Revascularization Revisited with Modified Triple Antibiotic Paste and NeoPutty MTA®.

Introduction and Aim: Performing endodontic treatment in an immature permanent tooth that has experienced trauma or carious exposure can pose challenges. The root canals in these teeth are typically open and fragile, making instrumentation and obturation difficult. Traditional apexification, which involves placing calcium hydroxide paste in the root canal for a specified period to induce the formation of a calcified barrier, has been a long-standing approach. While it is a widely used method, leaving the paste in the root for extended periods can weaken it due to the paste's hygroscopic properties and the proteolytic activities of calcium hydroxide. As a result, researchers have been exploring alternative treatments that allow for the full development of immature teeth. Revascularization has emerged as one such alternative, with a variety of treatment protocols documented in scientific literature. Description of the Case: This case report, for the first time, describes the use of NeoPutty MTA® and triple antibiotics paste for revascularization in a young female child on a carious, exposed lateral incisor with opex apex with success. Conclusion: The revascularization process attempted on the infected tooth met with success and closure of apex was noticed in a short period of time.

Bioactive Biosilicate Cements in Pediatric Dentistry - A Review of the Latest Materials.

Pediatric dentistry plays a critical role in ensuring the oral health and well-being of children and adolescents. The quest for effective dental materials that are safe, biocompatible, and capable of promoting natural remineralization has led to the emergence of biosilicate cements as a promising advancement in this field. Biosilicate cements are bioactive materials composed of amorphous silica, calcium oxide, phosphorus pentoxide, and other trace elements. The bioactivity of biosilicate cements allows them to interact with living tissues, promoting remineralization and stimulating the formation of hydroxyapatite, a vital component of teeth and bones. Their ability to release essential ions, such as calcium, phosphate, and fluoride, supports the natural healing processes, aiding in the preservation of pulp vitality and reducing the risk of secondary caries. Biosilicate cements offer versatility in pediatric dentistry, finding application indirect pulp capping, indirect pulp capping, and small-sized restorations. Their rapid setting time proves advantageous when treating young patients with limited cooperation. Furthermore, the continuous release of fluoride contributes to caries prevention and enhances the long-term oral health of children. While the advantages of biosilicate cements in pediatric dentistry are promising, this manuscript also discusses the limitations and challenges associated with their use. Some biosilicate cements may have different handling characteristics compared to traditional materials, necessitating adaptations in clinical techniques. In addition, long-term clinical data on the performance of these materials in pediatric patients are still limited, requiring further research to establish their efficacy and longevity. This manuscript explores the potential of biosilicate cements in pediatric dentistry.

Role of artificial intelligence in behavior management of pediatric dental patients-a mini review.

The influence of behavioral science on various organizations has been experiencing remarkable growth worldwide. With the integration of recent technological advancements, behavioral science's impact has expanded into diverse fields such as finance and policy. The term "artificial intelligence" (AI) has become increasingly prevalent, but it is essential to provide clarity before proceeding. AI pertains to the theory and creation of systems capable of executing tasks that typically necessitate human intelligence. Integrating artificial intelligence (AI) in pediatric dentistry has emerged as a promising avenue to enhance patient care, improve diagnostic accuracy, streamline treatment planning, and augment patient engagement. AI-driven tools such as image analysis, natural language processing, and machine learning algorithms assist in early caries detection, orthodontic treatment planning, behavior management, and personalized oral hygiene education for pediatric patients. This paper presents an overview of AI's applications in pediatric dentistry, particularly behavior management, highlighting its potential to revolutionize traditional pediatric dental practices.

Effect of herbal mouthrinsein dental ultrasonic scalers among Indians.

The use of herbal mouthrinse is gaining momentum in recent years. Therefore, it is of interest to evaluate the effect of 2 herbal mouthrinse (curcumin, cinnamon) in comparison with2 conventional mouthrinse (povidone iodine, chlorhexidine) when used as coolant in dental ultrasonic scalers. Hence, 200 participants were included in this study. Analysis of gingival index, periodontal index at baseline and one month follow up was completed. The inhibitory effects of both conventional and herbal mouth rinse in gingival health are similar. However, cinnamon and curcumin owing to its minimal adverse effects and low cost is useful as an alternative to chlorhexidine for reducing bacterial load in dental aerosols produced due to ultrasonic scalers.

The impact of climate change on paediatric dentistry.

The effects of global warming and climate change are happening at a faster rate than expected, and they are going to get worse. Global climate change has already started to show the effects on environment-fast melting glaciers, accelerated sea level rise and base shifting of native flora and fauna. There has been an increase in temperature globally with a few countries already showing intense heat waves and extreme cold temperatures. The interrelation between dentistry, environmental impact and human health is still in its nascent stage, but studies in medicine show that the healthcare industry contributes to greenhouse gas emissions and climate change, poor air quality, food and water insecurity, extreme weather events and vector-borne illnesses. The concept of eco-friendly dentistry has evolved in this context for providing environmentally feasible dental solutions. Paediatric dentistry is no exception. The concept of prevention has to be promoted more in paediatric dentistry to provide a positive impact on environment. The prevention of oral diseases will lead to less travel to paediatric dental clinics, less use of dental materials, lesser energy usage, minimal use of single-use plastics and less use of nitrous oxide/general anaesthesia for behaviour management. The greenhouse gases have an effect on teeth of children in relation to early childhood caries (ECC). Here, we discuss the impact of climate change on paediatric dentistry and what changes can be made to provide environment-friendly solutions.

Internet Addiction and Its Associated Factors among Undergraduate Students in Kathmandu, Nepal.

Background: Internet has penetrated all processes of life and has become an unavoidable part of people's daily life. This widespread use of the Internet has resulted in significant concerns with regard to problematic Internet behaviours and related conditions. The aim of the study was to find out the prevalence of Internet addiction and its associated factors among undergraduate students in Kathmandu. Materials and Methods: We included all together 344 undergraduate students from different colleges affiliated to Pokhara University for this cross-sectional study. We used self-administered questionnaire consisting of the Internet Addiction Test scale to assess the Internet addiction. We coded the data, entered it in Epi-Data 3.1 and transferred to IBM SPSS 25 for analysis. We applied bivariate and multivariate logistic regression analysis to identify factors associated with Internet addiction, and p value <0.05 was considered as statistically significantt. Results: The prevalence of Internet addiction was found to be 29.90% (95% CI: 25.0-34.9). In the chi-squared test relationship with parents, parental control over the Internet use, perceived feeling of loneliness, and time spent on internet per day were found to be statistically associated (p < 0.05) with Internet addiction. Conclusion: This study revealed nearly one-third of the Internet addiction among undergraduate students. Relationship with parents, parental control over the internet use, perceived loneliness feelings, and time spent on internet per day were significantly associated with Internet addiction along other factors. Therefore, it is important to raise awareness among young generation, parents, and teachers towards risk of Internet addiction.

Hypnopedia in Pediatric Dentistry: A Concept That Warrants Exploration.

Scientists throughout the world have been intrigued by the concept of hypnopedia or sleep learning. This concept was initially thought to be useful in learning new languages when heard during sleep. While having been in and out of favor with researchers over the years, recent evidence has supported the possibility that hypnopedia can actually take place. Although researchers propose that no one simply can learn new facts and figures in sleep without first being aware of them, the concept of targeted memory reactivation might help to reinforce things that an individual might learn when asleep. Evidence suggests that subtle sounds presented during sleep, such as repetitive statements and encouraging words, can strengthen memory processing. This concept may be useful in pediatric dentistry in an effort to help children, especially uncooperative ones, improve their behavior while being administered dental treatment.

Comparative Evaluation of the Antimicrobial Activity of NeoPutty MTA and Modified NeoPutty MTA: An In Vitro Study.

Aim: Mineral trioxide aggregate (MTA) is a relatively new versatile dental material. MTA has many advantages as well as disadvantages. To reduce most of the drawbacks of MTA, a premixed bioceramic MTA, NeoPutty MTA, was introduced in 2020. In this study, we assessed the antimicrobial activity of the newer MTA, NeoPutty MTA. We modified NeoPutty MTA and compared both against Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Materials and Methods: Using the agar diffusion method, NeoPutty MTA was tested for antibacterial activity against the above-mentioned microorganisms. A base layer of Petri plates was done using Muller-Hinton agar for S. aureus, E. coli, and P. aeruginosa and brain heart infusion agar for E. faecalis. A total of 32 plates were employed; the plates were divided randomly into four test groups having eight plates each, so microorganisms were tested eight times. Three cavities were made in agar and filled with freshly mixed materials after 24 h. A pour plate seeded the microorganisms. The plates were pre-incubated for 2 h at room temperature and incubated at 37°C for 24 h. An independent observer measured the inhibition zone diameters. Results: NeoPutty MTA, when tested alone, did not show much antibacterial activity against E. faecalis, S. aureus, and E. coli but had significant antimicrobial activity against P. aeruginosa when used at different concentrations. Modified NeoPutty (NeoPutty with antibiotics added individually) showed significant antibacterial activity against these microorganisms, as seen by the zone of inhibition of these bacteria. Conclusion: Modified NeoPutty with antibiotics has a better antimicrobial effect than NeoPutty MTA.

Body Image in Preschool Children Following Premature Loss of Primary Teeth: A Cross-sectional Study.

Introduction: Pediatric dentists often see a good number of children under 6 years of age and are likely to encounter a child with missing anterior teeth. Here the parents are more concerned about the facial esthetics of the child and also about the timing of permanent teeth to erupt. Aim: To know the impact on self-esteem or body image of preschool children following the premature loss of primary anterior teeth. Materials and methods: The present cross-sectional study was conducted among 780 children in the age group of 4-6 years. The COHIP-SF 19 was utilized to know the social well-being of the child following the premature loss of anterior teeth. The descriptive and inferential analysis of the data was done by using IBM SPSS software. Results: There was a statistically significant association between gender and social well-being. More number of boys were concerned about their looks (p = 0.054). However, girls were found to be significantly more (p = 0.003) shy or withdrawn as compared to boys. There was a statistically significant association between a child's age and social well-being. More number of children between the ages of 4 years (23.1%) and 6 years (25.8%) were worried or anxious due to premature loss of an anterior tooth. Significantly more no of children of age 5 years (48.6%) was uncomfortable when asked about the missing tooth as compared to 4- and 6-year-old children. No statistically significant (p > 0.05) difference in the mean social well-being scores between boys and girls. No statistically significant difference in the mean social well-being scores between children of ages 4, 5, and 6 years (p > 0.05). Conclusion: There is an association between the self-image of younger children and missing anterior teeth. How to cite this article: Acharya S, Biswas R. Body Image in Preschool Children Following Premature Loss of Primary Teeth: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(3):293-298.

The Role of Online Teaching Among the Undergraduate Dental Students During the Current COVID-19 Pandemic in India: A Pilot Study

ABSTRACT Objective: To assess the usefulness of online teaching for undergraduate students during this Corona pandemic, to point the drawbacks of online teaching, and to learn the areas of improvement in online teaching for the future. Material and Methods: A descriptive cross-sectional study on 130 students was done in Bhubaneswar, Odisha, India. The questionnaire consisted of two parts, personal details and specific information. The first part of the questionnaire consisted of questions related to age, gender, etc. The second part had questions pertaining to online teaching. Pearson's Chi-square test was applied and the level of significance was set at 5%. Results: Most of the students (83.3%) were in the view that classroom lectures are the best mean of imparting knowledge, which was significant (p<0.001). A significant number of students (88.1%) agreed that online teaching is the best method of teaching apart from classroom teaching. Almost all the students (93%) agreed significantly that online teaching is the best way to learn in this present pandemic scenario. Most students (59.6%) agreed that connectivity/network issue is a major drawback in online teaching, which is again significant (p<0.001). Conclusion: Here in these testing times, the role of online teaching becomes important for medical/dental students, both undergraduates and postgraduates, to keep up with their studies.

Knowledge and attitude of general and specialist dentist in pediatric dentistry: A pilot study in Odisha, India.

BACKGROUND: Pediatric dentists (PDs) treat children in a manner that builds a positive dental attitude in them. The treatment modalities for pulpally involved teeth in children are different by general dentists (GDs) as compared to PDs. AIM AND OBJECTIVES: The aim of this study is to determine the attitudes of PDs, GDs, and dentists of other specialties toward endodontic treatment of primary teeth. MATERIALS AND METHODS: A structured 14-item questionnaire was formulated in English and distributed to PD, GDs, and dentists of other specialties. The filled questionnaire survey was statistically analyzed using simple descriptive analysis, and inferential analysis was performed. RESULTS: Of the total survey respondents, 12 (20.68%) were PDs, 28 (48.27%) were GDs, and 18 (31.03%) were from other specialties. About 91.6% of the total respondents preferred endodontic procedures in the primary teeth. CONCLUSION: The study concluded that the GDs, PDs, and dentists of other specialties differ in their treatment recommendations for primary teeth. The GDs and dentists of other specialties were regularly performing pulp therapy in the primary teeth and should frequently update their knowledge about endodontic procedures in the primary teeth.

Parental Presence in Dental Operatory as a Behaviour Management Tool on Children in Bhubaneswar, Odisha, India

Objective: To interpret the change in child's behaviour in presence/absence of parents during dental care. Material and Methods: Sixty children were examined till the age of 12 years visiting the out patient department of pediatric dentistry where parents along with the child were allowed in the operatory. After sometime parents were asked to leave and behavioural changes were noted. During revisit again the behaviour was noted according to Frankl scale. McNemar test was applied to test the behaviour response of children with parental absence/presence. The significance level was set at 5 %. Results: In 1st visit, 78.3% showed positive behaviour and 21.7% showed negative behaviour in parental absence, indicating that the child has more likelihood of showing positive behaviour in the presence of parents (p<0.001). More positive behaviour of the children is noticed, when the parents are present in 3 -5 year age group. In other 6-8 and 9-12 year age group, no difference was noticed in the presence or absence of the parents (p>0.05). In second visit, the negative behaviour reduced. When parents were absent 21.7% showed negative behaviour (p=0.000). This indicated that the child has more likelihood of showing positive behaviour in the presence of parents. Age group-wise analysis revealed that in the 3-5 years age group presence or absence of parents is a significant factor for child's behaviour. This factor is a non-issue in the elder age group like 6-8 years and 9-12 years. When the parents are absent, no significant difference was observed (p>0.05). Conclusion: There was no significant difference in parental presence/absence in elder children while the same can't be said for younger children.

Knowledge, Attitude, and Practice of Pediatricians Regarding Pediatric Liquid Medicaments on Long-Term Oral Health: A Cross-sectional Study in Bhubaneswar, Odisha.

BACKGROUND: A pediatrician is supposed to be one of the first clinician who sees a child from infancy through adolescence. This study was carried for pediatricians serving in medical colleges and tertiary hospitals in Bhubaneswar City, Odisha, India. MATERIALS AND METHODS: A questionnaire was distributed among 30 pediatricians serving in various medical colleges and tertiary hospitals in Bhubaneswar City area. It consisted of questions regarding knowledge of pediatricians on the awareness of detrimental effects of long-term liquid medicaments use on oral cavity, including delivery of oral hygiene instructions and regular dental checkup. The data as obtained were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) software, version 17.0, for Microsoft Windows (Chicago, Illinois). RESULTS: The results showed that there is a good amount of awareness among the pediatricians working in medical colleges in Bhubaneswar regarding pediatric liquid medication and their ill effects on teeth. Most pediatricians considered age and body weight of the child (87%). Sixty five percent of pediatricians were aware that pediatric liquid medication (PLM) can cause dental caries. Ninety five percent of them were aware of PLMs with sugar substitutes are available in market. CONCLUSION: The overall awareness among the pediatricians regarding the ill effects of pediatric liquid medications on teeth is satisfactory.

Knowledge, attitudes, and practices among gynecologists regarding oral health of expectant mothers and infants in Bhubaneswar City, Odisha.

OBJECTIVE: Early intervention is aimed at preventing or mitigating common pediatric oral diseases and conditions while initiating a relationship between the mother, the child, and the dental caregiver. Every expectant mother should receive oral health education and risk assessment. There are a number of reports that showed the association between oral diseases and preterm, low birth weight, and gestational diabetes. The purpose of this study is to understand the attitude and knowledge regarding prenatal as well as infant oral health care among gynecologists in the medical colleges in Bhubaneswar, Odisha, India. MATERIALS AND METHODS: The study involved a survey involving gynecologists in medical colleges in Bhubaneswar, Odisha. A pretested questionnaire was provided to all the gynecologists (21) working in the medical colleges in Bhubaneswar regarding prenatal and perinatal oral health care. RESULTS: The study gave an idea that most gynecologists working in a medical college in Bhubaneswar, Odisha, India, had adequate knowledge regarding oral health of expectant mothers, but lack in knowledge when it comes to imparting knowledge on infants' health care. CONCLUSION: There is an adequate knowledge among the gynecologists about oral health of expectant mothers and infants, but still, there is a need of a multidisciplinary collaboration among gynecologists, pediatricians, and pediatric dentists to prevent the dental diseases rather than treating them.

Barriers in the Treatment of Early Childhood Caries amongst the General Dentists - A Cross Sectional Study in Bhubaneswar, Odisha, India

Objective: To find out the barriers in treating early childhood caries in children by general dentists. Material and Methods: A cross sectional descriptive study was undertaken among fifty general dentists in Bhubaneswar, Odisha, India, following a simple random sampling. Each selected candidate was given a barrier in childhood caries treatment (BaCCT) questionnaire. Descriptive statistics were used to calculate the absolute and relative frequencies, mean, median and standard deviation. Results: The general dentists exhibited quite a few barriers in providing treatment for early childhood caries. The children don't like to sit on dental chair (74%), they don't like the sound of drill (78%) and they are fearful of dental treatment (86%). Providing care for children can be stressful and troublesome for the dentist (80%) and that they feel time constrained, i.e they do not spend much time with children (70%). Training in the field of management of child behaviour enhances their ability to handle early childhood caries. Conclusion: The general dentists should be given proper training in handling children in their curriculum or through continuing education programmes so that they can act as a larger workforce to be able to treat early childhood caries effectively and efficiently for the benefit of society.

Parental Acceptance of Various Behaviour Management Techniques used in Pediatric Dentistry: A Pilot Study in Odisha, India

Objective: To assess the parents' acceptance towards the behavior management techniques commonly used in the pediatric dentistry. Materials and Methods: Fifty parents participated in the study. Parents were asked to view a power-point presentation on 10 behavior management techniques: 1) Voice control, 2) Tell-Show-Do, 3) Positive reinforcement, 4) Mouth prop, 5) Modelling, 6) HOME, 7) Physical restraint, 8) Oral premedication 9) N2O-O2 sedation and 10) General anesthesia. Parents were asked to arrange various behavior management techniques from most accepted technique to least accepted technique. Results: In the present study population, the preferred behavior management technique was Tell-Show-Do followed by positive reinforcement and the least preferred behavior management technique was HOME followed by voice control and physical restraint. Conclusion: The parental acceptance of various behaviour management techniques have changed. Tell-show-do technique is still the most acceptable technique; however, sedation and general anesthesia acceptance has increased as shown in this study.

Salivary IgA versus HIV and Dental Caries.

INTRODUCTION: The inter-relationship of Human Immunodeficiency Virus (HIV) infection and dental caries as well as Salivary Immunoglobulin-A (S-IgA) level appear to remain under explored while a manual and electronic search of the literature was made. Hence, the present study was undertaken to assess the relationship of S-IgA and dental caries status in HIV positive children. AIM: The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV positive and negative children and determine the dental caries status in HIV positive and HIV negative children, which may help in treatment planning and prevention of the same. MATERIALS AND METHODS: A total of 28 HIV positive children aged between 6-14 years and 28 age matched HIV negative children were included in this study and both samples were randomly selected from the same Non-Governmental Organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. Only 2cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to WHO criteria (1997) using a flat mouth mirror and CPI probe. RESULTS: In HIV +ve group mean S-IgA level was calculated as 81.61 ± 6.20 µg/ml, mean DMFT was 3.86 ± 3.37, mean deft was 4.75 ± 2.86. In HIV -ve group mean S-IgA level was calculated as 145.57 ± 17.83µg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong-ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, p < 0.001) and negative but Not Significant (N.S.) correlation (r = -0.19, t = 0.99, p > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, p < 0.001), S-IgA and deft (r = -0.942, t =14.32, p=<0.001) was found in HIV-ve group. CONCLUSION: This study suggests that the individuals who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

Salivary IgA and dental caries in HIV patients: A pilot study.

INTRODUCTION: The interrelationship of human immunodeficiency virus (HIV) infection and dental caries, as well as Salivary IgA (S-IgA) level, appear to remain underexplored while a manual and electronic search of the literature was made. Hence, this study was undertaken to assess the relationship of S-IgA and dental caries status in HIV +ve children. AIM: The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV +ve and HIV -ve children and to determine the dental caries status in HIV +ve and HIV -ve children, which may help in treatment planning and prevention of the same. MATERIALS AND METHODS: Twenty-eight HIV +ve children aged between 6 and 14 years and 28 age matched HIV -ve children were included in this study, and both samples were randomly selected from the same nongovernmental organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. 2 cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes, and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to the WHO criteria (1997) using a flat mouth mirror and Community periodontal index (CPI) probe. RESULTS: In HIV +ve group, mean salivary IgA level was calculated as 81.61 ± 6.20 µg/ml, mean decayed, missing, filled teeth (DMFT) was 3.86 ± 3.37, mean decayed, extracted and filled teeth (deft) was 4.75 ± 2.86. In HIV -ve group, the mean salivary IgA level was calculated as 145.57 ±17.83 µg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong -ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, P < 0.001) and negative, but not significant correlation (r = -0.19, t = 0.99, P > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, P < 0.001), S-IgA and deft (r = -0.942, t = 14.32, P < 0.001) was found in HIV -ve group. CONCLUSION: This study suggests that the individuals, who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

Oral and Dental Considerations in Management of Sickle Cell Anemia.

Sickle cell anemia is a genetic disease that primarily affects the black population. This anemia is due to a homozygous state of the abnormal hemoglobin S. An alteration occurs on the DNA molecule involving the substitution of the amino acid valine for glutamic acid at the sixth position on the beta polypeptide chain. This biochemical variation on the DNA molecule creates a physiological change that causes sickle-shaped red blood cells to be produced. The sickle-shaped cells are the result of the hemoglobin S being deoxygenated. This case report presents a case of 16-year-old female with sickle cell disease and its dental management. How to cite this article: Acharya S. Oral and Dental Considerations in Management of Sickle Cell Anemia. Int J Clin Pediatr Dent 2015;8(2):141-144.

Bilateral molariform mandibular second premolars.

Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots.