Evaluation of Remineralizing Potential of CPP-ACP, CPP-ACP + F and ß TCP + F and Their Effect on Microhardness of Enamel Using Vickers Microhardness Test: An In Vitro Study.

Context: The change in understanding of dental caries which is now believed to be a reversible lesion has led to the change in its management. Aim: To evaluate the remineralizing potential of three remineralizing agents [casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP), CPP-ACP + F, and beta-tricalcium phosphate (ß TCP) + F] and their effect on microhardness of enamel using Vickers microhardness test. Materials and method: Forty freshly extracted premolars, extracted for orthodontic purpose were collected and specimen prepared. The specimens were equally divided into four groups. Baseline surface microhardness measurement was taken for the specimens. Demineralization of enamel was carried out by keeping the specimens in 20 mL of demineralizing solution for 72 hours, and microhardness was evaluated. Remineralizing agents CPP-ACP, CPP-ACP + F, and ß TCP + F was applied to Group A, Group B, and Group C, respectively for 28 days and microhardness was evaluated again. Group D was kept as control group. Statistical analysis was done by One-way ANOVA test. Percentage microhardness recovery was calculated to evaluate the regain in microhardness after remineralization and thus assess the remineralizing efficacy of the agents. Results: After demineralization surface microhardness of enamel decreased to the range of Vickers hardness number (VHN) 155-167 but after application of remineralizing agents surface microhardness for Group B was found to be highest, in other words, VHN 240.78 followed by Group C, in other words, VHN 214.29 and Group A the least VHN 197.90. Conclusion: The result of this study concludes that surface microhardness of enamel decreased after demineralization procedure and increased after application of all the remineralizing agents. The highest increase was seen in group tested with CPP-ACP + F followed by ß TCP and least for CPP-ACP. The values for all the three groups were higher than the control so we can conclude that all the agents can be used as remineralizing agent with CPP-ACP + F being the best among the three. How to cite this article: Bhat DV, Awchat KL, Singh P, et al. Evaluation of Remineralizing Potential of CPP-ACP, CPP-ACP + F and ß TCP + F and Their Effect on Microhardness of Enamel Using Vickers Microhardness Test: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(S-2):S221-S225.

Quantitative evaluation of remineralizing potential of three agents on artificially demineralized human enamel using scanning electron microscopy imaging and energy-dispersive analytical X-ray element analysis: An in vitro study.

BACKGROUND: The aim of this study is to quantitatively evaluate the remineralization potential of three remineralizing systems as follows: fluoride, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and CPP-ACP with fluoride, under scanning electron microscope with energy-dispersive X-ray analysis. MATERIALS AND METHODS: In this in vitro study A total of 40 enamel specimens were prepared from the buccal or lingual surfaces of human premolars extracted for orthodontic reason. Specimens were then placed in demineralizing solution for 96 h, to produce artificial caries-like lesion. Calcium and phosphate weight percentage of demineralized specimens was measured. Specimens were divided into four groups as follows: (a) control, (b) CPP-ACP, (c) CPP-ACP with fluoride, and (d) fluoride varnish. Except for the control group, the entire specimens were subjected to remineralization using respective remineralizing agents of their groups. The prepared specimens were assessed for calcium and phosphate weight percentage using scanning electron microscopy-energy dispersive X-ray spectroscopy. One way analysis of variance (ANOVA), followed by Tukey's test, was performed with the help of critical difference (CD) or least significant difference at 5% and 1% level of significance. P ≤ 0.05 was taken to be statistically significant and P < 0.001 as statistically highly significant. RESULTS: The mean weight percentage of calcium and phosphorus of specimens treated with CPP-amorphous calcium phosphate nanocomplexes plus fluoride (ACPF) was significantly higher than other groups. CONCLUSION: All the groups showed statistically significant remineralization. However, because of added benefit of fluoride, CPP-ACPF showed statistically significant amount of remineralization than CPP-ACP.

The prevalence of dental anxiety and fear among 4-13-year-old Nepalese children.

AIM: The aim of the study was to assess the prevalence of dental fear and anxiety among children aged 4-13 years using three fear scales, i.e., facial image scale (FIS), Nepalese version of Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Modified Child Dental Anxiety Scale (MCDAS). MATERIALS AND METHODS: The study was conducted on 300 children (4-13 years) who visited the Department of Pedodontics and Preventive Dentistry. The fear and anxiety levels were measured using three fear measurement scales, i.e., FIS, Nepalese version of CFSS-DS, and MCDAS. The dental behavior observed was rated according to the Frankl's Behavior Rating Scale (FBRS). RESULTS: The prevalence of dental fear according to FIS was 11.9% as evident from children having FIS 4 and 5 scores. Dental fear with CFSS-DS ≥38 was identified in 49 children (21 [12.5%] male and 28 [21.21%] female). In assessment of the behavior of children in the clinics through FBRS, it was observed that the maximum number of respondents (70.6%) showed Frankl's rating 3, i.e., positive. CONCLUSION: The Nepalese versions of the CFSS-DS and the MCDAS are both reliable and valid scales for evaluating dental anxiety and fear in young children. Assessing dental anxiety and fear is useful, as behavior management can be designed accordingly for child patients.

Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India.

INTRODUCTION: Childhood obesity, dental caries, and periodontal disease are major public health problems due to their adverse impact on the growth and development of children. Obesity and oral health are associated as both share some common risk factors. AIM: The specific aim of the study was to determine the correlation, if there is any, between obesity and oral health in children. MATERIALS AND METHODS: A cross-sectional survey was conducted in five districts of West Bengal, India. A total of 1,227 school-going children of 6 to 12 years were examined from the districts of Howrah, Hooghly, West Midnapore, South 24-parganas, and North 24-parganas. Following indices were analyzed: Decayed-missing-filled teeth (DMFT), decayed, extracted, filled teeth (deft), simplified oral hygiene index (OHI-S). Depending on their nutritional status, subjects were categorized as being normal weight, overweight, and obese. Logistic regression analysis were applied to the study to find out the association between the above-mentioned dental indices and independent variables: Gender and nutritional status. RESULT: A positive association was found between obesity and oral health status in children. CONCLUSION: Considering the results of this study, it was concluded that obesity is related to oral hygiene status of children. In order to improve oral hygiene status in children, dietary modifications need to be done.How to cite this article: Halder S, Kaul R, Angrish P, Saha S, Bhattacharya B, Mitra M. Association between Obesity and Oral Health Status in Schoolchildren: A Survey in Five Districts of West Bengal, India. Int J Clin Pediatr Dent 2018;11(3):233-237.

A Reduced Set of Features for Chronic Kidney Disease Prediction.

Chronic kidney disease (CKD) is one of the life-threatening diseases. Early detection and proper management are solicited for augmenting survivability. As per the UCI data set, there are 24 attributes for predicting CKD or non-CKD. At least there are 16 attributes need pathological investigations involving more resources, money, time, and uncertainties. The objective of this work is to explore whether we can predict CKD or non-CKD with reasonable accuracy using less number of features. An intelligent system development approach has been used in this study. We attempted one important feature selection technique to discover reduced features that explain the data set much better. Two intelligent binary classification techniques have been adopted for the validity of the reduced feature set. Performances were evaluated in terms of four important classification evaluation parameters. As suggested from our results, we may more concentrate on those reduced features for identifying CKD and thereby reduces uncertainty, saves time, and reduces costs.

Knowledge, Awareness and Attitude towards Emergency Management of Dental Trauma among the Parents of Kolkata-An Institutional Study.

INTRODUCTION: Traumatic dental injuries are one of the commonly encountered dental emergencies. Missing anterior tooth in children due to any injury can be a source of considerable physical and psychological discomfort for the child. The prognosis of some dental injuries depends to a great extent on parents' knowledge of correct and prompt emergency measures. AIM: The purpose of this cross-sectional study was to assess the knowledge, attitude and awareness level of parents regarding the emergency management of dental trauma and to find out the relation of the responses to social variables. MATERIALS AND METHODS: A total of 2000 parents were surveyed over a period of three months using a pretested close ended questionnaire prepared in English, Hindi as well as in the regional language which was divided into three parts: Part 1 contained questions on personal information, Part 2 on an imaginary case of trauma to assess their knowledge regarding trauma management and Part 3 related to their attitude towards dental trauma management education. The data was statistically analysed using descriptive and chi-square statistics. RESULTS: The overall knowledge of parents regarding emergency management of trauma was not satisfactory. Although most of the people were in favour of taking professional consultation for emergency management of trauma but most of them were unaware of the steps that need to be taken on their part so as to minimize complications and improve prognosis. CONCLUSION: Educational campaigns are the need of the day to increase the knowledge of parents regarding emergency management of dental trauma.

Salivary IgA versus HIV and Dental Caries.

INTRODUCTION: The inter-relationship of Human Immunodeficiency Virus (HIV) infection and dental caries as well as Salivary Immunoglobulin-A (S-IgA) level appear to remain under explored while a manual and electronic search of the literature was made. Hence, the present study was undertaken to assess the relationship of S-IgA and dental caries status in HIV positive children. AIM: The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV positive and negative children and determine the dental caries status in HIV positive and HIV negative children, which may help in treatment planning and prevention of the same. MATERIALS AND METHODS: A total of 28 HIV positive children aged between 6-14 years and 28 age matched HIV negative children were included in this study and both samples were randomly selected from the same Non-Governmental Organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. Only 2cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to WHO criteria (1997) using a flat mouth mirror and CPI probe. RESULTS: In HIV +ve group mean S-IgA level was calculated as 81.61 ± 6.20 µg/ml, mean DMFT was 3.86 ± 3.37, mean deft was 4.75 ± 2.86. In HIV -ve group mean S-IgA level was calculated as 145.57 ± 17.83µg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong-ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, p < 0.001) and negative but Not Significant (N.S.) correlation (r = -0.19, t = 0.99, p > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, p < 0.001), S-IgA and deft (r = -0.942, t =14.32, p=<0.001) was found in HIV-ve group. CONCLUSION: This study suggests that the individuals who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

Aggressive dentigerous cyst with ectopic central incisor.

Dentigerous cysts form from accumulation of fluid between reduced enamel epithelium and the crown of an unerupted tooth. They cause several difficulties such as swelling, non-eruption of the involved teeth, and displacement of adjacent teeth, and thus require early detection and prompt treatment. Treatment ranges from marsupialisation to enucleation. Enucleation is rarely used in children compared with marsupialisation. This paper discusses successful use of enucleation for treating a dentigerous cyst and explains the need for such a radical procedure.

Evaluation and comparison of white mineral trioxide aggregate and formocresol medicaments in primary tooth pulpotomy: clinical and radiographic study.

AIM: The primary aim of the following study is to evaluate and secondary aim is to compare clinically and radiographically the success of using white mineral trioxide aggregate (MTA) versus formocresol (FC) medicament for primary tooth pulpotomy. MATERIALS AND METHODS: A total of 100 teeth were selected for pulpotomy; of which 50 teeth underwent FC pulpotomy and 50 teeth underwent pulpotomy with white MTA. Out of 100 treated teeth, 82 teeth (42 FC and 40 MTA teeth) were available at the end of 24 months for evaluation. 4 failures were found in FC group at 1 st month evaluation and no failures were found in white MTA group. A statistical analysis was performed to evaluate the overall success rate of study and individual success rates of medicaments. Overall success rate of the study was 95%, success rate of FC group was 90.48% and success rate of MTA group was 100%. RESULTS: MTA produced better results as pulpotomy medicament in comparison to FC. The superior success obtained in the present study was matching other studies mentioned in the literature. CONCLUSION: MTA seems to be a promising pulpotomy medicament for future use.

Prevalence of dental caries and treatment needs in children in coastal areas of West Bengal.

OBJECTIVE: This study was carried out to measure the caries prevalence and treatment needs in school children of 6-14 year old residing in coastal areas of West Bengal. MATERIALS AND METHODS: A total of 1764 children of 6-14 years age group, studying in different primary and high schools of the coastal areas were examined using World Health Organization criteria (1997) to record the prevalence of dental caries. The treatment needs were also calculated according to that given criteria. STATISTICAL ANALYSIS: The results were subjected to statistical analysis using the Chi-square test and unpaired 't' test. RESULTS: Dental caries were founded low in the studied population. The overall all caries prevalence in the permanent dentition was 28.06%, in boys it was 25.39% and in girls it was 30.86%. Therefore caries prevalence in female was higher and which was statistically highly significant (P < 0.05). The most frequently required treatment was one surface filling followed by other treatments irrespective of sex and age group. DISCUSSION: The presence of sea foods containing high fluoride and least availability of refined carbohydrate in the diet may be the reason of lower prevalence. CONCLUSION: child oral health is always a matter of concern for a developing country so further research is required to explore actual causes.

Correlation of total salivary secretory immunoglobulin A (SIgA) and mutans specific SIgA in children having different caries status.

BACKGROUND: Relation between secretory immunoglobulin A (SigA) and dental caries still imprecise. Studies have been conducted either for total SIgA or mutans specific SIgA with bizarre results. AIM: The aim of this study is to find out the relationship between mutans antigen specific SIgA and total salivary SIgA and its influence in caries status in children. MATERIALS AND METHODS: A total of 45 children aged between 6-14 years were divided based on their caries index (decayed, missing, filled, extracted tooth) score in high moderate and no caries group and their saliva were analyzed with enzyme linked immunosorbent assay for total SIgA and mutans specific SIgA. RESULTS: High caries group showed high mutans specific SIgA, but less total SIgA, whereas low caries group showed the reverse. CONCLUSION: The mutans specific SIgA and total SIgA has a weak, but negative correlation in children potentiating caries inhibitory action of SIgA.