Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study.

In the current odontological era, carious lesions are removed while tooth tissue is preserved. Most of these ideals are met by chemomechanical caries removal (CMCR) methods, which are easy and comfortable to use, differentiate and eliminate infected tissues, minimize pressure, vibration and heat, and are cost-effective. This study examines the efficacy of commercially available CMCR agents, namely Papacarie®, Carie-Care™ and BRIX3000™, and a conventional hand instrumentation method for caries removal in deciduous molars in terms of time consumption, ease of application, and pain perception. For this randomized clinical trial, 120 children aged 4 to 9 years were selected and randomly allocated to four groups of 30 patients each. Time consumption, ease of application, and pain perception were evaluated at three intervals: pre-, during- and post-caries removal, using Wong-Baker FACES (WBF) Pain Rating Scale and the Face, Legs, Activity, Cry, Consolability (FLACC) scale. The results showed that among the compared materials and conventional hand instrumentation technique, Carie-Care™ was statistically found to be the least time-consuming with a p-value of 0.019, have the least pain perception with a p-value of 0.02, and was clinically the best with respect to manipulation and handling. While all three CMCR agents aid in the removal of carious tissue, Carie-Care™ was the most effective based on time consumption, pain perception and simplicity of administration.

Comparative evaluation of Tell-Show-Do technique and its modifications in managing anxious pediatric dental patients among 4-8 years of age.

Background: Dentistry has made a remarkable progress in techniques, materials and technologies, however the anxiety of the child related to dental treatment still remains constant. Tell Show Do is the most common technique behaviour management of the child in the dental clinic since many years. Recently, many modifications of Tell Show Do technique have been researched and most of them provided an enhanced potential for the conventional technique research but were always individually compared to conventional technique. Aim: To evaluate the effectiveness of Tell Show Do technique in comparison with its 4 modifications Tell Play Do, Tell Play Do with Smart Phone Dentist Game, Tell Show Play Doh, Ask Tell Ask among 4-8 years old children during restorative treatment. Methodology: 150 children aged 4-8 years were randomly selected divided into 5 groups comprising of 30 patients each. Evaluation of anxiety was done using Physiologic-Pulse Rate, Facial Image Scale and Venham's Anxiety Scale. Results: Except for Ask Tell Ask Group the anxiety level of the subjects decreased in all groups according to physiologic readings and facial image score. Anxiety Score decreased preoperatively to postoperatively in all groups except for Tell Play Do and Ask Tell Ask group according to venhams anxiety scale. Conclusion: Although Tell Show Do technique is most widely accepted and modified technique, due to changing scenarios of today's children Tell Play Do, Tell Play Do with Smart Phone Dentist Game and Tell Show Play Doh are also showing encouraging results.

Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur.

Aim: To determine possible associations of early childhood caries (ECC) with risk factors such as feeding and dietary habits of children and oral hygiene practices by the parents or caregiver in rural and urban school children in Jaipur, India. Materials and methods: An observational cross-sectional study was designed with a dental examination and a standardized questionnaire. A total of 1,824 children, that is, 848 (46%) rural, and 976 (54%) urban school children were enrolled in the study. The data regarding their diet and feeding habits of children, oral hygiene practices of the parents or caregivers were collected with the help of a standardized questionnaire. The caries status of rural and urban school children was recorded using the decayed, missing, filled teeth (DMFT) index. Data thus collected were compiled, analyzed and were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS v 26.0, IBM). Comparison of frequencies of categories of variables with groups was done using Chi-square test with p < 0.05 was considered to be statistically significant. Results: The prevalence of ECC was 34.7% in rural and 45.5% in urban school children of Jaipur (p < 0.01). Caries risk increased with the use of both bottle and breast feeding, habit of milk at night, eating snacks between meals with no habit of rinsing teeth, and decrease in parental supervision during oral hygiene practices. In urban school children there is an increased access to junk food and refined sugar daily as compared to rural school children with more than two times in a week was found statistically highly significant in the study (p < 0.01). Conclusion: The prevalence of ECC was higher in urban school children as compared to rural school children in Jaipur. It was found that risk factors such as diet and feeding habits of children and oral hygiene practices by the parents or caregiver are strongly associated with the prevalence of ECC. It was concluded that the epidemiological data, which have been collected in a very comprehensive way can be utilized more effectively to eliminate the root cause of the disease by improving oral health services in the rural and urban school children in Jaipur, India. How to cite this article: Yadav SP, Meghpara M, Marwah N, et al. Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur. Int J Clin Pediatr Dent 2022;15(3):273-279.

Prescribing Patterns and Response to Antihyperglycemic Agents Among Novel Clusters of Type 2 Diabetes in Asian Indians.

Aim: To assess the prescribing patterns and response to different classes of antihyperglycemic agents in novel clusters of type 2 diabetes (T2D) described in India. Materials and Methods: We attempted to replicate the earlier described clusters of T2D, in 32,867 individuals with new-onset T2D (within 2 years of diagnosis) registered between October 2013 and December 2020 at 15 diabetes clinics located across India, by means of k-means clustering utilizing 6 clinically relevant variables. Individuals who had follow-up glycated hemoglobin (HbA1c) up to 2 years were included for the drug response analysis (n = 13,247). Results: Among the 32,867 participants included in the study, 20,779 (63.2%) were males. The average age at diagnosis was 45 years and mean HbA1c at baseline was 8.9%. The same four clusters described in India earlier were replicated. Forty percent of the study participants belonged to the mild age-related diabetes cluster, followed by insulin-resistant obese diabetes (27%), severe insulin-deficient diabetes (21%), and combined insulin-resistant and insulin-deficient diabetes (12%) clusters. The most frequently used antihyperglycemic agents were sulfonylureas, metformin, and dipeptidyl peptidase-4 inhibitors apart from insulin. While there were significant differences in HbA1c reduction between drugs across clusters, these were largely driven by differences in the baseline (pretreatment) HbA1c. Conclusions: In this new cohort, we were able to reliably replicate the four subtypes of T2D earlier described in Asian Indians. Prescribing patterns show limited usage of newer antihyperglycemic agents across all clusters. Randomized clinical trials are required to establish differential drug responses between clusters.

Morphological and dimensional characteristics of dental arch in children with beta thalassemia major.

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the arch dimensions of beta thalassemia major patients in comparison with normal individuals. MATERIALS AND METHODS: Dental arch dimensions were compared between thalassemic patients and normal individuals in the age group of 12-16 years in the maxillary and mandibular arch corresponding to each other regarding age, sex and Angle's molar relationship. A total number of sixty cases in each group were taken. Maxillary and mandibular impressions were made with alginate for all the sixty participants in each group and poured with die stone. Measurement of inter incisor, inter canine, inter premolar and intermolar arch width, arch depth, right anterior, right posterior, left anterior, and left posterior arch length was carried out from each cast using digital Vernier caliper. RESULTS: Unpaired t-test was used for comparison between the two groups. Statistically, a significant difference was found between the case and control groups in the maxillary arch in intercanine width, inter premolar width, intermolar width, right anterior arch length, right posterior arch length, and left anterior arch length. However, no statistically significant difference was found between the groups in inter incisor width, left posterior arch length, and arch depth in the maxillary arch. In the mandibular arch, statistically significant difference was found between the case and control groups in inter canine width, inter premolar width, inter molar width, and left anterior arch length. However, no statistically significant difference was found between the case and control groups in the mandibular arch in interincisor width, right anterior arch length, right posterior arch length, and left posterior arch length. CONCLUSION: Dental arch widths and arch lengths were significantly reduced in thalassemic patients as compared to normal individuals for the maxillary and mandibular arches.

A comparative evaluation of retention of pit and fissure sealant bonded using sixth-, seventh-, and eighth-generation adhesives: An in vivo study.

INTRODUCTION: Dental caries is one of the most common preventable childhood infections. a number of measures are available to prevent occlusal caries; pit and fissure sealants are one of the various methods currently available to cost effectively reduce dental caries. AIM: To evaluate the retention of pit and fissure sealant bonded using sixth (Adper promt), seventh (Optibond) and eighth (Futurabond Dual Cure) generations of adhesives. SETTINGS AND DESIGN: A total of 37 healthy children who fulfilled the inclusion were randomly selected. A total of 148 teeth (4 in each subject) were used as samples for the study. METHODS AND MATERIAL: The teeth to be sealed were then isolated using rubber dam. The placement of adhesives was done using split mouth design. The first permanent molars were randomly divided into four groups on the basis of sealant placed without and with using 6th, 7th and 8th generation bonding agents as follows: GROUP A (N=37):- Pit and fissure sealant placed without bonding agent. GROUP B (N=37):- Pit and fissure sealant placed following sixth generation bonding agent (ADPER PROMT). GROUP C (N=37):- Pit and fissure sealant placed following seventh generation bonding agent. (OPTIBOND). GROUP D (N=37):- Pit and fissure sealant placed following eighth generation bonding agent. (FUTURA BOND DUAL CURE). The integrity of the sealant placed was assessed immediately after completion of the procedure, 3 months and 6 months after placement. The post-operative evaluation for retention was done using Simonsen criteria. A score of 0 was given for complete retention, 1 for partial retention and 2 for no retention. STATISTICAL ANALYSIS USED: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) software version 21. RESULTS: It was found that there was no statistically significant difference between the groups after 3 and 6 months as the value obtained (0.133) was much greater than the p-value (0.05). CONCLUSIONS: This study concluded that the use of bonding agent prior to application of pit and fissure sealant does not necessarily aid in retention of sealant as compared to pit and fissure sealant placed without bonding agent, Sealants effectiveness is directly related to its retention and it dependent on application procedures. The failure of retention of pit and fissure sealants can attribute to moisture contamination, improper curing methods, inadequate adhesion, improper application procedure or early age placement.

Effect of Achyranthes aspera, 0.2% Aqueous Chlorhexidine Gluconate and Punica granatum Oral Rinse on the Levels of Salivary Streptococcus mutans in 8 to 12 Years Old Children.

BACKGROUND AND OBJECTIVES: To study the effect Achyranthes aspera, 0.2% aqueous chlorhexidine gluconate and Punica granatum oral rinse on salivary Streptococcus mutans count in children. MATERIALS AND METHODS: A total of 60 children of 8 to 12 years of age were randomly allocated into 3 groups. Group A was given 0.2% chlorhexidine mouthwash, group B was given 10% A. aspera mouthwash and group C was given 15% P. granatum mouthwash. The day 1 saliva samples were collected from the subjects and inoculated onto mitis salivarius bacitracin (MSB) agar. The colony counts were obtained by a clinical microbiologist who was blinded to the subject allocation. Plaque scores were then recorded by the investigator with the help of a volunteer. Following this, they received a thorough scaling and polishing. Subjects in each group were then provided with 140 ml of the respective mouthwash, as a daily supervised rinse after breakfast and before sleeping as per instructions. Following mouth rinsing, the children were instructed not to eat or drink for 15 minutes. At the 7th day, unstimulated saliva was again collected from the subjects of all 3 groups, inoculated onto MSB agar and colony count was obtained. Modified Quigley-Hein plaque index was also evaluated for the refreshed score at this stage. Colony counting was done using loop method and statistical analysis was done using Statistical Package for the Social Science (SPSS) software version 21. RESULTS: All the three mouthwashes showed statistically significant reduction of S. mutans count and plaque index after 7 days, i.e. chlorhexidine (p < 0.001 for reduction in S. mutans count and p < 0.05 for plaque score reduction), A. aspera (p < 0.01 for reduction in S. mutans count and p < 0.05 for plaque score reduction) and P. granatum (p < 0.01 for reduction in S. mutans count and p < 0.05 for plaque score reduction). Chlorhexidine had marginally better results in reducing S. mutans count. CONCLUSION: Efficacy of chlorhexidine, A. aspera and P. granatum was statistically significant with respect to reduction of S. mutans count with chlorhexidine being marginally better than the other two; All the three mouthwashes were found to be at par when plaque index values from baseline and after interception of 7 days was calculated; Punica granatum has better antimicrobial effect than A. aspera.

Consensus Statement on Management of Post-Prandial Hyperglycemia in Clinical Practice in India.

Postprandial hyperglycemia (PPHG) is a detrimental factor in the evolution of diabetes related complications. Numerous studies have established the role of PPHG in development of atherosclerosis and associated cardiovascular conditions. It is seen that management of PPHG can be more troublesome than fasting plasma glucose (FPG). Currently, there are various strategies both monitoring as well as therapeutic to control PPHG but there is no uniformity in practicing these strategies. In the absence of any standard guidelines, widespread variations in the management of PPHG are observed among physicians and diabetologists. The objective of this document is to set forth uniform guidelines to manage PPHG. This will not only result in optimal management and prevention of long term complications of diabetes but also better co-ordination and collaboration among the care providers. Moreover, an Indian perspective that can take into consideration the issues relevant to Indian patient pool will be effective. An expert committee comprising of prominent physicians and researchers associated with diabetes care provided their inputs to provide a basic platform for the formulations of guidelines. Their inputs were supplemented by extensive literature search to collect the relevant evidences. An initial draft was prepared which was reviewed by the core committee. Inputs from other experts were also sought and an initial guideline version was formulated that was presented in a conference, discussed and debated among experts. The guidelines on PPHG were then finalized and published.

Chronic complications in newly diagnosed patients with Type 2 diabetes mellitus in India.

BACKGROUND: Prevalence of diabetes is on an increase in India, currently there is limited nation-wide data regarding the prevalence of chronic complications in diabetic patients at diagnosis. This information will help health-care professionals approach management more aggressively to prevent complications. OBJECTIVE: To determine the prevalence of chronic complications in newly-diagnosed Type 2 diabetic (T2D) patients in India. DESIGN AND METHODS: This was a cross-sectional survey of T2D patients, diagnosed within 3 months of their first visit to the centers doing the survey. Each patient was screened for diabetic complications, hypertension, dyslipidemia, and body mass index. Family history was recorded. Standard protocols were used to make the diagnosis of retinopathy, neuropathy and nephropathy. Data analysis was carried out using the standard statistical techniques. RESULTS: Of the total 4,600 (males 67%, females 33%) newly diagnosed patients with T2D, majority were from the age group 41-50 years (40%). 13.15% of newly detected India T2D had neuropathy 6.1% had retinopathy and 1.06% had nephropathy. Risk factors of macro vascular complication such as hypertension, obesity, and dyslipidemia were observed in 23.3%, 26%, and 27% of patients respectively. Ischemic heart disease was noticed in 6%. CONCLUSION: High prevalence of micro vascular complications was present at diagnosis along with association of CV cardiovascular risk factors among Indian T2D. In view of this, screening must be instituted for all diabetics for complications at the time of diagnosis itself.

Camellia sinensis (Tea): Implications and role in preventing dental decay.

Tea is one of the most commonly consumed beverages with bioactive compounds like polyphenols-flavonoids-catechins, which are thought to be responsible for the health benefits that have traditionally been attributed to the tea. These compounds have multi-dimensional effects such as antibacterial action, inhibitory action on the bacterial and salivary amylase and inhibition of acid production. This article outlines the possible role of these compounds coupled with the presence of high fluoride content in tea to exhibit an anticariogenic effect.

Atypical presentation of bilateral maxillary supplemental lateral incisors: A rare case report.

Hyperdontia presents as a unique dental condition which may or may not require immediate corrective therapy. Supplemental teeth in the permanent dentitian comprises only 4% of all the supernumeraries, and bilateral supplemental teeth are even rarer entities. We present a rare case report of non-syndromic bilateral supplemental maxillary lateral incisors.

Correlation of general anxiety and dental anxiety in children aged 3 to 5 years: A clinical survey.

BACKGROUND: The aim of this study was to determine the prevalence of dental anxiety in a group of children aged 3 to 5 years and to explore the relationships between dental anxiety and general fearful nature of the child. MATERIALS & METHODS: A total of 250 children were selected for the study after due selection via inclusion criteria. Pre-school anxiety scale by Spence and Rapee (1999) was used to assess the general fear of the child and was filled by the parent during the first visit. Venham's anxiety scale was used to assess the dental anxiety which was seen during routine dental examination of the child on his first visit. RESULTS: The results were statistically analyzed using Chi square test and Karl Pearson coefficient of correlation. CONCLUSION: It was concluded that 24% of children showed association between high level of dental anxiety and high level of general fear; 56% of children also exhibited high level of dental anxiety with moderate score of general fear and 20% of children exhibited positive correlation between low level of dental anxiety and fear. How to cite this article: Nigam AG, Marwah N, Goenka P, Chaudhry A. Correlation of general anxiety and dental anxiety in children aged 3 to 5 years: A clinical survey. J Int Oral Health 2013;5(6):18-24 .

Estimation of fluoride release from various dental materials in different media-an in vitro study.

PURPOSE: This study was performed to study the pattern of fluoride release from glass ionomer cement, a resin modified glass ionomer cement, a compomer and a composite resin when stored in different storage media. METHODS: A total of 60 samples (Tablets of diameter 8.6 ± 0.1 mm and thickness 1.65 ± 0.1 mm) were prepared (15 samples for each material) pertaining to 4 different materials used. Five samples of each material were suspended in 4 ml of each studied solution. The studied media were deionized water, artificial saliva and solutions for pH-cycling (demineralizing solution pH 4.3 and remineralizing solution pH 7.0). The total experimental period was fifteen days the readings were taken after day 1, day 2, day 5, day 9 and day 15 using ORION fluoride ion specific electrode. RESULTS: Significant variations were found in the amount of fluoride release from all the materials in different storage media. Glass ionomer cement released significantly higher amounts of fluoride (p < 0.001) in all storage media. The difference between composite resin and other materials was also very significant (p 0.001) where composite resin released very less fluoride in all the media. CONCLUSION: From this study it was concluded that the greatest amount of fluoride release was from ART glass ionomer cement in all the media followed by resin modified glass ionomer cement, compomer and composite resin in decreasing order. The pattern of fluoride release was similar for all the examined materials. Maximum amount of fluoride release was observed in pH cycling model for all the materials followed by deionized water and artificial saliva in decreasing order. With this it can be concluded that pH strongly affects fluoride release from dental restorative materials.

Pediatric mandibular fractures: a review.

The pattern of craniomaxillofacial fractures seen in children and adolescents varies with evolving skeletal anatomy and socioenvironmental factors. The general principles of treating mandibular fractures are the same in children and adults: Anatomic reduction is combined with stabilization adequate to maintain it until bone union has occurred. But recognition of some of the differences between children and their adult counterparts is important in long-term esthetic and functional facial rehabilitation as effect of injury, treatment provided has a great influence on their ensuing growth.

Combined surgical and nonsurgical endodontic therapy in the treatment of dens invaginatus type 3: a case report.

An accurate understanding of the morphology of the root canal system is a prerequisite for successful root canal treatment. Invaginated teeth have a complex root canal configuration that cannot be instrumented effectively. Correct diagnosis and treatment planning are fundamental to treatment of dens invaginatus. Periapical surgery is indicated in cases where a nonsurgical approach fails. A case of dens invaginatus type 3 in a maxillary lateral incisor with a periapical lesion and its successful treatment by these combined methods is reported.