Volumetric Evaluation of Different Obturation Techniques in Primary Teeth Using Spiral Computed Tomography.

BACKGROUND: Various obturation techniques have been evaluated for better filling of the root canals in primary teeth using different methods. Spiral Computed Tomography (SCT) is a new revolution in the pediatric endodontics for assessment of quality of the obturation from 3 dimensions. OBJECTIVES: To evaluate the efficiency of 5 different obturation methods in delivering the filling material into the canals of primary teeth using Spiral Computed Tomography scan. STUDY DESIGN: A total of 50 canals of primary teeth were prepared, divided into 5 groups with 10 canals in each group and obturated with Zinc Oxide Eugenol cement using 5 different obturation techniques such as Local anesthetic syringe, Tuberculin syringe, Endodontic plugger, hand held Lentulo-spiral, and Lentulo-spiral mounted on slow speed hand piece. The pre and post obturation volume and finally the Percentage of Obturated Volume (POV) were calculated using SCT scan for each group. The data obtained was statistically analyzed using One-way Analysis of Variance (ANOVA) and Tukey's post-hoc test. RESULTS: Lentulo-spiral hand held showed highest POV value followed by Lentulospiral mounted to hand piece, Tuberculin syringe and Endodontic plugger; whereas Anesthetic syringe had least POV (P < 0.05). CONCLUSION: Lentulo-spiral hand held is the best obturating technique among the 5 groups evaluated as the canals of this group showed maximum percentage of filled material. However, a further study with large sample size is highly essential.

Revascularization Induced Maturogenesis of Non-Vital Immature Permanent Tooth Using Platelet-Rich-Fibrin: A Case Report.

The aim of this report is to describe a novel method of revascularization therapy done in a non-vital, immature permanent tooth using Platelet-rich fibrin (PRF),in a recently developed scaffold material to overcome limitations associated with the traditional method of revascularization using natural blood clot. PRF prepared from autologous blood was placed in the root canal and patient was followed up regularly at one, three, six, nine and 12 months for detailed clinical and radiographic evaluation. At 12 months, radiographic examination revealed root elongation, root end closure, continued thickening of the root dentinal walls, obliteration of root canal space, and normal periradicular anatomy. However, more long term prospective trials and histological studies are highly needed before to testify PRF a panacea for the regenerative endodontic therapy in children.

Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study.

OBJECTIVES: To compare CPP-ACP, Tri-calcium phosphate and Hydroxyapatite on remineralization of artificial caries like lesions on primary enamel. STUDY DESIGN: Ten extracted Primary molars coated with nail varnish, leaving a window of 2×4 mm on buccal and lingual surface were immersed in demineralizing solution for 96 hours and sectioned longitudinally to obtain 40 sections (4 sections per tooth) and were randomly divided into 4 groups (A to D) n=10; Group A: negative control, Group B: CPP-ACP, Group C: Tri-calcium phosphate, Group D: Hydroxyapatite. Sections were subjected to pH cycling for 10 days and were evaluated by polarized light microscope before and after treatment. RESULTS: Intra group comparison of demineralization and remineralization was done by paired t-test. One way ANOVA was used for multiple group comparisons followed by post HOC TUKEY'S Test for group wise comparisons. Remineralization was found more with Group D followed by Group B, C and A. CONCLUSION: Hydroxyapatite showed better remineralization when compared to CPP-ACP and Tri-calcium phosphate.

Dental Erosion and its Associated Factors In 11-16-Year Old School Children.

UNLABELLED: Dental erosion currently stands as a great challenge for the clinician, regarding the diagnosis, identification of the etiological factors, prevention and execution of an adequate treatment. AIMS: To evaluate the prevalence, severity, and associated factors on dental erosion in 11-16-years old. STUDY DESIGN: A cross sectional study was conducted among 2000 school children who were randomly selected. A questionnaire was given to the children that included personal demographic details and habit of consuming acidic foods and drinks. An index specific for dental erosion given by O Sullivan was used to assess every affected tooth. The values were subjected to chi-square test and multivariate logistic regression analysis. RESULTS: The prevalence of dental erosion was found to be 1.4%. Females (1.6%) were slightly more affected than males (1.3%). Public school children (2.1%) were found to be affected a little more than private children (0.7%). Chi square test showed significant association between type of school and erosion prevalence (p = 0.015). Most commonly affected teeth were lateral incisor (59.72%). CONCLUSION: The prevalence of dental erosion was found to be low when compared to various studies done all over the world.

Evaluation of probiotic milk on salivary mutans streptococci count: an in vivo microbiological study.

OBJECTIVE: The objective of the present study was to investigate the effect of probiotic Lactobacillus casei Shirota on the values of mutans streptococci counts in saliva. STUDY DESIGN: 31 children were included in this double blinded study. Study design included 4 periods which consisted of a run in period, two intervention periods and a washout period. During the intervention periods children were either given probiotic milk or control milk for 10 days. Pre and post intervention salivary samples were subjected to microbiological evaluation. Then numbers of mutans streptococci were taken by identifying colony morphology. RESULTS: A statistically significant reduction of mutans streptococci colony count was noted in the probiotic group (p=.003). The reduction in children with higher levels of mutans streptococci (105) after intervention was 34% in the probiotic group. CONCLUSION: Daily consumption of milk containing probiotic bacteria can reduce the levels of mutans streptococci and may contribute to the prevention of dental caries.

Comparison of relative efficacy of two techniques of enamel stain removal on fluorosed teeth. An in vivo study.

OBJECTIVE: The present study was conducted to compare and evaluate the relative efficacy of enamel microabrasion (using 18% HCl) and bleaching with McInnes solution in the esthetic improvement of fluorosed teeth and to check postoperative sensitivity. STUDY DESIGN: 30 children aged between 9-14yrs with a mild or moderate grade of fluorosis as classified according to Dean's fluorosis index and who complained of objectionable esthetics were selected. Split mouth study design was selected in our study. Each subject had one of their maxillary central incisor randomly selected for Enamel microabrasion and the contra lateral maxillary central incisor for McInnes bleaching. Esthetic improvement was assessed by comparing the pre and postoperative digital photographs. During the evaluation session, the pre and postoperative photographs of 30 subjects were incorporated into a power point presentation and were projected side by side in a darkened room. Four calibrated and blinded examiners, including a layman rated the photographs under standardized viewing conditions. Esthetic improvement was assessed for both short and long term improvement. The postoperative sensitivity was recorded for both the procedures immediately after treatment and at one, three and six months interval. RESULTS: The results proved that both immediate and long term (6 month) esthetic improvement achieved by McInnes bleaching were superior to enamel microabrasion. There is a reduction in aesthetics of teeth in both the procedures after six months, which was very minimal in McInnes procedure and significant in enamel micro abrasion. Postoperative sensitivity in both techniques were negligible. The sensitivity observed were transient and subsided within an one-month post operatively. None of the subjects reported sensitivity at one, three and six months intervals. CONCLUSION: McInnes bleaching is a better procedure compared to enamel microabrasion in improving the appearance of fluorosed teeth. Both techniques are conservative and safe.

The injury pattern and outcomes among elephant attack survivors presenting to the emergency department: A retrospective observational study.

BACKGROUND: Human-elephant conflicts (HECs) are becoming a disturbing public health concern in eastern India. This study highlights the pattern of injuries, epidemiological factors, and outcomes among the victims who survived an elephant attack (EA). METHODS: This retrospective observational study was conducted in a tertiary care hospital. Data were retrieved from the medical records of EA victims who presented to the emergency department of the hospital over five years (January 2019-January 2024). Data regarding sociodemographic characteristics, injury mode, injury pattern, radiological findings, emergency procedures, and outcome variables (admission, length of intensive care unit and hospital stay, and death) were collected. RESULTS: In total, 45 EA victims were included in this study. The mean participant age was 45.8 ± 14.57 years. Of the total participants, 35 (78 %) were men. Most EAs [n = 18 (40 %)] occurred in the forest area and during the early morning hours between 4am and 8am [n = 18 (40 %)] of the winter season [n = 37 (82 %)] and were unprovoked [38 (84 %)]. Of the total injuries, 26 (67 %) injuries were due to the direct mode of EA and 13 (33 %) were due to the indirect mode. The most common mechanism of EA was using the trunk and foot [20 (51 %)], followed by the tusk [6 (15 %)]. The median ISS in victims was 20 (13-29). The median AIS score of chest injuries was 1 (0-3). Thirteen (29 %) patients were positive on e-FAST. Of the total EA victims, 12 (26 %) were admitted to the intensive care unit (ICU) and 17 were admitted to the wards. Severe chest injury (AIS score ≥ 3) (p = 0.003), direct mode of injury, and polytrauma (ISS > 16) were identified as significant factors contributing to ICU admission. The median ICU stay of the victims was 6 (3-8) days, and the median length of hospital stay was 7 (0.5-11) days. One inpatient mortality was noted. CONCLUSION: Middle-aged men were the most common victims of EA occurring during the early morning hours. Extremity and soft tissue injuries were most common, followed by chest and abdominal injuries. Severe chest injury resulted in ICU admission and extended hospitalization.

DNA binding, antioxidant, cytotoxicity (MTT, lactate dehydrogenase, NO), and cellular uptake studies of structurally different nickel(II) thiosemicarbazone complexes: synthesis, spectroscopy, electrochemistry, and X-ray crystallography.

Three new nickel(II) thiosemicarbazone complexes have been synthesized and characterized by analytical, spectral, and single-crystal X-ray diffraction studies. In complex 1, the ligand 2-hydroxy-1-naphthaldehydethiosemicarbazone coordinated as a monobasic tridentate donor, whereas in complexes 2 and 3, the ligands salicylaldehyde-4(N)-ethylthiosemicarbazone and 2-hydroxy-1-naphthaldehyde-4(N)-ethylthiosemicarbazone coordinated as a dibasic tridentate donor. The DNA binding ability of the complexes in calf thymus DNA was explored by absorption and emission titration experiments. The antioxidant property of the new complexes was evaluated to test their free-radical scavenging ability. In vitro cytotoxicity assays were performed for the new complexes in A549 and HepG2 cell lines. The new compounds overcome cisplatin resistance in the A549 cell line and they were also active in the HepG2 cell line. The cellular uptake study showed the accumulation of the complexes in tumor cells depended on the nature of the ligand attached to the nickel ion.

Synthesis, DNA/protein binding and in vitro cytotoxic studies of new palladium metallothiosemicarbazones.

A series of four new thiosemicarbazone complexes of palladium have been synthesized, characterized and evaluated for their DNA/protein binding with CT-DNA and BSA, respectively. The new complexes bound to CT-DNA by intercalation mode and in protein binding studies, the complexes bound to BSA binding mechanism was found as static quenching. Among them the complex 4 had a strong binding affinity with BSA. In addition, in vitro cytotoxic studies were carried out on lung cancer (A549) and liver cancer (HepG2) cell lines and found that the complexes exhibited better activity than their parent thiosemicarbazone analogues. The complex 3 exhibited better activity than other complexes and this fact supported by the increased accumulation of the complexes in to the cancer cells which are evident from inter cellular uptake studies.

Allotransplantation of tooth: a case report.

Tooth transplantation has attracted great interests since ancient times. A successful case of tooth allotransplantation is presented. A mandibular first premolar from the donor was implanted into the socket of maxillary central incisor Follow up after 12 months indicated good periapical healing with no resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility. This article suggests tooth transplantation as an alternative to other restorative options.

Are free workplace health promotion apps adequately mapped with behavior change theories, techniques and desired features? A content analysis.

Free smartphone applications that aim to promote physical activity or reduce sedentary behavior at workplaces were questioned for its content such as technical features, behavior change techniques (BCT) and security concerns. To evaluate systematically whether smartphone apps are mapped adequately with BCTs and security concerns. Free apps in Google Play store were searched and coded for BCTs systematically in July 2020. Two reviewers independently coded apps that aimed to promote physical activity (n = 18) and reduce sedentary behavior (n = 16) using a taxonomy of 26 BCTs. BCTs, features and security concerns among apps promoting physical activity and reducing sedentary behavior were analyzed. While the features (social support, gamification, or rewards) help increase physical activity and decrease sedentary behavior, the apps do not typically include the above features. Further, the apps were based on an average of 13 (4-21) BCTs. The BCTs coded most frequently were "self-monitoring" (100%), "general encouragement" (97%), and "goal setting" (n = 94%). No significant relation between user rating and BCTs was found in the apps. Majority of the free apps that aimed to increase physical activity or reduce sedentary behavior at workplaces were not adequately based on BCTs and lacked essential features facilitating long term behavior compliance at workplaces. Hence, there is a need to develop newer applications mapped adequately with BCTs, involving the collaborative work of behavioral scientists, app developers and policymakers. Clinical Trial Registry of India CTRI/2020/03/024138.

Factor XIII deficiency: report of two cases.

Factor XIII deficiency is one of the rare clotting factor deficiencies. Although rare, it is an important disorder because of seriousness of its bleeding manifestations, in particular the incidence of intracranial hemorrhage is higher than any other bleeding disorder Hence an early diagnosis is extremely important where bleeding manifestations can be prevented by prophylactic factor XIII replacement given at every 4-6 week interval. Case1 presents the management of a factor deficiency associated with a very rare blood group AB+ve, while the case 2 reports the successful surgical management with a replacement therapy

A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report.

The aim of this paper is to present two methods of revascularization done in traumatized immature, nonvital anterior teeth using platelet-rich fibrin (PRF) and natural blood clot as a scaffold material. This was performed after disinfection of the root canal space using tri-antibacterial paste. In one tooth, PRF prepared from autologous blood was placed in the canal and in the other tooth, natural bleeding was induced to obtain a fresh blood clot. The patient was recalled regularly at 1, 3, 6, 9, and 12 months' interval for evaluation. After 12 months, on clinical examination, both teeth showed negative response to percussion and palpation tests but positive response to cold and electric pulp tests. On radiographic examination, the tooth treated with PRF exhibited comparatively faster root lengthening, complete closure of the root apex, more thickening of the root dentinal walls, and narrowing of root canal space compared to conventionally revascularized tooth. How to cite this article: Nagaveni NB, Poornima P, Mathew MG, et al. A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report. Int J Clin Pediatr Dent 2020;13(1):98-102.

Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach.

AIM: To evaluate the clinical and radiological results of a revascularization treatment done in a nonvital, immature permanent tooth using the amniotic membrane. CASE DESCRIPTION: A 12-year-old boy reported with a complaint of pain in the lower left back tooth since 1 month due to dental caries. On clinical examination, the mandibular left second premolar was tender on percussion and discolored due to dental caries. Radiographic examination of the same tooth revealed open apex, thin root dentinal walls, and periodontal ligament widening. An access opening was prepared, necrotic pulp extirpated completely followed by thorough irrigation. After drying the canal, closed dressing with the 3-mix antibacterial paste was given for 15 days. After 15 days, the paste was removed and the amniotic membrane was placed inside the canal extending 1 mm beyond the apex and mineral tri-oxide aggregate was placed over this followed by sealing of the cavity. The patient was followed up at 1, 3, and 6 months for clinical and radiographic evaluation. CONCLUSION: After 6 months, clinically the tooth found asymptomatic. Radiographic examination showed continued root elongation, closure in the periapical opening, thick root dentinal walls with narrowing of the canal space, and normal periradicular architecture. CLINICAL SIGNIFICANCE: Amniotic membrane can be used as a scaffold for revascularization in nonvital immature teeth. HOW TO CITE THIS ARTICLE: NB Nagaveni, P Poornima, et al. Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach. Int J Clin Pediatr Dent 2019;12(2):150-152.

Comparative evaluation of compressive strength and surface microhardness of EQUIA Forte, resin-modified glass-ionomer cement with conventional glass-ionomer cement.

PURPOSE: The study aimed to evaluate and compare the compressive strength and surface microhardness of EQUIA Forte, light cure, and conventional glass-ionomer cement (GIC). METHODOLOGY: Fifty-four pellets of G-Coat (GC) Gold Label 2, GC Gold Label light-cured universal restorative material, and EQUIA Forte GIC were prepared of dimensions (6 × 4) mm and were divided into three groups (18) each and were stored at 37°C for 1 h and then immersed in 20 ml of deionized water, artificial saliva, and lactic acid six each, respectively, over 30 days. Samples were subjected to surface microhardness and compressive strength test on the 1st day, 7th day, and 30th day. Results were subjected to ANOVA and Bonferroni post hoc test. RESULTS: Comparing the compressive strength of EQUIA Forte from day 1 to 30 when placed in artificial saliva, there was a significant increase on day 30 (P = 0.007); compared to other groups. The surface microhardness of EQUIA Forte from day 1 to 30 when placed in artificial saliva nonsignificantly decreased comparing to other groups. CONCLUSION: Surface microhardness and compressive strength of EQUIA Forte were significantly high in comparison to the other groups.

Comparison of digital radiography, decalcification, and histologic sectioning in the detection of accessory canals in furcation areas of human primary molars.

Although the terms lateral secondary and accessory canals are often used interchangeably they mean different things. The accessory canal is derived from the secondary canal branching off to the periodontal ligament in apical sections. Different methodology was used to study the accessory canals. Decalcification method appeared to the important in studying the accessory canals as compared to digital radiography and histological sectioning.

Oxidative stress evoked damages on rat sperm and attenuated antioxidant status on consumption of aspartame.

Although several studies on toxic effect of aspartame metabolite have been studied, controversial reports over the use of aspartame owing to the fact that it releases methanol as one of its metabolite during metabolism exist. This present study is proposed to investigate whether aspartame (40 mg kg-1 b.wt) administration for 90 days could induce oxidative stress and alter antioxidant status of epididymal sperm in Wistar strain male albino rats. To mimic the human methanol metabolism, methotrexate (MTX)-treated rats were included to study the effects of aspartame. Oral intubations of FDA approved 40 mg kg-1 b.wt aspartame were given daily for 90 days to Wistar strain male albino rats and studied along with controls and MTX-treated controls. Sperm count, viability, morphology, morphometry and motility were assessed. A significant decrease in sperm function of aspartame treated animals was observed when compared with the control and MTX control. The free radical generation were observed in epididymal sperm by assessing the scavenging enzymes, enzymatic and non-enzymatic antioxidants. Result suggest that there was a significant increase glutathione-s-transferase (GST), with a significant decrease in reduced glutathione (GSH), superoxide dismutase activity (SOD), glutathione peroxidase levels (GPx), catalase activity (CAT) and glutathione reductase concentration. The increase in free radicals generation could have ultimately caused the lipid peroxidation mediated damages on the testis. Aspartame treated animals also revealed the reduced space in seminiferous tubules, which resulted in reduced Leydig cells when compared with control in histopathology. These findings demonstrate that aspartame metabolites could be a contributing factor for development of oxidative stress in the epididymal sperm.

Volumetric evaluation of various obturation techniques in primary teeth using cone beam computed tomography - An in vitro study.

AIM: The aim of this study was to compare and evaluate the efficiency of five different obturation methods in delivering the filling material into the canals of primary teeth using cone beam computerized tomography (CBCT) scan. METHOD: A total of fifty prepared canals of primary teeth which further divided into five groups with ten canals in each group were obturated with zinc oxide-eugenol cement using five different obturation methods such as endodontic plugger, lentulo spiral (handheld), lentulo spiral mounted on slow speed handpiece, local anesthetic syringe, and tuberculin syringe. Using CBCT scan, the pre- and post-obturation volume and the percentage of obturated volume (POV) were calculated for each group. The results obtained were statistically analyzed using one-way analysis of variance and Tukey's post hoc test. RESULTS: Following CBCT scan, the method obturated with lentulo spiral mounted to handpiece showed the highest POV value followed by the method of lentulo spiral mounted to handpiece, hand plugger, and tuberculin syringe. Local anesthetic syringe gave the least POV (P < 0.05). CONCLUSION: Lentulo spiral mounted to handpiece showed the best technique of obturation using CBCT evaluation among the five groups evaluated in primary teeth. However, more studies are highly essential to prove it a boon for estimating obturation quality in primary teeth.

Inhibition of Residual Cariogenic Bacteria in Atraumatic Restorative Treatment by Chlorhexidine: Disinfection or Incorporation.

PURPOSE: The purpose of this study was to compare the efficacy of chlorhexidine (CHX) cavity disinfection and of CHX containing glass ionomer cement (GIC) in inhibiting residual cariogenic bacteria. METHODS: Ninety, five- to nine-year-olds were randomly allocated to three groups: Group 1-CHX containing GIC; Group 2-CHX cavity disinfection; and Group 3-conventional GIC. Total viable count (TVC), Streptococcus mutans (SM), and Lactobacillus (LB) were analyzed pre-, post-, and three months after atraumatic restorative treatment (ART). The results were statistically analyzed by one-way analysis of variance. RESULTS: At three months microbial evaluation, Group 1 showed 65 percent reduction of both TVC and LB and 67 percent of SM. Group two showed 64 percent, 58 percent, and 56 percent reduction of TVC, LB, and SM respectively. Group 3 exhibited 41 percent, 42 percent, and 46 percent reduction in mean TVC, LB, and SM counts respectively. Residual microbial counts for Group 3 were 0.41, 0.61, and 0.53 (105 colony forming units) for TVC, LB, and SM, respectively, which was significantly higher (P<0.01) compared to the respective microbial counts in Groups 1 and 2. CONCLUSION: Both chlorhexidine disinfection and incorporation showed superior efficacy in inhibiting residual microbes compared to conventional ART.

Malocclusion and dental caries experience among 8-9-year-old children in a city of South Indian region: A cross-sectional survey.

BACKGROUND: Although numerous studies have documented malocclusion in various age groups in India, the literature on the prevalence of malocclusion in mixed dentition is scanty. Dental caries is another most common condition affecting the general health. However, its association with malocclusion in mixed dentition is not well known. AIM: The purpose of this study was to establish the prevalence of malocclusion and its association with caries experience in 8-9-year-old children of Davangere city, South Indian region. SETTING AND DESIGN: The study design was a cross-sectional survey. MATERIALS AND METHODS: A total of 800 children from 350 schools (both males and females) were randomly selected for the study. t-test and Chi-square test were used for statistical analysis. RESULTS: The overall prevalence of malocclusion among 8-9-year-old children was 40.9%. The most prevalent malocclusion was crowding (11.5%), followed by excessive overjet (9.4%), deep bite (6.8%), spacing (6.5%), crossbite (4.5%), and open bite (3.2%). Class I molar relationship prevailed in 95.5% of children. CONCLUSION: The prevalence of malocclusion in our study was in accordance with the other studies reported in India, which ranged from 19.6% to 90%. Furthermore, correlation of malocclusion and dental caries in the primary dentition, although nonsignificant, presented children with malocclusion to have a higher caries experience than children without malocclusion.