Comparative Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste Herbal Combination and Camphorated Monochlorophenol as Intracanal Medicaments against Enterococcus faecalis in Deciduous Molars: An In Vivo Study.

Aim: Compare the efficacy of triple antibiotic paste (TAP), herbal extracts, and camphorated monochlorophenol (CMCP) as intracanal medicaments against Enterococcus faecalis (E. faecalis) in deciduous molars. Materials and methods: A total of 60 samples were collected from canals of first and second molars of 4-10-year-old children, with more than two-thirds root length, and fitting the inclusion criteria. Samples were collected at three intervals-S1 was collected just after access opening, S2 was collected after biomechanical preparation (BMP) and irrigation, and just before placement of medicament. Randomization was done to place the medicaments into three groups: group I-CMCP, group II-TAP, and group III-herbal combination. Sample S3 was taken 48 hours after removal of medicament from the canals. The collected samples were transported via Amies media to the laboratory, where they were anaerobically incubated for 24 hours. Growth of E. Faecalis was observed, and manual counting of the colony-forming unit (CFU) was done. The change in CFU in all samples was calculated, and the results were statistically analyzed. Results: The results show that there is a change from S1 (TAP = 118.67 ± 122.48, herbal = 109.07 ± 106.43; CMCP = 110.73 ± 120.53) to S2 (TAP = 34.13 ± 63.47; herbal = 27.67 ± 39.39; CMCP = 16.40 ± 26.32) and S3 (TAP = 12.33 ± 24.82; herbal = 4.73 ± 12.78; CMCP = 3.40 ± 7.12). It is seen that there is a significant difference seen from S1 to S2 in all three groups (p ≤ 0.05) using repeated measure analysis of variance (ANOVA) test. This shows that all three medicaments were effective in reducing bacterial counts of E. Faecalis from sample S1 (pre) to S3 (post) significantly after exposure to root canal bacterial flora for 48 hours (2 days). The pairwise comparison of the change in CFU within each group, S1-S3, also shows significant changes. There is a significant decrease in CFU seen from S1 to S2 and S1 to S3 but not from S2 to S3 for all three groups, which was evaluated using the post hoc Bonferroni test. It was also observed that in between the canals, although there was a change from S1 to S3 in terms of the CFU, there was no significant difference in the decrease in the bacterial count when intercanal comparison was made. There was, however, a change that was seen to be significant when values from each canal were compared from S1 to S3. Conclusion: All three medicaments have successfully shown a decrease in the numbers of E. faecalis, which the study aimed at checking. Although the effect varied intergroups, it was mild, so herbal alternatives could be used instead of antibiotics and CMCP. Also, because the local application is effective in controlling interappointment flare-ups, the medicaments can be successfully given without having to prescribe systemic antibiotics. How to cite this article: Tawde MM, Lakade L, Patil S, et al. Comparative Evaluation of Antimicrobial Efficacy of Triple Antibiotic Paste Herbal Combination and Camphorated Monochlorophenol as Intracanal Medicaments against Enterococcus faecalis in Deciduous Molars: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(3):243-254.

Scanning electron microscope analysis to evaluate the effect of pretreatment with ozone and sodium hypochlorite on pits and fissures of primary teeth.

Introduction: The cornerstone of preventative therapy is made up of pit and fissure sealants and fluorides. Resin sealants have been shown to help reduce fissure decay in both primary and permanent teeth. Etching of primary molars is not effective due to prismless enamel, higher organic content, and diversity in fissure shape. Methods of pretreatment of pits and fissures have been hypothesized to promote microporosities in etched enamel and hence sealant adherence. Examining the etching pattern and surface roughness of the enamel surface can be used to gauge these. Objective: This study aimed to evaluate the effect of pretreatment with ozone gas and 5.25% sodium hypochlorite solution on pits and fissures of primary teeth to check for the etching pattern and surface roughness. Materials and Methods: Thirty noncarious primary molars were sectioned to retain the crowns, and randomly divided into three groups, sodium hypochlorite, ozone gas, and control. Each sample was pretreated with the agent, washed, followed by etching with 37% phosphoric acid. Samples were sectioned and subjected to scanning electron microscope analysis to evaluate the etching pattern and surface roughness. Results: Comparison of the etching pattern in three groups showed a statistically insignificant difference (P=0.364). Surface roughness was highest in the hypochlorite group followed by ozone and control which showed a statistically significant difference (P = 0.001). The surface area between the three groups showed a statistically insignificant difference. Conclusion: Sodium hypochlorite is a better pretreatment agent compared to ozone gas and acid etching alone. However, as all results were not statistically significant further research must be carried out to prove the effectiveness of these agents.

A Systematic Review on Polyester Scaffolds in Dental Three-dimensional Cell Printing: Transferring Art from the Laboratories to the Clinics.

Objective: The purpose of this systematic review is to describe developments in three-dimensional (3D) cell printing in the formation of dental pulp tissue using polyester as a scaffold to revitalize the damaged dental pulp tissue. Materials and methods: A literature search for all the data published in PubMed and Google Scholar from January 2000 to April 2022 was conducted. Articles with the keywords 3D cell printing, scaffolds, polyester, dental pulp, and dentistry were used. Inclusion criteria consisted of any publication in electronic or print media directly studying or commenting on the use of polyester scaffolds in 3D cell printing technology in the regeneration of dental pulp. A total of 528 articles were selected, of which 27 duplicates and 286 irrelevant articles were discarded. A total of 215 articles were finally included in the systematic review. Result and conclusion: For dental pulp regeneration, several scaffolds have been discovered to be appealing. Polylactic acid (PLA), polyglycolic acid (PGA), and their copolymers are nontoxic and biocompatible synthetic polyesters that degrade by hydrolysis and have received Food and Drug Administration (FDA) approval for a variety of applications. This review paper is intended to spark new ideas for using a certain scaffold in a specific regenerative approach to produce the desired pulp-dentin complex.

Clinical Evaluation of Overall Efficacy and Pain Perception of Ultrasonic Oscillating Tips and Conventional High-speed Burs for Removal of Dental Caries in Children in Age-group of 6-8 Years.

Aim: To clinically evaluate the overall efficacy and pain perception of ultrasonic oscillating tips and conventional high-speed burs to remove enamel and dentinal caries in children of ages 6-8 years. Materials and methods: Bilateral deciduous canines with caries involving enamel or enamel and dentin were excavated by using a high-speed airrotor on one tooth and ultrasonic oscillating tips on another tooth in the same appointment. The overall response of the patient, both ultrasonic oscillating tips and airrotor along was recorded by Wong-Baker's Facial Pain Rating Scale (WBFPS) along with time taken to make each cavity and noise level generated by high-speed and ultrasonic system. Results: Evaluation of WBFPS after every method of caries excavation showed that 84% of subjects in the ultrasonic group reported score of 0 as compared to only 24% of subjects in the airrotor group. Score 2 was reported by 16% of the subjects in the ultrasonic group and 32% of the subjects in the airrotor group. Score 4 was reported by 44% of the subjects in the airrotor group. Ultrasonic groups reported more time to remove caries as compared to the airrotor group. The ultrasonic group reported less noise as compared to the airrotor group and the difference between the two was significant. Conclusion: Patients preferred the ultrasonic method for caries excavation because of less pain and noise. The use of ultrasonic oscillating tips is as effective in caries excavation, less painful, and more time-consuming than the conventional airrotor. Significance: Ultrasonic oscillating tips can be successfully used in pediatric dentistry to aid patient cooperation and reduce pain during caries excavation. How to cite this article: Kenjale MA, Shah P, Desai S, et al. Clinical Evaluation of Overall Efficacy and Pain Perception of Ultrasonic Oscillating Tips and Conventional High-speed Burs for Removal of Dental Caries in Children in Age-group of 6-8 Years. Int J Clin Pediatr Dent 2023;16(2):251-258.

Clinical evaluation of feasibility and effectiveness using a virtual reality device during local anesthesia and extractions in pediatric patients.

PURPOSE: Pediatric dentistry requires more than routine dental knowledge and skills in executing quality dental care. The quality of dental treatment is indirectly proportional to a child's anxiety and fear. The recent distraction technique, the use of virtual reality (VR) devices has intrigued many researcher's minds. Therefore, this study was conducted to assess the clinical feasibility and effectiveness of the VR device in reducing pain and anxiety in pediatric patients during mandibular primary molar extraction. METHODS: This research trial had 30 healthy children between the ages of 6 and 12 who required mandibular primary molar extraction. The subjects were divided into two groups using a simple randomization method. In the study group (n = 15), extraction was carried out using a VR device, whereas, in the control group (n = 15), extraction was carried out without the use of a VR device. Pre- and post-extraction anxiety levels were measured by Venham's picture test (VPT) and the heart rate. After the procedure, pain and behavior were evaluated by the Wong-Bakers Faces pain rating scale (WBS) and FLACC Scale respectively. RESULTS: The pre-extraction values of the VPT and heart rate showed no statistically significant difference. This indicates that participants of both groups had a similar level of anxiety at baseline. There was a statistically significant increase (p = 0.028) between pre- and post-heart rates in the control group, with no significant change in the study group. CONCLUSION: The use of a virtual reality device in children can reduce anxiety during primary molar extractions as evaluated by heart rate. Virtual reality devices might be an adjunct to high-quality dental care and to other behavior management methods. Definitive outcomes can be attained by encouraging studies overcoming the present limitations, and considering salivary biochemical indicators for the assessment of these devices.

Assessment of the Changes in the Salivary Profile and Its Clinical Correlation in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy: A Follow-up Study.

Aim: To assess the changes in salivary profile and its clinical correlation in patients with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. Materials and methods: Children who have been diagnosed with ALL undergoing chemotherapy at Bharati Hospital, Pune, were included in the study. Those children were included who fulfilled the following inclusion and exclusion criteria. Stimulated salivary samples were collected in sterile vials at 1-, 3-, and 6-month intervals and ware assessed for salivary pH and buffering capacity. Caries and oral manifestations were also checked at each interval. Results: A total of 25 children with ALL undergoing chemotherapy were included to participate in the study. The results were analyzed using Statistical Package for the Social Sciences software. There was a statistically significant difference in the change in salivary pH during the 1st and 6th months of chemotherapy (p-value of 0.001). Salivary buffering capacity was also found to be low in these patients during the 1st month of chemotherapy, which gradually increased during the entire course of chemotherapy (p-value of 0.011). Progression of dental caries was seen during the entire course of treatment. Conclusion: All the major changes were seen in the 1st month, that is, the induction phase of chemotherapy. Hence, we can say this is the most affected phase of chemotherapy. Clinical significance: The parents and children should be educated and motivated to maintain proper oral hygiene. Whenever possible, all preventive dental procedures should be undertaken before the start of chemotherapy to avoid future complications. How to cite this article: Paranjape MN, Shah P, Patil S, et al. Assessment of the Changes in the Salivary Profile and Its Clinical Correlation in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy: A Follow-up Study. Int J Clin Pediatr Dent 2023;16(S-3):S268-S271.

Comparative Evaluation of Water Sorption, Solubility, and Microhardness of Zirconia-reinforced Glass Ionomer, Resin-modified Glass Ionomer, and Type IX Glass Ionomer Restorative Materials: An In Vitro Study.

The challenge that practicing dentists face every day is to decide which dental material is best suited for each dental treatment. New glass-ionomer cement (GIC) formulations have been introduced in order to overcome the drawbacks of conventional ones thereby catering to the needs of the pediatric population. Aim and objective: The study aimed to evaluate and compare water sorption, solubility, and microhardness of zirconia-reinforced glass ionomer, resin-modified glass ionomer, type IX glass ionomer cements. Materials and methods: 90 specimens were prepared in total of which 45 cylindrical specimens with dimensions of (6 × 4) mm and 45 disks with (10 × 2) mm were prepared from Zirconomer, RMGIC, and Type IX GIC restorative materials, each material having 30 specimens (15 disks, 15 cylinders). After taking the initial weight (W1), the 45 cylinders (15 of each material) were immersed in artificial saliva at 37°C for 28 days after which the weights W2 and W3 were weighed. The other 45 disks (15 of each material) were subjected to microhardness test under microhardness tester. Results were subjected to ANOVA and Tuckey's post hoc test. Results: Zirconomer showed the maximum resistance to water sorption and solubility followed by RMGIC and type IX GIC with a significant p value of < 0.001 difference. For microhardness, Zirconomer showed the highest value with a significant p value of < 0.001 difference. But, there was no significant difference between RMGIC and Type IX GIC depicting almost equal strength. Conclusion: Water sorption, solubility, and microhardness of Zirconomer were significantly high in comparison to the other groups and it can be used as a posterior restorative material for stress-bearing areas. Clinical Significance: As pediatric dentistry demands restorations to be completed frequently in less than ideal conditions, Zirconomer has shown to be better than RMGIC and conventional GIC probably because of the improvisation in the GIC properties. How to cite this article: Bethapudy DR, Bhat C, Lakade L, et al. Comparative Evaluation of Water Sorption, Solubility, and Microhardness of Zirconia-reinforced Glass Ionomer, Resin-modified Glass Ionomer, and Type IX Glass Ionomer Restorative Materials: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):175-181.

Teeth in forensics: A review.

With the ever-increasing crime rate in our society, the field of forensic sciences has become highly evolved. Forensic dentists play a pivotal role in various areas of crime scene investigations and thereby help solve innumerable mysteries. Teeth appear to be vital pieces of evidence in several such investigations. Teeth are preserved in the closed cavities of the mouth and are generally resistant to the threatening environmental conditions that may be associated with the death of an individual, making them very useful in postmortem analysis. Teeth thus obtained may be useful in age estimation of the deceased victim or in determining his blood group. Identification of individuals in mass disasters can also be performed based on the unique morphological characteristics of the human dentition and through dental DNA fingerprinting. Again teeth play an all important role in catching a culprit through the positive correlation of the bite marks left behind at the crime scene and the suspect's own teeth marks. Thus, teeth prove to be an important adjunct in forensics. Its scope is ever-increasing with time, and a great amount of research is being carried out to implement the same. A PubMed, MEDLINE, and Scopus search was conducted of the past 70 years using several search terms like "Forensic odontology," "history of forensic odontology," "dental DNA fingerprinting," "forensic age estimation," "age estimation from teeth" and "bitemarks." Other articles and textbook references which were considered to be important were also included in this study. The articles gathered were divided into the following groups: history of forensic odontology, teeth and DNA (dental DNA fingerprinting), teeth and blood grouping, teeth and age estimation, and teeth in bite marks.

A Newly Proposed Regression Equation for Mixed Dentition Analysis Using the Sum of the Width of Permanent Mandibular Central Incisors and Permanent Mandibular First Molars as a Predictor of Width of Unerupted Canine and Premolars

Objective: To determine linear regression equation to predict the mesiodistal widths of the permanent canines and premolars based on the sum of the widths of the two permanent mandibular first molars and two mandibular central incisors. Material and Methods: The sample consisted of 800 (400 males and 400 females) permanent dentition casts of Chhattisgarh population. Mesiodistal crown widths of teeth were measured with digital caliper. The correlation and linear regression equations between the calculated four teeth (two permanent mandibular first molars and two central incisors) and the canine-premolars segments of both the arches were developed. Results: No significant differences were found in right and left side of the arch. Sexual dimorphism was significant in teeth sizes with higher mesiodistal dimension in males. A good correlation values varying from 0.51 to 0.67 was found. New standardized regression equations were formulated for the prediction of the mesiodistal widths of unerupted canines and premolars for Chhattisgarh population. Conclusion: Calculating mesiodistal widths of unerupted canine and premolars with help of two permanent mandibular molars and two mandibular central incisors, which erupt early in the oral cavity, can be an alternative and best predictor for the mixed dentition analysis.

Determination of ABO Blood Groups and Rh Typing from Dry Salivary Samples.

INTRODUCTION: A unique blood group is a characteristic every individual possesses. Blood group antigens like A, B, D, H, etc., are found to be present on the cell surfaces of red blood cells (RBCs). Besides blood, these are also secreted in various body secretions like semen, sweat, amniotic fluid, and saliva. Blood grouping has several applications in forensic sciences and is also a major part of routine medical investigations. Presence of these antigens in saliva is dependent on the secretor status of an individual. Saliva samples at the crime scene are very crucial, as they help in deoxyribonucleic acid typing, sex determination, bite mark analysis, and blood grouping. Dried salivary samples are often obtained in more number of cases as compared with the wet form, due to the variable time lapse between the occurrence of the crime and the start of the investigation. Blood grouping from these samples proves to be very efficient. Thus, the present study aims at evaluating the accuracy of ABO blood group determination and Rh typing from dried salivary samples. Also, the study would establish the use of saliva as a noninvasive technique in routine blood examinations, especially in children who have needle phobia. MATERIALS AND METHODS: Blood grouping and Rh typing were performed on the dry salivary samples obtained from the 47 subjects using the absorption-inhibition technique. This was then compared with the results obtained using extraction socket blood and evaluated. RESULTS: The present study showed a 100% positive correlation for ABO blood grouping, but a mere 14.81% positive correlation for Rh typing between the dried salivary samples and the extraction socket blood. CONCLUSION: Dried salivary samples can thus be put to immense use in several areas of forensic investigations. It could also help in developing alternate methods for routine blood investigations in children and adults.How to cite this article: Velani PR, Shah P, Lakade L. Determination of ABO Blood Groups and Rh Typing from Dry Salivary Samples. Int J Clin Pediatr Dent 2018;11(2):100-104.

Comparison of antimicrobial efficacy of chlorhexidine and combination mouth rinse in reducing the Mutans streptococcus count in plaque.

BACKGROUND: The removal of plaque is utmost important to control dental caries. But in children, factors like lack of dexterity, individual motivation and monitoring limit the effectiveness of tooth brushing. This necessitates the use of chemotherapeutic agents for control of plaque. AIMS: To compare the antimicrobial efficacy of 0.2% chlorhexidine mouth rinse and mouth rinse containing 0.03% triclosan, 0.05% sodium fluoride, and 5% xylitol in reducing the Mutans streptococcus count in plaque. MATERIALS AND METHODS: Thirty healthy children aged 8-10 years with dmft (decay component) of three or four were selected. They were divided randomly into two groups: The control or chlorhexidine group and the study group or combination mouth rinse. Both the groups practiced rinsing with respective mouth wash for 1 min for 15 d twice a day. The plaque samples were collected and after incubation Mutans streptococcus count was estimated on the strips from the Dentocult SM kit and evaluated using manufacture's chart. STATISTICAL ANALYSIS USED: Wilcoxon matched pairs signed ranks test and Mann-Whitney U test were used to analyze the findings. RESULTS: Statistically significant reduction in the Mutans streptococci count in the plaque was seen in the control and study group from baseline level. But when both the groups were compared, the antimicrobial effect of chlorhexidine was more.

Assessment of awareness amongst school teachers regarding prevention and emergency management of dentoalveolar traumatic injuries in school children in Pune City, before and 3 months after dental educational program.

Children have boundless energy, so, they are continuously engaged in some or the other physical activity. It is seen that when child reaches school age, accidents in the school environment in the form of falls, injuries due to contact sports, fights, abuse, etc. are very common and the main cause of traumatic dental injuries. Trauma may vary from minor enamel chipping or avulsion to extensive maxillofacial damage, more serious neck and brain injury, which may cause pain, disfigurement and mental agony, having immediate and long lasting effects. In such cases, a school teacher is in the right position to handle such an emergency and refer the child to the concerned dental surgeon or a pedodontist for further needful care. The main reason for delayed treatment of dental trauma is that people present at the site of injury are unaware of protocol of rapid and appropriate management leading to improper first aid treatment. The purpose of this study was to investigate the awareness of a group of school teachers from different schools about the prevention and emergency management of dental trauma in school children, by means of a questionnaire. Then educating them and reassessing their knowledge after a period of 3 months. Unfortunately, the public is unaware of the risks and does not have enough information about first aid emergency treatment or to avoid traumatic injuries.