Clinical Outcome of Direct Pulp Therapy in Primary Teeth A Systematic Review and Meta-analysis

Background: Direct pulp treatment is carried out when a healthy pulp gets mechanically/accidentally exposed during the operative procedures or trauma. Aim: To determine the effects of various direct pulp capping materials as measured by the clinical and radiographic analysis. Design: Two reviewers performed a database search of the studies published between January 2005 and November 2020. The inclusion criteria were papers published in the English language; children aged 3–12 years having deep carious lesions in primary teeth. All potential studies were acknowledged by their title and abstract. The full-text analysis of potentially relevant studies, the selected studies were included in the systematic review. A meta-analysis calculation was performed for the overall data and the subgroup data. Results: The database searching led to 57 articles, which were of direct pulp treatment in primary teeth, after the removal of duplicates, 55 records remained but did not meet all inclusion criteria. A high variability was observed among the papers. Further filtering with criteria led to nine articles, which met all inclusion criteria. Meta-analysis demonstrated the success rates of DPT in primary teeth (95% confidence interval −0.799–0.898); P < 0.001. Clinical assessments of various direct pulp capping materials suggested 84.9% of success irrespective of the material used. The nine studies were heterogeneous according to the random effect model (P < 0.001, I2 = 84.08%). Conclusions: Direct pulp treatment has the advantage of being a conservative vital pulp therapy reducing the need for a more invasive treatment.

Comparative evaluation of antimicrobial efficacy of silver diamine fluoride, chlorhexidine varnish with conventional fluoride varnish as a caries arresting agent. An in vivo sodium dodecyl sulfate-polyacrylamide gel electrophoresis study

Introduction: Silver diamine fluoride (SDF) is employed as an adjunct cariostatic agent in the management of dental caries in high-risk population. Other than fluorides, chlorhexidine (CHX) is the most potent antimicrobial and efficacious agent against Streptococcus mutans. Aim: The aim of this study is to evaluate and differentiate the efficacy of 38% silver diamine fluoride, CHX varnish, and fluoride varnish on carious primary teeth. Materials and Methods: Ninety children having a count of ?1 carious lesion were recruited. Thirty-eighty percent silver diamine fluoride or fluoride varnish and CHX varnish were topically applied on the lesion. The primary outcome measured was the arrest of carious lesion (lesion rendered inactive as per the Nyvad criteria) after a follow-up of 14–21 days. Dental biofilm sample was obtained from each child and subsequently assessed for microbial composition by colony-forming unit method before and after treatment followed by protein analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis method. Results: Average proportion of arrested caries lesions in the SDF group was higher followed by CHX and fluoride varnish groups. Decreased total protein amount was found in SDF group. This proves that there is decrease in microbial load posttreatment in SDF group. Conclusion: Thirty-eight percent SDF is more effective than CHX varnish and fluoride varnish in arresting dentin carious lesions in young children.

Intrauterine retention of fetal bones, a cause for secondary infertility

Secondary infertility due to retained products of conception in the form of fetal bones is a rare entity. It is usually associated with a history of abortion, either spontaneous or induced. The bony fragments probably act as an intrauterine contraceptive device to stimulate the secretion of endometrial prostaglandins, resulting in secondary infertility. The common symptoms include menstrual disturbances, pelvic pain, dyspareunia, vaginal discharge, spontaneous passage of fetal bones and infertility. Advanced diagnostic technique like hysteroscopy has helped in the diagnosis.

Cariogenic potential of most commonly prescribed liquid oral medicines for children.

Consumption of liquid oral medicine by frequently ill children, significantly increases the risk of tooth demineralization. In this study a survey was conducted wherein the pediatricians, pharmacist and medical representatives of Bhopal city were enquired about the most commonly prescribed liquid oral medicines for children. The four categories of medicines reported were: antipyretics/analgesics, antibiotics, antihistaminics/antitussives and multivitamins. Three samples from each category were taken. Sugar concentration was evaluated by Lane-Eynon general volumetric method and pH was measured by using digital pH meter (EU-TECH). High concentration of sugar was found in 50% of samples and 90% samples showed low pH. Sugar concentration was in a range of 20.6 to 68.2% and pH in a range of 3.8 to 8.5. As sugar in medication is a potential threat to teeth, therefore, alternatives including sugar substitute should be considered.