Effect of non-thermal atmospheric pressure plasma and ErCr:YSGG LASER activation of three fluoride varnishes on surface re-mineralization of enamel: A SEM-EDX analysis.

Background: Dental remineralization is the process of transporting minerals from the surrounding environment (i.e., saliva and biofilm) into partially demineralized tooth structures. Remineralization can be induced by professional therapies such as fluoride-based treatments that have the highest level of supporting evidence. High-intensity LASER and nonthermal atmospheric pressure plasma therapy have been known to increase the resistance of enamel to demineralization by surface modification. Aim: The aim of the study was to evaluate and compare the surface remineralization of enamel using ErCr:YSGG LASER and nonthermal atmospheric pressure plasma (NTP) activation with three different fluoride varnishes. Methodology: Sixty-eight extracted premolars were used which were sectioned mesiodistally to obtain 135 specimens and artificial caries were induced on the experimental surface. They were then randomly divided into three groups (n = 45): MI Varnish (GC Japan), Vanish Varnish (3M ESPE), and Embrace Varnish (Pulpdent). After varnish application, these groups were further divided into three subgroups based on the activation therapy used. Fifteen samples from each group were treated with ErCr:YSGG LASER, 15 samples with NTP, and 15 samples were the control that did not undergo activation. After 9 days of pH cycling, the mean ion concentration of the surface calcium and phosphate ions was recorded using FEG-SEM and EDX analysis. The data were statistically analyzed. Results: One-way ANOVA and post hoc Tukey test accepting P < 0.05 were performed for comparisons between all analyses groups. Vanish Varnish showed a higher Ca/P ratio in LASER, NTP, and control subgroups, followed by MI Varnish and Embrace Varnish. ErCr:YSGG LASER therapy showed an improved Ca/P ratio in all varnishes than NTP therapy and control. Conclusion: ErCr:YSGG LASER therapy showed positive effects toward improving the Ca/P, followed by NTP therapy as compared to control in all three varnishes indicating their role in enhancing the effects of remineralization. Vanish Varnish showed a higher Ca/P ratio indicating better remineralization post activation.

Comparative evaluation of bioactivity, fluoride release, shear bond strength, and compressive strength of conventional glass ionomer cement incorporated with three inorganic bioactive nanoparticles: An experimental analysis.

Background: Over the course of four decades, the bioactive materials have changed. They have become more specialized, more manageable, possessing superior qualities. Thus, it should be encouraged to conduct ongoing research to improve these materials even further in order to meet the growing clinical and restorative needs. Aims and Objectives: To evaluate and compare bioactivity, fluoride release, shear bond strength and compressive strength of conventional GIC incorporated with three inorganic bioactive nanoparticles. Materials and Methods: For the study, total of 160 samples were included. The samples were divided in four groups (40 samples per group) i.e. 3 wt% of forsterite (Mg2SiO4) (Group 2), wollastonite (CaSiO3) (Group 3) and niobium pentoxide (Nb2O5) (Group 4) nanoparticles incorporated into GIC (Group 1). The bioactivity (FEG-SEM and EDX analysis), fluoride release (ion-selective electrode), shear bond strength testing (UTM followed by evaluation under stereomicroscope) and the compressive strength (UTM) was checked for each group. Results: Wollastonite nanoparticles (3wt %) incorporated to GIC showed maximum increase in the apatite crystal formation,Ca and P content and highest fluoride release. Mean shear bond strength was highest in niobium pentoxide nanoparticles (3wt %) incorporated to GIC while mean compressive strength was highest in forsterite nanoparticles (3wt %) added to GIC. Conclusion: Positive results were observed which showed increase in the bioactivity alongwith enhancement of the fluoride release, shear bond strength and compressive strength but further research on these materials is warranted before its use in clinical practice.

Comparative evaluation of antibacterial efficacy different bioactive smart composites: An in vitro study.

BACKGROUND: Composites are the widely used restorative materials, and over the year, newer restorative composites have been introduced to eliminate the drawbacks of previous ones. The recent advance in restorative dentistry is bioactive restorative materials. However, bacterial plaque formation on these restorations is the primary reason for secondary caries. AIMS AND OBJECTIVES: The purpose of this study was to do the comparative evaluation of bioactive restorative composites (Beautifil Flow Plus, Activa BioACTIVE, and Filtek Z250 XT as control) for their antibacterial efficacy under in vitro conditions. MATERIALS AND METHOD: Thirty material blocks were used for this evaluation. Antibacterial efficacy was checked against Streptococcus mutans and observed under confocal laser scanning microscopy. RESULTS: The results showed that Activa BioACTIVE shows maximum number of dead bacteria on the material surface compared to other groups. CONCLUSION: It can be concluded as it has maximum antibacterial efficacy among tested materials.

Comparative evaluation of calcium release of the apical plugs formed by mineral trioxide aggregate, Biodentine, and EndoSequence root repair material with and without 2% triple antibiotic powder: An in vitro study.

BACKGROUND: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. AIM: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. METHODS: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. RESULTS: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. CONCLUSION: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.

Evaluation of Change in Microhardness by Application of MI Varnish on Primary Tooth Enamel, Affected by Use of Frequently Prescribed Paediatric Syrups: An In Vitro Study.

Introduction Dental erosion is considered as an irreversible progressive loss of tooth structure due to chemical dissolution by acids not of bacterial origin. Frequent intake of syrups can be an effective factor in tooth erosion when prescribed for illnesses. In the acidic environment, MI Varnish releases calcium, phosphate and fluoride from the covering layer and the teeth can be prevented from such acidic attacks from the erosive content of the syrups. Aim  To evaluate change in microhardness by application of MI Varnish on primary tooth enamel, affected by use of frequently prescribed paediatric syrups. Method  The effects of three paediatric syrups (Ibugesic Plus, Novamox, Becozinc H) and distilled water (control group) with different ingredients on primary tooth enamel were evaluated. Immersion cycles were applied three times a day for one minute. The measurements of the samples prepared were taken on 0 (baseline), third, fifthand seventh day. Microhardness was measured using a Vickers hardness tester. Then, those samples were coated with MI Varnish, and changes in microhardness were evaluated using the Vickers hardness tester after one week (14th day). The pH, titratable acidity and buffer capacity of the syrups were also evaluated. Results  There was a significant decrease in microhardness in all the syrups (p < 0.001) on days 3, 5, 7 and 14. Novamox syrup and distilled water (control group) were the least erosive on the primary tooth enamel and Becozinc H syrup being the most erosive on primary tooth enamel was seen. MI Varnish remineralized the enamel but not with any significant difference. Conclusion  In our findings, Novamox syrup showed the least erosion on primary tooth enamel compare to other syrups. Enamel microhardness was significantly reduced on all days after immersion in all syrups. Application of MI Varnish to enamel resisted erosion but was not significant. Paedodontists should be aware of the erosive potential of all the frequently prescribed syrups and stress on compliance with oral hygiene measures and application of varnishes releasing fluoride, calcium and phosphate on the tooth.

A clinical trial comparing antimicrobial efficacy of "essential oil of Ocimum sanctum" with triple antibiotic paste as an intracanal medicament in primary molars.

OBJECTIVES: To evaluate the aerobic and anaerobic antimicrobial efficacy of Ocimum Sanctum (Tulsi) essential oil and compare it with that of triple antibiotic paste (TAP) by collecting microbiological samples from the root canals of primary molars. STUDY DESIGN: Forty children were selected for the study and were randomly divided into two groups of twenty each, namely, TAP group and O. sanctum group (basil). Six intracanal samples were collected for every patient, comprising of two each after access opening, irrigation and after 3 days of intracanal medicament placement. These samples were cultured in aerobic and anaerobic environment and later colony-forming units (CFUs) were counted and intragroup as well as intergroup comparison was done. RESULTS: Analysis of the results showed that there was a statistically significant reduction in CFUs after using essential oil of O. sanctum as an intracanal medicament. Saline use also leads to a statistically significant reduction in CFUs irrespective of the intracanal medicament used. TAP showed better antibiotic properties in comparison with that of O. sanctum. CONCLUSION: Antibiotic use is often associated with the adverse effects and development of resistance due to injudicious use. O. sanctum can be used in cases of long-standing infection owing to its antimicrobial efficacy and anti-inflammatory potential as an intracanal medicament in primary teeth.

An insight into diagnosis of a hidden entity: Impacted food material.

INTRODUCTION: Foreign bodies and tissue reactions to foreign materials are commonly encountered in the oral cavity. Exogenous materials causing foreign body reactions may be metallic (amalgam) or nonmetallic (suture materials, vegetable matter). Implantation of food particles in the oral tissues has been known to cause reactive lesions such as oral pulse granuloma. Implantation could be through extraction sockets, deep periodontal pockets, associated with tumor growth, interdental areas of teeth, unfilled root canals, and grossly decayed teeth. These get rapidly digested and altered by host responses. Cellulose persists as hyaline material and invokes chronic granulomatous response. This change may mimic other pathologies. MATERIALS AND METHODS: Representative specimens from commonly consumed food groups were selected, fixed in 10% neutral buffered formalin, processed, sectioned, stained with hematoxylin and eosin stain and observed under light microscope. RESULTS: Each specimen revealed unique, distinct histology of each food type. The plant materials had a characteristic appearance of rigid double cell wall while rigid regular partitions containing nutrient material were revealed in seeds and beans. Starch-contained lentils exhibited clear spaces. Following is a brief description of some of the significant histological findings of each of the specimens processed and stained. CONCLUSION: Thus, the study of histological structure of vegetables and legumes will enable their easy recognition in oral biopsy samples and help in distinguishing them from other pathologies and artifact.

Comparison of Antimicrobial Activity of Child Formula Dentifrices at different Concentrations: An in vitro Study.

AIM: The aim of the present in vitro study is to evaluate and compare antimicrobial efficacy of commercially available child's dental formulas in reduced concentrations containing different forms of fluoride against Streptococcus mutans activity. MATERIALS AND METHODS: The selected dentifrices were prepared in dilutions of 1:1, 1:2, 1:4, 1:8, and 1:16 using sterile pyrogen-free distilled water. Various dilutions of the selected toothpaste slurries were incubated in the agar plate containing pure strains of S. mutans, and antimicrobial activity of each was assessed by measuring the diameter of zones of inhibition (in mm). Agar well plate diffusion method and minimum inhibitory concentration (MIC) determination were the methods used in this study. The inhibitory circle of each dentifrice was measured and MIC was achieved by considering the value of diameter of the circle. RESULTS: The results of the study showed that even at a lower concentration of fluoride, inhibition halos were obtained for all the formulations at different dilutions. CONCLUSION: The kid's formulations having lower fluoride concentration show antimicrobial activity even after dilutions. Thus, commercially, the fluoride concentrations can be further lowered down in the dentifrices, thereby reducing the risk associated with fluoride. HOW TO CITE THIS ARTICLE: Malhotra R, Singla S, Shashikiran ND. Comparison ofAntimicrobial Activity of Child Formula Dentifrices at different Concentrations: An in vitro Study. Int J Clin Pediatr Dent 2017;10(2):131-135.

Prevalence of Dental Caries and Traumatic Dental Injuries among 6- to 12-year-old Children in Bhopal City, India.

INTRODUCTION: Dental caries and trauma are the most common oral health problems for many decades. There is need for prevalence data to analyze the nature of the problems and to take necessary steps in improving public health. AIM AND OBJECTIVES: To assess the prevalence of dental caries and traumatic dental injuries among schoolchildren of age 6 to 12 years in Bhopal city. SETTINGS AND DESIGN: Cross-sectional study design was selected. Universal sampling method was followed in this study. MATERIALS AND METHODS: A total of 1,204 children were examined. The distribution of samples was done based on age, gender, residing area, and type of school. STATISTICAL ANALYSIS: Data were collected and statistically evaluated under chi-square test and analysis of variance. RESULTS: The overall caries experience (73.17%) was found to be higher than that of traumatic injury experience (20.9%). There was age-related correlation between age and decay, missing, and filled teeth score. CONCLUSION: Since most injuries occur at home or at school, educating the individual is the key that will have a great impact on the prognosis of traumatic injuries. Also good food habits need to be instilled in children from a tender age with the help of parents, which is the ultimate solution to fight caries. HOW TO CITE THIS ARTICLE: Maran S, Shashikiran ND, Ahirwar P, Maran P, Kannojiya PR, Niranjan B. Prevalence of Dental Caries and Traumatic Dental Injuries among 6- to 12-year-old Children in Bhopal City, India. Int J Clin Pediatr Dent 2017; 10(2): 172-176.

Comparative Evaluation of Bond Strength and Microleakage of Standard and Expired Composite at Resin-Dentin Interface: An in vitro Study.

BACKGROUND: Evaluation of bond strength and microleakage caused by polymerization shrinkage provides a screening mechanism and an indication of the potential for the clinical success of composite restorations. AIM: The aim of this study was to determine the effect on shear bond strength and microleakage of standard and expired composites. MATERIALS AND METHODS: Selected specimens were etched using 37% phosphoric acid for 15 seconds and were randomly divided into four groups. Group I: Standard composite and bonding agent; group II: Expired composite and bonding agents; group III: Standard composite and expired bonding agent; and group IV: Expired composite and standard bonding agent. Specimens were further subdivided into two subgroups. In subgroup A, specimens were sheared with a universal testing machine, and the results were calculated in MPa; in subgroup B, specimens was sectioned longitudinally and analyzed for leakage (dye penetration) using a stereomicroscope. RESULTS: The results of the present study showed that acceptable values for bond strength and microleakage were obtained even if one of the components of the dental resin composite is expired. CONCLUSION: In Indian scenario, the expired composite material may provide some assistance in compromised clinical situations. It can be used as an interim restoration and compensate for the high material cost. HOW TO CITE THIS ARTICLE: Talreja N, Singla S, Shashikiran ND. Comparative Evaluation of Bond Strength and Microleakage of Standard and Expired Composite at Resin-Dentin Interface: An in vitro Study. Int J Clin Pediatr Dent 2017;10(1):1-4.

Degradation of Resin Restorative Materials by Streptococcus Mutans: A Pilot Study.

OBJECTIVE: To evaluate the degradation of three resin based restorative materials by S Mutans. STUDY DESIGN: Class I cavity was prepared in extracted premolars and were randomly divided into 3 groups (Group I - Conventional composite (CC), Group II - Resin Modified GIC and Group III-Giomer). Teeth were then restored by respective restorative material and equally divided in two subgroups (Control and Experimental). Experiment subgroup samples were then incubated in 2 ml of BHI with 1:10 dilution of SM (MTCC-497) grown overnight in BHI whereas control subgroup samples were incubated in BHI without SM. The incubation solution was collected at 2,14 and 30 days interval, and the analysis for identification and quantification of Bis-HPPP was done by High performance Liquid Chromatography. RESULTS: Statistical analysis of the collected data revealed a statistically increased Bis HPPP production in the presence of SM in all the tested materials, with minimum in Resin Modified GIC and a maximum in Conventional Composite (CC). CONCLUSION: SM degrades the resin based restorative materials & among the tested materials Resin Modified GIC appears to be most Biostable.

Comparative evaluation of secondary caries formation around light-cured fluoride-releasing restorative materials.

AIM: The aim of this study was to compare and evaluate secondary caries formation around light-cured fluoride-releasing restorative materials. METHODOLOGY: Standard Class V cavities were prepared on the buccal and lingual surfaces of forty extracted healthy premolars. The teeth were randomly divided into four groups of ten teeth each and labeled as Group I, II, III, and IV and restored with one of the following materials, namely, Fuji II LC (Group I), Vitremer (Group II), F-2000 (Group III), and Z-100 (Group IV; Control). The teeth were thermocycled and immersed in jars containing an acid gel for caries-like lesion formation. After 15 weeks, the samples were removed, washed, and sectioned buccolingually through the restoration. The sections were then grounded to a thickness of 80-100 µm. After imbibition in water, the sections were mounted on slides and lesions were examined, measured, and photographed with Leica DMRB Research Microscope. The observation recorded was subjected to (a) analysis of variance, (b) Studentized range test (Newman-Keuls), (c) Snedecor's F-test. RESULTS: The depth of the outer lesion in teeth restored with Z-100 (Group IV; Control) was significantly higher than the teeth restored with F-2000 (Group III), Vitremer (Group II), and Fuji II LC (Group I) (P < 0.01). The depth of the outer lesion in teeth restored with F-2000 (Group III) was also significantly higher than the teeth restored with Vitremer (Group II) and Fuji II LC (Group I) (P < 0.01). However, there was no significant difference in depth of the outer lesions among the teeth restored with Vitremer (Group II) and Fuji II LC (Group I). No wall lesion (WL) was evident in teeth restored with Vitremer (Group II) and Fuji II LC (Group I). The WL length and body depth in teeth restored with Z-100 (Group IV; Control) were significantly higher than the teeth restored with F-2000 (Group III) (P < 0.01). CONCLUSION: It was concluded that Fuji II LC and Vitremer had a inhibitory effect on the development of WL and OL depth. Even though F- 2000 was not fully effective in preventing the development of WL, there was significant reduction in WL and depth when compared to Z-100.

Evaluation and comparison of the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism.

BACKGROUND: Autism is a neurobiological disorder characterized by impaired social interaction, communication difficulties, and lacking manual dexterity. These limitations make the oral hygiene maintenance very difficult. AIM: The aim of this present study is to evaluate and compare the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism. SETTING AND DESIGN: Sample comprised 22 children with autism who daily visited a day care and education center named ARUSHI - a center for children with special health care needs in Bhopal. METHODS: Children were divided into two groups (Group A and B) according to toothbrush used and further divided into subgroups (A1 and B1 [low fluoridated - Pediflor toothpaste] and A2 and B2 [calcium sucrose phosphate - Enafix toothpaste]). Oral hygiene instructions and brushing technique demonstration were given every day for a period of 1-month. Oral health status was evaluated before and after the study using simplified oral hygiene index (OHI-S) and its Miglani's modification for primary dentition, plaque index (PI), gingival index (GI), and decayed, missing, and filled teeth (DMFT)/deft index. The perception of parents regarding oral hygiene practices for their kids was also evaluated by an awareness and attitude questionnaire. STATISTICAL ANALYSIS: OHI-S, GI, PI, and DMFT/deft were statistically evaluated using Mann-Whitney U- test. RESULTS AND CONCLUSION: Mean value of OHI-S decreased significantly with powered toothbrush (0.035 [P < 0.05]) in both groups. However, PI decreased significantly for Enafix when used with powered toothbrush (0.042 [P < 0.05]). Perception of parents was seen to improve significantly after 1-month study (0.000 [P < 0.05]).

Evaluation of treatment related fear using a newly developed fear scale for children: "Fear assessment picture scale" and its association with physiological response.

INTRODUCTION: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. AIMS: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. SETTINGS AND DESIGN: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. STATISTICAL ANALYSIS USED: Shapiro-Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. RESULTS: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure. CONCLUSIONS: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.