredictable hence they become victims of the dog attacks. Educating children on safe animal behavior can prove vital in reducing gruesome maxillofacial injuries resulting from dog attacks.

Concomitant Temporomandibular Joint Ankylosis and Maxillomandibular Fusion in a Child with Klippel- Feil Syndrome: A Case Report.

Klippel-Feil syndrome (KFS) is classically characterized by fusion of any of the two of seven cervical vertebrae. It is identified by the presence of a triad of clinical signs including short neck, limitation of head and neck movements and low posterior hairline. Unusual bony malformations leading to facial asymmetry is the most common oral manifestation associated with KFS. Such maxillomandibular fusion can also result in restricted mouth opening in children. It's a challenge to provide complete rehabilitation in such children. This paper presents a report of a type II KFS with both maxillomandibular fusion and temporomandibular joint ankylosis which led to the limited mouth opening in a six-year-old child. Also, the child showed an inadequate development of speech, facial asymmetry and compromised oral health owing to the restricted mouth opening. After thorough investigations, surgery was done which restored limited mouth opening which led to normalizing of speech and oral health.

Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness.

AIM: To evaluate the effectiveness of resin infiltration on artificial caries lesion by assessing the depth of resin penetration and the change in microhardness of lesion postinfiltration. MATERIALS AND METHODS: Totally 45 human extracted premolars were used to create an artificial demineralized lesion in enamel using demineralizing solution. A total of 15 samples (group I) were infiltrated with resin. The depth of resin penetration was studied using scanning electron microscope (SEM). Other half (n = 30) of samples was equally divided into three subgroups and Vickers hardness number (VHN) values were obtained to measure the surface microhardness as group 11 a-before demineralization, 11 b-after demineralization, IIc-postresin infiltration. RESULTS: Mean depth of penetration in group I was 516.8 urn. There was statistically significant increase in VHN values of demineralized lesion postresin infiltration (independent Student's t-test, p < 0.001). CONCLUSION: Penetration depth of the resin infiltrant was deep enough to render beneficial effects, while significant increase in microhardness was observed postresin infiltration. CLINICAL SIGNIFICANCE: Infiltrant used can be considered as a valid treatment option for noncavitated lesions. HOW TO CITE THIS ARTICLE: Prajapati D, Nayak R, Pai D, Upadhya N, Bhaskar VK, Kamath P. Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness. Int J Clin Pediatr Dent 2017;10(3):250-256.

A comparative evaluation of the remineralization potential of three commercially available remineralizing agents on white spot lesions in primary teeth: An in vitro study.

BACKGROUND: The focus in caries management has shifted to early detection of caries lesions and targeted noninvasive management of incipient lesions using novel remineralizing agents. AIM: This study aimed to compare and evaluate the remineralization potential of commercially available agents containing nano-hydroxyapatite (nano-HA), casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), and Tricalcium phosphate (TCP) on artificially induced white spot lesions in primary teeth. SETTINGS AND DESIGN: This is an in vitro double-blind randomized study. MATERIALS AND METHODS: Forty extracted or exfoliated primary teeth were selected and randomized as follows: Group I: FTCP, Group II: fluoridated dentifrice, Group III: CPP-ACPF, and Group IV: Nano-HA. DIAGNOdent readings and scanning electron microscope (SEM) energy dispersive X-ray (EDX) analysis were carried out at baseline. The samples were subjected to the test agents after inducing white spot lesions. The readings were repeated postdemineralization and postremineralization. STATISTICAL ANALYSIS: The data were analyzed using IBM SPSS version 20 software with one-way ANOVA, post hoc Tukey's HSD, and paired t-test. RESULTS: SEM evaluation showed favorable surface changes in all the four study groups after remineralization therapy. Intragroup comparison of DIAGNOdent and EDX readings showed a highly significant difference between baseline, postdemineralization, and postremineralization values. However, the intergroup comparison was statistically nonsignificant. CONCLUSION: All test agents were comparable in their remineralization potential.

Concomitant Central Giant Cell Granuloma and Aneurysmal Bone Cyst in a Young Child.

Although Central Giant Cell Granuloma (CGCG) is a benign tumor of the jaw and aneurysmal bone cyst seen in children, its aggressive behavior causes extensive loss of hard tissue requiring wide excision and extensive rehabilitation. We report a rare case of concomitant CGCG and aneurysmal bone cyst in a two-year-old male child, involving the coronoid and condylar process. Young age, large tumor, its aggressive nature, and future growth of orofacial region pose a significant challenge in the management of such conditions. For a successful outcome, the systematic approach to the presurgical evaluation and appropriate treatment planning is essential for such conditions.

Oral Health Characteristics and Dental Rehabilitation of Children with Global Developmental Delay.

Global developmental delay (GDD) is a chronic neurological disturbance which includes defects in one or more developmental domains. The developmental domain can be motor, cognitive, daily activities, speech or language, and social or personal development. The etiology for GDD can be prenatal, perinatal, or postnatal. It can be diagnosed early in childhood as the delay or absence of one or more developmental milestones. Hence the role of pedodontist and pediatricians becomes more crucial in identifying this condition. The diagnosis of GDD requires a detailed history including family history and environmental risk factors followed by physical and neurological examinations. Investigations for GDD include diagnostic laboratory tests, brain imaging, and other evidence-based evaluations. GDD affects multiple developmental domains that not only have direct bearing on maintenance of oral health, but also require additional behavior management techniques to deliver optimal dental care. This paper describes two different spectra of children with GDD. Since the severity of GDD can vary, this paper also discusses the different behavior management techniques that were applied to provide dental treatment in such children.

Pernicious Effects of Toe Sucking Habit in Children.

Digit sucking is common nonnutritive sucking habit in childhood. However it is unusual to find toe sucking habit in children. We report a case of a seven-year-old child sucking great toe of the left foot. The child was referred by her paediatrician for dental evaluation due to her complaint of recurrent episodes of pyrexia. A dental evaluation was warranted as no particular system contributed to such recurrent episodes of fever in this child. Although dental examination did not reveal any cause for recurrent episodes of pyrexia, as a part of routine history taking we discovered that this child indulges frequently in sucking the great toe of her left foot since infancy. Any nonnutritive sucking habit is considered deleterious; this habit also caused significant effect on the child's dentofacial structures, sucked toe, and her general health. Hence the treatment plan was formulated for immediate cessation of habit. Appropriate interception of habit and timely orthodontic intervention led to not only early interception of cross-bite but also decrease in pyrexial episodes. This case report describes the pernicious effects of toe sucking habit and its relevance to recurrent pyrexia in children.

Our Experience in the Management of Traumatic Wound Myiasis: Report of 3 Cases and Review of the Literature.

Compromised health and hygiene can lead to many complications and one among them is traumatic wound myiasis. Myiasis is the invasion of living tissues by larvae of flies. Three cases of traumatic orofacial wound myiasis and treatment strategies followed for the management of them are reported in this paper.

Use of laser fluorescence and scanning electron microscope to evaluate remineralization of incipient enamel lesions remineralized by topical application of casein phospho peptide amorphous calcium phosphate (CPP-aCP) containing cream.

The aim of this in vitro study was to evaluate the remineralization of incipient enamel lesions by the topical application of Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) using laser fluorescence and scanning electron microscope. Sixty caries free extracted teeth were used in the study. Forty teeth were used as test samples, ten as positive and ten as negative controls. The samples were demineralized and then remineralized by the topical application of CPP-ACP for a period of 14 days. The remineralization was evaluated with the use of laser fluorescence and scanning electron microscope (SEM). The results of this study showed that the laser fluorescent readings of test samples after remineralization were highly significant (p < 0.001). A significant number of test samples observed under SEM showed high scores of remineralization.