Comparative Evaluation of Bacterial Colonization Color Stability and Halitosis of Oral Appliances Fabricated Using Cold Cure Acrylics, Heat Cure Acrylics and Thermoforming Sheets: An In Vivo Study.

Aim: Removable oral appliances form an integral part of interceptive orthodontic procedures. Bacterial colonization leading to halitosis and poor color stability are the major disadvantages of the same in spite of patient acceptability. The aim of the present study was to evaluate bacterial colonization, color stability, and halitosis from the oral appliances fabricated using cold cure, cold cure under pressure pot, heat cure acrylics, thermoforming sheet, Erkodur and antibacterial thermoforming sheet, Erkodur-bz. Materials and methods: A group of 40 children was divided into five groups and the appliances were delivered. Bacterial colonization and halitosis were evaluated before giving the appliance to the patient after 1 and 2 months. Color stability was evaluated before giving the appliance to the patient and then after 2 months. This study was designed as a single-blinded randomized clinical trial. Results: Results have shown that after 1 and 2 months, bacterial colonization was higher from the appliances fabricated with cold cure and was lower for the Erkodur group, which was statistically significant. Color stability was more from the appliances fabricated with Erkodur and was less for cold cure, which was statistically significant. Halitosis after 1 month was more from the appliances fabricated with cold cure and less from Erkodur group, which was statistically significant. After 2 months, halitosis was more from the cold cure group and less from Erkodur group, which was not statistically significant. Conclusion: Thermoforming sheet, Erkodur showed better results than other groups in terms of bacterial colonization, color stability, and halitosis. Clinical significance: When removable appliances are indicated for minor orthodontic tooth movement, Erkodur is preferable due to the advantages of easy fabrication and less bacterial colonization. How to cite this article: Madhuri L, Puppala R, Kethineni B, et al. Comparative Evaluation of Bacterial Colonization Color Stability and Halitosis of Oral Appliances Fabricated Using Cold Cure Acrylics, Heat Cure Acrylics and Thermoforming Sheets: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(5):499-503.

Comparison of Three Treatment Techniques for Deep Carious Lesions in Primary Teeth: An In Vivo Study.

Aims: To evaluate and compare three different treatment modalities in the management of deep carious lesions in primary molars. Material and methods: A total of 60 primary molars from patients aged 4-9 years were randomly divided into three groups with 20 samples each. Sample in Group I received indirect pulp therapy with Mineral Trioxide Aggregate [MTA] as lining material, Group II received the modified Hall technique, and Group III MTA pulpotomy. The patients were evaluated at 1, 3, 6, and 9 months as per evaluation criteria for success or failure of the same. A Chi-square test was used for proportions and for comparison between groups. Results: Clinically, the success rate for the modified Hall technique and MTA pulpotomy was higher than indirect pulp therapy. Radiographically, the modified Hall technique had the highest success rate of 100 percent among the indirect pulp therapy and MTA pulpotomy. This success rate was however not statistically significant. Conclusion: All three techniques had promising results clinically and radiographically. Since the results were not statistically significant, conservative treatment like Modified Hall's technique can be preferred over the surgical approach [MTA Pulpotomy]. Clinical significance: This study compares newer techniques called Hall's technique with traditional techniques like indirect pulp capping and MTA pulpotomy. Hall's technique is a quick and noninvasive procedure, which involves fitting the crown and seating it over the tooth without any caries removal/ tooth preparation and no local anesthesia is being practiced. In the present study Hall's technique showed higher rates of success compared to the other two procedures. How to cite this article: Poludasu M, Kumar Mallela GM, Puppala R, et al. Comparison of Three Treatment Techniques for Deep Carious Lesions in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(S-2):S201-S206.

Antimicrobial Efficacy of Triple Antibiotic Paste and Propolis as an Intracanal Medicament in Young Permanent Teeth: An In Vivo Study.

AIM AND OBJECTIVE: To evaluate the antimicrobial efficacy of triple antibiotic paste and propolis extracts as an intracanal medicament in young permanent teeth. MATERIALS AND METHODS: A total of 30 single-rooted non-vital young permanent teeth with open apex were selected randomly from the children aged between 7 years and 14 years with no systemic complications. Group I-triple antibiotic paste and group II be propolis allocating 15 teeth in each group. After access opening, the first sample (S1) was collected by inserting paper point into the root canal, the second sample (S2) was collected immediately after irrigation, and the third sample (S3) was collected after post-intracanal medication after 3-4 weeks. Samples were sent for microbiological analysis to assess the bacterial count, and for the obtained data, statistical analysis was done. RESULTS: The mean colony count among the triple antibiotic paste group was 1906.75. After access opening, which was reduced to 315.12 after irrigation, and after 3-4 weeks, it was 817.25. There was a significant difference between sample 1, sample 2, and sample 3 (p value = 0.008). The mean colony count among the propolis group was 1427.87 after access opening, which was reduced to 436.00 after irrigation, and after 3-4 weeks, it has reduced to 252.37. There was a significant difference between sample 1, sample 2, and sample 3 (p value = 0.032). Intergroup comparison between the groups showed no statistical difference between the samples. CONCLUSION: Propolis exhibited similar antimicrobial efficacy, which is comparable to triple antibiotic paste. So, propolis can be utilized as an intracanal medicament in young permanent teeth with an open apex. CLINICAL SIGNIFICANCE: Propolis is a naturally occurring flavonoid-rich resinous product with antibacterial, antifungal, antiviral, immunomodulatory, and antioxidant effects. It is safe without any drug allergies and bacterial sensitivity and is a promising alternative to triple antibiotic paste for disinfecting non-vital young permanent teeth. HOW TO CITE THIS ARTICLE: Lillygrace E, Kethineni B, Puppala R, et al. Antimicrobial Efficacy of Triple Antibiotic Paste and Propolis as an Intracanal Medicament in Young Permanent Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(2):243-248.

Efficacy of Mineral Trioxide Aggregate and Biodentine as Apical Barriers in Immature Permanent Teeth: A Microbiological Study.

AIM: To compare the bacterial leakage of mineral trioxide aggregate (MTA) and biodentine when used as an apical plug in immature permanent teeth. MATERIALS AND METHODS: It was a randomized double-blind in vitro study. A total of 60 teeth were divided into 2 groups of MTA and biodentine, which were further divided into 2 subgroups (n = 30) each based on the apical plug thickness of 2 and 4 mm. The teeth were cleaned and shaped; root-end resection and canal preparation were done. Mineral trioxide aggregate and biodentine were mixed and filled as apical plugs of 2 or 4 mm thickness. Enterococcus faecalis was used to assess the bacterial leakage of the filled samples. STATISTICAL ANALYSIS: The comparison between the two groups was done by Chi-square test for categorical data. All p values <0.05 were considered as statistically significant. RESULTS: A 4 mm apical plug of biodentine showed the least amount of bacterial leakage followed by 2 mm MTA and 4 mm MTA. A 2 mm apical plug of biodentine showed the maximum bacterial leakage. But this was not statistically significant over a period of 3 months. There was a statistically significant difference (p value = 0.042) among the total number of samples that leaked in the 2 and 4 mm biodentine group. CONCLUSION: Mineral trioxide aggregate and biodentine had a similar apical sealing ability. The apical sealing ability of biodentine at 4 mm thickness was greater than 2 mm thickness. CLINICAL SIGNIFICANCE: The apical leakage of the materials used in apexification is one of the main causes of endodontic failures in immature necrotic teeth. Materials like MTA and biodentine have overcome various drawbacks of calcium hydroxide as apexification material. The thickness of the apical plug plays an important role in preventing any microorganism from entering the periapical area, hence maintaining an adequate seal. HOW TO CITE THIS ARTICLE: Abbas A, Kethineni B, Puppala R, et al. Efficacy of MTA and Biodentine as Apical Barriers in Immature Permanent Teeth: A Microbiological Study. Int J Clin Pediatr Dent 2020;13(6):656-662.

Comparative Evaluation of Three Different Materials: Mineral Trioxide Aggregate, Triple Antibiotic Paste, and Abscess Remedy on Apical Development of Vital Young Permanent Teeth.

AIMS: The aim of the study is to compare the success rate of mineral trioxide aggregate (MTA), Triple antibiotic paste, and Abscess remedy in apical development of vital young permanent teeth. SUBJECTS AND METHODS: A total of 60 children aged 6-14 years were selected and were randomly divided into three groups, each comprising of 20 children. Group I, Group II, and Group III in which MTA (Pro root), triple antibiotic paste (3Mix MP), and Abscess remedy (Product Dentaire, Switzerland) was used pulpotomy medicament. The children were recalled 1, 6, 9, 12, 18, and 24 months for clinical and radiographic evaluation and were designed as single-blinded randomized clinical trial. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: The follow-up evaluations revealed that 56 teeth appeared to be clinically and radiographically successful at 24 months' postoperative evaluation. Four teeth treated with Abscess remedy reported pain and periapical lesion. CONCLUSIONS: Overall success rate for all the material was 93%, MTA and Triple antibiotic paste have shown 100% success rate, and Abscess remedy has shown 80% success rate.

Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study.

BACKGROUND: The medicament formocresol (FC) used for pulpotomy in primary teeth has great concerns regarding its toxicity due to one of its constituent formaldehyde which acts by tissue fixation. Therefore, new medicaments were introduced which claimed preservation and regeneration of pulp. AIM: The present study is aimed to compare and evaluate the clinical and radiographic success of FC, pulpotec, mineral trioxide aggregate (MTA), and emdogain (EMD) as pulpotomy medicaments in human primary molars. DESIGN: A sample of 21 patients with 84 teeth were selected. All the patients have at least four teeth eligible for pulpotomy according to selection criteria. In each mouth, the teeth selected were randomly allocated into four groups with 21 each. RESULTS: After 24 months of follow-up, the clinical success rates were FC (94%), pulpotec (94%), MTA (100%), and EMD (83%) and radiographically FC (88%), pulpotec (83%), MTA (94%), and EMD (72%), which were statistically not significant (p > 0.05). CONCLUSION: The outcome of this study demonstrates MTA has a high success rate compared with FC, pulpotec, and EMD as pulpotomy agent. In addition, MTA, pulpotec, and EMD can be considered as alternatives to FC as pulpotomy agent. HOW TO CITE THIS ARTICLE: Sunitha B, Puppala R, Kethineni B, Mallela MK, Peddi R, Tarasingh P. Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study. Int J Clin Pediatr Dent 2017;10(3):240-244.

Use of butane-isobutane refrigerant spray in the management of a mucocoele in a visually impaired child.

Mucocoeles are commonly observed lesions in children and young adults. Conventional management using a scalpel aims at enucleation, requiring psychological preparation of the parent as well as the child because of inherent fear and apprehension towards surgery. This is still more complex in children with visual impairment. The other management techniques are laser, cryotherapy and micromarsupialisation, management strategies that, being painless and tolerable, reduce the anxiety of the child and are therefore more acceptable. The basic technique of cryotherapy stresses on rapid cooling, gradual thawing and repeated freezing to ensure tissue destruction. We report a case of a 13-year-old boy with visual impairment, presenting with a mucocoele on the lower lip, which was managed using butane-isobutane refrigerant spray, which is otherwise routinely employed for pulp vitality testing. A single, 2 min freeze/thaw cycle was used. The healing was uneventful.

Right attitude, right decision and timely planning in surgical pedodontics -scoop out or expose it.

UNLABELLED: Radicular cysts are the most common odontogenic cystic lesions of inflammatory origin and are usually asymptomatic and are left unnoticed, until detected by routine radiography. It is managed either by surgical enucleation or marsupialization. Conventional nonsurgical endodontic treatment has a high degree of clinical success, but in certain cases surgical intervention becomes necessary. This is the case report of a patient presenting with unilateral radicular cyst. The lesion is managed by marsupialization using a novel and safe method of separating the soft tissue mass of the periapical lesion which was in proximity to vital and vulnerable anatomical tissue, emphasizing the need of application of treatment in the best interest of patients. The treatment of choice is dependent on the size and localization of the lesion, the bone integrity of the lesions wall and its proximity to vital structure. This case report of radicular cysts emphasis on the advantages and disadvantages of the leading criteria that should be taken into consideration when assessing the treatment modalities for radicular cyst. KEYWORDS: Odontogenic cysts, Radicular cyst, Marsupialization, Enucleation. How to cite this article: Kethineni B, Peddi R, Puppala R, Sunitha B, Chowdary U K, Raj D. Right Attitude, Right Decision and Timely Planning in Surgical Pedodontics -Scoop Out or Expose It. J Int Oral Health 2013; 5(2):50-54.