Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial.

Aim: The main objective of the present study was to estimate the production of hydrogen peroxide present in saliva and correlate it to early childhood caries using high-performance liquid chromatography [HPLC] method. Design: The study was conducted on children aged 3-6 years with a sample size of 20 who had decayed, missing, or filled teeth in accordance to WHO pro forma and were divided into two groups: Study group: Caries active [CA][n = 10] and Control group caries free [CF] [n = 10]. The whole saliva was collected into the vials with a buffer solution and was stored in cold storage. HPLC was done to estimate, detect, and correlate the amount of production of H2O2 in CA and CF groups. To compare age and gender distribution among two groups, Independent student "t" test was used. To compare the mean production of H2O2 levels between two study groups with a significance of p > 0.05 was done using Mann-Whitney U test. Spearman's correlation was done between caries and H2O2. Results: Comparison of mean H2O2 levels [in ppm] between groups was statistically significant at p = 0.03, which showed as age increases H2O2 production also increases. Age-wise estimation of H2O2 obtained a statistically significant result [p = 0.04]. However, gender-wise comparison of mean H2O2 levels [in ppm] in both the groups showed no difference. Conclusion: Findings in our study strongly suggested that H2O2 levels are more in children without any caries experience. H2O2 production is the same among males and females but according to age, H2O2 production increases as the child grows with age. How to cite this article: Thimmegowda U, Belagatta V, Krishnamurthy NH, et al. Identification, Quantification and Correlation of Hydrogen Peroxide Present in Saliva to Early Childhood Caries: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(S-2):S140-S146.

A CBCT Study to Evaluate the Root and Canal Morphology of Permanent Maxillary First Molars in Children.

Introduction: For the correct diagnosis and endodontic therapy, a complete understanding of root canal morphology is required. One of the causes of endodontic failure is the inability to identify every canal in the root canal system; the second mesiobuccal canal (MB2) in the permanent maxillary first molar is the most commonly missed canal. Studies examining the root canal differences in pediatric Indian populations' permanent maxillary first molars are somewhat uncommon. Aim: Cone-beam computed tomography (CBCT) will be used to assess the root and canal morphology of permanent maxillary first molars in the pediatric Indian population. Materials and methods: In the age range of 7-13 years, 25 children's CBCT pictures (50 images) were gathered from the institutional database and private diagnostic facilities. SCANORA® software was used to reconstruct the CBCT pictures, and Statistical Package for the Social Sciences (SPSS) for Windows was used to evaluate and analyze the data. Results: The roots of each permanent maxillary first molar were distinct. And all of the palatal and distobuccal roots were found to have a single root canal (100%), whereas the mesiobuccal roots were found to have a single root canal in 80% of cases and a double root canal in 20% of cases. The Vertucci type II structure, followed by types IV and V, was the most prevalent in roots with two channels. Conclusion: Within the constraints of this investigation, we came to the conclusion that the permanent maxillary first molar root canal configuration varied among the patients from the pediatric Indian population. How to cite this article: Krishnamurthy NH, Athira P, Umapathy T, et al. A CBCT Study to Evaluate the Root and Canal Morphology of Permanent Maxillary First Molars in Children. Int J Clin Pediatr Dent 2022;15(5):509-513.

Knowledge about the Harmful Effects of Environmental Tobacco Smoke, Perceptions toward Initiation of Smoking and Factors Influencing Smoking in Adolescents: A Cross-sectional Study.

Background: The main hope of a nation lies in the proper education of its adolescents because the youths of today are the leaders of tomorrow. About 15% of children of ages 13-15 years are ingesting tobacco in certain forms and are getting addicted to tobacco. Hence, tobacco has become a burden in our society. Similarly, environmental tobacco smoking (ETS) is more dangerous than smoking and is common among young adolescents. Aim: This study is aimed to explore the knowledge about the hazards of ETS and the factors which are responsible for adolescents to initiate tobacco smoking among parents visiting the pediatric dental clinic. Materials and methods: A cross-sectional survey on the knowledge about the harmful effects of ETS and factors influencing the initiation of tobacco use among adolescents was assessed using a self-administered questionnaire. A sample size of 400 parents of adolescents aged between 10 and 16 years visiting the pediatric clinics was included in the study; data thus obtained was subjected to statistical analysis. Results: The effect of ETS in increasing the risk of cancer was known to be 64.4%. But the effect on premature babies was least known by 37% of the parent population, which is statistically significant. About 14% of parents perceive that children initiate smoking to experiment or relax, which is statistically significant. Conclusion: Parents have very little knowledge regarding the effects of ETS on children. They can be counseled regarding types of smoking and smokeless tobacco products, health hazards, the deleterious health effects of ETS, and passive smoking, particularly in children with respiratory diseases. How to cite this article: Thimmegowda U, Kattimani S, Krishnamurthy NH. Knowledge about the Harmful Effects of Environmental Tobacco Smoke, Perceptions toward Initiation of Smoking and Factors Influencing Smoking in Adolescents: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(6):667-671.

A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population.

Aim: To determine the location of mandibular foramen (MF) and mental foramen (MeF) in 8-18-year-old children using cone beam computed tomography (CBCT). Materials and methods: Hundred CBCT images of children (8-18 years) were evaluated to determine the shortest distance from MF to the anterior border of ramus (A), posterior border of ramus (P) and inferior border of the mandible (MI), most superior point of the curvature of mandibular notch (MN), occlusal plane of the mandibular permanent molars (O), and the distance from MeF to lower border of mandible (BM) and to the alveolar crest (AC). Results: There was a statistical increase in A-MF, P-MF, MI-MF, MN-MF, and O-MF values with age. MF was found to be 3.53 mm below the occlusal plane in 8-11-year-old children, and it reaches the occlusal plane by 12-14 years of age, and it moves posterior-superiorly 3.58 mm above the occlusal plane in 15-18-year-old individuals. AC-MeF value decreases whereas the BM-MeF value increases with age and there was a significant difference based on sex. Conclusion: The location of the MF is just posterior to the middle of the ramus, it reaches the level of the occlusal plane by the age of 12-14 years, and MF and MeF are shifting posterior-superiorly with increasing age. Clinical significance: The awareness of localization of MF and MeF is of greater importance when administering regional anesthesia in mandible, especially in children. Its position varies according to gender and age, especially during growth spurts. Failure to achieve proper nerve block leading to repeated injection of the local anesthetic solution will not only pose a behavior problem in children but can also lead to systemic toxic level of anesthetic solution being administered. Its accurate position enables more effective local anesthesia and improves child cooperation, minimizing the risk of complications. How to cite this article: Vathariparambath N, Krishnamurthy NH, Chikkanarasaiah N. A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population. Int J Clin Pediatr Dent 2022;15(4):422-427.

Applicability of new proposed novel tooth numbering system for primary teeth: An observational study.

OBJECTIVE: The aim of the present study was to check the reliability and applicability of new proposed tooth numbering system (TNS) for primary teeth that will aid the dentist to overcome the disadvantages of existing TNS and enable to note the primary teeth in an easier and more precise way. STUDY DESIGN: This observational questionnaire survey was conducted in an institution consisting 11 questions in English format. Four hundred samples were randomly selected which included under graduates, postgraduates, and faculty. Self-structured questionnaires were given in order to assess the reliability and applicability of the new proposed TNS. Data obtained were subjected to statistical analysis. Chi-square test was used to compare the responses between different study groups, and P value was set at P < 0.05. RESULTS: According to the participants, the new TNS maintains the anatomical midline, easily readable, written and typed though required extra concentration. It is easy to converse and can be followed by beginners. It does not require extra timing and can be used routinely. With mixed dentition, it does not take more time, but there are chances of confusion or overlap while recording. CONCLUSION: The new Havale's Alphaneumarical Dental Notation system can be used routinely by undergraduates and postgraduates as well as clinicians and can apply or follow the system in regular dental practice.

Marginal microleakage of glass ionomer cement with two different cavity conditioners on primary anterior teeth - An in vitro study.

BACKGROUND AND OBJECTIVE: Glass ionomer cements (GICs) are the most commonly used restorative material in pediatric dentistry. They have numerous advantages; however, they show some marginal microleakage at the restoration-tooth interface. Various conditioning agents have been tested for alteration or dissolution of smear layer which has been attributed to the occurrence of microleakage; however, very limited studies have been done using primary teeth. AIMS: To evaluate and compare the effect of 10% polyacrylic acid and 17% EDTA on marginal microleakage of high-viscosity GIC. SETTINGS AND DESIGN: Experimental, in vitro study. METHODOLOGY: Class V cavities of standardized dimensions were prepared on 60 primary anterior teeth and were randomly divided into three groups. Except Group I, the cavities of Groups II and III were conditioned with 10% polyacrylic acid and 17% EDTA, respectively. All the 60 teeth were then restored with high-viscosity GIC. The samples were thermocycled and immersed in methylene blue solution for 24 h. The teeth were removed from the stain, rinsed, and sectioned buccolingually and were observed under stereomicroscope at 30× to score the marginal microleakage. STATISTICAL ANALYSIS USED: Kruskal-Wallis test followed by Mann-Whitney post hoc analysis were used to compare the mean marginal leakage scores between the three study groups. RESULTS: Statistical significance difference was found between all the three groups (P < 0.05). The mean marginal microleakage score was maximum for Group I (control group; 3.00), whereas it was the least for Group II (1.30) where 10% polyacrylic was used for conditioning the cavity surface. CONCLUSION: Among the study groups, none of them was completely devoid of microleakage in all its samples. 10% polyacrylic acid emerged as a better conditioning agent when compared with 17% EDTA in altering or removing the smear layer thereby resulting in better adhesion.

Evaluation of Relative Position of Mandibular Foramen in Children as a Reference for Inferior Alveolar Nerve Block using Orthopantamograph.

INTRODUCTION: The Mandibular Foramen (MF) is a landmark for administering local anaesthetic solution for Inferior Alveolar Nerve Block (IANB). The position of MF shows considerable variation among different ethnicity, ages and on either sides even within the same individual. Failure to achieve IANB leading to repeated injection of the local anaesthetic solution will not only pose a behaviour problem in children but can also lead to systemic toxic level of anaesthetic solution being administered. AIM: To determine the relative position of the mandibular foramen in 7 to 12-year-old children in relation to the mandibular occlusal plane and the deepest point on coronoid notch. MATERIALS AND METHODS: Ninety orthopantamograph of 7 to 12-year-old children were selected from the database and were divided into three groups: Group 1 (G1): seven to eight-year-old, Group 2 (G2): 9 to 10-year-old and Group 3 (G3): 11 to 12-year-old. The radiographs were traced on acetate paper, anatomical landmarks were marked and linear measurements were noted from the Mandibular Lingula (ML) to the occlusal plane, and to the deepest point on coronoid notch. The data obtained was tabulated and subjected to statistical analysis. One way ANOVA test followed by Bonferroni post hoc analysis and Student's paired t-test were used. RESULTS: Mandibular foramen is approximately, 2-3 mm above the occlusal plane and 11.6-13.0 mm from deepest point of coronoid notch for seven to eight-year-old children, 3-4 mm above the occlusal plane and 13.0-13.9 mm from deepest point of coronoid notch for 9-10 year age group and 5.5-6.5 mm above the occlusal plane and 11.9-12.2 mm from deepest point of coronoid notch for children of the ages 11-12 years. The linear distance from the deepest point of coronoid notch to the mandibular lingula showed statistical significance in G2 vs G3 on right side G1 vs G2 and G2 vs G3 on the left side. The variance of this distance for either side showed statistical significance for G1 and G2. CONCLUSION: The distance from the mandibular lingula to the occlusal plane showed gradual increase in all the three groups, which was statistically significant. The position of the mandibular foramen is not bilaterally symmetrically for any of the considered age groups.

Cleidocranial dysplasia presenting with retained deciduous teeth in a 15-year-old girl: a case report.

INTRODUCTION: Cleidocranial dysplasia is a rare congenital defect of autosomal dominant inheritance caused by mutations in the Cbfa1 gene, also called Runx2, located on the short arm of chromosome 6. It primarily affects bones which undergo intramembranous ossification. This condition is of clinical significance to dentistry due to the involvement of the facial bones, altered eruption patterns and multiple supernumerary teeth. CASE PRESENTATION: Our patient, a 15-year-old Indian girl, presented with the typical features of prolonged retention of deciduous dentition and delayed eruption of permanent teeth, that is, mandibular prognathism along with other skeletal abnormalities like shrugged shoulder and the absence of clavicles. A multidisciplinary approach was followed, comprising orthodontic, surgical and pedodontic teams for management. CONCLUSION: Successful treatment of such a case lies in a holistic approach that takes care of all aspects, including the primary pathology, the deformity itself and even the psychological angle.