Postoperative Pain of Pediatric Patients Undergoing Dental Treatment under General Anesthesia Visiting a General Hospital: A Cross-Sectional Study.

Dental general anesthesia (GA) is a day-stay procedure and is a suitable choice for complicated cases. It is undertaken in a controlled hospital setting that ensures the quality, safety, efficacy, and efficiency of dental treatment. The purpose of this study is to determine the prevalence, severity, duration, and factors related to the occurrence of postoperative discomfort in young children following GA in a general hospital. This study includes a minimum sample size of 23 children that were undergoing GA over a 1-month period. Informed consent was obtained from the parent prior to the treatment. A preoperative questionnaire via the Survey Monkey program was used for the purposes of recording the responses of the survey population. All data related to the immediate postoperative period while the child was in the post-anesthetic recovery room (PAR) was collected and assessed by one of the investigators using the Face, Legs, Activity, Cry, and Consolability (FLACC) pain assessment scale. Postoperative data was gathered using the Dental Discomfort Questionnaire (DDQ-8) and was performed by phone 3 days after the GA procedure. The participating 23 children ranged from 4 to 9 years old (mean 5.43 ± 1.53). A total of 65.2% were girls and 34.8% were boys, with 30.4% experiencing a recent history of pain.

Factors for choosing a pediatric dentist in Saudi Arabia.

The choice of a pediatric dentist is a crucial decision for parents, influenced by a variety of factors. This study aimed to investigate the key determinants that guide parents in the Kingdom of Saudi Arabia in their selection of a pediatric dentist. A cross-sectional survey was administered to a diverse participant pool. The survey captured demographic information, history of dental visits, parents' level of concern about dental treatment for their children, and the importance of specific factors in the choice of a pediatric dentist. The survey was completed by a balanced representation of different age groups and genders. Most participants from Riyadh and other regions had a history of dental visits. Parents' concern about dental treatment varied based on the number of children they had. The most significant factors influencing the choice of a pediatric dentist were the quality of the dental unit's disinfection process, the dentist's ability to communicate with the child and manage uncooperative behaviour, and the dentist's experience. The least influential factors were the proximity of the dental office to the child's school, the dentist's gender, and the number of pediatric dentists in the practice. This study provided valuable insights into the factors that influence parents' decision in choosing a pediatric dentist in The Kingdom of Saudi Arabia. Data helps dental professionals understand parents' priorities and improve their services accordingly to meet patient needs and expectations.

Manual and Powered Toothbrushing Effectiveness on Autistic Children's Oral Hygiene Status.

Background: Autistic children want a lot of help cleaning their teeth and they have a higher risk of periodontal disorder and less caries than the general public. The study's purpose is to see how helpful manual and powered toothbrushing are for autistic kids aged 6-12 years. Materials and Methods: A total of 40 autistic children aged 6-12 years were chosen at random from Mangalore city schools. The simplified oral hygiene index was used to determine the baseline oral health (OHI-S). Children were split into two classes during an oral review. Children in Group 1 received a manual toothbrush, and those in Group 2 received a powered toothbrush. Many of the children were given Colgate fluoride-free toothpaste. Under the guidance of care professionals, children were taught to brush for 3 min. They were taught to count from 1 to 20 when brushing each buccal and lingual section. The index was rechecked at the conclusion of the 1st month (30th day) and the next month (3rd month) (90th day). On the 60th day, the recently learned techniques were reinforced (end of the 2nd month). Result: In Group 1, a statistically significant reduction in mean OHI-S scores was observed in baseline versus 30 days and baseline versus 90 days, while in Group 2, a statistically highly significant reduction in baseline versus 30 days, baseline versus 90 days, and 30 days versus 90 days was observed. Conclusion: Furthermore, in autism children, powered teeth brushing shows potential. Long-term follow-up and greater sample size are, however, needed.

Propofol's Efficacy and Outcomes on Anxious Children's Behavior in the Course of Dental Therapy: An Interventional Trial.

Introduction: Tranquility therapies have recently been more popular as a means of reducing anxiety amongst children in the course of painful diagnostic and therapeutic procedures. As a result, a variety of techniques (oral tranquility, intravenous (IV) tranquility) have been developed to assist practitioners in order to deal with such instances. The goal of this trial was to see how effective propofol could be in calming anxious youngsters during the course of dental therapy. The interventional investigation was undertaken at the Hazaribag College of Dental Sciences and Hospital in Jharkhand. Materials and Methods: To assess the outcomes of intravenous propofol on their performance in the course of therapy, 40 children within the age group of 3-6 years pursuing good physical health but uncooperative in nature (negative or definitely negative, bestowing to Frankel's performance scale) were comprised in the study. The performance rating scale was utilized to assess their performance throughout the therapy (BRS). In addition, the point of tranquility was assessed beforehand. Mann-Whitney U test was utilized to equate male and female points of performance along with gradations of drowsiness. The P value for significance was fixed at 0.05. Results: All participants' performance and point of tranquility in the course of therapy were promising, and therapy was accomplished for everyone. Mann-Whitney U test revealed no statistically significant differences in point of performance, or gradation of drowsiness amid males and females. Pearson's correlation coefficient revealed a strong positive association of therapy time with awakening time. Conclusion: Intravenous propofol deep tranquility in the presence of an anesthesiologist was found to be beneficial in restraining nervous and recalcitrant youngsters in the course of dental therapy.

Modified Mineral Trioxide Aggregate-A Versatile Dental Material: An Insight on Applications and Newer Advancements.

Mineral Trioxide Aggregate (MTA) has been a material of revolution in the field of dentistry since its introduction in the 1990s. It is being extensively used for perforation repairs, apexification, root-end filling, obturation, tooth fracture repair, regenerative procedures, apexogenesis, pulpotomies, and as a pulp-capping material because of its desired features such as biocompatibility, bioactivity, hydrophilicity, sealing ability, and low solubility. Even though its application is wide, it has its own drawbacks that prevent it from reaching its full potential as a comprehensive replacement material, including a long setting time, discoloration, mud-like consistency, and poor handling characteristics. MTA is a material of research interest currently, and many ongoing studies are still in process. In this review, the newer advancements of this versatile material by modification of its physical, chemical, and biological properties, such as change in its setting time, addressing the discoloration issue, inclusion of antimicrobial property, improved strength, regenerative ability, and biocompatibility will be discussed. Hence, it is important to have knowledge of the traditional and newer advancements of MTA to fulfill the shortcomings associated with the material.

Current Trends in Root Canal Irrigation.

Chemical and mechanical root canal debridement are the primary methods used in endodontic therapy to remove all dead tissue, bacteria, and microbial byproducts from the canal. Sodium hypochlorite, a powerful organic tissue dissolver with a broad spectrum of antibacterial properties, is an excellent choice for disinfecting surfaces. Chelating agents, on the other hand, may be used to remove the inorganic components found on the smear layer. This irrigation method is capable of removing the smear layer; however, it is less effective in the apical third. While using irrigant activation devices, irrigating solutions need to be in direct contact with the whole root canal wall surfaces, especially in the apical portions of tiny root canals. The role of irrigants is extremely important because they help not only to clean the canal but also to allow the seepage of the medicaments into the canal system. Thus, the canal needs to be healthy before the obturation procedure. Nowadays, many irrigants have been studied and hence compilation of the various available sources and their effect has to be studied both in vivo and in vitro. The correlation between the irrigants and the canal cleanliness is of utmost importance, as the success of endodontic root canal treatment depends on its proper activation and characteristics. Hence, this review incorporates the current use of various irrigating solutions and their advantages and disadvantages. In the future, endodontists may employ the novel irrigants and irrigant activation devices that were discovered in this study.

Collagen Structure, Synthesis, and Its Applications: A Systematic Review.

Resorbable collagen has been utilized to treat wounds, close graft, and tooth extraction sites, and enhance recovery. Collagen-based membranes are also used as barriers in periodontal and implant therapy to limit epithelial migration and allow cells with the regenerative capacity to fill the problem area. This systematic review was carried out to analyze the studies focusing on collagen structure, synthesis, and its applications. A detailed and extensive search was performed with the help of the keywords "collagen structure", "collagen synthesis" and "collagen applications". There was extensive literature search in reliable and authentic databases like PubMed, Scopus, Web of Sciences, Ovidsp, and Cochrane library to obtain papers focusing on collagen structure, synthesis, and applications. During the systematic review, data were obtained concerning the following parameters. Type of study, nature of aim of the study, size of the sample in the study, gender and age of the subjects included in the study, prevalence of skin diseases where collagen was used for treatment, dose of collagen used, form in which collagen was used, the origin of collagen used, analysis of different variables, structure, and synthesis of collagen. Twenty-two studies were included in this systematic review. The studies discussed the structure, synthesis, and applications of collagen in treatment. In studies focusing on the application of collagen supplements, most of the study subjects were females (68.3%). The study subjects included both healthy and unhealthy subjects. The study subjects were divided into two categories. One category was the intervention group, while another group was the placebo group. Collagen was administered in hydrolysate form (90%) in some studies, bovine form (2.3%), and porcine form (3.4%) in other studies. Collagen supplementation was found to provide better results in both healthy and unhealthy effects in improving the health of skin, cornea, bone, periodontium, face, etc. It can be concluded that collagen is an integral part of the body. The application of collagen supplements can be pretty effective in maintaining the proper health of several important structures of the body like skin, face, cornea, nails, periodontium, etc. Thus, a detailed study of the molecular structure of collagen and genes associated with each type of collagen is essential for further research and treatment of collagen-associated disorders.

Noncarious cervical lesion pretreated using antimicrobial photodynamic therapy and diode laser in reducing dentin hypersensitivity bonded to different restorative material: Valuation of bond values and invitro dye leakage.

AIM: The present study aimed to appraise the effect of Diode laser (DL), riboflavin, and curcumin on the bond strength of adhesive restorative material and the effects of pretreatment on microleakage scores. MATERIAL AND METHODS: Ninety caries-free human permanent premolars were obtained and disinfected. All specimens were mounted till CEJ. To provide standardization, a 2 × 2 mm flat non-carious cervical lesion (NCCL) dentin surface was exposed. This was followed by dentin surface roughening/cervical groove preparation with a round bur. After tooth surface preparation, ninety specimens were divided arbitrarily into three groups. Group 1: NCCL exposed to DL; group 2: NCCL pretreated with riboflavin photosensitizer (RFP) and group 3 pretreated with curcumin photosensitizer (CP). All the three groups were further divided into two subgroups A1, A2, B1, B2, C1, and C2 based on the restorative material used (n = 15). Subgroup A1, B1, and C1 were restored with composite resin (CR). Subgroup A2, B2, and C2 were restored with RMGIC. Ten samples from each subgroup were evaluated for shear bond strength (SBS) testing under a universal testing machine (UTM). Five from each subgroup were evaluated for microleakage assessment. Bond strength and microleakage analysis were performed using analysis of variance (ANOVA) with a Post-hoc test (Tukey's post hoc test) at a significance level (p = 0.05). RESULTS: The group A1, DL-CR shows the highest SBS (16.41± 0.4 MPa). However, CP-RMGIC groups demonstrated the lowest bond integrity. RFP-CR and the DL-CR group displayed comparable outcomes of SBS (p>0.05). The highest microleakage was observed with CP-RMGIC. The least microleakage was displayed by DL-CR. CONCLUSION: Noncarious cervical lesions pretreated with diode laser and riboflavin photosensitizer showed better shear bond strength and reduced microleakage when bonded to composite resin than non-carious cervical lesions pretreated with curcumin.

Assessment of Remineralization Capacity of Various Remineralizing Agents on Artificial Enamel Lesions Using Confocal Laser Scanning Microscope: An In Vitro Study.

AIM AND OBJECTIVE: The present study aimed at evaluating the effectiveness of diverse remineralizing agents on artificial enamel lesion using confocal laser scanning microscope (CLSM). MATERIALS AND METHODS: Totally 80 mandibular premolars which were single rooted were included. All teeth were suspended in a demineralizing solution to create artificial enamel lesions on the exposed enamel. The samples were separated randomly into four groups (20 each) depending on the application of the remineralizing agents as follows: group 1: control; group 2: calcium sucrose phosphate (CaSP); group 3: fluoride varnish; and group 4: casein phosphopeptides-amorphous calcium phosphate (CPP-ACP). The samples in individual group were treated with the corresponding remineralizing agent (except for the control group) two times a day for 14 days. The experimental and control groups were exposed to CLSM assessment to analyze the data of remineralization and demineralization. RESULTS: The mean depth of remineralization of fluoride varnish group was slightly more compared to other groups. The highest mean depth of remineralization was found in the fluoride varnish group (122.26 ± 0.28) followed by CaSP (110.58 ± 1.34), CPP-ACP (107.08 ± 0.48), and control (157.78 ± 0.46) groups. The different comparisons among the remineralization material groups showed a statistically significant difference (p < 0.05) in almost all groups except group 2 vs group 4. CONCLUSION: This study concluded that improved remineralization of artificial enamel lesion could be achieved with the fluoride varnish group when compared to the CaSP and CPP-ACP groups. CLINICAL SIGNIFICANCE: Remineralization as a treatment technique has received a lot of consideration from clinicians. The process of remineralization and demineralization is considered an active process categorized by the movement of calcium and phosphate in and out of the enamel. Presently, the attention has changed toward increasing the resistance of the tooth by applying remineralizing agents topically, which has led to the notable fall in dental caries.

Effectiveness of Various Dental Varnishes in Prevention of Enamel Demineralization around Orthodontic Brackets: An In Vitro Study.

AIM: The present study aimed to assess the efficacy of different dental varnishes in prevention of demineralization of enamel along the orthodontic brackets. MATERIALS AND METHODS: A total of 60 premolars that do not have caries and were extracted for orthodontic purposes were used in this study. Transbond™ Plus was used to bond premolar brackets onto the treated surface of enamel. The teeth were then divided into three groups. Group I: Profluorid varnish, group II: CPP-ACP varnish, and group III: Duraflor™ varnish. A Vickers diamond indenter was used to assess the microhardness of the surface of enamel at baseline, fourth day, and seventh day. RESULTS: A slightly meaner surface microhardness (SMH; 334.20 ± 2.10) was seen in group III when compared with group I (332.16 ± 3.02) and group II (330.40 ± 2.02). The mean SMH was 342.02 ± 0.82 in group I on the fourth day which was slightly higher than that of the baseline values, followed by group III (339.48 ± 0.34) and group II (336.64 ± 1.14). No statistically significant differences were noted between the groups. A higher mean microhardness of 349.84 ± 0.66 was seen in group I on the seventh day, followed by group III (342.26 ± 1.08) and group II (338.18 ± 1.08). A statistically highly significant difference was seen between the groups. CONCLUSION: The present study concluded Profluorid varnish to have maximum potential to reduce demineralization of enamel followed by Duraflor and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group. CLINICAL SIGNIFICANCE: A most common clinical challenge encountered in orthodontic clinical practice is enamel demineralization or white spot lesion (WSL) development throughout the fixed appliance treatment. Thus, the information about several available varnishes is important to prevent demineralization in regular dental practice.

Prevalence of pacifier use and the impact of maternal education and regularity of dental visits on the age of pacifier withdrawal.

AIM: The aim of this study was to assess the prevalence of pacifier use among Saudi children and analyze the effects of maternal education and dental visits on the age of pacifier withdrawal. METHODS: The dental histories of mothers of 300 children with age group of 2-7 years were obtained along with their educational level, frequency of dental checkups, and age of pacifier withdrawal. Data were analyzed using the cross-tabulation and Chi-square tests. RESULTS: Forty percent (n = 133) of the children used pacifier. There was an effect of maternal education on the age of pacifier withdrawal: higher the maternal education, younger the age of pacifier withdrawal. The frequency of dental visits influenced the relationship between maternal education and age of pacifier withdrawal. CONCLUSIONS: Unhealthy oral habits such as prolonged pacifier use can be reduced with regular dental checkups and higher levels of mother education. Hence, we recommend that children should start dental visits at an early age and maintain visits at regular intervals.

Clinical Efficiency of Three Caries Removal Systems: Rotary Excavation, Carisolv, and Papacarie.

PURPOSE: The removal of dentinal caries using the rotary method of excavation is most often associated with pain and anxiety in children. Chemo-mechanical caries removal may eliminate some of the drawbacks of the rotary technique and improve patient comfort. The purpose of this study was to compare the efficiency of the rotary, Carisolv, and Papacarie methods for caries removal in primary teeth, length of time needed, influence on child behavior, pain perception, and treatment preference of the child. METHODS: This controlled, split-mouth study with a cross-over design compared three caries removal methods in the primary molars of 50 five- to 12-year-old children. RESULTS: The rotary method was the most efficient and least time-consuming (P<0.001). Pain perception, however, was highest with this method (P<0.05). Papacarie exhibited a higher efficiency and required fewer applications than Carisolv (P<0.01). The Papacarie method was the most preferred, and the rotary method the least-preferred (P<0.05). CONCLUSIONS: Chemo-mechanical caries removal may be a promising alternative treatment procedure, particularly for anxious young patients.