Dental Caries Experience among Children and Adolescents with Cleft Lip and/or Palate: An Umbrella Review.

Aim and objective: To assess the systematic reviews and meta-analyses investigating the dental caries experience in children with cleft lip and/or palate (CL/P). Study design and methodology: A systematic search was carried out from MEDLINE Via PubMed, JBI Database of Systematic Reviews and Implementation Reports, EMBASE, OVID, Cochrane Database of Systematic Review, and Epistemonikos databases. Two independent reviewers carried out the collection and analysis of the study data. Methodological quality was assessed by ROBIS (Risk of bias assessment in systematic review) tool. Review results: An initial search of electronic databases yielded a total of 25 relevant reviews, of which only three systematic reviews were taken into consideration for qualitative synthesis. The total number of unique primary studies among the three included systematic reviews were 25, of which overlap of the studies was calculated using citation matrix. The corrected covered area (CCA) was estimated to be 0.26. Based on the ROBIS tool, only one systematic review reported with low risk of bias. Conclusion: Individuals with CL/P report more decayed, missing, or filled teeth/surfaces than those without CL/P in primary, mixed, and permanent dentition. Future studies should focus on the factors which could modify the caries risk of an individual with CL/P. Clinical significance: This umbrella review offers a more reliable and balanced view regarding the dental caries experience among individuals with cleft lip and/or palate. This paper also highlights the important role of pediatric dentist in multidisciplinary health care team in implementing first dental visit and anticipatory guidance to consider early diagnosis and specific preventive interventions for Early Childhood Caries (ECC) in individuals with CL/P. How to cite this article: Abirami S, Panchanadikar NT, Muthu MS, et al. Dental Caries Experience among Children and Adolescents with Cleft Lip and/or Palate: An Umbrella Review. Int J Clin Pediatr Dent 2022;15(S-2):S261-S268.

Comparison of viscosities of human breast milk versus infant milk formulae with and without addition of sweetening agents.

Context: Early childhood caries is a major health problem affecting children worldwide. Although incorrect feeding practices hold a prime position in the etiology, there are gaps in the literature pertaining to the physical properties of milk. Aim: To assess the viscosity of human breast milk (HBM) versus infant milk formulae, with and without the addition of sweetening agents. Materials and Methods: All commercially available infant milk formulae (60 samples) and breast milk from 30 donor mothers were assessed for viscosity using Brookfield DV2T viscometer. The study period was from April 2019 to August 2019. Viscosity of infant milk formulae sweetened with sugar, honey, and brown sugar was further investigated and compared with that of HBM. Statistical Analysis: Inter-group and intra-group mean viscosity was compared using independent t-test and repeated-measures ANOVA. Results: Viscosity of HBM ranged from 18.36 centipoise (cP) to 91.30 cP, the mean viscosity being 45.7 cP. Viscosity values varied for each formula group, the least being as low as 5.1 cP and the highest being 89.3 cP. The mean viscosities of each group were in the range of 33 to 49 cP. Conclusions: HBM was found to have a tendency toward higher viscosity than most of the infant milk formulae. Also, varied viscosity values were obtained when commonly used sweetening agents were added to infant milk formulae. Greater viscosity of HBM might increase its adherence to enamel surface leading to prolonged demineralization and potentially altering the caries risk, needs to be investigated further.

Glanzmann Thrombasthenia: Use of the Soft Splint with Tranexamic Acid Paste to Reduce Spontaneous Oral Bleeding.

BACKGROUND: Glanzmann thrombasthenia is a rare bleeding disorder due to defects in the glycoprotein Ilb/IIIa complex present on the platelet membrane. The most common mode of treatment for this disorder is platelet transfusion. However, scientific evidence does state that repeated transfusions could lead to auto immunization making transfusions ineffective. AIM AND OBJECTIVE: To describe the use of a novel technique of soft splint with tranexamic acid paste to stop oral bleeding in a patient with Glanzmann thrombasthenia (GT). CASE DESCRIPTION: A 7-year-old female patient with a known history of GT was referred to the pediatric department. The chief complaint of the patient revealed a history of spontaneous bleeding from the oral cavity. The patient required multiple teeth extractions due to severely carious teeth. History revealed that the patient was admitted to the hospital (casualty) three times within 1 month due to a similar complaint leading to hypovolemic shock. Several transfusion procedures were done to stop the spontaneous bleeding. To stop the intraoral bleeding without transfusions, a novel method of using a soft splint with tranexamic acid paste (500 mg tablet crushed and mixed with saline) in the area of spontaneous bleeding was employed with a successful follow-up of 7 months. CONCLUSION: Soft splint with the tranexamic acid paste can serve as an effective method of treatment for patients with spontaneous oral bleeding due to medical conditions like GT. CLINICAL RELEVANCE: This case report highlights the need for awareness among all the healthcare providers about the importance of regular dental visits. The healthcare providers also need to emphasize the same to all patients with medical conditions to avoid such life-threatening situations. HOW TO CITE THIS ARTICLE: Bhavyaa R, Vignesh KC, Muthu MS, et al. Glanzmann Thrombasthenia: Use of the Soft Splint with Tranexamic Acid Paste to Reduce Spontaneous Oral Bleeding. Int J Clin Pediatr Dent 2021;14(4):580-585.

Embracing Psychological Ownership in Dental Education: A Potential Game Changer.

Psychological ownership (PO) is conceptually defined as the state in which individuals feel as though the target of ownership or a piece of it is "theirs" (i.e., "It is MINE!"). Theoretical dimensions of PO are promotion oriented (self-efficacy, self-identity, belongingness, accountability, autonomy, and responsibility) and prevention oriented (territoriality). This paper describes the application of PO in dental education and assists us to establish or master numerous aforementioned skills during the learning process in dental school. This PO system will facilitate a gradual transition of students from the dental school environment to private practice smoothly without any apprehensions.

A Comparative Evaluation of Fracture Toughness of Composite Resin vs Protemp 4 for Use in Strip Crowns: An In Vitro Study.

AIM: The aim of this study was to compare the fracture toughness of pedo shade packable composite resin (Z100, 3M ESPE, St. Paul, USA) vs Protemp 4 (3M ESPE, Seefeld, Germany) when used inside a strip crown to restore primary incisors. MATERIALS AND METHODS: Thirty-six exfoliated noncarious human primary central and lateral incisors were randomly divided into two equal groups. The teeth were prepared to standardized dimensions to receive a strip crown. All the teeth were etched, rinsed, and dried following which bonding agent was applied and light cured. In group I, pedo shade packable composite resin (Z100, 3M ESPE, St. Paul, USA) was packed into strip crowns, placed on the prepared tooth, and light cured. In group II, the strip crowns were filled with Protemp 4 (3M ESPE, Seefeld, Germany), placed on the prepared tooth, and left to autopolymerize for 10 minutes. The strip crowns were removed, and the teeth were tested using the universal testing machine until fracture. Fracture toughness of the two groups was recorded and analyzed statistically using Student's "t" test. RESULTS: The mean force required to fracture strip crowns restored with Protemp 4 (416.89 ± 124.58 N) was higher when compared with pedo shade packable composite resin (338.27 ± 130.99 N). However, statistical analysis did not show a significant difference in the fracture toughness between the two groups (p = 0.074), based on Student's "t" test results. CONCLUSION: The fracture toughness of teeth restored with Protemp 4 was comparable with pedo shade packable composite resin when used inside a strip crown. CLINICAL SIGNIFICANCE: The use of Protemp 4 is a possible alternative to pedo shade packable composite resin in restoring the primary anterior teeth, when used inside the strip crowns. The data also showed that the fracture toughness of Protemp 4 was comparable with pedo shade packable composite resin. HOW TO CITE THIS ARTICLE: Vignesh KC, Kandaswamy E, Muthu MS. A Comparative Evaluation of Fracture Toughness of Composite Resin vs Protemp 4 for Use in Strip Crowns: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(1):57-60.