Enamel Deproteinization using Papacarie and 10% Papain Gel on Shear Bond Strength of Orthodontic Brackets Before and After Acid Etching.

OBJECTIVE: To suggest Papacarie(®) as a new deproteinizing agent in comparison with indigenously prepared 10% papain gel before and after acid etching that may enhance the quality of the bond between enamel surface and composite resin complex. STUDY DESIGN: One hundred and twenty five extracted human premolars were utilized and divided into five groups: In the group 1, enamel surface was etched and primer was applied. In group 2, treatment with papacarie(®) for 60 seconds followed by etching and primer application. In group 3, etching followed by treatment with papacarie(®) for 60 seconds and primer application. In group 4, treatment with 10% papain gel for 60 seconds followed by etching and primer application. In group 5, etching followed by treatment with 10% papain gel for 60 seconds and primer application . After bonding the brackets, the mechanical testing was performed using a Universal testing machine. The failure mode was analyzed using an adhesive remnant index. The etching patterns before and after application of papacarie(®) and 10% papain gel was also evaluated using SEM. The values obtained for shear bond strength were submitted to analysis of variance and Tukey test (p < 0.05). RESULTS: It was observed that group 2 and group 4 had the highest shear bond strength and was statistically significant from other groups (p=0.001). Regarding Adhesive remnant index no statistical difference was seen between the groups (p=0.538). CONCLUSION: Papacarie(®) or 10% papain gel can be used to deproteinize the enamel surface before acid etching to enhance the bond strength of orthodontic brackets.

Relationship between severe early childhood caries and body mass index.

AIM: This study was undertaken to evaluate the relationship between Severe Early Childhood Caries (S-ECC) and Body Mass Index (BMI) in the absence of any underlying medical condition for the school going (3 to 6 years old) children of Mathura city, India. METHOD: One hundred caries free children (50 boys and 50 girls) and one hundred children (50 boys and 50 girls) affected with S-ECC in the age range of 3-6 years without any contributing medical history were included in the study. Measurements of the weight (kg) and height (m) were done using a standard balanced beam scale and stadiometer. The BMI (kg/m2) was determined and the body weight status was evaluated using CDC based classification for each child. Independent t-test was used to evaluate whether the weight, height and BMI of S-ECC children is significantly different from caries free children. RESULT: Although the weight of the S-ECC children is more when compared to the normal children, the difference is not statistically significant. However, the mean BMI of S-ECC children is more when compared to the caries free children which was found to be statistically significant at p < 0.05. The body weight status of the Normal and S-ECC affected children based on the CDC classification revealed that 48% have been classified in underweight category and 43% in normal weight category and very few children are found to be at risk of overweight and overweight. CONCLUSIONS: A positive correlation between the BMI and S-ECC was observed in this study. 51% of caries free children and 45% of S-ECC children were classified in underweight category based on CDC classification.

Enamel deproteinization before acid etching and its effect on the shear bond strength--an in vitro study.

OBJECTIVE: This study was undertaken to assess the effect of enamel deproteinization with 5.25% sodium hypochlorite (NaOCl) before phosphoric acid (H3PO4) etching on the shear bond strength ofAdperTM Single Bond 2 adhesive and Filtek Z-350 XT composite resin. STUDY DESIGN: Forty human sound permanent molars which were extracted for periodontal reasons were used in the experimental protocol as under: Group-A (20 teeth):-A 5X4 mm window of the enamel surface was etched with 37% H3PO4 gel for 15 seconds, washed with distilled water and air dried. A single coat of Adper Single Bond 2 adhesive was applied and photo polymerized for 20 seconds and Filtek Z-350 XT composite resin block of length 5 mm, width 4 mm and height 5mm respectively was built and photo polymerized in increments for 20 seconds each. Group-B (20 teeth):--Similarly the enamel surface was treated with 5.25% NaOCl for 60 seconds, washed with distilled water and then etched with 37% H3PO4 gel for 15 seconds, washed with distilled water and air dried. A single coat of Adper Single Bond 2 adhesive was applied and photo polymerized for 20 seconds and Filtek Z-350 XT composite resin block of length 5 mm, width 4 mm and height 5 mm respectively was built and photo polymerized in increments for 20 seconds each. The shear bond strength of all the samples were measured (in MPa) on Instron Mechanical Testing Machine. RESULTS: The mean shear bond strength value for Group-A was 13.51 +/- 5.726 MPa and for Group-B being 15.06 +/- 6.220 MPa. No statistically significant difference in the shear bond strengths was observed between the two groups. CONCLUSIONS: No significant effect of sodium hypochlorite enamel deproteinization on the shear bond strength of Adper Single Bond 2 adhesive and Filtek Z-350 XT composite resin before acid etching was observed in this study.

Decreasing cariogenic bacteria with a natural, alternative prevention therapy utilizing phytochemistry (plant extracts).

The association between the oral microbiota and oral diseases is well established. Various antimicrobial agents including antibiotics are commercially available against oral pathogenic bacteria. For the reasons of antibiotic resistance, their adverse effects and financial considerations in the developing countries, there is a need for alternate preventive and curative treatment options that are also safe, effective and economical. Traditional medicines have been used since ancient times for the treatment of oral diseases including dental caries, periodontal diseases that affect the majority of the population and can affect a person's overall health. Natural phytochemicals are certain organic components isolated from plants and some of these extracts are considered to be beneficial to health. They serve as antioxidants, enhance immune response, provide protection against oral cancer and other diseases and also repair DNA damage caused by smoking and other toxic exposure, and detoxify carcinogens. The natural products derived from medicinal plants have proven to be an abundant source of biologically active compounds, many of which have been the basis for the development of new lead chemicals for pharmaceuticals. They are considered to be good alternatives to synthetic chemicals. This article presents a review of natural alternatives derived from plants and plant products that can serve as a prevention and treatment option against cariogenic bacteria.

Enamel deproteinization before acid etching--a scanning electron microscopic observation.

OBJECTIVES: This study was undertaken to evaluate the topographical features of enamel surface deproteinized with sodium hypochlorite (NaOCl) and etched with phosphoric acid (H3PO4) compared to phosphoric acid alone using Scanning Electron Microscopic (SEM) Analysis. STUDY DESIGN: 30 enamel blocks of 1 mm2 from ten human sound extracted permanent molars were obtained and treated as under: Group 1 (10 blocks): Enamel surface was etched with 37% H3PO4 gel for 15 seconds. Group 2 (10 blocks): Enamel surface was treated with 5.25% NaOCl for 60 seconds and then etched with 37% H3PO4 gel for 15 seconds. 10 enamel blocks were included in the control group where no treatment was carried out. The samples were subjected to SEM analysis and 5 microphotographs of each sample were obtained at 500X magnification and evaluated for the quality of etching pattern of the enamel in percentage (%) using Auto-CAD 2007 software. RESULTS: Mean values of etching pattern in Group 1 being 55.76% and Group 2 being 53.58%. No significant difference was observed between the two groups. CONCLUSION: The use of 37% phosphoric acid for 15 seconds still remains the best method for pretreatment of enamel.

Post-traumatic epidermoid inclusion cyst in the chin region.

Epidermoid cysts of traumatic origin are found mainly on palms, fingers and soles. They are believed to originate through implantation of epithelium by either surgical or accidental trauma into deeper mesenchymal tissue. A case of traumatic epidermoid inclusion cyst of the chin region is described.

Banking stem cells from human exfoliated deciduous teeth (SHED): saving for the future.

Tooth derived cells are readily accessible and provide an easy and minimally invasive way to obtain and store stem cells for future use. Banking ones own tooth-derived stem cells is a reasonable and simple alternative to harvesting stem cells from other tissues. Obtaining stem cells from human exfoliated deciduous teeth (SHED) is simple and convenient, with little or no trauma. Every child loses primary teeth, which creates the perfect opportunity to recover and store this convenient source of stem cells--should they be needed to treat future injuries or ailments and presents a far better alternative to simply discarding the teeth or storing them as mementos from the past. Furthermore, using ones own stem cells poses few, if any, risks for developing immune reactions or rejection following transplantation and also eliminates the potential of contracting disease from donor cells. Stem cells can also be recovered from developing wisdom teeth and permanent teeth. Individuals have different opportunities at different stages of their life to bank these valuable cells. It is best to recover stem cells when a child is young and healthy and the cells are strong and proliferative. The purpose of this review is to discuss the present scenario as well as the technical details of tooth banking as related to SHED cells.

Fiber-reinforced Composite Resin Bridge: A Treatment Option in Children.

A number of treatment options, ranging from Maryland bridges to implants, are available for the replacement of congenitally or traumatically missing permanent anterior teeth. But, there are several limitations of these therapeutic options when they have to be used before the completion of the growth, particularly in children. Reinforcement of composite resins with polyethylene fibers significantly improves their mechanical properties. Fiber-reinforced composite (FRC) bridge can offer a good alternative to conventional treatment options in replacing a missing permanent anterior tooth until a more definitive prosthesis can be provided at the end of the growth period. The purpose of this article is to present a clinical case of a single tooth replacement utilizing noninvasive and metal free fixed FRC bridge in a 13 years old child as an interim treatment option. How to cite this article: Gupta A, Yelluri RK, Munshi AK. Fiber-reinforced Composite Resin Bridge: A Treatment Option in Children. Int J Clin Pediatr Dent 2015;8(1):62-65.

Malocclusion and orthodontic treatment need of handicapped individuals in South Canara, India.

AIMS: To estimate the prevalence and the severity of malocclusion and treatment need for 329 handicapped individuals. SUBJECTS AND SETTING: 329 handicapped individuals aged 11-30 years, attending eight different nonresidential special schools of South Canara, India. METHOD: Examination and recording using the Dental Aesthetic Index (DAI). RESULTS: 53% had a dental appearance which required no orthodontic treatment, 24% had a definite malocclusion, where treatment was 'elective' and treatment for a further 12% was considered to be 'highly desirable'. The remaining subjects (11%) had a handicapping malocclusion where treatment was considered mandatory. CONCLUSIONS: The prevalence of definite and severe malocclusions was higher in the mentally subnormal individuals when compared to other handicapping conditions. Orthodontic services for the handicapped have generally been neglected.

Additional distal root in permanent mandibular first molars: report of a case.

The case of a patient with an additional distal root in each permanent mandibular first molar is reported. A thorough review of the dental literature failed to reveal any significant data concerning such cases because much of the literature is concerned with variation in root canal morphology rather than variations in root number. Inability to recognize these aberrations could lead to failure of endodontic treatment.

Late development of supernumerary teeth in the premolar region: a case report.

Supernumerary teeth are considered to be among the most significant dental anomalies affecting the primary and the early mixed dentitions. Early removal of such teeth is recommended if they impede the eruption of adjacent permanent teeth, appear inverted or rudimentary, or are associated with certain pathologic conditions. This report describes the appearance of late-developing supernumerary teeth in the premolar region in three quadrants.

Management of an impacted, dilacerated mandibular left permanent first molar: a case report.

A case of an unerupted mandibular left permanent first molar, a partially erupted permanent second molar, and a congenitally absent third molar in a 12-year-old girl is described. The permanent first molar, being dilacerated and impacted, required surgical exposure of the crowns of the first and second molars and distalization of the second molar, with the help of a space regainer, to bring the molars into occlusion.

Rieger's syndrome: a case report.

Rieger's syndrome is a rare autosomal-dominant disorder characterized by dental, ocular, and periumbilical abnormalities. Essential ocular features include goniodysgenesis, which leads to increased intraocular pressure and subsequent glaucoma and visual loss. Dental findings include midfacial hypoplasia and the absence of primary and permanent incisors and second premolars. Comprehensive preventive dental care in the form of fluorides and sealants is required, especially in patients with severe hypodontia, to increase the resistance of the remaining teeth to dental caries. This article describes a case of Rieger's syndrome in a 9-year-old child and emphasizes the need for comprehensive oral rehabilitation.

Prognostic factors in intracerebral haemorrhage.

In a prospective study, the prognostic value of clinical characteristics and CT scan findings in 50 patients of intracerebral haemorrhage (ICH) has been examined. Follow up has been done over 6 months period. Each patient has been individually followed up for 8 weeks. At the end of the follow up period 34% of the patients died, 36% were dependent on outside help for daily living while 30% were capable of independent existence. Age of more than 60 yrs, Glasgow Coma Scale (GCS) Score of 6 or less (in a modified Scale of 10) at the time of admission, ICH volume greater than 30 ml., midline shift in CT scan of more than 3 mm and presence of intraventricular haemorrhage (IVH) and hydrocephalus had an adverse impact on outcome. Young age, GCS score of more than 8, ICH volume of less than 20 ml, presence of lobar haemorrhage and absence of IVH/hydrocephalus were associated with relatively favourable outcome.

Leopard syndrome--report of a variant case.

This case report presents a patient with Leopard syndrome, with multiple lentigines all over the body and face, ocular hypertelorism, delayed secondary sexual characteristics, mild cardiac abnormalities and supernumerary teeth. Clinical relevance of this syndrome lies in its early recognition and precautions to be taken during any invasive dental procedure, which if not performed under antibiotic prophylaxis and premedication, could lead to infective endocarditis. Additionally, a multidisciplinary approach with pediatric and medical consultants is mandatory during the management of such cases.

Fusion of primary incisors--a report of six cases.

Six cases of asymptomatic dental twinning anomalies in the primary dentition are reported in 4205 school children. A clinical and radiographic presentation of the cases of fusion of primary incisor teeth is illustrated. This clinical entity has been found to appear with varied clinical and radiographic appearances. An association of fusion of primary incisors with the number of succedaneous teeth was seen.

Traumatic injuries to the anterior teeth among South Kanara school children--a prevalence study.

The present study was carried out to assess the prevalence and distribution of the traumatic injuries to anterior teeth among 4500 school children in the age group of 3 to 16 years from South Kanara District of Karnataka. Information concerning sex, age, cause of trauma, number of injured teeth, type of the teeth, lip competence, terminal plane relationship and the molar relationship were recorded. A total of 238 cases (5.29%) had incisor and canine fractures, which was more prevalent among the boys (72.27%) than the girls (27.73%). The leading cause of injury was undefined falls and the maxillary central incisors were commonly affected in both the primary and the permanent dentition. Enamel fracture was the most common form of injury noted. Class 1 Type 2 and Class 2 division 1 molar relationship cases exhibited significantly very high number of fractured teeth. Only 1.68% of the cases with traumatized teeth had undergone treatment.

Oral habits in children--a prevalence study.

This epidemiological study was conducted upon 4,590 school children to find the prevalence of oral habits in Mangalore in relation to their age and sex and to find the correlation, if any, between the habits and the malocclusion status. We noted that 29.7% of the population had habits of which 3. 1% had digit sucking, 4.6% mouth breathing, 3.02% tongue thrusting, 6.2% bruxism, 6% lip/cheek biting, 12.7% nail biting, 9.8% pencil biting and 0. 09% masochistic habits respectively. Digit sucking, pencil biting and tongue thrust were highly prevalent among Group 1 (3-6 years) children. Mouth breathing and bruxism were significant in Group 2 (7-12 years) cases whereas lip/cheek biting and nail biting were more common in Group 3 (13-16 years) cases. Digit sucking, tongue thrust, mouth breathing and bruxism were more prevalent among the boys whereas lip/cheek biting, nail biting and pencil biting were more prevalent among the girls. 28.95% of the children in Group 2 and 3 with habits had malocclusion. There was a significant correlation between class I type 2, class II div 1 and tongue thrust and mouth breathing whereas children with digit sucking showed a high correlation with class I type 2 malocclusion.

Midline space closure in the mixed dentition: a case report.

Supernumerary teeth which occur both in the primary and the permanent dentition are seen more frequently in the permanent dentition causing a variety of pathological disturbances. Presented herewith is a case report of a patient with a mesiodens which had caused flaring of the maxillary central incisors and impeded normal eruption of the maxillary lateral incisors. Extraction of the mesiodens was carried out; subsequently followed by the space closure utilizing simple fixed orthodontic therapy.

Relationship between the existing caries status, plaque S. mutans and Cariostat caries activity test in children.

An attempt was made in this study to find out the sensitivity and specificity of a caries activity test, CARIOSTAT and its relationship to the existing caries status and the plaque S. mutans level. The test proved to be highly sensitive and specific with significant relationship to the S.mutans count in the dental plaque. There also was a significant relationship between both the cultured microorganisms on MSB agar and the plaque in the Cariostat medium.