Evaluation of Iontophoresis as a Tool in Comparison to Topical Remineralization Systems by Transverse Microradiography and Polarized Light Microscopy: An In Vitro Study.

Aim: To compare the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (GC Tooth Mousse) and tricalcium phosphate formulation (Clinpro) by topical application and iontophoresis. Background: Noninvasive treatment of dental caries is a major advance in the clinical management of the disease. Materials and methods: A total of 20 primary anterior and 20 primary molars were included in the study to be analyzed by transverse microradiography (TMR) and polarized light microscopy (PLM). The samples were coated with acid-resistant varnish, leaving a window on the buccal/lingual surface of enamel and immersed in demineralizing solution for 96 hours. Each sample was coated with varnish on the left half (control), and the right half served as a test. All the samples were divided into four groups. The test windows of specimens in groups I (GC Tooth Mousse) and II (Clinpro) were subjected to remineralization treatments for 10 days. Similarly, groups III and IV were subjected to iontophoresis using GC Tooth Mousse and Clinpro for 7 minutes. The samples were analyzed by TMR and PLM. Results: There was no significant difference in the mean difference of mineral loss among the four groups. There was a significant difference in the mean difference of lesion depth among the four groups. Conclusion: Both iontophoresis and topical application were equally efficient, but one remineralization by iontophoresis equals 10 topical applications. How to cite this article: VC R, Muppa R, Nallanchakrava S, et al. Evaluation of Iontophoresis as a Tool in Comparison to Topical Remineralization Systems by Transverse Microradiography and Polarized Light Microscopy: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S85-S90.

A comparative evaluation of the fluoride content in commercially available infant formulae in India: An in vitro study.

CONTEXT: The most critical period for enamel fluorosis to develop is during the early years of life when enamel formation occurs. To minimize the risk of dental fluorosis development, monitoring fluoride intake during teeth development has been suggested. As infant formulae are major source of nutrition in infants, it is important to determine the fluoride content in them in order to monitor the fluoride intake in infants. AIMS: To estimate and comparatively evaluate the fluoride content in different commercially available infant formulae in India. METHODOLOGY: A total of 16 commercially available infant formulae were collected from local pharma/grocery stores, in which 14 were milk based (Group M) and 2 were soy based (Group S). Fluoride content of the formulae was evaluated using ORION F selective electrode. STATISTICAL ANALYSIS USED: ANOVA test, t-test. RESULTS: The mean F values for groups M and S were found to be 0.031 and 0.07 ppm, respectively. Fluoride content of milk-based formulae was significantly lesser (P < 0.001) than soy-based formulae. Daily fluoride intake through the tested formulae was in the range of 0.013 mg and 0.105 mg when calculated following the manufacturer's preparation guidelines. CONCLUSIONS: Infant formulae alone were unlikely to be a risk factor for dental fluorosis, but when reconstituted with optimally fluoridated water, they can be a risk factor for the development of dental fluorosis.

A cross-sectional and histological analysis to understand the cytological effects of cell phone radiation on buccal mucosa of children.

Context: The ongoing pandemic has affected all the spheres of life and one of the severely affected avenues is the education of a child. The online education has seen an upward curve since the start of COVID-19 pandemic. Schools globally have adopted online class tutorials as the main method to impart education and directly increasing the screen time for a child. Aim: The aim of the present study was to evaluate the cytological effects of prolonged mobile phone usage on the buccal mucosa of children. Settings and Design: Stratified sampling was used for the selection of subjects for the study. After a questionnaire regarding the usage of a mobile phone was distributed among the parents of children. Among them, 90 children were selected on the basis of pattern and frequency of mobile phone usage in the child. Materials and Methodology: The children were divided into three groups based on the per day hours of viewing of mobile phone, i.e., Group 1: Usage of 1-2 h a day, Group 2: Usage of 3-6 h a day, and Group 3: Usage of >6 h a day. The time frame taken into consideration was 1 year after the pandemic started. This was specifically to understand the impact of the online education. Swab was obtained by using the conventional ice-cream stick method from the buccal mucosa. Statistical Analysis: The samples were subjected to histological and microscopical analysis to observe for cytological changes. One-way ANOVA was used to determine the statistical significance if any. Results: The results obtained clearly showed that Group 3 (>6 h usage per day) showed the highest number of cellular and chromosomal aberrations which was significant. Conclusion: The results indicated that impact due to the prolonged screen time on the buccal mucosa is significant. A direct proportionality was seen between the apoptotic changes and chromosomal aberrations and the number of daily hour usage.

Molar Incisor Hypomineralization Prevalence in the Schoolchildren of Gannavaram Mandal, Krishna District, Andhra Pradesh, India: A Cross-sectional Study.

AIM AND OBJECTIVES: To evaluate the prevalence of molar incisor hypomineralization (MIH) in schoolchildren of the ages between 8 and 14 years of Gannavaram Mandal, Krishna district, Andhra Pradesh, India. MATERIALS AND METHODS: A total of 2,250 children of ages between 8 and 14 years were selected randomly from different schools. After obtaining requisite permissions from Mandal Educational Officer (MEO), children was screened for the prevalence of MIH according to European Academy of Paediatric Dentistry (EAPD) 2003 diagnostic criteria and severity for MIH was examined using Wetzel and Reckel scale. RESULTS: Prevalence of MIH was observed to be 2.1% with higher cases of mild severity and with no sex predilection (p > 0.05). CONCLUSION: Early diagnosis and treatment can significantly reduce complications associated with MIH. Very few studies have been conducted in India and studies encompassing extensive population are warranted to better understand its etiology. CLINICAL SIGNIFICANCE: MIH lesions lead to carious development. Hence there is need to identify MIH in children as early as possible to reduce the clinical complications. HOW TO CITE THIS ARTICLE: Tarannum, Ravichandra KS, Muppa R, et al. Molar Incisor Hypomineralization Prevalence in the Schoolchildren of Gannavaram Mandal, Krishna District, Andhra Pradesh, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(6):737-740.

Indigenous irrigants as potent antimicrobials in endodontic treatment: An in vitro study.

BACKGROUND: The success of an endodontic treatment depends on effective disinfection and complete sealing of root canal. The irrigants that are currently used in the field of endodontics have certain limitations, so the quest for an ideal root canal irrigant continues. Nowadays, the use of herbal extracts such as Triphala and liquorice are used for their potent antimicrobial activity and less side effects. AIM: This study aims (1) to evaluate the antimicrobial efficacy of Triphala and liquorice against Enterococcus faecalis.(2) To determine any cytotoxic effect on isolated human periodontal ligament (PDL) fibroblasts. MATERIALS AND METHODS: The antimicrobial efficacy of Triphala and liquorice extracts was analyzed at different concentrations (12.5, 25, 50, 75, and 100 mg/ml) using the well-diffusion method. Three percent sodium hypochlorite (NaOCl) and distilled water were taken as positive and negative controls. Minimum inhibitory concentration of the active extract was determined by the broth dilution assay. Human PDL fibroblast tissue culture was used to assess the cytotoxicity of the preparations. The data thus obtained were subjected to statistical analysis. RESULTS: The results showed that the mean antimicrobial efficacy of Triphala and liquorice at 50 mg/ml is 20.33 and 9.33, respectively, which are statistically significant (P < 0.0001) as compared with a concentration 12.5 and 25 mg/ml. 50 mg/ml showed significant results (P < 0.001) on comparing with hypochlorite. Triphala and liquorice showed no cytotoxic effect as compared to NaOCl on human PDL fibroblasts. CONCLUSION: Among the three tested materials Triphala showed the highest antimicrobial efficacy followed by NaOCl and liquorice.

Fracture resistance of reattached fragments using three different techniques with emphasis on vertical grooves and fiber-reinforced composite post: A novel technique.

BACKGROUND: The aim of this study was to evaluate and compare relatively less explored fragment reattachment methods following traumatic injury. MATERIALS AND METHODS: Eighty sound permanent maxillary incisors were selected and mounted in acrylic blocks. Teeth were sectioned using the diamond disc and randomly divided into 4 groups (n = 20), Group A, B, C, D. In Group A, after reattachment with composite, a 1 mm-depth circumferential chamfer was placed in the fracture line using a diamond disc bur and filled with composite. In Group B, two vertical grooves 1 mm deep, 1 mm wide, and 4 mm length were placed on the labial surface perpendicular to the fracture line and filled with two fiber-reinforced composite (FRC) posts and composite. In Group C, dentin is removed from the fragment and filled with composite. In Group D, the teeth were intact which served as control group. The force required to fracture the reattached teeth were recorded in Newton's using an onscreen calibration tool of the universal testing machine. RESULTS: Teeth in Groups A, B, C required lesser force to fracture when compared with the teeth of the Group D. When compared to Group D, Group A showed a fracture resistance of 36%, Group B 62%, and Group C 32%. CONCLUSION: This study proves that reattachment by vertical grooves with FRC posts showed highest fracture resistance and it is the most preferred method. So far no attempt has been made to reattach fractured fragment using vertical grooves and reinforcing with FRC posts.

Clinical and Radiographic Evaluation of Success of Two commercially Available Pulpotomy Agents in Primary Teeth: An in vivo Study.

AIM: The aim of this study is to evaluate and compare Biodentine and mineral trioxide aggregate (MTA) as pulpotomy agents by clinical and radiological assessments in primary teeth. MATERIALS AND METHODS: In this study, 90 decayed primary molars indicated for pulpotomy were chosen and are divided into two groups. Soft enamel and dentinal caries were removed using spoon excavator. Access opening was done using highspeed cool water handpiece. Normal saline was used to irrigate pulp chamber, later saline moistened cotton pellet was used to obtain hemostasis in both groups. Restorations were placed in respective groups and immediate postoperative radiographs were taken. Follow-ups were done at every 3 months intervals, i.e., 3, 6, 9, and 12 months respectively. RESULTS: Statistical evaluation was carried out by using paired t-test which showed no significant difference between the two groups (p ≥ 0.05) with high success rate of 95.5%. CONCLUSION: Pulpotomy with MTA and Biodentine is a reliable biological method for pulp treatment of primary teeth. CLINICAL SIGNIFICANCE: Mineral trioxide aggregate and Biodentine could be considered as a reliable biological method for pulp-otomy of primary teeth.

Nonsyndromic localized aggressive periodontitis of primary dentition: A rare case report.

Periodontitis is an inflammatory disease of the gingiva and tissues of the periodontium. It is characterized by pocket formation and destruction of supporting alveolar bone. Periodontal diseases of aggressive nature are not very common in children. They are usually associated with systemic conditions. The present case report is of a 5-year-old male child who reported with rapid attachment loss and bony defects of the gingiva and supporting structures. His family and medical history gave no contribution for the diagnosis. Blood investigations did not reveal any abnormality. The microbial examination of culture revealed the presence of periodontal pathogen Aggregatibacter actinomycetemcomitans. The treatment objective in the present case was to prevent the further progress of the condition, restore esthetic and function in the child which would psychologically benefit the child.

Comparison of shear bond strength and micro-leakage of three commercially available seventh generation bonding agents in primary anterior teeth: an in vitro study.

PURPOSE: The study was conducted with the aim of comparing the shear bond strength (SBS) and microleakage of Tetric N-Bond, G-bond, and Xeno V (seventh generation dentin adhesives) in primary anterior teeth. MATERIALS AND METHODS: For the shear bond strength, 45 teeth were randomly divided in to three groups namely group A, B, C (n = 15). Samples were mounted horizontally on acrylic block exposing the facial surface and bonded with different adhesives according to manufacturer instructions. A split Teflon mold was used to build the composite resin cylinder and light cured. Shear bond strength was tested using a universal testing machine. The values were statistically analysed. For microleakage, another 45 teeth were similarly grouped. Two class V cavities were prepared on the labial surface and treated with different dentine bonding agents and restored with resin composite (Ivoclar vivadent) A2 shade. The restorations were subsequently thermally stressed for 200 cycles and were subjected to dye penetration test, followed by sectioning through the center of the restoration labiolingually. Each section was examined using stereomicroscope at × 40 magnification to asses dye penetration at the margins of the restoration. RESULTS: The SBS varied between 22.12-23.77 N/mm 2 (P-value = 0.231). The microleakage scores varied between 0.6-1.2 (P-value = 0.03; Post-hoc test A vs B (0.007)).There was a statistically higher degree of microleakage observed in group A when compared to group B. CONCLUSION: Among the three commercially available bonding agents, there were no statistically significant differences in SBS. G bond had higher microleakage when compared to the others.

Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study.

OBJECTIVES: The study is to evaluate changes in microhardness of enamel after exposure to acidic center filled chewing gum on primary and permanent teeth. METHODS: Thirty primary and 30 permanent molar extracted teeth were painted with acid resistant varnish except a small window over buccal surface. Teeth were divided into four groups according to type of teeth and type of chewing gum (Center fresh and Bubbaloo) (D1, P1, D2 and P2); each tooth was exposed to whole chewing gum mashed with 5 ml of artificial saliva for five minutes at room temperature twice a day for 5 days. After the exposure, teeth were stored in deionized water and submitted for microhardness tests. RESULTS: Paired t-test and independent sample t-test were used for statistical analysis. A significant reduction in microhardness was found between exposed and unexposed areas in all groups. There was no statistically significant difference in reduction of microhardness to chewing gums, and between primary and permanent enamel. CONCLUSION: There is a definite reduction in microhardness in all groups exposed to chewing gums. Both the chewing gums are equally erosive; both permanent and primary teeth were affected. How to cite this article: Mudumba VL, Muppa R, Srinivas NCH, Kumar DM. Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):24-29.

Type III B dens invaginatus: diagnostic and clinical considerations using 128-slice computed tomography.

Endodontic therapy is successful only when thorough knowledge of root canal morphology is understood. Dens invaginatus is malformation of teeth resulting from invagination of tooth before biological mineralization occurs. It is clinically significant with an early pulpal involvement and chronic periapical lesion, which are often associated with this anomaly. The present case report describes a 13-year-old female patient who reported to our institution with complaint of pain and swelling in the right maxillary region. Intraoral examination revealed Ellis Type II fracture of right maxillary central incisor and normal appearing right maxillary lateral incisor. On radiographic examination right maxillary, lateral incisor roots are morphologically altered with an immature apex and a large periradicular lesion. Conventional radiographs help in the assessment of complex root morphology, but certain limitations pertaining to detail of complexity needs for the use of more advance imaging modalities. Complex anatomic variations can best be diagnosed with the use of computed tomography (CT). A combined endodontic and surgical treatment was performed followed by postobturation CT images which were reviewed as axial slices and in volume rendering multiplanar reconstruction. The scope of using spiral CT in the endodontic diagnosis and treatments is increasing as it provides better resolution than other methods.

Comparison of anxiety levels associated with noise in the dental clinic among children of age group 6-15 years.

Fear or anxiety due to noise produced in the dental clinic is rated third among the reasons to avoid dental visits. The aim of the present study was to determine anxiety levels associated with noise in a dental clinic. The study was done using a survey questionnaire containing 10 questions and was divided into two parts. The first part included demographic information such as name, age, gender, and school; the second half included questions regarding patient's feelings toward noise in the dental clinic and its possible link to dental anxiety. Two-hundred and fifty children and adolescents of age group 6-15 years participated in the study. Results of the study showed that 50% of females, 29% males avoided a visit to the dentist because of anxiety and fear, 38% subjects of age group 6-11 years reported that sound of the drill makes them uncomfortable, followed by having to wait in the reception area. Gender gap was also observed with more females feeling annoyed than males on the 1-10 annoyance level scale. More than 60% felt "annoyed" to "extremely annoyed" by noise in the dental clinic. 45% of subjects preferred watching television to cope with such noise. This study concludes that the noise produced in dental clinic is anxiety provoking and significantly contributes to avoidance of dental treatment and the best way opted by the majority of subjects to overcome this anxiety was audiovisual distraction method.

Conservative approach in the management of radicular cyst in a child: case report.

Radicular cyst is the most common odontogenic cystic lesion of inflammatory origin. It is also known as periapical cyst, apical periodontal cyst, root end cyst, or dental cyst. It arises from epithelial residues in the periodontal ligament as a result of inflammation. The inflammation usually follows the death of dental pulp. This paper presents a case report of a patient with radicular cyst associated with a primary molar.

Odontogenic fibromyxoma of maxilla: a rare case report.

Fibromyxoma is a rare odontogenic tumour which is benign, but locally aggressive. The etiology of these tumours is unknown, but because of its limitation to the teeth bearing areas and occasional presence of odontogenic epithelial fragments within the tumour which suggest that it is of odontogenic origin. It is a slow growing painless tumour that frequently occurs in second and third decades of life. Females are more commonly affected than males. The tumour can cause gradual expansion of the cortical plates and cause loosening and displacement of teeth, although root resorption may be rare. The surgical treatment of these tumours consists of complete enucleation or radical excision. The aim of this paper is to present the rarity of a fibromyxoma of the maxilla.

Iatrogenic inflammatory fibrosis of hard palate in a 13-year-old female patient.

Palatal swellings are rare in children and the incidence differs from that of the adult counterparts. When the palatal swellings do arise in children, they usually are palatal abscess from periapical region, and few cases like pleomorphic adenoma in young adults have also been reported. But inflammatory fibrosis of palate in children is a rare occurrence. Inflammatory fibrosis is formation of excess fibrous connective tissue in an organ or tissue, as a reparative or reactive process. This report describes an unusual case of iatrogenic inflammatory fibrosis on the palate due to extraction of tooth number 22 in a 13-year-old female patient. The patient presented with a single large well-circumscribed oval palatal swelling that was soft, fluctuant, not fixed, and nontender. Surgical excision of the lesion was done and it was sent for histopathological assessment. The biopsy showed fibrous tissue with collagen fibers, spindle shaped fibroblasts, neovascularization, RBCs, chronic inflammatory cells, and traces of salivary gland and nerve tissue.

Non syndromic gingival fibromatosis in a mild mental retardation child.

Gingival fibromatosis is a benign oral condition characterized by enlargement of gingival tissues. It usually develops as an isolated disorder but can be one of the features of a syndrome. This case report is of a 5-year-old male with severe gingival hyperplasia and mild mental retardation which was complicated by open bite, abnormal occlusion, open lip posture, and disabilities associated with mastication and speech. Full mouth gingivectomy in single sitting under general anesthesia was done with electrocautery.

Hand, foot and mouth disease.

Hand, foot and mouth disease (HFMD) is an acute viral illness with a distinct clinical presentation of oral and characteristic distal extremity lesions. Knowledge of this is important for the dentists as the oral lesions are the first clinical signs and sometimes may be the only sign because the condition occasionally may regress even before the lesions appear on the extremities. This case describes a 5-year-old boy in whom low-grade fever of 38.7°C and oral lesions were the initial manifestations. Proper diagnosis was established later based on the typical location of the initial intraoral ulcers on the soft palate followed by cutaneous lesions on the hands and feet with vesicle formation surrounded by an erythematous halo. The recognition of HFMD is important for both pediatricians and pedodontists as oral manifestations are the first signs and may mimic many other conditions like acute herpetic gingivostomstomatitis, apthous stomatitis, chickenpox, erythema multiformae and misdiagnosis may involve an inappropriate prescription of medication.

Papillon-lefevre syndrome: a combined approach from the dermatologist and dentist - a clinical presentation.

Papillon-Lefevre syndrome (PLS) is a rare disease characterized by skin lesions, which includes palmar-plantar hyperkeratosis and hyperhidrosis with severe periodontal destruction involving both the primary and the permanent dentitions. It is transmitted as an autosomal-recessive condition, and consanguinity of parents is evident in about one-third of the cases. This paper describes a 13-year-old male patient who presented to the department of pedodontics, with rapidly progressing periodontitis. A general physical examination revealed scaling on the hands and feet, which had been medically diagnosed as PLS. The incidence of this rare entity is increasing in the recent times, which is associated with irreparable periodontal destruction at an early age, with not so prominent skin lesions in some cases. In such instances, the dentist has a more important role in diagnosing, treatment planning and preservation of the periodontal tissues and, at the same time, referring for the treatment of the skin lesions. This paper emphasizes the combined effort of the two specialities in order to maintain skin as well as dental conditions in health by early intervention and a synergistic treatment approach.