An in vitro comparative assessment of manual hand file, rotary protaper ni-ti, erbium:yttrium-aluminum-garnet laser, canal brush, and ultrasound methods for smear layer removal.

Background: Selection of instruments is important to prevent any complications such as ledge formation and instrument breakage. The main drawback linked with instrumentation is smear layer formation. Objectives: This study was done for comparison of manual hand file, rotary ProTaper Ni-Ti, erbium:yttrium-aluminum-garnet (Er:YAG) laser, ultrasound, and CanalBrush (CB) methods for smear layer removal. Methodology: Sixty freshly extracted single-rooted mandibular first premolars extracted for orthodontic treatment purpose were selected and classified into six groups. Group I was negative control in which no final agitation of irrigant was performed. In Group II, solution activation was performed with ProTaper Universal System, in Group III, solution activation was done with canal brush, in Group IV, ultrasound activation was done, in Group V, solution agitation was performed with Er:YAG laser agitation, and in Group VI, canal preparation with hand files was performed. Smear layer score was evaluated after canal preparation with each method. Results: Score 1 was seen in 3 (30%) in Group IV and 6 (60%) in Group V, score 2 was seen in 3 (30%) in Group I, 8 (80%) in Group II, 7 (70%) in Group III, 5 (50%) in Group IV, 3 (30%) in Group V, and 4 (40%) in Group VI. Score 3 was observed in 7 (70%) in Group I, 2 (20%) in Group II, 3 (70%) in Group III, 2 (20%) in Group IV, 1 (10%) in Group V, and 6 (60%) in Group VI. A statistically significant difference was found in smear layer removal score in all groups (P < 0.05) except between Group I versus VI (P > 0.05). Conclusion: Complete removal of the smear layer was not observed in any of the methods used in the study; however, Er: YAG laser was found to be better as compared to other methods.

Résumé Contexte: La sélection des instruments est importante pour éviter toute complication telle que la formation de rebords et la rupture d'instruments. Les Le principal inconvénient lié à l'instrumentation est la formation d'une couche de frottis. Objectifs: Cette étude a été réalisée pour comparer des limes manuelles, méthodes rotatives ProTaper Ni-Ti, laser erbium:yttrium-aluminium-grenat (Er:YAG), ultrasons et CanalBrush (CB) pour l'élimination des frottis. Méthodologie: Soixante premières prémolaires mandibulaires monoracinaires fraîchement extraites à des fins de traitement orthodontique ont été sélectionnées et classés en six groupes. Le groupe I était un témoin négatif dans lequel aucune agitation finale de l'irrigant n'a été effectuée. Dans le groupe II, l'activation de la solution a été réalisée avec le système universel ProTaper, dans le groupe III, l'activation de la solution a été effectuée avec une brosse canalaire, dans le groupe IV, l'activation par ultrasons a été fait, dans le groupe V, l'agitation de la solution a été effectuée avec une agitation au laser Er:YAG, et dans le groupe VI, la préparation du canal avec des limes manuelles a été effectué. Le score de la couche de frottis a été évalué après la préparation du canal avec chaque méthode. Résultats: le score 1 a été observé chez 3 (30 %) dans le groupe IV et 6 (60 %) dans le groupe V, le score 2 a été observé chez 3 (30 %) dans le groupe I, 8 (80 %) dans le groupe II, 7 (70 %) dans le groupe III, 5 (50 %) dans le groupe IV , 3 (30%) dans le groupe V, et 4 (40 %) dans le groupe VI. Le score 3 a été observé chez 7 (70 %) dans le groupe I, 2 (20 %) dans le groupe II, 3 (70 %) dans le groupe III, 2 (20 %) dans Groupe IV, 1 (10 %) dans le groupe V et 6 (60 %) dans le groupe VI. Une différence statistiquement significative a été trouvée dans le score d'élimination des frottis dans tous les groupes (P < 0,05) sauf entre le groupe I et VI (P > 0,05). Conclusion: L'élimination complète de la frottis n'a été observée dans aucun des méthodes utilisées dans l'étude; cependant, le laser Er:YAG s'est avéré meilleur par rapport aux autres méthodes. Mots-clés: Brosse canalaire, erbium : laser yttrium-aluminium-grenat, ProTaper, frottis, ultrasons.

Child Dental Patient's Anxiety and Preference for Dentist's Attire: A Cross-sectional Study.

Aim and objective: Initial perceptions of physicians can affect the level of comfort. Creating a strong rapport on the child's first visit helps to create a comfortable atmosphere. Child-friendly clothing of the dentists might possibly contribute to the dentist's empathy. Different attires may evoke different feelings. Hence, the purpose of the study was to assess the children's preferences for dentist's attire and its relation with anxiety. Materials and methods: Eighty children aged 5-12 years were included in the study. Five photographs of dentists wearing different attires were placed in the same order for every child. The child was asked to look at the photographs and decide which dentist they would prefer to take care of them. A facial image scale was used to evaluate the child's anxiety level. The children were asked to point at which face they felt almost like at that moment. Results: 42.7% of males and 38.5% of females chose child-friendly attire. The least preferred by males was a pink apron (7.5%) compared with females (28.1%). Whereas the blue apron was least preferred by females (5.1%) compared with males (20%). A Chi-square test was done to access the association between dental anxiety and the dental attire the children chose, where statistically significant (0.030) results were found. Anxious children were found to prefer child-friendly attire. Conclusion: Although the view that children are fearful of the white coat was not found, the concept of child-friendly attire might be more appropriate for anxious children and enhance an easy first communication with them. How to cite this article: Sujatha P, Nara A, Avanti A, et al. Child Dental Patient's Anxiety and Preference for Dentist's Attire: A Cross-sectional Study. Int J Clin Pediatr Dent 2021;14(S-2):S107-S110.

Oral Health-related Quality of Life in HIV: A Systematic Review.

AIM: To systematically evaluate the literature evidence related to oral health and quality of life (QoL) among HIV-positive adults. BACKGROUND: The oral health-related quality of life (OHRQoL) is an essential entity to be measured for understanding the domains affected due to oral health problems. HIV comes with an array of complexities in the oral cavity and is also reflection of the systemic illness of the oral cavity. Hence, it is essential to know the area affected and also the lesions that contribute the most to decrease the QoL in this aspect. A systematic review was carried out in relation to studies across PubMed and Google Scholar regarding HIV and OHRQoL from January 1970 to May 2019. Of the 1,374 articles screened, 11 studies were filtered for the final review. REVIEW RESULTS: The physical domain followed by the psychological domain is the most affected in the HIV-positive patients. The maximum effect is due to dental caries and periodontitis. No studies report about oral substance abuse and its effect. CONCLUSION: Studies are further needed on a larger sample size and on similar scales and parameters to ensure greater evidence for intervention related to areas that should be focused upon for improving the QoL of HIV-positive patients. CLINICAL SIGNIFICANCE: There is a greater need to include quality-based assessment while treating HIV-positive people. Also not just physical indicators like pain or dental caries, even social indicators like mental and social dimensions of a patient's life should be included while deciding the treatment approach.

Comparative Study of Probiotic Ice Cream and Probiotic Drink on Salivary Streptococcus mutans Levels in 6-12 Years Age Group Children.

BACKGROUND: Dental caries is one of the most common health problems in the world. Probiotics are one the various preventive methods to reduce dental caries. The aim of this study is to compare the effectiveness of probiotic ice cream and drink on salivary Streptococcus mutans levels in children of 6-12 years age group. MATERIALS AND METHODS: A three phase study was carried out in children (n = 50) of 6-12 years age with zero decayed missing filled teeth (dmft)/DMFT. They were randomly divided into two equal groups. Saliva samples were collected before the consumptions of probiotic ice cream and probiotic drink. Colony count obtained was recorded as baseline data. For both groups probiotic ice cream and drink was given randomly for 7 days and a washout period of 90 days were given and then the saliva samples were collected and colony counting was done. RESULTS: Statistical analysis was performed using Student's paired t-test and multiple comparisons by Tukey's honest significant difference test which showed, there is a significant reduction in salivary S. mutans level in both groups after 7 days period. However, after washout period only probiotic ice cream showed reduction whereas drink did not. Also, there was no significant difference between probiotic ice cream and drink. CONCLUSION: Probiotic organisms definitely have a role in reducing the salivary S. mutans level and ice cream would be a better choice than drink. However, the prolonged use of the agents and their effects on caries is still to be determined.

Effect of Rubber Dam on Arterial Oxygen Saturation in Children.

BACKGROUND: The placement of rubber dam has the potential to alter the airflow through nasal and oral cavities. Pediatric dentist should be aware whether the use of a rubber dam affects the oxygen saturation (SpO2) in children. To assess the effect of rubber dam on arterial blood SpO2 in children of 6-12 years age. MATERIALS AND METHODS: Totally, 60 ASA Class I patients of 6-12 years age, randomly allocated in two groups: Group A: Rubber dam isolation of maxilla and Group B: Isolation of the mandible. A pulse oximeter was used to detect SpO2. To establish a baseline, each patient's SpO2 was recorded every 30 s for 2 min. A rubber dam was then placed which extended over the nose. Class I cavity and glass ionomer cements restoration were performed. The rubber dam was cut to expose the nasal cavities SpO2 were recorded every 30 s for 5 min throughout the procedure. A two-way ANOVA test was applied. RESULTS: In both groups there was no significant difference in SpO2 after rubber dam placement with nose covered or uncovered (P > 0.05). CONCLUSION: There was no significant change in SpO2 after rubber dam isolation with nose covered or uncovered in children of 6-12 years age.

Effect of Probiotic Containing Ice-cream on Salivary Mutans Streptococci (SMS) Levels in Children of 6-12 Years of Age: A Randomized Controlled Double Blind Study with Six-months Follow Up.

INTRODUCTION: To evaluate the caries risk based on the salivary levels of streptococcus mutans in children of 6-12 years of age group before and after consuming probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5. MATERIALS AND METHODS: A double blind, placebo controlled trial was carried out in 60 children aged between 6 to 12 years with zero decayed, missing, and filled teeth (DMFT). They were randomly divided into two equal groups. Saliva sample were collected before the consumption of ice-cream and Streptococcus mutans count was calculated and recorded as baseline data. For the next seven days both the groups were given ice creams marked as A and B. Saliva samples were collected after ice-cream consumption at the end of study period and also after a washout period of 30 days and again after six months. Samples were inoculated and colonies were counted. RESULTS: On statistical evaluation by students paired t-test, probiotic ice-cream brought significant reduction in the Streptococcus mutans count after seven days of ice-cream ingestion (p<0.001) and also after 30 d of washout period (p<0.001). There was no significant reduction (p=0.076) by normal ice-cream consumption. After six months of the study period in both the groups the salivary levels of Streptococcus mutans was similar to the baseline. CONCLUSION: Probiotic ice-cream containing Bifidobacterium lactis Bb-12 and Lactobacillus acidophilus La-5 can cause reduction in caries causative organism. The dosage of the probiotic organisms for the long term or synergetic effect on the oral health are still needed to be explored.

A comparative evaluation of oral hygiene using Braille and audio instructions among institutionalized visually impaired children aged between 6 years and 20 years: A 3-monthfollow-up study.

AIM: The aim of this study is to compare the oral hygiene status among institutionalized visually impaired children of age between 6 and 20 years given with Braille and audio instructions in Raichur city of Karnataka. MATERIALS AND METHODS: A total of 50 children aged between 6 to 20 years were included in this study from a residential school for visually impaired children. These children were randomly divided into two equal groups. One group was given oral hygiene instructions by audio recordings and another written in Braille and were instructed to practice the same. After three months time the oral hygiene status and dental caries experience was recorded and compared using patient performance index. Statistical analysis was done by student paired t test and multiple comparison by Tukey's HSD (honest significant difference) test. RESULTS: The mean PHP (Patient Hygiene Performance) score of group A at baseline was 3.88 compared to 3.90 of group B. At 7 days PHP score of group A and group B was 3.42 and 3.45 respectively. At 3 month PHP score of group A and group B was 2.47 and 2.86 respectively. Even though over a period of time the mean score of PHP index reduced the score comparison between the 2 groups were statistically non significant. In group A the mean difference of PHP score between baseline and 7 days was 0.46, between baseline and 3 months it was 1.40. The PHP score between 7 days and 3 months was 0.94. All the above values were statistically significant. CONCLUSION: Effective dental health education method has to be instituted for visually impaired children. The present study shows improvement of oral health status in both the study population by decrease in the mean plaque score. Hence continuous motivation and reinforcement in the form of Braille and audio instruction is beneficial to achieve good oral hygiene levels in visually impaired children.

Pre: Surgical orthopedic pre-maxillary alignment in bilateral cleft lip and palate patient.

Pre-surgical orthopedic appliances are mainly used to retract and align the protruded and deviated pre-maxilla and to facilitate initial lip repair. This article presents a case report of a five year old male child patient with bilateral cleft lip and palate in whom a special custom made pre-surgical orthopedic appliance was delivered. Use of a special custom made presurgical orthopedic appliance for repositioning pre-maxilla in bilateral cleft lip and palate patient is discussed in this article.

Comparative Evaluation of Antimicrobial Efficacy of MTAD, 3% NaOCI and Propolis Against E Faecalis.

AIM: The present study sought to compare the antimicrobial efficacy of 3% NaOCl, Biopure MTAD (Tulsa Dentsply, Tulsa, OK) and Brazilian ethanolic extract of propolis (EEP) against Enterococcus faecalis (E. faecalis). METHODOLOGY: The study utilized 55 extracted human permanent teeth with single root canal. The samples were decoronated, instrumented and sterilized. The teeth were infected with E faecalis for 48 hours. The teeth were divided randomly into 3 groups according to the irrigants used and kept in contact with the respective irrigant for 5 minutes. All the samples were incubated in brain heart infusion (BHI) broth for 96 hours. Disinfection of the samples was determined based on presence or absence of turbidity in the BHI broth 96 hours later. Statistical analysis was done using Chi-square test. RESULTS: All the samples treated with MTAD showed complete absence of turbidity, while all the 15 teeth treated with propolis showed presence of turbidity, 8 out of 15 teeth treated with NaOCl showed presence of turbidity. Statistical analysis of the data using chi-square test showed significant difference between the groups (P < 0.05). CONCLUSION: The study concluded that MTAD was more effective than 3% NaOCl and propolis against E. faecalis.