Antimicrobial Efficacy of Chlorhexidine and Herbal Mouth Rinse on Salivary Streptococcus mutans in Children with Mixed Dentition: A Randomized Crossover Study.

Aim and objective: Streptococcus mutans (S. mutans) shows increased resistance to currently available antibiotics and chemotherapeutics. The present study compares the effectiveness of chlorhexidine and Herbal mouth rinse against salivary S. mutans in children with mixed dentition. Materials and methods: Subjects (n = 60) with mixed dentition were selected for the study. Caries status was recorded using Nyvard's criteria. Baseline saliva samples were collected and assessed for quantifying S. mutans. Subjects were instructed to rinse their mouths with 0.2 % w/v chlorhexidine and herbal mouth rinse for 7 days. Saliva samples were collected after 7 days and assessed for S. mutans. After a run-in period of 21 days, both the mouth rinses were crossed over according to the Latin square design, and a similar procedure was carried out. Later, determination of mean colony-forming units (CFU/mL) from the saliva samples was done. For statistical analysis, Kolmogorov and Mann-Whitney U tests were applied. Results: Both the groups showed a significant reduction in S. mutans count, at baseline and 7 days (p = 0.0001), and the reduction of S. mutans count in herbal mouth rinse as compared to chlorhexidine mouth rinse (p = 0.0209) was statistically significant. Conclusion: Herbal mouth rinse proved to have better antimicrobial efficacy than Chlorhexidine mouth rinse. How to cite this article: Shah SV, Badakar CM, Hugar SM, et al. Antimicrobial Efficacy of Chlorhexidine and Herbal Mouth Rinse on Salivary Streptococcus mutans in Children with Mixed Dentition: A Randomized Crossover Study. Int J Clin Pediatr Dent 2022;15(1):99-103.

Comparative evaluation of root ZX Mini® apex locator and radiovisiography in determining the working length of primary molars: An In Vivo study.

INTRODUCTION: Working length determination is a crucial step for success of pulpectomy. Various new modalities have been developed. The newest technology includes EAL. Electronic apex locators require less chair side time, do not produce pain and avoid unnecessary radiation which makes it more superior in paediatric endodontic procedures. AIM: To evaluate and compare Root ZX mini apex locator and Radiovisiography (RVG) for determining working length in primary molars. MATERIALS AND METHODS: A sample of 30 primary molar teeth was subjected to working length determination by Root ZX mini and RVG. The data was collected and then tabulated and subjected to statistical analysis. RESULTS: On comparison among two groups, it was found there was no difference between the efficiency of modalities. A positive correlation was seen among Root ZX mini and RVG (ICC â€‹= â€‹0.99). CONCLUSION: Root ZX mini and radiovisiography are seen to be precise in determination of working length in primary molars. It can be said that Root ZX mini i. e the electronic apex locators can be used as an adjunct to Radiovisiography and conventional radiography.

Comparative evaluation of antibacterial efficacy of conventional glass-ionomer cement and bulk-fill alkasite material when combined with doxycycline and double antibiotic paste containing ciprofloxacin and metronidazole against Streptococcus mutans and Lactobacillus spp.: An in vitro study.

INTRODUCTION: Glass-ionomer cement (GIC) have been indispensable to pediatric dentistry. Along with these, newer materials like bulk-fill alkasite cement (Cention N) are popularizing. In spite of this, the search is still on for the "ideal" bioactive material which could provide a therapeutic edge. In light of this, incorporation of antibiotics in GIC or newer materials like bulk-fill alkasite cement (Cention N) would provide a novel alternative material to the dentists. AIM: The study was aimed at comparing the antibacterial efficacy of conventional glass-ionomer cement (CGIC) and bulk-fill alkasite cement (Cention N) with doxycycline (DOX) and double antibiotic paste (DAP) containing metronidazole and ciprofloxacin (1.5% w/w) on Streptococcus mutans and Lactobacillus. MATERIALS AND METHODS: Agar well diffusion method was followed, in which material discs of 10 mm were made and inserted into the wells. Inhibition zones were calculated after incubation for 24 h at 37°C with zone interpretation scale. RESULTS: A highly significant statistical correlation was found between antibacterial efficacy of the control groups (CGIC and bulk-fill alkasite cement [Cention N]) without antibiotics as compared to the experimental group (CGIC and bulk-fill alkasite cement [Cention N] with DOX and DAP), P = 0.0001 and P = 0.0006 for the CGIC group and P = 0.0147 and P = 0.0080 for the Cention N group (P < 0.05). CONCLUSION: Incorporation of antibiotics significantly enhanced the antibacterial efficacy of CGIC and bulk-fill alkasite cement (Cention N).

Comparative evaluation of the antimicrobial susceptibility and cytotoxicity of husk extract of Cocos nucifera and chlorhexidine as irrigating solutions against Enterococcus Faecalis, Prevotella Intermedia and Porphyromonas Gingivalis - An in-vitro study.

AIM AND BACKGROUND: The aim of the present study is to evaluate and compare the antimicrobial susceptibility and cytotoxicity of Cocos nucifera and chlorhexidine (CHX) as irrigating solutions against Enterococcus faecalis, Prevotella intermedia, and Porphyromonas gingivalis. MATERIALS AND METHODS: The ethanolic extract of husk of C. nucifera was prepared. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the extract were determined using the serial broth dilution method and its cytotoxicity was evaluated against human periodontal fibroblasts using 3-(4,5-dimethyl-thiazole-2-yl)-2,5-diphenyl tetrazolium bromide assay. Antibacterial susceptibility for two irrigating solutions, namely 2% CHX gluconate irrigant (Group I) and 1.5% C. nucifera husk irrigant (Group II), was tested against P. gingivalis, P. intermedia, and E. faecalis. RESULTS: The MIC and MBC of C. nucifera husk extract for P. gingivalis were 468.75 µg/ml and 1562.5 µg/ml, for P. intermedia were 48.8 µg/ml and 1875 µg/ml, and for E. faecalis were 1562.5 µg/ml and 3750 µg/ml, respectively. The extract was nontoxic to the human periodontal fibroblast. Both the materials have shown similar antibacterial susceptibility and no difference was observed at baseline, 10, 30, and 60 min using two-way repeated measures of ANOVA. However, a statistically significant difference was observed between different time points for P. gingivalis and P. intermedia using Bonferroni multiple comparison test (f = 826.1390, P ≤ 0.05). CONCLUSION: 1.5% of ethanolic husk extract of C. nucifera has a significant antibacterial action against polymicrobial dental biofilm and its activity is comparable to that of 2% CHX which validates its use as a future irrigating solution for overcoming bacterial resistance with synthetic agents.

An In Vivo Comparative Evaluation of Dental Anxiety Level and Clinical Success Rate of Composite and Multicolored Compomers in 6 to 12 years of Children.

BACKGROUND: Pediatric dentistry is not just about treating the tooth, but it also involves giving an overall comprehensive treatment to the child. Children like different colors and when the child is allowed to select the color of the restoration, it will positively motivate the child to accept dental treatment. AIM: The aim of our study was to evaluate and compare the clinical success rate of composite and multicolored compomer restorations and dental anxiety level in children. MATERIALS AND METHODS: A total of 60 samples equally divided into two study groups by of split-mouth design. In the control group, subjects received composites and in experimental group, they received colored compomers. The dental behavior was assessed using the Frankl behavior rating scale for both the groups. Dental anxiety was checked in the patients using visual analogue scale (VAS) before and after the treatment for both the groups. Children were recalled for follow up at 1, 3 and 6 months to evaluate clinical success rate amongst control and experimental group and results were subjected to statistical analysis. RESULTS: Colored compomer proved to reduce the anxiety in the child and had a better behavioral response and positive attitude. Both restorative materials had comparable clinical success rates. CONCLUSION: At 6 months follow-up evaluation colored compomer restorative material showing promising with similar properties like that of composites with the added advantage of multicolors and can be considered as the new restorative material in the child dentistry. CLINICAL SIGNIFICANCE: Colored compomers are known to be excellent alternative restorative materials for restoration of teeth in children as they aid in behavior modification and good compliance from the patient. HOW TO CITE THIS ARTICLE: Hugar SM, Kohli D, Badakar CM, Gokhale NS, Thakkar PJ, Mundada MV. An In Vivo Comparative Evaluation of Dental Anxiety Level and Clinical Success Rate of Composite and Multicolored Compomers in 6 to 12 years of Children. International Journal of Clinical Pediatric Dentistry, 2018;11(6):483-489.

Comparison of the Effect of Fluoride Varnish, Chlorhexidine Varnish and Casein Phosphopeptide- Amorphous Calcium Phosphate (CPP-ACP) Varnish on Salivary Streptococcus mutans Level: A Six Month Clinical Study.

INTRODUCTION: Dental caries is the most widespread disease which has a multi factorial origin. Streptococcus mutans is considered to be the chief pathogen in its development. Different varnishes are available which can be used for the prevention of the carious process. AIM: To compare the effect of fluoride varnish, chlorhexidine varnish and fluoride varnish containing Casein Phosphopeptide - Amorphous Calcium Phosphate (CPP-ACP) on salivary Streptococcusmutans count in children with mixed dentition over a period of six months. MATERIALS AND METHODS: Seventy two children of age 6-12 years with mixed dentition were selected fulfilling inclusion and exclusion criteria and divided into three groups: Group I- Fluoride varnish group; Group II- Chlorhexidine varnish group; Group III- MI varnish (fluoride varnish containing CPP-ACP) group. After thorough oral prophylaxis and restorative treatment the varnishes were applied to the teeth once a week for four consecutive weeks in the respective groups. Salivary Streptococcus mutans count (CFU/ml of saliva) was estimated at baseline, 1 month, 3 months and 6 months after varnish application. Bonferroni post-hoc test and paired t-test for inter group and intra group comparison was used in the study. RESULTS: A statistically significant reduction in salivary S. mutans colony count was seen with all three groups at all the different time intervals. Maximum reduction was noted in chlorhexidine varnish group at all the intervals after varnish application. CONCLUSION: Prevention of dental caries plays a vital role in paediatric dental practice. The use of dental varnish has proved to be effective in reducing the dental caries. Chlorhexidine varnish was found to show maximum reduction in salivary S. mutans count for six month period, when compared to MI varnish and fluoride varnish. Thus, chlorhexidine varnish can be used as potent caries inhibiting agent and promote good oral health.

An in vitro comparison of casein phosphopeptide-amorphous calcium phosphate paste, casein phosphopeptide-amorphous calcium phosphate paste with fluoride and casein phosphopeptide-amorphous calcium phosphate varnish on the inhibition of demineralization and promotion of remineralization of enamel.

AIM: This study aims to determine and compare the extent of inhibition of demineralization and promotion of remineralization of permanent molar enamel with and without application of three remineralizing agents. MATERIALS AND METHODS: Forty extracted permanent molars were randomly divided into two groups 1 and 2, longitudinally sectioned into four and divided into subgroups A, B, C, and D. The sections were coated with nail varnish leaving a window of 3 mm × 3 mm. All sections of Group 1 were treated with their respective subgroup-specific agent: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste for subgroup A, CPP-amorphous calcium phosphate fluoride (ACPF) paste for subgroup B, CPP-ACPF varnish for subgroup C and subgroup D served as a control. The sections were then subjected to demineralization for 12 days following which lesional depth was measured under the stereomicroscope. All the sections of Group 2 were subjected to demineralization for 12 days, examined for lesional depth, then treated with their respective subgroup specific agents and immersed in artificial saliva for 7 days. The sections were then examined again under the stereomicroscope to measure the lesional depth. RESULTS: CPP-ACPF varnish caused significant inhibition of demineralization. All three agents showed significant remineralization of previously demineralized lesions. However, CPP-ACPF varnish showed the greatest remineralization, followed by CPP-ACPF paste and then CPP-ACP paste. CONCLUSION: This study shows that CPP-ACPF varnish is effective in preventing demineralization as well as promoting remineralization of enamel. Thus, it can be used as an effective preventive measure for pediatric patients where compliance with the use of tooth mousse may be questionable.

Comparative Assessment of Conventional Composites and Coloured Compomers in Permanent Molars of Children with Mixed Dentition: A Pilot Study.

INTRODUCTION: Early treatment of carious lesions in children is important for the maintenance of oral health. Multicoloured restorations could be the impetus for an extremely nervous or defiant child to take dental treatment. AIM: The aim of this study was to assess and compare the clinical success of conventional composites and coloured compomer material in first permanent molars of children with mixed dentition. MATERIALS AND METHODS: A total of sixty sites, divided into two groups, with thirty subjects in each group using split mouth design were chosen amongst patients reporting to Department of Pedodontics and Preventive Dentistry. In control group conventional composites were placed, similarly coloured compomers were placed in experimental group under standard operating protocol. Patients were recalled for assessment of clinical success amongst control as well as experimental group at regular intervals of one; three and six months follow up based on Modified Ryge's Criteria. Statistical analysis was done using Chi-square test using SPSS version 20.0 (Chicago, USA). RESULTS: Both conventional composites and coloured compomers had comparable retention rates in terms of anatomical form, marginal integrity, secondary caries and marginal discolouration. CONCLUSION: The coloured compomer material showed promising results in this six month follow up study in permanent molars and had properties comparable to that of conventional composites.

Fracture resistance of microhybrid composite, nano composite and fibre-reinforced composite used for incisal edge restoration.

Traumatized anterior teeth need quick, aesthetic and functional repair. Along with aesthetics, the physical properties of restorative material should also be considered for long-lasting restoration. Fibre reinforcement has been tried as a newer technique to improve the physical properties of composite materials. Hence, this study was carried out to evaluate the fracture resistance of microhybrid composite, nano composite and fibre-reinforced composite used for restoration of incisal edge of fractured maxillary central incisors. Extracted permanent maxillary central incisors were randomly divided into four groups of 10 samples each: control group with intact teeth (Group A), microhybrid composite (Esthet X; Dentsply/Caulk, Milford, DE, USA) (group B), nano composite (Ceram X; Dentsply/Caulk) (group C) and microhybrid composite reinforced with polyethylene fibre - flowable composite unit [(Ribbond THM; Ribbond Inc., Seattle, WA, USA; Esthet X flow; Dentsply/Caulk)] (group D). The fracture resistance was measured under universal testing machine at a speed of 1mmmin(-1) with the loading tip of 2mm diameter. The samples were further evaluated for mode of fracture under stereomicroscope at 3.5× magnification. The data were analysed using one-way anova and Tukey's test for fracture resistance. Group A and group D exhibited significantly higher fracture resistance than group B and group C. No significant difference was found between group B and group C as well as between group A and group D. Fisher's exact test for the mode of fracture revealed no statistical significance. It was concluded that fibre reinforcement of composite could be an alternative technique for restoration of fractured anterior teeth for better aesthetics and longevity of the restoration.