Recent Advances in Caries Prevention-An Update.

Management of dental caries has seen a significant development in recent years. A diagnosis based on risk indicators and risk factor assessments, early identification, and caries prevention are some of the most recent and efficient strategies. The recent advancements in dental caries prevention strategies are briefly covered in this overview.

Experimental and computational investigation of the α-amylase catalyzed Friedel-Crafts reaction of isatin to access symmetrical and unsymmetrical 3,3',3''-trisindoles.

Trisindoles are of tremendous interest due to their wide range of biological activities. In this context, a number of methods have been reported in the past to synthesize 3,3',3''-trisindoles. However, most of the methods are only able to produce symmetrical 3,3',3''-trisindoles. Herein, we develop a sustainable and efficient approach to synthesize symmetrical as well as unsymmetrical 3,3',3''-trisindoles in a very selective manner using the α-amylase enzyme as a catalyst. Furthermore, various differently substituted isatin and indoles were used to prove the generality of the protocol and symmetrical or unsymmetrical 3,3',3''-trisindoles were obtained in 43-97% isolated yields. Next, a probable mechanism is proposed and investigated using molecular dynamics (MD) investigation to gain more insight into the role of residues available in the active site of the α-amylase enzyme. These studies revealed that Glu230, Lys209, and Asp206 in the active site of α-amylase play an important role in this catalysis. Moreover, the DFT studies suggested the formation of bisindole and alkylideneindolenine intermediates during the transformation. We synthesized four different biologically important 3,3',3''-trisindoles on a gram scale, which proved the robustness and scalability of this protocol.

In Vitro Assessment of Sealing Ability of Various Materials Used for Repair of Furcal Perforation: A SEM Study.

AIM: The aim of the current in vitro research was to evaluate the sealing capacity of three different agents employed for the repair of perforations at the furcation area. MATERIALS AND METHODS: Recently 60 extracted human mandibular permanent molars having well apart plus fully formed roots, and intact furcation were chosen. The 60 samples were allocated at random to three groups of 20 samples: Group I: Furcation perforation repair by means of mineral trioxide aggregate (MTA)-Angelus, Group II: Furcal perforation repair using Biodentine, Group III: Furcal perforation repair by EndoSequence. The specimens were subjected to sectioning with a hard tissue microtome and the sectioned parts of the samples were then examined. The specimens were subjected to gold sputtering and visualizing beneath scanning electron microscope (SEM) at 2000× magnification for assessing the sealing capacity of the agents. RESULTS: The highest sealing capacity was noted with the use of Biodentine at 0.96 ± 0.10, in pursuit by EndoSequence use at 1.18 ± 0.14 and MTA-Angelus use at 1.74 ± 0.08. The disparity amid the three groups was statistically significant with p < 0.001. CONCLUSION: In conclusion, it may be inferred that Biodentine exhibited the finest sealing capacity than EndoSequence and MTA- Angelus. It may thus be given consideration as a substance of preference for the repair of furcal perforation. CLINICAL SIGNIFICANCE: Using biologically compatible substances may be suggested to amend perforations thereby decreasing the occurrence of inflammatory response in the neighboring tissues. The sealing capacity is a significant feature in supporting the result of a root canal treatment of a tooth.

Ternion Cusp: An Unusual Variant of Talon's Cusp: A Case Report.

Background: Teeth are hard mineralized anatomical components of the dentofacial skeleton that are developed during the gestation period by odontogenesis. This dental development comprises five stages viz. initiation, proliferation, histodifferentiation, morphodifferentiation, and apposition. Excitation to the dental organ during morphodifferentiation is responsible for the formation of a talon cusp, which manifests as a cusp-like structure of hard tissue projecting from the cingulum to a varying measurable length toward the incisal edge of maxillary and mandibular anterior teeth. Various literature has reported that it comprises enamel, dentine, and an inconsistent amount of pulp tissue. Old literature suggests its occurrence in primary and permanent teeth and mostly on the palatal aspect of teeth as one cusp; therefore, known as a talon cusp (eagle's talon). Case description: An exceptional case of three cusped structures projecting from the palatal side of a maxillary central incisor is thus reported. The rare occurrence of an atypical talon cusp with three well-defined mamelon-like cusps on the palatal surface of the permanent maxillary central incisor is coined as ternion cusp, meaning "three" by authors. Its occurrence is repercussed as attrition of the teeth in the opposite arch. Selective or retruded contact position (RCP) was done, followed by topical fluoride application was rendered. Conclusion: Managing and treating these exceptional cusps depends upon their size, present complications, and patient compliance. How to cite this article: Sharma V, Mohapatra A, Bagchi A. Ternion Cusp: An Unusual Variant of Talon's Cusp: A Case Report. Int J Clin Pediatr Dent 2022;15(6):784-788.

Cementoblastoma Relating to Right Mandibular Second Primary Molar.

Cementoblastoma is a benign lesion of the odontogenic ectomesenchymal origin. It rarely occurs in primary dentition. This report describes a case of a cementoblastoma relating to the right mandibular second primary molar in a 7-year-old girl. Her panoramic radiograph revealed a well-defined radiopaque lesion with a radiolucent border extending from the distal surface of the mandibular right first primary molar to the distal surface of mandibular second primary molar. The tumor was attached to the mesial root of primary second molar and was excised along with the teeth involved and sent for histopathological evaluation, which showed irregular trabeculae of mineralized tissue interspersed with fibrovascular connective tissue, trabeculae of mineralized tissue with prominent reversal lines, and peripheral rimming of the mineralized tissue with blast cells. On a six-month follow-up, there has been no recurrence of the lesion.

Impacted mandibular permanent incisors related to supernumerary teeth: a rare condition.

Supernumerary permanent teeth in the mandibular incisor area are rare, and there are very few reported cases of the supernumerary teeth in the mandibular incisor area leading to impaction of incisors. A south Indian boy aged 14 presented with 3 supernumerary teeth in the mandibular right permanent incisor area resulting in impacted permanent central and lateral incisors.

Anterior fixed interim prosthesis with natural tooth crown as pontic subsequent to replantation failure.

Facial trauma resulting in tooth avulsion results in problems of physical and emotional nature for the patient and a challenge for the dentist. Avulsion accounts for 0.5-16% of traumatic injuries in the permanent dentition that can occur at any age and is most common in the young permanent dentition. As an emergency procedure, it is advisable to replant a traumatically avulsed tooth, but unfortunately long-term success is rather low. After unsuccessful replantation and subsequent extraction, it is prudent to replace the lost tooth to avoid aesthetic, masticatory, and psychological difficulties and also to prevent arch length discrepancy with various alternatives are available for the same. We presented a method for management of one of the two replanted teeth that showed failure, using the natural crown as pontic in a fixed semi-permanent bridge until a more definitive prosthesis can be fabricated at a later age for better patient compliance.

Atypical presentation of bilateral supplemental maxillary central incisors with unusual talon cusp.

Delayed eruption of maxillary permanent central incisors in a child poses a distressing esthetic quandary to parents, by virtue of its location in the dental architecture. Well-aligned anterior teeth add confidence to smile and have enhanced self-esteem, which is critical even in early life. Impaction of the maxillary central incisors compared to third molars or the canines is less reported; bilateral supplemental maxillary central incisors related to impacted permanent maxillary central incisors are rare and one of the supplemental central incisors showing unusual talon is still infrequent. A case of impacted maxillary permanent central incisors related to supplemental maxillary central incisors, with one of them showing an unusual talon cusp, is presented.

Microleakage evaluation using acetate peel technique.

OBJECTIVES: To evaluate and measure the interfacial space or the restoration cavity integrity for probable microleakage using acetate film; acetate peel technique under different magnifications. STUDY DESIGN: Premolar tooth was obtained and standardized class V restoration with Z-350 done both buccally and lingually. The tooth was hemisectioned buccolingually and embedded in epoxy resin, polished, acid etched, washed and dried. The sectioned sample was flooded with acetone and a pre-cut acetate film placed over it. As the acetone evaporated, the film took the shape of the micro relief produced by etching and dried in 10-15 mins. It was pulled off the tooth surface and mounted between two glass slides for examination under research microscope with different magnifications. RESULTS: This enabled us to measure the interfacial space that might lead to leakage of restoration and also could detect the intricate details of tooth. CONCLUSION: The acetate peel technique is an efficient way to study the interfacial space/restoration-cavity marginal integrity at a higher magnification and was a fast and reliable tool for assessing the microleakage of a restorative material.

Efficacy of various disinfectants on microbially contaminated toothbrushes due to brushing.

AIMS: To evaluate the effectiveness of different disinfectant agents in decontaminating the toothbrushes, and to educate the children, parents and the community on the decontamination of toothbrushes. MATERIALS AND METHODS: Fifty healthy male children in the age range of 8-11 years were enrolled. They were divided into five groups of 10 each and provided with toothbrushes and disinfectants. Instructions were given to the children and the toothbrushes were collected after brushing and cultured for the growth of microorganisms. The efficacy of Hexidine(®), 3.0% hydrogen peroxide and Listerine(®) and Dettol(®) were evaluated. Chi-square test was used for statistical analysis. RESULTS: Hexidine, 3.0% hydrogen peroxide and Listerine showed 100% efficacy, whereas Dettol showed 40% effectiveness in decontaminating the toothbrushes. Water as a control showed the least effectiveness in cleaning the toothbrushes. CONCLUSIONS: The study concluded that 3.0% hydrogen peroxide is the most economical and effective disinfectant when compared with the other disinfectants.

An unusual triplication of primary teeth-a rare case report.

Odontogenic anomalies can occur as a result of conjoining or twinning defects. This article reports the case of fusion in a 10-year-old boy in relation to the primary maxillary right incisors. Clinicoradiographic examination revealed the presence of triple teeth, ie, fusion between the maxillary right incisors along with a supernumerary tooth on the labial surface. The offending triple tooth was extracted under local anesthesia. The extracted tooth was sectioned using a hard tissue microtome at three levels-the coronal, middle root, and apical levels, respectively-and these sections were visualized under a stereomicroscope. Based on the histologic findings, a final diagnosis of fusion was confirmed. A brief review of the literature on triple teeth is also presented.

Management of immature teeth with apical infections using mineral trioxide aggregate.

Traumatic injuries to the young permanent teeth lead to devitalization of the pulp with concomitant arrest in further development of the immature root of the involved tooth. Hermetic seal of the root canal system during obturation is not possible in such cases, due to the lack of an apical constriction. The traditional management technique in such cases has been apexification involving induction of a calcific barrier at the apex using calcium hydroxide, which in turn facilitates obturation of the root canal. However this becomes complicated when there is persistent infection leading to periapical changes. This case report describes the use of mineral trioxide aggregate (MTA) for management of a periapically compromised immature tooth.