Variation of OXIS contact areas in primary molars among 3-6-year-old children with intraoral digital scanning.

PURPOSE: To determine the variation of OXIS contact areas in primary molars using digital impressions generated from an intraoral scanner (IOS). METHODS: A cross-sectional study was carried out on 214 caries-free posterior quadrants of 80 children (38 males and 42 females) aged 3-6 years. Calibration of taking digital impressions with the IOS procedure was performed initially through scanning of ten quadrants of children to provide a learning environment to the examiner. The digital impressions were then exported, and the type of interproximal contact areas present between the distal surface of the primary first molar and the mesial surface of the primary second molar were identified according to the OXIS classification. The prevalence of the types of OXIS contact areas was expressed in the form of numbers and percentages. The chi-square test was applied to investigate the variability among the arches and to understand the association of OXIS contact areas across age, gender, and arches. RESULTS: The most common contact area type observed was I-type (59.8%), followed by S-type (15.4%), X-type (12.6%), and O-type (12.2%). The I-type contact area was most frequently seen in both males (51.6%) and females (65.5%), while the S-type contact area in males (14.7%) and X-type contact area in females (8.4% each) were the least frequent with no statistical significance between genders (p > 0.05). All three age groups studied showed the highest prevalence of the I-type contact area, which increased with an increase in age (p < 0.05). The inter-arch comparison showed a significant result in terms of the X-type contact area on the right side, and O-type, X-type, and I-type contact areas on the left side, while no statistical difference was seen in the intra-arch comparison for all contact types. CONCLUSION: I-type contact areas were the most prevalent across the arches, age groups and genders.

Evaluation of RURS elbow guard in the management of thumb-sucking habit in children with and without intellectual disability.

BACKGROUND: Digit sucking is a common oral habit among many children, which involves placing the thumb/finger into the mouth, which can cause malocclusion in mixed and permanent dentition. AIM: To evaluate the efficacy of the RURS elbow guard in the management of thumb-sucking habits in children with intellectual disabilities and those without in terms of the mean duration of appliance therapy. The secondary objective was to compare the RURS elbow guard with an intraoral crib in healthy children (without intellectual disabilities) to manage the habit of thumb-sucking. DESIGN: Children with intellectual disabilities and those without between the age of 4 and 16 years were included in the study and categorised into three groups, namely group I (50 normal children; intraoral crib appliance), group II (50 normal children; RURS elbow guard) and group III (50 children with intellectual disabilities; RURS elbow guard). RESULTS: The mean duration of appliance therapy for groups I, II and III were 200.20 ± 20.43 days, 204.34 ± 20.56 days, and 218.43 ± 15.66 days, respectively (p < 0.001). The differences in the mean duration between group I and group II were statistically non-significant, with statistically significant differences between group I and group III (p < 0.001) and between group II and group III (p < 0.05). CONCLUSION: The RURS elbow guard was found to be an efficient appliance in treating thumb-sucking among children who had mild to moderate intellectual disabilities. RURS elbow guard was equally efficient as an intraoral crib appliance in managing thumb-sucking habits in children without intellectual disabilities.

Reliability and validity of artificial intelligence-based innovative digital scale for the assessment of anxiety in children.

AIM: To assess the reliability and validity of an AI-based, innovative digital scale for the assessment of dental anxiety in children. BACKGROUND: Dental anxiety still persists as a potential problem in managing the child in the dental office. There is a need to develop a gold standard scale to measure anxiety in children incorporating newer technology. An innovative self-reported scale known as RMSDigital Anxiety Scale (RMS-DAS) incorporating artificial intelligence (AI) was developed. METHODS: Seventy-six children (aged 4-12 years) were included in the reliability group. The RMS-DAS test score was recorded on Day 1 where the child was asked to click on the expression produced by AI that matches his/her anxiety level the most at that moment. RMS-DAS retest score was recorded after 7 days. The validity group included 140 children. The anxiety scores were recorded using three scales; RMS-DAS, RMS-Pictorial Scale (RMS-PS) and Facial Image Scale (FIS) during the same visit where the child was asked to click on the expression that matches his/her anxiety level the most at that moment. Reliability was assessed by the internal consistency using Cronbach's alpha and the test-retest was assessed using paired t-test, scatterplot, and coefficient correlation. The validity of RMS-DAS was assessed by correlating it with RMS-PS and FIS using Spearman's correlation coefficient. CONCLUSION: RMS-DAS is a reliable and valid scale that can be used as a new digital tool to assess children's dental anxiety.

Attitude and Practices of Paediatric Dentists towards Parental Guidance on Dental Trauma. A cross-sectional survey.

AIM: There is a lack of sufficient information about the protocols followed by paediatric dentists in informing parents about traumatic dental injuries as a part of anticipatory guidance. Hence, the aim of this study was to assess paediatric dentists' attitudes and practices about parental guidance regarding these injuries. MATERIALS: This was a cross-sectional survey conducted using a validated questionnaire emailed through Google form to approximately 2500 paediatric dentists in various world regions. The sampling method used was a list-based sampling frame followed by simple random sampling. Participants were recruited through national member societies of the International Association of Paediatric Dentistry, personal contacts and social media groups. Only paediatric dentists with at least three years of experience after their post-graduation were only included in the study. Their attitudes and practices towards parental education on dental trauma during the child's first and recalled dental visits were assessed as per their age, gender, country of post-graduation qualification and years of experience in the profession. Chi-Square test was used to evaluate the association between the paediatric dentist response and the continent of practice. Kruskal-Wallis H test was used to assess the level of significance within each variable in relation to the continent of practice. A 95% confidence interval with a significance level of α = 0.05 was used. CONCLUSION: The overall attitude and practice of paediatric dentists toward parental education on traumatic dental injuries were not satisfactory. Many paediatric dentists do not impart education on emergency care and dental trauma prevention in primary teeth. Parents should be informed about oral hygiene instructions and prevention-oriented interventions during the first visit and about managing traumatic dental injuries.

Comparative evaluation of surface roughness of posterior primary zirconia crowns.

AIMS: To compare the surface roughness of four commercially available posterior zirconia crowns on the occlusal surface and occlusal edge (buccal cusps) of first and second primary molars crowns. METHODS: Surface roughness of 40 posterior primary zirconia crowns was measured using a mechanical stylus profilometer. Ten mandibular right molar crowns, consisting of five first primary molar and five second primary molar crowns from four brands-Cheng, Sprig EZCrowns, NuSmile and Kinder Krowns were selected. Mean roughness, Ra and mean roughness depth, Rz was measured for all crowns on two selected surfaces, occlusal surface and buccal cusp tips. Data was evaluated by one way analysis of variance and Tukey's honestly significant difference test at 0.05 level of significance. RESULTS: Statistically significant differences were observed in the mean Ra and Rz values at both selected surfaces among four prefabricated paedodontic zirconia crowns. Kinder Krowns had higher Ra and Rz values compared to Cheng, Sprig EZCrowns and NuSmile. Roughness profile of Kinder Krowns also showed higher vertical scale values co-relating with higher Ra and Rz scores, irrespective of the measurements taken on relatively flat surfaces (occlusal edge) or deeper surface (occlusal pits and fissures). CONCLUSIONS: Mechanically polished posterior primary zirconia crowns had a smoother surface profile than the combined polished-glazed primary zirconia crowns. Cheng Crowns had the lowest mean Ra and Rz values although not statistically significant from Sprig EZCrowns and Nu Smile. Kinder Krowns had the highest mean Ra and Rz scores than other crown groups.

An in vitro comparison of three delivery techniques for obturation of root canals in primary molars.

AIM: This in vitro study evaluated the efficacy of three different obturation techniques with regards to quality of two filling pastes-Ca(OH)2/iodoform syringe paste and zinc oxide eugenol paste in primary molars. METHODS: Root canals of 45 extracted primary molars were prepared and randomly divided into three groups of 15 teeth each. Group A-canals were filled with Ca(OH)2/iodoform syringe paste, Group B-zinc oxide eugenol paste with handheld lentulo spiral and Group C-zinc oxide eugenol paste with rotary lentulo spiral. The quality of filled root canals was evaluated with conventional radiography in antero-posterior and lateral dimensions. RESULTS: There were significant differences between all groups in the presence of voids (p = 0.03) and length of filling (p = 0.002). Half of the sampled teeth in handheld lentulo spiral group had voids in the filled canals, while 80% of the teeth filled with Ca(OH)2/iodoform syringe resulted in overfilling of the paste. CONCLUSIONS: All three delivery methods for the obturation of primary molars' root canals showed inherent limitations in terms of voids and quality of filling. Voids are inevitable and were present in all the techniques. Overfilling was more frequently seen with the syringe method, while the lentulo spiral technique, both handheld and rotary, showed a better quality of filling.

Comparison of Parental Satisfaction with Three Tooth-Colored Full-Coronal Restorations in Primary Maxillary Incisors.

OBJECTIVES: To evaluate and compare the parental satisfaction among resin composite strip crown, preveneered stainless steel crown (PVSSC) and the newly introduced pre-fabricated primary zirconia crown for restoring maxillary primary incisors. STUDY DESIGN: A prospective clinical study on 39 children with carious or traumatized primary maxillary incisors. They were randomly and equally distributed in three groups and received one of the full-coronal restorations. Children were recalled to evaluate and compare parental satisfaction about performance of crowns after one year through a questionnaire. RESULTS: Parents were satisfied with all three tooth colored full-coronal restoration techniques. A significant relationship was found between colour of PVSSC (p=0.003) and durability of resin strip crowns (p=0.009) with the overall parental satisfaction levels. Parents who gave poor ratings in these two variables however rated their overall acceptance levels as being satisfied. CONCLUSION: Parental overall satisfaction was highest for zirconia primary crowns followed by resin composite strip crowns and lowest satisfaction was reported for pre-veneered SSCs. Parents were least satisfied with durability of resin composite strip crowns and colour of pre-veneered stainless steel crowns. However, this did not affect their overall satisfaction with these crowns.

A randomised controlled trial of three aesthetic full-coronal restorations in primary maxillary teeth.

AIM: This randomised clinical trial (RCT) compared the clinical outcomes of three aesthetic full-coronal restorations (composite strip crowns, pre-veneered stainless steel crowns (SSCs) and pre-fabricated primary zirconia crowns) in carious and traumatised primary maxillary incisors. MATERIALS AND METHODS: One hundred and twenty nine teeth in 39 children aged between 3 to 5 years were included. Children were randomly assigned to one of three treatment groups using a permuted block randomisation technique with a total of 43 teeth in each group. After trainee calibration, restorations were placed and evaluated after 6 months. Outcomes evaluated were restoration failure, tooth wear of opposing teeth and gingival health. RESULTS: The retention rate was highest for zirconia crowns (100%) followed by pre-veneered SSCs (95%). Strip crowns were the least retentive (78%). Zirconia crowns showed low grade abrasion in four opposing teeth. Teeth restored with resin composite and pre-veneered SSC showed an increase in mean gingival index score, while corresponding values decreased in zirconia crowns. CONCLUSION: Resin composite strip crown is a highly sensitive technique leading to lower retention rate. Pre-veneered stainless steel crowns showed increased incidence of facial veneer fracture. Zirconia crowns are highly retentive and biocompatible but cause low grade of abrasion of their opposing natural dentition at the 6-month follow-up.

Cyclopentanone thiosemicarbazone, a new complexing agent for copper determination in biological samples by adsorptive stripping voltammetry.

A selective and sensitive stripping voltammetric method for the determination of trace amounts of copper(II) with cyclopentanone thiosemicarbazone (CPTSC) is presented. The method is based on the adsorptive accumulation of the resulting copper-CPTSC complex on a hanging mercury drop electrode, followed by the stripping voltammetric measurements at the reduction current of the adsorbed complex at -0.37 V vs. Ag/AgCl. The optimal conditions for the stripping analysis of copper include pH 9.3, deposition time of 120 s, and a deposition potential of -0.1 V (vs. Ag/AgCl). The peak current is linearly proportional to the copper concentration over a range 3.14 x 10(-9) M to 1.57 x 10(-6) M with a limit of detection of 1.57 x 10(-9) M. The technique has been applied to the determination of copper in biological samples, like urine and whole blood.

Analysis of physical and chemical parameters of bottled drinking water.

Seventeen different brands of bottled drinking water, collected from different retail shops in Amritsar, were analyzed for different physical and chemical parameters to ascertain their compliability with the prescribed/recommended limits of the World Heath Organization (WHO) and the United States Environmental Protection Agency (USEPA). It was found that the majority of the brands tested were over-treated. Lower values of hardness, total dissolved solids (TDS) and conductance than the prescribed limits of WHO showed that water was deficient in essential minerals. Minerals like magnesium, potassium, calcium and fluoride were present in some cases in such a low concentration that water seemed to be as good as distilled water. Samples showing fluoride lesser than 0.5 mg/l warranted additional sources of fluoride for the people consuming only bottled water for drinking purposes. Zero values for chlorine demand as shown by all the bottled water samples showed that water samples were safe from micro-organisms. In case of heavy metals, only lead had been found to be greater than the limit of 0.015 mg/l as prescribed by WHO and USEPA, in seven out of 17 samples. Lead even at such a low concentration can pose a great health hazard.

The versatility of salicylaldehyde thiosemicarbazone in the determination of copper in blood using adsorptive stripping voltammetry.

The adsorptive cathodic stripping voltammetry technique (AdCSV) is used to determine copper(II) using salicylaldehyde thiosemicarbazone (N, S- donor) as a complexing agent on hanging mercury drop electrode at pH 9.3. Variable factors affecting the response, i.e. the concentration of ligand, pH, adsorption potential and adsorption time are assessed and optimized. The adsorbed complex of copper(II) and salicylaldehyde thiosemicarbazone gives a well defined cathodic stripping peak current at -0.35 V, which has been used for the determination of copper in the concentration range of 7.85 x 10(-9) to 8.00 x 10(-6)M with accumulation time of 360 s at -0.1 V versus Ag/AgCl. This technique has been applied for the determination of copper in various digested samples of whole blood at trace levels.

Dissociative disorder presenting as catatonia.

Three cases of dissociative disorder presenting with catatonia are described. Catatonia is generally believed to be associated with schizophrenia. However, many other conditions are also known to cause catatonia. A brief review of literature is provided. All the cases improved rapidly with a few ECTs. This report aims to highlight the presentation of dissociative disorders with catatonia. It also seeks to bring to notice the need to avoid lumping all non-organic catatonics under the rubric of schizophrenia so as to ensure proper treatment.

Effect of Short-term Psychiatric Intervention in Amputees.

A total of 40 patients with limb amputations were included in the present study aimed at evaluating the psychological status of amputees. All patients filled a specially designed proforma and the following psychological questionnaires: General Health Questionnaire, Carroll Rating Scale for Depression, State-Trait Anxiety Inventory, Michigan Alcoholism Screening Test and Disability Assessment Questionnaire. Analysis of the results showed that 29 (72.5%) of the amputees had psychiatric disorders and this number had reduced to 20 (50%) after therapy. The difference was statistically significant. Psychiatric treatment also resulted in a statistically significant reduction in level of depression as measured by Carroll Rating scale for Depression. The amputees had the highest score on vocational subscale of Dysfunction Analysis Questionnaire. Short term psychiatric treatment was found to be very useful in treating psychiatric morbidity and depression in amputees.

Determination of metals of toxicological significance in sewage irrigated vegetables by using atomic absorption spectrometry and anodic stripping voltammetry.

Soil and vegetable samples drawn from the fields being irrigated by the city sewage have been analysed for some toxic metals namely copper, iron, cadmium, lead and chromium using atomic absorption spectrometry and anodic stripping voltammetry. It has been found that these vegetables contain an appreciable amount of these metals per unit dry mass, which the general public is ingesting everyday. It is further seen from the differential results that the fields being irrigated with the sewage water for the last so many years till date as compared to the ones, irrigation of which was replaced with the tubewell water some ten years ago, that the content of toxic metals is much larger in the former case. The results and the gravity of the situation is discussed.

Management of wide open apices in non-vital permanent teeth with Ca(OH)2 paste.

A retrospective study on 15 non-vital immature incisor teeth was done using Ca(OH)2 Pulpdent paste. A success rate of 100 percent was achieved within one year. The variables influencing the time taken for apexification were also evaluated. The teeth were followed up to a period of 24 months. It was found that older children having narrow open apex had a shorter treatment time than the younger children (NS); teeth without periapical infection showed some amount of root growth and closing of apex that was faster than those with periapical infection (p < 0.001). The calcified bridge formed following apexification is a porous structure. This investigation provides information about the time taken and procedure required to achieve apical barrier formation in non-vital immature incisors.