Effect of Neonatal Factors on the Eruption of Primary Teeth in Children: A Longitudinal Prospective Cohort Study.

Introduction: Eruption of first primary teeth is a normal physiological process. Antenatal nutritional deficiency and prenatal and neonatal factors play an important role in eruption of primary teeth. Neonatal factors, such as gestational age (GA), degree of prematurity, severity of neonatal illness, and birth weight are primarily related to eruption of primary teeth. The relation between neonatal factors and the timing of eruption of primary teeth has not been studied prospectively among Indian preterm infants. Aims: To evaluate the influence of neonatal factors on the eruption of primary teeth in children born preterm. Materials and methods: A prospective longitudinal cohort study design was adopted. A total of 150 subjects were recruited by simple random sampling. Each child was followed up from birth up to 36 months. Intraoral examination was done and the teeth present in each visit were recorded. Data were statistically analyzed and interpreted. Statistical analysis used: Descriptive statistics, t-tests for independent sample, and Pearson's chi-squared tests were applied. Tooth showing statistically significant difference in mean age of eruption between term and preterm categories was studied for the effect of maternal and neonatal characteristics on eruption using multivariate regression analysis. Results: The mandibular central incisor was the first tooth to erupt. Significant determinant of eruption of mandibular incisor in term children was found to be parity, weight for GA, and complementary feeding, whereas for preterm children, significant determinants were parity, birth weight birth length, weight for GA, and complementary feeding. Conclusion: Neonatal factors, such as birth weight, birth length, weight for GA, and introduction of complementary feeding have a strong significant association with the eruption of primary teeth. Clinical significance: The findings of this study will guide in the preventive management of oral health in preterm children. How to cite this article: Indira MD, Nandlal B, Narayanappa D, et al. Effect of Neonatal Factors on the Eruption of Primary Teeth in Children: A Longitudinal Prospective Cohort Study. Int J Clin Pediatr Dent 2023;16(2):321-326.

Establishing Cephalometric Norms in Primary Dentition Using Comprehensive Craniofacial Growth Analysis - A Digital Cephalometric Study

ABSTRACT Objective: To establish cephalometric norms in primary dentition among males and females using novel customized Comprehensive Cephalometric Growth (CCG) Analysis. Material and Methods: The study was conducted on 67 subjects with a mean age of 5.5 yrs. Digital lateral cephalometric radiographs were obtained using Planmeca Pro One. The digital images were then transferred to Nemoceph software. Craniofacial Growth (CCG) Analysis was configured in the software with five sub-groups. This sub-grouping was done such that related components were grouped together and comprehensively; it would provide an assessment of every component of the craniofacial region that could be affected either by treatment maneuver or growth process. The same was used for the cephalometric analysis and to determine the cephalometric norms in the primary dentition. Results: Certain linear measurements were higher among males when compared to females. However, most measurements remained similar among males and females during this age group. The CCG analysis provided a comprehensive knowledge of the craniofacial parameters during the growth process. Conclusion: The cephalometric norms during primary dentition thus established using Comprehensive Craniofacial Growth analysis would provide the data for early diagnosis and treatment planning in interceptive orthodontic treatment procedures.

The Utility of Salivary Heme to Stratify Healthy Volunteers from Individuals with Gingivitis and Periodontitis: a Pilot Study.

Gingival bleeding due to poor oral hygiene is reported globally. Assessment of blood in saliva may improve diagnostics, serve as an outcome measure in clinical trials and support patient education through point-of-care tests. This work analyzed salivary heme using a rapid test format and separately using a lateral flow immunoassay assay [LF] for chair-side implementation. Clinical examinations stratified adult subjects into healthy, gingivitis or periodontitis groups at baseline. Healthy subjects presented no periodontal pockets and whole mouth gingivitis scores of less than 1.0. Gingivitis subjects registered gingival index scores greater than 1.0. Included in the periodontal disease group were subjects with periodontal pockets greater than 4 mm. The rapid test is based on the peroxidase activity salivary heme converting a colourless probe to a coloured compound for spectrophotometric analysis. For the LF assay, saliva was placed in the test window of the device with reactions scored after room temperature incubation. Average salivary heme concentrations in the healthy, gingivitis and periodontal disease groups were 27, 201 and 326 nM respectively, by the rapid test, representing significant differences by analysis of variance and Tukey's-multiple comparison tests (p<0.05). Similarly, results in the LF assay demonstrated increasing band intensity from the healthy to the periodontal disease groups and was quantifiable by image analysis. This pilot study emphasizes the potential efficacy of rapid heme measurement in investigations of oral health.

Influence of Various Desensitizing Mouthrinses and Simulated Toothbrushing on Surface Roughness and Microhardness of Tetric N-Ceram Bulk-Fill Resin Composite: An In Vitro Study and Scanning Electron Microscope Analysis.

OBJECTIVES: Bulk-filled composite resins are popularly used for posterior restorations due to various advantages. Routine oral hygiene measures like toothbrushing and the use of various mouthrinses can influence the mechanical properties of composite resins. Desensitizing mouthrinses are widely used as well, to manage dentinal hypersensitivity. Studies on the influence of desensitizing mouthrinses on bulk-filled composites are limited. Hence, the objective of the present in vitro study was to evaluate the influence of toothbrushing and various desensitizing mouthrinses on the surface roughness and microhardness of Tetric N-Ceram bulk-fill composite resin. MATERIALS AND METHODS: Fifty Tetric N-Ceram bulk-fill composite resin disks were prepared and were randomly divided into five groups (n = 10). Group 1 (Control): no toothbrushing and no mouthrinse; Group 2: toothbrushing only; Group 3: toothbrushing + HiOra-K mouthrinse; Group 4: toothbrushing + Listerine Sensitive mouthrinse; and Group 5: toothbrushing + Shy-OR mouthrinse. The specimens were brushed with a soft bristle brush using a toothpaste slurry and immersed in respective mouthrinse twice daily for 1 month. The mean surface roughness (average roughness) and microhardness (Vickers Pyramid number) values were determined and the data were tabulated. Data were analyzed using one-way analysis of variance, Post-hoc Tukey test, and Pearson correlation test. A p-value less than 0.05 was considered statistically significant. RESULTS: Specimens treated with HiOra-K mouthrinse exhibited maximum surface roughness (p < 0.05) and specimens treated with Listerine Sensitive exhibited the least microhardness (p < 0.05). A weak negative correlation was found between surface roughness and microhardness for groups 1, 2, and 5, while a weak positive correlation was found for groups 3 and 4. CONCLUSIONS: It is suggested that desensitizing mouthrinses containing alcohol or essential oils can lead to increased surface roughness and reduction in microhardness of bulk-fill composites, which could have an undesirable effect on their clinical performance.

Influence of gestational age on eruption of primary teeth in Indian children - A prospective longitudinal study.

Context: Eruption of primary teeth is the most anticipated event in a child's life. Genetics, gender, socio-economic status, gestational age are a few of the determinants of the primary teeth eruption. However, the effect of gestational age on the timing of primary teeth eruption among the Indian population has not been explored to date. Aim: The study was conducted to evaluate the influence of gestational age on time and sequence of eruption of primary teeth among children of Mysore. Settings and Design: A prospective longitudinal cohort study design was conducted at 'Baby Oral Health Promotion Clinic' at the Department of Paediatrics, JSS Hospital, Mysore. Methods and Material: 150 newborn babies were recruited by simple random sampling and followed up from birth to 36 months. Teeth present during each visit were recorded. Data were statistically analysed and interpreted. Statistical Analysis Used: Descriptive statistics, t-test for an independent sample, and Pearson's Chi-squared test were applied. Results: The mandibular central incisor was the first tooth to erupt. Statistically insignificant early eruption in males was noted in both term and preterm children. When the chronological ages were compared, the preterm group showed a statistically significant delay in the eruption of all the teeth. However, when the age was adjusted for prematurity, only the central incisors and second molars showed a statistically significant delay. Conclusions: Gestational age has a strong significant association with the eruption of primary teeth and maybe one of the strong predictors for delayed eruption among children of Mysore.

In-vitro Evaluation of toothpaste containing enzymes and proteins on inhibiting plaque re-growth of the children with high caries experience.

BACKGROUND: Dental caries belong to a disease which has a complex etiology. Individual preventive measures are not adequate enough to control the disease especially in children with high caries experience The aim of the study was to evaluate the efficacy of tooth paste containing enzymes and proteins in inhibiting plaque re-growth when compared to fluoride tooth paste in children with high caries experience. MATERIAL AND METHODS: A total of 15 plaque samples are collected from 15 subjects in the age group of 5-7 years with High caries experience. The participants were asked to fast overnight for 12 h. On the day of the study, the participants were asked to report without brushing. Pre brushing pooled plaque was collected from buccal and palatal/lingual surfaces of maxillary and mandibular teeth and transferred to chilled Eppendorf tubes. Samples were divided into two groups; according to the test toothpaste used; Zendium toothpaste and Colgate cavity protection along with controls. Inhibition of plaque re-growth is assessed by comparing optical density using a spectrophotometer at intervals between 0-8 hours. RESULTS: Results demonstrated that toothpaste containing enzymes and proteins can significantly inhibit plaque growth when compared to normal toothpaste (p<0.05) in children with high caries experience. CONCLUSIONS: Toothpaste containing enzymes and proteins can augment natural salivary defenses and control plaque re-growth which plays a major role in dental caries formation. Key words:Enzymes, proteins, toothpaste, children, caries, dental plaque.

Clinical Evaluation of Preventive Effect of Fissure Sealants on Initial Carious Lesion of Permanent Mandibular Molars Pretreated with and without Fluoride Varnish by Fluorescence Camera.

The important armamentarium in the present day scenario against caries prevention is considered to be a combination of preventive methods. The present study was conducted to evaluate the preventive effect of pit and fissure sealant pretreated with fluoride varnish on initial carious lesion by fluorescence camera (FC). How to cite this article: Lakshmi MS, Srilatha KT, Nandlal B, Deshmukh S. Clinical Evaluation of Preventive Effect of Fissure Sealants on Initial Carious Lesion of Permanent Mandibular Molars Pretreated with and without Fluoride Varnish by Fluorescence Camera. Int J Clin Pediatr Dent 2018;11(2):89-93.

Assessment of plaque regrowth with a probiotic toothpaste containing Lactobacillus paracasei: A spectrophotometric study.

BACKGROUND: Probiotics are live microorganisms which when administered in adequate amounts confer health benefits on the host. Commonly, most of the organisms ascribed as having probiotic properties belong to the genera Lactobacillus and Bifidobacterium and milk is the most commonly used vehicle. OBJECTIVES: The study was aimed at analyzing the biofilm formation by plaque regrowth method upon the usage of a probiotic toothpaste containing Lactobacillus paracasei by measuring the optical density using a spectrophotometer. MATERIALS AND METHODS: A commercially available probiotic toothpaste, PerioBiotic (spearmint flavored) from the company Designs for Health, has been tested. The toothpaste contains the strain L. paracasei, which has been found to co-aggregate with Streptococcus mutans (MS). The Plaque Glycolysis and Regrowth Method (PGRM) was used for the evaluation of the antimicrobial effects on plaque metabolism in vivo. PGRM is based on the observation that natural fasted dental plaque, sampled from different quadrants of the dentition, exhibits similar metabolic and regrowth properties when suspended at equal "biomass" in standardized media. CONCLUSION: The results suggest that L. paracasei-based toothpaste, PerioBiotic, is effective in the reduction of MSmonospecies biofilm, but the activity appears short lived when high sucrose exposure is administered.

Invitro Evaluation of Fluoride Release from Hydroxyapatite Reinforced Glass Ionomer with or without Protective Coating.

INTRODUCTION: Glass Ionomer Cement (GIC) is well known for its fluoride releasing property but has its own drawbacks of poor mechanical properties, sensitivity to initial desiccation and moisture contamination. To overcome these, search led to the reinforcement of hydroxyapatite and application of surface coating agent but their effect on fluoride release is still not clear. AIM: To evaluate and compare the release of fluoride from Hydroxyapatite Reinforced Glass Ionomer (HA-GIC) with and without protective coating. MATERIALS AND METHODS: Specimens were prepared as follows- Eight percent by weight conventional glass ionomer was replaced by hydroxyapatite powder (HA) and an indigenous product was prepared (HA-GIC). This powder was mixed with liquid of conventional GIC and allowed to set, then G coat plus coating agent was applied in surface coated group and light cured. Fluoride release of the sample was measured every 24 hrs for seven days and weekly from 7(th) to 21(st) day using combination ion selective electrode. RESULTS: Mean values clearly reveal a significant decrease in the fluoride release from day 1 to day 21 for both the groups. Results of repeated measure ANOVA revealed statistically significant difference between two groups (p <0.001). CONCLUSION: Coating the hydroxyapatite reinforced glass ionomer will allow for slow and steady release of fluoride for a long period of time into oral environment.

Comparative evaluation of shear bond strength of nano-hydroxyapatite incorporated glass ionomer cement and conventional glass ionomer cement on dense synthetic hydroxyapatite disk: An in vitro study.

AIM: The aim was to evaluate and compare the shear bond strength of nano-hydroxyapatite (Nano-HAp) incorporated and conventional glass ionomer cement (GIC). MATERIALS AND METHODS: Nano-HAp GIC was prepared by replacing 8 wt% of GIC powder with nano-HAp powder. Twenty-six HAp disks were used as substrate for bonding and divided into two equal groups. Before bonding the HAp disk was prepared by silicon carbide (no. 2500) followed by 10% polyacrylic acid conditioning. The standardized samples were prepared using split teflon mold on customized bonding jig so as to adhere testing materials to pretreated HAp disk. These samples were stored in distilled water for 24 h at 37°C before bond strength testing. RESULTS: The descriptive statistical analysis and independent samples t-test were used. The nano-HAp incorporated and conventional GIC had the mean shear bond strength of 3.28 ± 0.89 MPa and 5.25 ± 0.88 MPa, respectively. Nano-HAp incorporated GIC had lower shear bond strength with very high level of significance (P < 0.001). The nano-HAp incorporated GIC showed mainly mixed type of failure whereas conventional GIC showed mainly a cohesive failure. CONCLUSION: The lower shear bond strength of nano-HAp incorporate GIC revealed that the addition of nano-HAp interfered with the bonding ability of GIC to the substrate interface, but the mixed type of failure in nano-HAp incorporated GIC suggests that it increases the strength of the matrix. However, the role of nano-size particles on the micro-size particles of GIC for the bonding mechanism and the ratio and proportions of nano-HAp to the GIC needs further elucidation.

Guided bone regeneration: A novel approach in the treatment of pediatric dentoalveolar trauma.

Traumatic injuries in the primary dentition pose major challenges for management. This emergency treatment requires proper planning so as to achieve favorable results. Trauma causing severe dentoalveolar injuries, especially in children, needs an interdisciplinary approach so as to retain normal functional anatomy for that age. This article describes a clinical innovative technique, which utilizes a resorbable membrane in management of pediatric dentoalveolar trauma. The membrane was shaped to cover the multiple alveolar bone fracture, thereby favoring the healing of the bone defects. The use of this resorbable membrane maintained a secluded space for the bone growth and prevented overgrowth of the soft tissue in the region of the defect. This resulted in uneventful healing leading to well-maintained functional bone contour, which further favored the esthetic rehabilitation as well as protected the underlying permanent tooth buds.

An in vitro evaluation of the effect of sandblasting and laser surface treatment on the shear bond strength of a composite resin to the facial surface of primary anterior stainless steel crowns.

OBJECTIVES: The present study was conducted to evaluate the optimal method of enhancing the bond strength of a composite resin to the facial surface of the primary anterior stainless steel crowns using various surface treatments namely Nd: YAG laser surface treatment, sandblasting , alloy primer application and no surface treatment. STUDY DESIGN: The study sample consisted of 60 primary anterior stainless steel crowns (UnitekTM size R 4), with 15 samples randomly divided into the 4 study groups, embedded in acrylic blocks. The facial surface of these surface treated crowns was utilized as the bonding surface to which 2.5mm diameter composite resin cylinders were bonded for the evaluation of the shear bond strength. Shear bond strength measurements were made using a universal testing machine utilizing a shearing blade (jig).The mode of failure at composite-metal interface was determined using a Stereomicroscope at 10 X magnification. RESULTS: The mean bond strength values obtained for surface treatment of Nd: YAG laser surface treated, Sandblasting ,Alloy Primer and No surface treatments were 17.01±.92 , 13.18 ± .73, 7.46 ± .70 and 7.33 ± .77 MPa respectively. The obtained bond strength values were subjected to a one way ANOVA and a Scheffe's post-hoc comparison test. The results of the present study indicated that Laser surface treatment of the facial surface of the crowns enhanced the bond strength of the composite resin significantly compared to the other groups. CONCLUSIONS: Nd: YAG laser surface treatment produced an excellent surface roughness and obtained the highest shear bond strength values suggestive for recommendation as an optimal surface treatment to be used to enhance the resin-metal bond at the interface of the composite resin and the facial surface of primary anterior stainless steel crowns for the purpose of chairside veneering. Key words:Nd: YAG laser treatment, Sandblasting, Primary anterior stainless steel crown, Chairside veneering, Enhancing Resin-Metal Bond, Early childhood caries, Shear bond strength (SBS).

Correlation of oral health status of socially handicapped children with their oral heath knowledge, attitude, and practices from India.

BACKGROUND: Information on oral health knowledge and practice in orphanage house children is essential for healthcare policy makers to promote oral health resources and address oral health needs of this unprivileged group of society. OBJECTIVES: To assess the source of information, level of knowledge, attitude, and practice toward oral hygiene and oral health among socially handicapped children from city of Mysore, Karnataka state, India. MATERIALS AND METHODS: A cross-sectional survey was conducted among 488 children of 12-14 years of age living in five different orphanage houses of Mysore district. Data regarding knowledge and practice were collected through structured questionnaire and oral health status by type III clinical oral examinations by two trained examiners. Decayed, Missing, Filled, Teeth (DMFT) and OH I-S was then correlated with the above information. Spearman's correlation test was used to measure the correlation. RESULTS: The final data analysis included 488 children, of which 216 (44.26%) were boys and 272 (55.74%) were girls. A total of 88.5% children showed one or more decayed teeth in their oral cavity, with an overall mean DMFT of 3.55. Among DMF, component D showed maximum value with mean 3.42, followed by components F and M. Correlation between source of information, knowledge, and attitude for oral health to oral hygiene index (OHI-S; P < 0.05) and gingival index (P < 0.001) showed highly significant negative values. Correlation between oral hygiene practice to OHI-S, DMFT, and gingival index (P < 0.001) showed highly significant (P < 0.001) negative values. CONCLUSIONS: Although children of orphanage have positive attitude toward oral health, knowledge and practice among children are still below the satisfactory level. The children did not receive appropriate information or, if informed, were not re-evaluated or reinforced for its practical application by the concerned authority. The findings of this study suggest that awareness on the importance of oral health needs to be enhanced among the orphanage children of Mysore.

Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India.

BACKGROUND: To determine the prevalence and severity of oral condition related to untreated dental caries with PUFA index and to relate period of institutional stay, oral hygiene practice and diet of orphan children to caries experience ratio. MATERIALS & METHODS: A cross sectional survey conducted among 488 children of 12-14 years living in 5 different orphanages of Mysore district, India. Data regarding oral hygiene practices and oral health status (PUFA, DMFT, OH I-S and GI) were collected through structured questionnaire and by type III clinical oral examinations. The collected data were processed statistically. RESULTS: The PUFA ratio indicates 21% of decayed component had progressed to pulp involvement and abscess formation. The overall prevalence of PUFA was 37.7%. 31.1% children showed one or more pulpally involved tooth in their oral cavity. Correlation between periods for being the child in the institute to DMFT showed negative value indicting decrease in DMFT as the duration of stay in orphanage increases. CONCLUSION: The result show oral health condition in orphan children was neglected. Children from this disadvantaged background have shown a high prevalence of dental caries with low dental care utilization. PUFA index is an effective index in evaluating clinical consequences of un-treated caries. How to cite this article: Shanbhog R, Godhi BS, Nandlal B, Kumar SS, Raju V, Rashmi S. Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India. J Int Oral Health 2013; 5(5):1-9.