Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial.

AIM: To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. MATERIALS AND METHODS: A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. RESULTS: Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. CONCLUSION: The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.

Comparative Evaluation of Shear Bond Strength and Microleakage of Two Self-adhering Composite Resins: An in vitro Study.

INTRODUCTION: A good dental cement used as repair material should possess chemical binding, easy handling characteristics, minimal marginal breakdown and minimal polymerization shrinkage, high resistance to wear, high cohesive strength, and good color stability. This study was undertaken to compare the in vitro microleakage and shear bond strength among the newly introduced Prime fill flow and Dyad flow. AIM: The aim of this study was to determine the effect on shear bond strength and microleakage of two self-adhesive composite resin. MATERIALS AND METHODS: Selected specimens were collected and stored in deionized water with an antibactericidal agent, 0.2% sodium azide, until ready to be used and were randomly divided into two groups: group I: Dyad flow and group II: Prime fill flow; specimens were sheared with a universal testing machine, and the results were calculated in megapascal, specimens were sectioned in a mesiodistal direction at four different locations, and analyzed for leakage (dye penetration) using a stereomicroscope. RESULTS: The results of the present study showed that acceptable values for Prime fill flow seemed to have least microleakage and high bond strength as compared with Dyad flow. CONCLUSION: Here, it can be concluded that there was significant difference in the in vitro microleakage and shear bond strength among the Prime fill flow and Dyad flow. CLINICAL SIGNIFICANCE: Self-etch adhesives when compared with total-etch systems have the advantage of reducing the application time and the number of steps in pediatric dentistry. Patients' age and cooperation are not always ideal; the treatment outcome is greatly influenced by the patients' behavior. It is therefore imperative to recede the application time of some materials mostly in pediatric dentistry.

Relationship between oral health status and hematological values in pediatric leukemic patients: an evaluative survey.

INTRODUCTION: Leukemia is a malignancy of the bone marrow and constitutes 30% of all childhood cancers. The leukemic condition itself and its therapy cause oral signs and symptoms with significant morbidity. AIMS AND OBJECTIVES: The aim of this study was to review the oral health status in children with leukemia and relate the gingival and periodontal findings to the changes in their hematological values. MATERIALS AND METHOD: The oral health status in 47 pediatric leukemic patients in the age group of 6 to 14 years was assessed using the dmft/DMFT index, OHI(S) index and modified gingival index (MGI). Their hematological reports on the day of examination were obtained. The patients were divided into three groups based on the status of treatment. The relation between the platelet count and the WBC count with the MGI score was checked. RESULTS: The highest dmf and DMF scores were seen in patients who were currently under treatment. Though an inverse relation was seen between the platelet count and the MGI score, a statistically significant value was not obtained. CONCLUSION: A longitudinal follow-up of patients should be carried out in order to establish a relation between the hematological parameters and the gingival inflammation score

Utilization of different management concepts in fractured tooth fragment reattachment: a report of three cases.

Traumatic injuries of teeth involve varying degrees of damage to the supporting soft tissues or the teeth itself. A very common injury to the permanent dentition affecting children and adolescents during their growing years is the anterior crown fracture. Recent developments in restorative material, placement techniques, preparation designs, and an adhesive protocol allow clinicians to predictably restore fractured teeth. With the advent of adhesive dentistry the process of fragment reattachment has become simplifed and more reliable. This procedure provides an improved function, is relatively faster to perform and at the same time provides long lasting esthetics. This paper discusses various innovative techniques of fracture reattachment depending on the complexity of the case.

Abnormal odontogenesis following management of childhood cancer (retinoblastoma): review and a new variant.

A young child being diagnosed with cancer naturally generates a pretty melancholy reaction. Each cancer can be managed with a vast array of treatment options that are available either individually or as a combination, the final goal of which is total eradication of the condition in the affected individual. Since, most of these treatments are administered during the age of tooth formation, they may affect stages of odontogenesis. Most common treatment of childhood cancers includes--chemotherapy and radiotherapy. With recent advancements in cancer therapy additional treatment options like laser therapy, radiation in the form of brachytherapy or teletherapy, cryotherapy, thermochemotherapy, etc. are available. As treatment of childhood cancers starts at a very young age coinciding with dental development, a number of dental malformations have been reported in childhood cancer survivors. The most common ocular cancer in children is retinoblastoma. This is the first such reported case and unique one where microdontia has affected all the first premolars.

Comparison of reproducibility of natural head position using two methods.

UNLABELLED: Lateral cephalometric radiographs have become virtually indispensable to orthodontists in the treatment of patients. They are important in orthodontic growth analysis, diagnosis, treatment planning, monitoring of therapy and evaluation of final treatment outcome. AIM: The purpose of this study was to evaluate and compare the maximum reproducibility with minimum variation of natural head position using two methods, i.e. the mirror method and the fluid level device method. MATERIALS AND METHODS: The study included two sets of 40 lateral cephalograms taken using two methods of obtaining natural head position: (1) The mirror method and (2) fluid level device method, with a time interval of 2 months. Inclusion criteria • Subjects were randomly selected aged between 18 to 26 years Exclusion criteria • History of orthodontic treatment • Any history of respiratory tract problem or chronic mouth breathing • Any congenital deformity • History of traumatically-induced deformity • History of myofacial pain syndrome • Any previous history of head and neck surgery. RESULTS: The result showed that both the methods for obtaining natural head position-the mirror method and fluid level device method were comparable, but maximum reproducibility was more with the fluid level device as shown by the Dahlberg's coefficient and Bland-Altman plot. The minimum variance was seen with the fluid level device method as shown by Precision and Pearson correlation. CONCLUSION: The mirror method and the fluid level device method used for obtaining natural head position were comparable without any significance, and the fluid level device method was more reproducible and showed less variance when compared to mirror method for obtaining natural head position. CLINICAL SIGNIFICANCE: Fluid level device method was more reproducible and shows less variance when compared to mirror method for obtaining natural head position.

In vivo evaluation of lesion sterilization and tissue repair in primary teeth pulp therapy using two antibiotic drug combinations.

AIM: The purpose of this study is to evaluate and compare the clinical and radiographic effectiveness of Ciprofloxacin, Minocycline, Metronidazole combination with Ciprofloxacin, Minocycline and Tinidazole combination when used for Lesion Sterilization and Tissue Repair in primary teeth. METHOD: 25 healthy children, visiting Dept. of Pediatric & Preventive Dentistry, D.A.P.M.R.V. Dental College, Bangalore, India, aged between 6-9 years who were having 30 infected primary teeth are selected and divided into 2 groups. In Group A, a mixture of 3mix-MP Ciprofloxacin, Metronidazole and Minocycline was placed on the floor of the pulp chamber covering the root canal orifices. In Group B a mixture of Ciprofloxacin, Tinidazole and Minocycline was placed as a layer on the floor of the pulp chamber. The procedure was completed in a single visit. Post operative clinical evaluation was done after 1,6,12 and 24 months. Postoperative radiographic evaluation was done at 6, 12 and 24 months. RESULTS: No statistically significant difference is observed between both the groups and a combination of Ciprofloxacin, Minocycline and Tinidazole antibacterial drugs can be used on teeth pulpally involved with physiologic root resorption. CONCLUSION: After a 24 Month follow up, we can conclude that primary teeth with the periradicular lesions, can be conserved by using combination of Ciprofloxacin, Minocycline and Tinidazole antibacterial drugs.

Comparative evaluation of application of different fluoride varnishes on artificial early enamel lesion: An in vitro study.

INTRODUCTION: In an attempt to manage noncavitated carious lesions noninvasively through remineralization, a range of novel fluoride varnishes with additional remineralizing agents have been made available for clinical application. AIM AND OBJECTIVES: The aim of this study was to compare and evaluate the remineralization potential of three commercially available varnishes on artificial enamel lesions. MATERIALS AND METHODS: This in vitro study involves eighty intact enamel specimens prepared from premolars extracted for orthodontic purposes. After specimen preparation, the eighty samples were divided randomly into two groups (n = 40) for measurement of baseline surface Vickers microhardness and baseline calcium/phosphorus ratio (% weight) through EDAX testing. Thereafter, the specimens were subjected to demineralization for 96 h to induce initial enamel lesions and the measurements were repeated. Following demineralization, each of the two groups was divided randomly into four subgroups (n = 10) from which one was used as the control group and the others three were allotted to each of the three test varnishes. After varnish application, all the specimens were subjected to a pH cycling regimen that included alternative demineralization (3 h) and remineralization (21 h) daily, for 5 consecutive days. The Vickers microhardness and EDAX measurements were then repeated. RESULTS: One-way ANOVA and post hoc Tukey's tests were conducted for multiple group comparison. All the three commercially available varnishes were capable of remineralizing initial enamel lesions that were induced artificially. No difference was noted in the remineralizing efficacy of the varnishes despite their different compositions. MI Varnish™ (casein phosphopeptide-amorphous calcium phosphate fluoride varnish) showed slightly better recovery in surface microhardness as compared to the other two varnishes. CONCLUSION: All the varnishes used in this in vitro study are capable of reversing early enamel lesions.

Pro-Activeness of Parents in Accepting Behavior Management Techniques: A Cross-Sectional Evaluative Study.

INTRODUCTION: The contemporary parents are more active and participate in the decision making during dental treatment. AIM: To assess the parents' acceptance towards behavior management techniques commonly used in the pediatric dentistry in different dental situation. MATERIALS AND METHODS: Fifty-one parents participated in the study. Children's dental fear was assessed by the parents before attending power point presentation using Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents viewed power point presentation of eight behavior management techniques being used during pediatric dental treatment. The techniques were: 1) Voice control; 2) Tell-Show-Do; 3) Positive reinforcement; 4) Parental presence or absence; 5) HOME; 6) Physical restraint; 7) N2O-O2 sedation; 8) General anesthesia. Parents were asked to arrange various behavior management techniques from most accepted technique to least accepted technique in various dental situations according to their view. RESULTS: All the parents completed the questionnaire. Most children show increased anxiety related to dental component of CFSS-DS scale particularly during the administration of local anesthetic. In present study most preferred behavior management technique was Tell-Show-Do followed by positive reinforcement and least preferred behavior management technique was general anesthesia followed by physical restraint. CONCLUSION: Children's anxiety level increases during the condition related to dentistry which can be overcome by developing positive approach in children and parents towards dentistry and by utilizing various behaviour management strategies. A generalized low parental tolerance level for firm management techniques was seen in the present study population.

Evaluation of antimicrobial effect of azadirachtin plant extract (Soluneem (™)) on commonly found root canal pathogenic microorganisms (viz. Enterococcus faecalis) in primary teeth: A microbiological study.

AIM: The aim of this study is to evaluate the antimicrobial activity of Soluneem ™ when used as an irrigating solution along with other commonly used irrigating solution sodium hypochlorite (NaOCl) against Enterococcus faecalis. MATERIALS AND METHODS: Microorganism used in this study was E. faecalis (Microbial Type Culture Collection 439). Test substance used was Soluneem ™, which was obtained from Vittal Mallya Scientific Research Foundation (VMSRF), Bengaluru. This study was conducted in a microbiology laboratory (Biocare Research India Pvt., Ltd. Laboratory, Ahmedabad, Gujarat) to evaluate the antimicrobial effect of Soluneem ™ (Azadirachtin) on E. faecalis. Antimicrobial activity testing was performed using the macrobroth dilution method according to the Clinical Laboratory Standards Institute guidelines. All determinations were performed thrice. RESULTS: Minimum bactericidal concentration (MBC) was seen as 2.6% for Soluneem ™ while the same was seen at 0.1% for NaOCl. Independent sample t-test was carried out to compare the MBC of Soluneem ™ and NaOCl, which showed that there was no statistically significant difference between them, i.e., 2.6% Soluneem ™ was as effective as 0.1% NaOCl. CONCLUSION: Soluneem ™ showed antimicrobial activity against E. faecalis at various concentrations. It was also found that the efficacy of Soluneem ™ at 2.6% concentration and above was relatively similar to that of gold standard irrigating solution (NaOCl) on inhibition of E. faecalis.

An Evaluation of the Effect of Therapeutic Ultrasound on Healing of Mandibular Fracture.

The mandible is the most frequently fractured bone in maxillofacial trauma, the treatment of which consists of reduction and fixation of dislocated fragments by open or closed approach. Innovative techniques toward reducing the period of the postoperative intermaxillary fixation (IMF) are being researched. A relatively unknown treatment that may have an effect on fracture healing is ultrasound. Recent clinical trials have shown that low-intensity pulsed ultrasound (LIPUS) has a positive effect on bone healing. The aim of this study was to evaluate the effect of LIPUS on healing by its application in fresh, minimally displaced or undisplaced mandibular fracture in young and healthy individuals. A total of 28 healthy patients were selected randomly from the outpatient department needing treatment of mandibular fractures. They were then randomly allocated to either of the following two groups-experimental group and study group. After IMF, patients in experimental group received pulsed ultrasound signals with frequency of 1 MHz, with temporal and spatial intensity of 1.5 W/cm(2), pulsed wave for 5 minutes on every alternate day for 24 days, whereas patients in control group received no therapy except IMF. Radiographic density at the fracture zone was assessed from the radiograph by Emago (Emago, Amsterdam, Netherlands) Image Analysis software before IMF then at 1st to 5th weeks post-IMF. The amount of clinical mobility between fracture fragments was assessed by digital manipulation of fractured fragment with the help of periodontal pocket depth measuring probe in millimeters at pre-IMF and after 3 weeks. Pain was objectively measured using a visual analogue scale at weekly interval. The data collected were subjected to unpaired "t" test. The experimental group showed significant improvement in radiographic density compared with control group at 3- and 5-week interval; pain perception was significantly reduced in experimental group compared with study group in the subsequent weeks. No significant difference was found in clinical mobility between fracture fragments at 3-week interval. The present study provides a basis for application of therapeutic controlled ultrasound as an effective treatment modality to accelerate healing of fresh, minimally displaced mandibular fracture.

Erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration: An in vitro study.

AIM: This study evaluates erosive potential of commonly used beverages, medicated syrup, and their effects on dental enamel with and without restoration in vitro. MATERIALS AND METHODS: Test medias used in this study included carbonated beverage, noncarbonated beverage, high-energy sports drink medicated cough syrup, distilled water as the control. A total of 110 previously extracted human premolar teeth were selected for the study. Teeth were randomly divided into two groups. Test specimens were randomly distributed to five beverages groups and comprised 12 specimens per group. Surface roughness (profilometer) readings were performed at baseline and again, following immersion for 14 days (24 h/day). Microleakage was evaluated. The results obtained were analyzed for statistical significance using SPSS-PC package using the multiple factor ANOVA at a significance level of P < 0.05. Paired t-test, Friedman test ranks, and Wilcoxon signed ranks test. RESULTS: For surface roughness high-energy sports drink and noncarbonated beverage showed the highly significant difference with P values of 0.000 and 0.000, respectively compared to other test media. For microleakage high-energy sports drink had significant difference in comparison to noncarbonated beverage (P = 0.002), medicated syrup (P = 0.000), and distilled water (P = 0.000). CONCLUSION: High-energy sports drink showed highest surface roughness value and microleakage score among all test media and thus greater erosive potential to enamel while medicated syrup showed least surface roughness value and microleakage among all test media.

Clinical and oral implications of dengue Fever: a review.

Dengue is a viral infection with fatal potential complications. It is also called as break-bone fever. Worldwide dengue infection is the most common mosquito-borne viral disease. It is caused by vector Aedesa egypti and represents a major public health issue in more than 100 tropical countries. The word dengue is obtained from Swahili phrase Ka-dinga pepo meaning "cramplikeseizure." Dengue viral infections are characterized by abrupt febrile illness, but can also lead to significant morbidity and mortality. Hence, it requires an early and correct diagnosis. Gingival bleeding is the most common oral manifestation of dengue infection. Although oral lesions are uncommon in dengue infections and if manifested, may be mistaken for bleeding disorders. This review emphasizes the significance of oral lesions as it may be the early indicators of dengue hemorrhagic fever.

Evaluation of Health on the Net seal label and DISCERN as content quality indicators for patients seeking information about thumb sucking habit.

AIMS: The aim of this study was to evaluate the reliability of websites on the thumb sucking habit using DISCERN instrument and Health on the Net (HON) seal code at a single moment in time. SUBJECTS AND METHODS: An Internet search engine (www.google.com) was used to identify websites comprising information on "thumb sucking habit." Of over 204,000 links for thumb sucking habit, the first 100 were analyzed in detail. After excluding discussion groups, news and video feeds, and removing carbon copy sites, only 36 relevant websites remained, which were then assessed using the DISCERN instrument and HON seal code. Using the 16 questions of DISCERN for assessing the reliability and quality of the consumer information which were scored from 1 to 5, an appropriate index of the quality of the information was generated. All the assessed websites were also checked for presence or absence of HON seal code. RESULTS: The maximum score attainable for an outstanding website is 80. Of the 36 websites that were scored the highest score obtained by one of the websites according to the DISCERN tool was 55 of 80, and the lowest score achieved was 16 of 80. The websites achieving the maximum and minimum score were children.webmd.com and thebehaviorsolution.com, respectively. The HON seal was displayed only in three websites, which were medicinenet.com, righthealth.com, and children.webmd.com. CONCLUSIONS: By directing patients to validated websites on the thumb sucking habit, clinicians can ensure patients find appropriate information.

Polycarbonate crowns for primary teeth revisited: restorative options, technique and case reports.

Esthetics by definition is the science of beauty - that particular detail of an animate or inanimate object that makes it appealing to the eye. In the modern, civilized, and cosmetically conscious world, well-contoured and well-aligned white teeth set the standard for beauty. Such teeth are not only considered attractive but are also indicative of nutritional health, self esteem, hygienic pride, and economic status. Numerous treatment approaches have been proposed to address the esthetics and retention of restorations in primary teeth. Even though researchers have claimed that certain restorations are better than the others, particularly owing to the issues mentioned above, the search for the ideal esthetic restoration for the primary teeth continues. This paper revisits and attempts to reintroduce the full coverage restoration, namely, polycarbonate crown, for use in primary anterior teeth.

Transposition of mandibular lateral incisor-canine (mn.i2.C) associated with hypodontia: a review and rare clinical case.

Transposition is a unique and extreme form of ectopic eruption in which a permanent tooth develops and erupts in the position which is normally occupied by other permanent teeth. Tooth transpositions are rare and they can be complete or incomplete. The aetiology of transposition is still obscure. Various populations have been studied, to determine the prevalence of tooth transpositions. 20% of the transpositions which occur on the maxillary arch involve the canine and the lateral incisor. Although they are rare, transpositions may involve the maxillary lateral and central incisors. Among all transpositions, Mandibular Lateral Incisor-Canine (Mn.I2.C) is the rarest, with a prevalence rate of 0.03%. Although various reports have been published on tooth transpositions, very few have noted the agenesis of teeth, particularly Mn.I2.C and its management. We are reporting a rare clinical case with associated hypodontia.

Comparing gray and white mineral trioxide aggregate as a repair material for furcation perforation: an in vitro dye extraction study.

INTRODUCTION: Furcation perforation can have a negative impact on the prognosis of the affected tooth by compromising the attached apparatus. Hence these perforations require immediate repair. A variety of materials have been suggested for repair, of that MTA is the most promising material. The purpose of this study was to compare the ability of Gray and White MTA to seal furcation perforations using a dye extraction method under spectrophotometer. MATERIALS AND METHODS: A total of 60 permanent mandibular molars were randomly divided into four experimental groups of 15 samples each as follows: Group A: Perforation repaired with White MTA. Group B: Perforation repaired with Gray MTA. Group C: Perforation left unsealed (positive). Group D: without perforation (negative). Dye extraction was performed using full concentration nitric acid. Dye absorbance was measured at 550 nm using spectrophotometer. The data analyzed using one-way-Anova Ratio and Unpaired t-test showing statistically significance difference among the groups. RESULT: It was seen that Group D samples without perforation showed least absorbance followed by Group A (perforation repaired with White MTA) and Group B (perforation repaired with Gray MTA). Group C (perforation left unsealed) showed highest absorbance. CONCLUSION: The White and Gray Mineral Trioxide Aggregate performed similarly as a furcation perforation repair material. There was no significant difference between the Gray MTA and White MTA.

Management of a dentigerous cyst associated with inverted and fused mesiodens: a rare case report.

Inverted mesiodens is a disorder of Odontogenesis relatively characterized by an excess number of teeth in the premaxillary region, in between the central incisors and in an inverted direction. The etiology of inverted mesiodens is still unknown. The complications associated with inverted mesiodens include eruption disturbance of adjacent teeth, displacement & rotation of the central incisors, diastema, root resorption, abnormal occlusion, cyst formation or nasal eruption of the mesiodens. Early detection and timely surgical intervention of inverted mesiodens is crucial to prevent unwanted consequences. Dentigerous cysts are developmental cysts of odontogenic origin, which are found to surround the crown of unerupted/erupting teeth, odontomas or even supernumerary teeth. Dentigerous cysts' involving an inverted mesiodens is a rare occurrence with only few cases reported.This article reports a rare and unusual case of a dentigerous cyst of the anterior maxilla involving an inverted and fused mesiodens. How to cite this article: Patel K, Patel N, Venkataraghavan K. Management of a Dentigerous Cyst Associated with Inverted and Fused Mesiodens: A Rare Case Report. J Int Oral Health 2013; 5(4):73-77.

Mesiodens: A clinical and radiographic study of 82 teeth in 55 children below 14 years.

INTRODUCTION: Supernumerary teeth refers to an excessive number of teeth and are relatively common in the oral cavity. The supernumerary tooth located in the midline of the maxilla between the central incisors is referred to as "mesiodens". The present study emphasizes the importance of multidisciplinary management and long-term follow-up of patients with mesiodens. AIM OF THE STUDY: This study investigates the characteristics of mesiodens among children in patients reported to department of pediatric and preventive dentistry in an institution in the state of Tamil Nadu, India. MATERIALS AND METHODS: The study population consisted of 55 children below 14 years. The characteristics of mesiodens were obtained from radiographs and clinical examination. And all these were confirmed as mesiodens by surgical intervention. RESULTS: Results showed that males were affected approximately 2 times as frequently as females. Predominant shape of the mesiodens was conical (79.7%). 27 (49.09%) of 55 patients had multiple mesiodens. 25 (45.45%) of 55 patients required orthodontic correction after surgery. CONCLUSIONS: Mesiodens can cause many complications. So routine radiographic examination of all pediatric patients is advised. And when identified, they should be extracted as early as possible in children and adolescents in order to avoid possible complications.

Chemomechanical Caries Removal: A Review & Study of an Indigen-ously Developed Agent (Carie Care (TM) Gel) In Children.

The invention and application of engine driven or rotary instruments in operative treatment of carious lesions has resulted in removal of considerable toothe structure. However, with the introduction of adhesive materials for restorations, and the advent of minimal cavity design this principle has been challenged and is now considered to be too destructive to the tooth structure during caries removal. A number of techniques are available for cutting tooth tissue. The chemo mechanical method of caries removal/treatment is considered to be less painful when compared to the traditional treatment method (use of drill). The present study was carried to study the effect of an indigenously developed caries removal agent viz. Carie Care (TM) & its effectiveness as a chemo mechanical caries removal agent. How to cite this article: Venkataraghavan K, Kush A, Lakshminarayana CS, Diwakar L, Ravikumar P, Patil S, Karthik S. Chemomechanical Caries Removal: A Review & Study of an Indigenously Developed Agent (Carie Care (TM) Gel) In Children. J Int Oral Health 2013; 5(4):84-90.