Efficacy of eutectic topical anesthesia in stainless steel crown procedures for primary molars: A randomized controlled trial.

BACKGROUND: Prior literature highlights the importance of local anesthesia (LA) for stainless steel crown (SSC) preparation and placement. Nevertheless, the effectiveness of a eutectic mixture of local anesthesia (EMLA), a topical anesthesia, for this purpose remains unexplored. AIM: The study evaluated the effectiveness of two EMLA application methods during SSC preparation and placement. DESIGN: Eighty-four children between 4 and 8 years of age were randomly allocated to three intervention groups. Group A received EMLA applied supragingivally, Group B received a gingival retraction cord impregnated with EMLA (GRC_EMLA), and Group C (control) received LA. Pain was recorded using Wong-Baker Faces Pain Scale (WBFPS) and Children Hospital Eastern Ontario Pain Scale (CHEOPS) at three time intervals. RESULTS: Control had highest mean pain scores at the first time interval in both maxillary and mandibular arches, followed by Group B and Group A, with statistically significant p-values (p = .00, p < .05). After preparation and placement, all three groups had low mean pain scores, with no statistically significant differences. Group A had minimal pain scores at all three time intervals, although not statistically significant. CONCLUSION: EMLA is a potent topical anesthetic and can be used as an alternative to LA for conventional SSC preparation and placement in primary molars.

Biocompatibility, Bioactivity and Gene Expression Analysis of SHEDS Cultured in Various Calcium Silicate Based Cements: A Systematic Review and Meta-Analysis of in Vitro Studies.

AIM: To assess the biocompatibility, bioactivity and gene expression analysis of SHEDs incubated in various Calcium Silicate Based Cements. STUDY DESIGN: Following PRISMA statement, a search was carried out in the electronic databases-PubMed, Scopus, Embase, Google Scholar, JSTOR, and DOAJ from January 2000 to 31 May 2021. In vitro trials examining the response of SHEDs to the treatment with CSCs were eligible. RESULTS: 10 trials were included after the selection process. These trials involved the assessment of cell viability, cell migration, cell adhesion, mineralization potential and gene expression analysis of SHEDs cultured in MTA, Biodentine, EndoCem Zr, RetroMTA, TheraCal & iRoot BP plus. CONCLUSION: MTA, Biodentine, EndoCem Zr, RetroMTA and iRoot BP showed adequate biocompatibility, bioactivity and genetic expression towards SHEDs, to support their clinical use in vital pulp treatment of primary teeth.

Enhancing special care dentistry with waiting room based multisensory-adapted dental environment: A randomized controlled-trial.

AIM: To assess the effectiveness of waiting room based multisensory adapted dental environment (SADE) as a novel, non-invasive behavior management technique in alleviating anxiety levels in children with Down syndrome. MATERIALS AND METHODS: This study was conducted in the Department of Pediatric and Preventive Dentistry, D.Y. Patil University School of Dentistry, Nerul, Navi Mumbai. A total of 40 children between 8 and 13 years of age diagnosed with Down syndrome were included in our study. Prior to the first dental evaluation, they were divided equally into two groups using simple randomization via lottery system. Group A (Intervention group): Patients were subjected to a sensory adapted environment (SADE) in the waiting room for 10 min prior to dental evaluation. Group B (Control group): Patients were subjected to a regular dental environment (RDE) in the waiting room for 10 min prior to dental evaluation. Outcome parameters evaluated at baseline and post dental evaluation were anxiety and behavior, using a pulse oximeter and the Modified Venham's Scale respectively. Data were subjected to statistical analysis using SPSS version 21.0 (SPSS Inc. Chicago, IL). The 'p' value < .05 was taken as significant at 95% confidence interval. RESULTS: Mann-Whitney U test was used to carry out the inter group analysis which showed a significant increase in the heart rate (26.00, p = .00) in Group B and a significant decrease in the Modified Venham Scale score (90.00, p = .001) in Group A. The Wilcoxon Signed ranks test was used to carry out the intra group analysis for which a significant difference between the two time intervals for heart rate (-3.69, p = .00) and Modified Venham Scale score (-1.46, p = .03) was obtained in Group A whereas a significant difference was obtained only in the heart rate (-3.04, p = .002) in Group B. CONCLUSION: Multisensory-adapted dental environment (SADE) in the waiting room effectively improves behavior, reduces anxiety and sensory discomfort among children with Down syndrome.

Effectiveness of an extraoral cold and vibrating device in reducing pain perception during deposition of local anesthesia in pediatric patients aged 3-12 years: a split-mouth crossover study.

Background: Local anesthetic injections may induce pain in children, leading to fear and anxiety during subsequent visits. Among the various approaches recommended to reduce pain, one is the use of a Buzzy Bee™ device that operates on the concept of gate control theory and distraction. The literature regarding its effectiveness during the deposition of local anesthesia remains limited; hence, the aim of the present study was to determine the efficacy of extraoral cold and vibrating devices in reducing pain perception during the deposition of local anesthesia. Methods: A split-mouth crossover study in which 40 children aged 3-12 years requiring maxillary infiltration or inferior alveolar nerve block for extractions or pulp therapy in the maxillary or mandibular posterior teeth were included. The control intervention involved the application of topical anesthetic gel for one minute (5% lignocaine gel), followed by the administration of local anesthetic (2% lignocaine with 1:80,000 adrenaline) at a rate of 1 ml/minute. Along with the control protocol, the test intervention involved using the Buzzy Bee™ device for 2 minutes before and during the deposition of the local anesthetic injection. The heart rate and face, legs, arms, cry, and consolability revised (FLACC-R) scale scores were recorded by the dentist to assess the child's pain perception. Results: The mean age of the participants in Group A and Group B was 7.050 ± 3.12 years and 7.9 ± 2.65 years respectively. A reduction in the mean heart rate and FLACC-R score was observed during the deposition of local anesthetic solution in the tissues when the Buzzy Bee™ was used in both groups at different visits in the same subjects (P < 0.05) The Buzzy Bee™ device was effective in reducing the heart rate and FLACC-R scores when used during maxillary infiltration and inferior alveolar nerve block local anesthesia techniques (P < 0.05). Conclusion: The use of extraoral cold and vibrating devices significantly reduces pain perception during local anesthetic deposition in pediatric patients. Considering the results of this study, the device may be incorporated as an adjunct in routine dental practice while administering local anesthesia in children.

Prevalence of molar incisor hypomineralization in India: A systematic review and meta-analysis.

Research Question: To estimate the pooled prevalence of molar incisor hypomineralization (MIH) in children from India. Research Protocol: The PRISMA guidelines were followed. Literature Search: An electronic search of the databases was performed to find prevalence studies of MIH in children above age 6 years in India. Data Extraction: Two authors independently extracted the data from the 16 included studies. Quality Appraisal: The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale adapted for cross-sectional studies. Data Analysis: The pooled prevalence estimate of MIH was calculated using logit transformed data with inverse variance approach in a random-effects model with 95% confidence interval (CI). Heterogeneity was assessed with the I2 statistic. The subgroups were analyzed to assess the pooled prevalence of MIH according to sex, arch-wise proportion of MIH-affected teeth, and proportion of children with the MIH phenotypes. Results and Interpretation of Results: Sixteen studies included in the meta-analysis represented 7 states of India. A total of 25,273 children were included in the meta-analysis. The pooled prevalence of MIH in India was estimated to be 10.0% (95% CI: 0.07, 0.12) with significantly high heterogeneity between the included studies. The pooled prevalence did not vary according to sex. The pooled proportions of MIH-affected teeth were similar in the maxillary and mandibular arches. The pooled proportion of children with MH phenotype was higher (56%) than those with M + IH phenotype (44%). Further studies with standardized criteria for recording MIH are needed to ascertain the prevalence of MIH in India.

Comparison of pain perception between computer-controlled local anesthetic delivery and the conventional syringe for inferior alveolar nerve block in children.

BACKGROUND: Local anesthesia (LA) is commonly used for pain control in clinical dental practice. However, it is often perceived as the most painful part of the treatment and the factor leading to the avoidance of dental care. Hence, research on better means of pain management is being conducted. OBJECTIVES: The aim of the study was to evaluate and compare pain perception using the No Pain III™ computer-controlled local anesthesia delivery (CCLAD) system and the conventional syringe, for inferior alveolar nerve block (IANB) in children. MATERIAL AND METHODS: Thirty children aged 6-12 years were included in the study. Children were randomly allocated into 2 groups by the flip of a coin. Group A received LA by conventional syringe and group B received LA by No Pain III™, on the contralateral side. Physiological parameters including blood pressure (BP), heart rate (HR) and respiratory rate (RR) were assessed at baseline, during the deposition and after the deposition of LA. A subjective evaluation of pain perception was assessed using the Wong-Baker FACES Pain Rating Scale (WBS). The measured values were subjected to statistical analysis. RESULTS: A statistically significant difference was observed between group A and group B for pain perception using the WBS, systolic BP and RR. CONCLUSIONS: The use of the No Pain III™ CCLAD system resulted in reduced pain perception and better acceptance when compared to the use of the conventional syringe, for IANB in children.

Knowledge and attitude of Indian dentists regarding dental stem cells: A cross-sectional descriptive survey.

BACKGROUND: Dental stem cells derived from tooth structures are adult stem cells that have received attention of researchers over the past decade. Dental stem cells can be used to regenerate dental tissues as well as non dental organs. These dental stem cells are readily accessible as compared to other sources of stem cells and can be obtained and stored for future use through minimally invasive procedures. Research in this field is growing at a fast pace and it is essential that awareness regarding the same should be present amongst professionals. AIM: This study was carried out to assess the knowledge and attitude of Indian dentists regarding dental stem cells. MATERIAL AND METHODS: A cross sectional descriptive, questionnaire based survey based on Knowledge, Attitude and Practice (KAP) was conducted and a total of 823 dentists from Maharashtra, India participated in the survey. The Pearson's Chi-Square Test and percentages of the total were used for statistical analysis. RESULTS AND CONCLUSION: A total of 823 dentists completed the questionnaire survey; out of which 396 were male and 427 were female. Maximum respondents (53%) were dental graduates, followed by post graduates (45%) and PhD (1.7%). Data from the study revealed that there is good awareness regarding stem cells in general. However; the awareness, knowledge regarding sources, applications, uses and clinical research guidelines regarding dental stem cells is lacking amongst most dentists. Despite this lack of knowledge, dentists are keen on updating their knowledge regarding dental stem cells.

Comparison of three diagnostic techniques for detecting occlusal dental caries in primary molars: An in vivo study.

AIM: To compare the accuracy and repeatability of three diagnostic systems; visual inspection, bitewing radiography, and CarieScan PRO for occlusal caries diagnosis in primary molars. MATERIALS AND METHODS: 216 occlusal surfaces of primary molars examined in turn by two examiners using each of three diagnostic systems (visual inspection, bitewing radiography, and CarieScan PRO). Examiners indicated operative intervention (validation method) for 104 teeth which were used for statistical analysis. The validation method was cavity preparation when the two examiners agreed about the presence of dentinal caries. Sensitivity, specificity, likelihood ratio, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each diagnostic technique. Inter- and intra-examiner repeatability was calculated for each diagnostic system using the Cohen's kappa statistics. RESULTS: Visual inspection showed the highest sensitivity (0.93). The highest sensitivity and NPVs were provided by CarieScan PRO (0.97 and 0.95, respectively) however this was offset by a lower specificity (0.82) compared to other techniques. The CarieScan PRO gave the highest values of Cohen's kappa statistics. CONCLUSION: This study showed low sensitivity but substantial specificity with visual inspection. Bitewing radiography performed poorly overall when compared with the other two systems. The CarieScan PRO technique gave the highest overall combination of sensitivity and specificity for detection of occlusal caries.

Comparison of three diagnostic techniques for detecting occlusal dental caries in primary molars: An in vivo study.

Aim: To compare the accuracy and repeatability of three diagnostic systems; visual inspection, bitewing radiography, and CarieScan PRO for occlusal caries diagnosis in primary molars. Materials and Methods: 216 occlusal surfaces of primary molars examined in turn by two examiners using each of three diagnostic systems (visual inspection, bitewing radiography, and CarieScan PRO). Examiners indicated operative intervention (validation method) for 104 teeth which were used for statistical analysis. The validation method was cavity preparation when the two examiners agreed about the presence of dentinal caries. Sensitivity, specificity, likelihood ratio, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each diagnostic technique. Inter‑ and intra‑examiner repeatability was calculated for each diagnostic system using the Cohen’s kappa statistics. Results: Visual inspection showed the highest sensitivity (0.93). The highest sensitivity and NPVs were provided by CarieScan PRO (0.97 and 0.95, respectively) however this was offset by a lower specificity (0.82) compared to other techniques. The CarieScan PRO gave the highest values of Cohen’s kappa statistics. Conclusion: This study showed low sensitivity but substantial specificity with visual inspection. Bitewing radiography performed poorly overall when compared with the other two systems. The CarieScan PRO technique gave the highest overall combination of sensitivity and specificity for detection of occlusal caries.