Effect of silver diamine fluoride, potassium iodide, and glutathione on micro-shear bond strength of glass ionomer cement to caries affected dentine

Background: Silver diamine fluoride (SDF, 38%) is an efficient topical fluoride used to arrest dental caries though it causes black staining of both teeth and restoration. The application of potassium iodide (KI) after SDF reduces the stain, but the color change is only temporary. An alternative method suggested is by mixing glutathione (GSH) with SDF, which preserves the silver ions of SDF within the solution. Hence, the purpose of this in vitro study was to evaluate the microshear bond strength (?SBS) of glass ionomer cement (GIC) to caries affected dentin (CAD) pretreated with SDF/KI/GSH. Materials and Methods: Thirty dentine slices of 2 mm thickness from human permanent upper premolars were demineralized using pH cycling method to mimic CAD. They were allocated to three groups of 10 each and treated with SDF, SDF-KI (SDF followed by KI), SDF + GSH (SDF mixed with GSH), respectively. Specimens were bonded with GICs. The ?SBS was assessed using a universal testing machine and the data obtained were analyzed using one-way ANOVA and Tukey's post hoc test. Results: The ?SBS (mean ± standard deviation) values for groups SDF, SDF-KI, and SDF + GSH were 4.81 ± 2.026, 5.78 ± 1.809, 8.18 ± 2.828 megapascal respectively. Group 3 showed significantly better bond strength compared to groups 1 and 2. In group 2, the addition of KI showed better bond strength when compared to group 1, but the difference was not statistically significant. Conclusion: Pretreatment of teeth with GSH along with SDF application showed significantly better bond strength of GIC to CAD compared to SDF and SDF-KI.

Idiopathic Hypoparathyroidism in a Cerebral Palsy Child Presenting with Extensive Intracranial Calcifications: A Rare Case Report

Introduction: Hypoparathyroidism is a rare endocrinedisorder characterized by low serum calcium and parathyroidhormone levels. The most common cause is iatrogenic surgicalremoval. However, idiopathic primary hypoparathyroidismis to be kept in mind especially in children as a cause ofhypoparathyroidism. Since PTH is important in calciumhomeostasis, this condition may cause ectopic calcifications,including intra cerebral calcifications, though rare.Case report: 11 year old MCH,with history of birth asphyxiaand global developmental delay was presented to emergencywith seizures. The child had seizures since the age of 5years,and wasn’t on regular treatment. The patient was admittedwith a provisional diagnosis of Cerebral Palsy with seizuredisorder with polymorphic seizures was made and treatedconservatively. Neuroimaging showed bilateral symmetriccalcification in basal ganglia,thalami and capsule. A completeworkup showed low serum calcium, high serum phosphorusand low parathormone. Calcium supplementation was givenand seizures was made under control.Conclusion: Idiopathic hypoparathroidism, though rarely, asit was in our case, may cause exuberant cerebral presentationswith extensive intracranial calcifications and extremehypocalcemia which may or may not correlate with severity ofsymptoms. Not only this is a treatable disorder that may havedangerous implications if untreated, but also its symptomsmay be completely reversed with prompt treatment.