Global variations in eruption chronology of permanent teeth: A systematic review and meta-analysis.

OBJECTIVES: Population-based variations have been reported in permanent teeth eruption but only sparse literature exists on the same. A systematic review and meta-analysis were performed to assess the global variations in eruption chronology of permanent teeth in children and adolescents and the role of sexes, jaws and classes of socio-economic status (SES) on timing of eruption was explored. METHODS: The protocol for the systematic review was registered in PROSPERO. An extensive search of PubMed, EMBASE, Google Scholar, EBSCO, Cochrane library, and anthropology databases was carried out until April 2023. Additionally, grey literature search and hand-searching of relevant key journals was done. RESULTS: Overall, 3797 cross-sectional and longitudinal studies were retrieved from multiple databases. A total of 939, 191 participants were included from 80 studies of which, 41 were carried out in Asia, 26 in Europe, 5 in Africa, 4 in North America, and 4 in Oceania. The mandibular first molar eruption was found to be as early as 4.09 years while the maxillary second molar erupted as late as 13.45 years. Using a random effects model, 28 forest plots were generated. Meta-regression interpreted tooth eruption to be earlier in females and in the mandible. CONCLUSIONS: The findings of this study show that the ages of permanent teeth eruption was advanced in the European population followed by Africa and Asia.

Global variations in eruption chronology of primary teeth: A systematic review and meta-analysis.

OBJECTIVES: This systematic review aimed to assess global variations in the eruption chronology of primary teeth in children and the role of sexes, jaws, and socio-economic status on eruption timing. DESIGN: An extensive search of electronic databases, grey literature, and hand-searching was carried out until April 2023 RESULTS: A total of 42,109 children, with an age range of 0-83 months were included from 42 studies (22 in Asia, 7 in Europe, 5 in Africa, 4 in North America, 3 in Oceania and 1 in South America). The mandibular central incisor was the first tooth to erupt at 6 months in North America and 13.5 months in Asia while the mandibular second molar erupted at 20.1 months in Europe and 29 months in South America. CONCLUSIONS: The age of primary teeth eruption was advanced in the European population followed by North America, Africa, Oceania, and Asia while it was delayed in the South American population. Meta-analysis showed that tooth eruption was earlier in the left quadrant than the right but the role of other factors (sexes, jaws, and socio-economic status) was insignificant. Population-specific data on primary teeth emergence may serve as a baseline for future research. In clinical practice, these population-based eruption charts can serve as a valuable asset for diagnosis and treatment planning in children.

Impact of different modes of school dental health education on oral health-related knowledge, attitude and practice behaviour: an interventional study.

PURPOSE: The study was planned to evaluate the effectiveness of three modes of school dental health education (SDHE) on the oral health-related knowledge, attitude and practice (KAP) behaviour of school children. METHODS: An interventional study was carried out among 8-9 year old school children from January 2016 to January 2018. Three hundred and sixty children from three schools in Tiruchengode, Tamil Nadu, India participated in this study. Each school was randomly allotted with a mode (drama, modified snake and ladder game, flashcard) of SDHE, which was delivered for 20 min, every 6 months for 2 years. A validated questionnaire with 18 questions was used to record oral health-related KAP behaviour at baseline and after 2 years. RESULTS: At the end of 2 years, there was an increase in the percentage of correct response for all the nine knowledge questions, in all the three modes. The mean difference in the cumulative knowledge score between baseline and 2 years was 1.39 ± 2.05 for drama mode, 1.8 ± 1.51 for game mode and 1.7 ± 1.5 for flashcard mode of SDHE. There was a significant difference in three knowledge questions and one attitude practice behaviour question between the three groups at the end of 2 years. CONCLUSIONS: All the three modes were effective in improving the oral health-related KAP behaviour of school children. Game mode made a better impact on the knowledge scores of these children, and it was observed to be more child-friendly and entertaining.

Effectiveness of school dental health education on the oral health status and knowledge of children: A systematic review.

OBJECTIVE: To evaluate the effectiveness of school dental health education on the oral health status, oral health-related knowledge, and practice behavior of 6-12-year-old children. METHODS: Hand search and electronic search based on the keywords on school dental health education in seven search engines till 2017 identified 7434 articles. Trials involving school-based dental health education with a minimum follow-up period of 6 months were screened. Risk of bias assessment was done independently by two authors. RESULTS: Among the 18 articles which fulfilled the eligibility criteria, six were randomized controlled trials (RCTs) and 12 were non-RCTs. Quality assessment showed that 12 trials had a low risk of bias. Oral health-related knowledge improved in children. Oral health-related practice behaviors such as frequency and duration of brushing improved. Use of fluoridated toothpaste was increased. Plaque scores and gingival bleeding scores reduced. CONCLUSION: School dental health education had a positive impact on the oral health status, knowledge, and practice behavior of children. There is a definite need for high-quality RCTs analyzing the effectiveness of school dental health education on specific oral health outcomes.

Objective and subjective parameters of oral health in South Indian children: A cross-sectional study.

BACKGROUND: Oral health of schoolchildren is a strong predictor of their overall well-being. This study was planned to assess and compare the objective and subjective parameters of oral health of South Indian school children. METHODOLOGY: Three hundred and sixty school children participated in this cross-sectional study. Their oral hygiene status, dental caries status, and treatment needs were assessed. Two questionnaires were filled by these children, to assess their oral health-related quality of life (OHRQoL) and their knowledge on oral health. Their academic scores were collected from the schools. Statistical analysis was done using Kruskal-Wallis ANOVA test and Spearman correlation test appropriately. RESULTS: Children with no caries had better OHRQoL (P = 0.02). There was a negative correlation between dental caries status and OHRQoL score (P = 0.003) and dental caries treatment needs and OHRQoL score (P = 0.01). There was a positive correlation between knowledge on oral health and OHRQoL score (P = 0.02). CONCLUSION: Children with no caries had a better OHRQoL when compared to children with caries. Children with caries had more treatment needs, poor oral hygiene, low quality of life, and performed lesser in academics. However, they had adequate knowledge on oral health. Hence, both objective and subjective parameters of oral health should be given importance while treating children.

Comparison of Oral Health Status and Knowledge on Oral Health in Two Age Groups of Schoolchildren: A Cross-sectional Study.

INTRODUCTION: Oral health plays a pivotal role in the overall wellbeing of children. As children grow, there is a variation in their oral health status due to the changing trends and lifestyle. AIM: To evaluate and compare the factors related to oral health status in two age groups of school going children. MATERIALS AND METHODS: A total of 582 children aged 8 to 11 years from 3 schools were included. Based on their school grade, they were grouped as younger (third grade) and older (fifth grade) children. Their dental caries status, caries treatment needs, oral hygiene status were assessed. A questionnaire was given to them to assess their knowledge on oral health. RESULTS: Both third and fifth grade children had similar caries status. The caries treatment needs was significantly higher (p = 0.02) in fifth grade children of school III. The oral hygiene status was significantly better (p = 0.004) in fifth grade children of school I and third grade children (p < 0.001) of school III. Fifth grade children were found to have more knowledge on oral health and it was statistically significant in school II (p = 0.001). In school III, as caries status increased, the oral hygiene index score significantly increased (p = 0.001). CONCLUSION: Age did not have any influence on the oral health status of children. The older children had better knowledge on oral health, but the oral hygiene practices were not followed effectivelyHow to cite this article: Geethapriya PR, Asokan S, Kandaswamy D. Comparison of Oral Health Status and Knowledge on Oral Health in Two Age Groups of Schoolchildren: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(4): 340-345.

Dental unit waterlines disinfection using hypochlorous acid-based disinfectant.

OBJECTIVE: The purpose of the study was to investigate the efficacy of a new disinfectant to disinfect the dental unit waterlines. MATERIALS AND METHODS: New dental unit waterlines were installed in 13 dental chairs, and biofilm was allowed to grow for 10 days. Disinfection treatment procedure was carried out in the 12 units, and one unit was left untreated. The dental unit waterlines were removed and analyzed using the scanning electron microscope (SEM) (TESCAN VEGA3 SBU). RESULT: On examination, SEM images showed that there was no slime layer or bacterial cells seen in any of the 12 cut sections obtained from the treated dental waterlines which mean that there was no evident of biofilm formation. Untreated dental unit waterlines showed a microbial colonization with continuous filamentous organic matrix. There was significant biofilm formation in the control tube relative to the samples. CONCLUSION: The tested disinfectant was found to be effective in the removal of biofilm from the dental unit waterlines.

Health camps in schools and content analysis of the school textbooks: A cross-sectional study in Tamil Nadu.

BACKGROUND: School textbooks have been considered as an effective platform for promoting oral health. The information on oral health in the Indian school textbooks has not been evaluated. AIM: The aim of this study was to evaluate the contents of school textbooks on oral health and to quantitatively analyze the school health camps and guest lectures/demonstrations conducted in the schools of three districts in Tamil Nadu. METHODOLOGY: Twenty schools which participated in the study followed the Central Board of Secondary Education, matriculation, or the state board syllabus. A questionnaire was designed to collect information about the medical camps, dental camps, guest lectures, and demonstrations conducted in the last academic year from the schools. The questionnaires were distributed among the school teachers of grades I-V. They were asked to provide photocopies of the topics on oral health which were included in the syllabus. Content analysis of the information on oral health-related topics in the school textbooks was done. Descriptive statistics of the details of the camps and lectures was done using Pearson's Chi-square test (SPSS version 17) (SPSS Inc. Chicago, Illinois, USA). RESULTS: There was no significant difference in the number of medical camps (P = 0.445), dental camps (P = 0.055), and guest lectures (P = 0.069) organized among the three boards of schools. Basic information on the parts and type of teeth, tooth decay, and brushing were present in the textbooks of all three boards of schools. CONCLUSION: The school textbooks of all the three boards contained basic and adequate information on oral health. Periodic revisions of the content and quality of information in the school textbooks are essential. To make the information sticky for long-term, reinforcements in the form of school health education is needed.

A Confocal Microscopic Evaluation of the Dehydration Effect on Conventional, Resin Reinforced Powder/Liquid and Paste to Paste Glass Ionomer Luting Cements.

BACKGROUND: The purpose of this study was to evaluate the effect of dehydration of resin-modified glass ionomer powder/liquid system, resin-modified glass ionomer paste/paste luting cements in three different quantities and to compare them with a conventional glass ionomer luting cement using confocal laser scanning microscope. MATERIALS AND METHODS: A conventional glass ionomer (Group I), a resin modified powder/liquid system (Group II), and a resin-modified paste/paste system (Group III) were selected for the study. In Group III, there were three subgroups based on the quantity of material dispensed. 50 premolar teeth were selected and randomly divided among the groups with 10 samples in each. The teeth were ground flat to expose a flat occlusal dentin. A device was made to standardize the thickness of cement placed on the teeth. The teeth were stored in distilled water for 24 h and then longitudinally sectioned to examine the tooth dentin interface under a confocal microscope. The specimens were allowed to dehydrate under the microscope for different time intervals. The width of the crack after dehydration near the dentinal interface was measured at definite intervals in all the groups and analyzed statistically using Student's t-test. RESULTS: Conventional glass ionomer cement showed the maximum width of the crack followed by resin modified paste/paste system during the dehydration period. Resin modified powder/liquid system did not show cohesive failure. CONCLUSIONS: Conventional glass ionomer luting cement is more susceptible to cohesive failure when subjected to dehydration compared to resin-modified glass ionomer paste/paste luting cement. Among the luting cements, resin-modified glass ionomer powder/liquid system showed the best results when subjected to dehydration.

Influence of various herbal irrigants as a final rinse on the adherence of Enterococcus faecalis by fluorescence confocal laser scanning microscope.

AIM: The aim of this study was to assess the antibacterial efficacy of three different herbal irrigants against Enterococcus faecalis. MATERIALS AND METHODS: Single rooted teeth were extracted due to orthodontic and periodontal reasons. The teeth were then inoculated with E. faecalis. The teeth were randomly divided into three experimental groups and two control groups of six samples each. Group 1 specimens were treated with 5.2% sodium hypochlorite (NaOCL) for 30 min followed by 5 mmol/L Ethylenediaminetetraacetic acid (EDTA) for 5 min and saline as final irrigant. Group 2 specimens were treated with and 5.2% NaOCl for 30 min as final irrigant. Group 3 were treated with Morinda citrifolia (MC) for 30 min as final irrigant. Group 4 were treated with Azadiracta indica (AI) as final irrigant. Group 5 were treated with green tea (GT) for 30 min as final irrigant. The dentin specimens were carefully spread onto a microscope slide and stained with BacLight and examined in a confocal laser scanning microscope set to monitor fluorescein isothiocyanate and propidium iodide. A total of nine fields were examined for each treatment and the bacteria presented were counted. STATISTICAL ANALYSIS: Using the one-way ANOVA with multiple comparison, significantly less bacteria were found adhering to the samples treated with Neem followed by NaOCL, GT, MC, Saline. RESULTS: AI treatment produced the maximum reduction in adherence of E. faecalis to dentin (9.30%) followed by NaOCl (12.50%), GT (27.30%), MC (44.20%) and saline (86.70%). CONCLUSION: Neem is effective in preventing adhesion of E. faecalis to dentin.

Evaluation of the sealing ability of two sealers after using chlorhexidine as a final irrigant: An in vitro study.

AIMS AND OBJECTIVES: The aim of this study was to evaluate the effect of the precipitate formed by using sodium hypochlorite and chlorhexidine as a root canal irrigant on the sealing ability of different root canal sealers, using a push-out bond strength test. MATERIALS AND METHODS: Twenty single rooted premolars were used for this study. The teeth were divided into two groups (Groups I and II) of ten teeth each, according to the obturation done with AH Plus with GuttaPercha and Resilon with epiphany, respectively. The groups were in turn divided into two subgroups of five teeth each (Subgroups A and B) according to the irrigation protocol, and were evaluated using a micro push-out bond strength, with the help of a universal testing machine. Statistical analysis was done using the paired t test. RESULTS: The mean value of the AH Plus GuttaPercha group with precipitate formation (17.66 ± 0.56) showed the highest mean value for the bond strength, which was statistically higher (P < 0.05) than the rest of the groups. In the Resilon Epiphany group, the samples with precipitate formation showed (13.28 ± 1.35) the least bond strength, which was statistically lower than all the groups, except the Resilon samples without precipitate (13.99 ± 0.48). CONCLUSION: The precipitate formed by a combination of sodium hypochlorite and chlorhexidine tends to affect the bond strength of the sealers used for obturation.

Three-dimensional helical computed tomographic evaluation of three obturation techniques: In vitro study.

AIM: The purpose of this study was to evaluate the adequacy of three obturation techniques namely lateral condensation, EQ Fil (backfill obturation) and thermafil (core carrier obturation) techniques using three-dimensional (3D) helical computed tomography (CT) by volume rendering method. MATERIALS AND METHODS: Thirty freshly extracted teeth were randomly divided into three groups of 10 teeth each. Biomechanical preparation was done in all the teeth using rotary instruments. All three sets of teeth were placed in helical CT slice scanner and were imaged before obturation. The three sets were then obturated by following methods: Group I: lateral condensation, Group II: EQ Fil (backfill) and Group III: thermafil (core carrier obturation).Volume of the pulp chamber and gutta-percha after obturation were calculated using volume rendering technique and adequacy of the obturation techniques were calculated. STATISTICAL ANALYSIS USED: One-way ANOVA and Multiple-Range Tukey Test by Tukey-HSD procedure RESULTS: Mean change in lateral condensation (0.005±0.002) was significantly higher than that of thermafil obturation (0.002±0.001) [P<0.05]. CONCLUSIONS: Conventional lateral condensation technique showed maximal inadequacy of obturation and thermafil obturation technique showed the least inadequacy of obturation when the volume of the specimens were calculated and reconstructed.

Management of recently traumatized maxillary central incisors by partial pulpotomy using MTA: Case reports with two-year follow-up.

In traumatized, young, permanent teeth, pulpotomy is classically undertaken to promote apexogenesis. The objective is to promote root development and apical closure. Once root end development and apical closure is achieved, the root canal treatment is completed. However, it has been suggested that mere pulp exposure does not cause pulpitis in the absence of bacteria. Recent studies have proposed that as long as a good seal is ensured, root canal treatment may not be necessary following pulpotomy. In this article we report two cases of traumatized, fully matured, maxillary permanent central incisors, which have been treated with mineral trioxide aggregate following partial pulpotomy, with a two-year follow-up.

Dentinal tubule disinfection with 2% chlorhexidine gel, propolis, morinda citrifolia juice, 2% povidone iodine, and calcium hydroxide.

AIM: To investigate the antimicrobial activity of 2% chlorhexidine gel, propolis, Morinda citrifolia juice (MCJ), 2% povidone Iodine (POV-I), and calcium hydroxide on Enterococcus faecalis-infected root canal dentine at two different depths (200 microm and 400 microm) and three time intervals (day 1, 3 & 5). METHODOLOGY: One hundred and eighty extracted human teeth were infected for 21 days with E. faecalis. Samples were divided into six groups. Group I (Saline) (Negative control), Group II (Propolis), Group III (MCJ), Group IV (2% Povidone Iodine), Group V (2% Chlorhexidine Gel), Group VI (Calcium hydroxide). At the end of 1, 3, and 5 days, the remaining vital bacterial population was assessed. Dentine shavings were collected at two depths (200 microm and 400 microm), and total numbers of colony forming units were determined. The values were analysed statistically with one-way analysis of variance followed by Tukey multiple comparison test. The paired t-test was used to check for differences in growth at different time intervals within groups and for differences at the two depths (P < 0.01) RESULTS: The number of colony-forming units was statistically significant in all groups compared to the control group (Saline). Group V (chlorhexidine gluconate) (100%) produced better antimicrobial efficacy followed by 2% POV-I (87%), propolis (71%), MCJ (69%), and calcium hydroxide (55%). There was no significant difference between propolis and MCJ and no significant difference between data at 200 microm and 400 microm. CONCLUSION: Propolis and MCJ were effective against E. faecalis in dentine of extracted teeth.

Shear bond strength evaluation of resin composite bonded to GIC using three different adhesives.

The current study evaluated the bonding ability of composite to glass ionomer cement (GIC) using three different bonding systems. One hundred samples of composites bonded to GIC were prepared and divided into five groups. In Group A, the composite was bonded to GIC after the initial setting of the GIC being employed as a total-etch adhesive. In Group B, the self-etch primer was employed to bond composite to GIC before the initial setting of the GIC. In Group C, the self-etch primer was employed to bond composite to the GIC after the initial setting of the GIC. In Group D, the GIC-based adhesive was employed to bond composite to the GIC before the initial setting of the GIC. In Group E, the GIC-based adhesive was employed to bond composite to the GIC after the initial setting of the GIC. Shear bond strength analysis was performed at a crosshead speed of 0.5 mm/minute. The results were tabulated and the statistical analysis was performed with one-way ANOVA; the Tukey's test showed that the bond strength of composite to GIC was significantly higher for the self-etch primer group employed on unset GIC and the GIC-based adhesive group employed on the set GIC for bonding composite to GIC.

Two-rooted mandibular second premolars: case report and survey.

Mandibular premolars have earned the reputation for having an aberrant anatomy. Literature is replete with reports of extra canals in mandibular second premolars, but reports about the incidence of extra roots in these teeth are quite rare. This paper attempts at explaining a rare case of successful endodontic management of a two-rooted mandibular second premolar with diagnostic, inter-operative and postoperative radiographic records along with a substantial data on the incidence of extra roots in these teeth. The standard method of radiographic appraisal was maintained as the criteria for determining the presence of extra roots. Totally, 600 patients were examined for a period of four months by three endodontists. Out of them, eight patients had an extra root in one of the mandibular second premolars and three patients showed a bilateral presence of two roots.

Restoration of a vertical tooth fracture and a badly mutilated tooth using canal projection.

Management of vertically fractured tooth or a perforation frequently poses problem during endodontic management. Such teeth often need a pre-endodontic restoration prior to initiation of root canal therapy to aid in the placement of rubber dam clamp. This paper describes a simple method of placement of a pre-endodontic restoration using the canal projection technique using hollow metallic needles as sleeves.

MB2 in maxillary second molar.

Occurrence of the second mesiobuccal canal (MB2) is a frequent finding. Literary reports have shown it to be found more in the cases of the maxillary first molar. However the maxillary second molars have also been found with this variation in a number of canals. This paper presents a case report on the occurrence of a second mesiobuccal canal or the MB2 in the maxillary second molar.

Assessment of the efficacy of an indigeniously developed pulse oximeter dental sensor holder for pulp vitality testing.

Current routine methods of assessment of pulp vitality rely on stimulation of nerve fibres and give no direct indication of blood flow within the pulp. Pulse oximeter is a proven, atraumatic method of measuring vascular status, by evaluating oxygen saturation. This study explores the use of customized dental pulse oximeter sensor holder to assess pulpal vascular oxygen saturation in permanent teeth. Pulse oximeter readily differentiated between known vital and nonvital teeth. Vital teeth consistently provided oxygen saturation values that were lower than the values recorded on the patient's fingers. Pulse oximeter is an accurate, atraumatic clinical alternative to the present electrical and thermal methods of assessing pulp vitality in teeth.