Effect of Passion Fruit Juice in Removal of Smear Layer in Root Canal of Ex Vivo Human Teeth: A Scanning Electron Microscopic Study.

Context: The smear layer produced during the instrumentation of the root canal contains both organic and inorganic components, and it is recommended to be removed as it has a mixture of bacteria and their byproducts. Irrigants like sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), endodontic irrigant, citric acid, etc., possess the ability to remove the smear layer. Considering the antimicrobial effect, antiinflammatory, cavity disinfectant, nontoxicity, better taste, and aroma of herbal products, a novel approach has been introduced in the field of endodontics. Aims: To assess the efficacy of passion fruit juice in removing the smear layer and its erosive potential in root canals after instrumentation by scanning electron microscopy. Materials and methods: About 35 single-rooted premolars were divided into five groups-30% passion fruit extract (PFE), 17% EDTA, 17% EDTA + 5.25% NaOCl, 30% PFE + 17% EDTA, and saline. Following irrigation with the above irrigants, each tooth was split into two halves and examined and scored for smear layer removal (modified Torabinejad's criteria) using a scanning electron microscope. Statistical analysis: Overall comparison of the irrigant's action on removing the smear layer and their erosive potential was done using the Kruskal-Wallis test, and intergroup comparison of the irrigant action was done using the Mann-Whitney U test. All the statistical analyses were set with a significance level of p < 0.05. Results: A total of 30% PFE produced less erosion and statistically significant smear layer removal in the coronal and middle third of the root. When combined with 17% EDTA, it effectively removed the smear layer in all three-thirds of the root. Around 30% PFE + 17% EDTA is less erosive when compared to 17% EDTA + 5.25% NaOCl. Conclusion: This study revealed that 30% PFE and 30% PFE + 17% EDTA are promising irrigants as root canal disinfectants in endodontics. How to cite this article: Venkatachalamoorthi V, Shivashankarappa PG, Adimoulame S, et al. Effect of Passion Fruit Juice in Removal of Smear Layer in Root Canal of Ex Vivo Human Teeth: A Scanning Electron Microscopic Study. Int J Clin Pediatr Dent 2023;16(S-2):S190-S194.

Evaluation of the Working Length Determination Accuracy by Cone-beam Computed Tomography in Primary Teeth.

Background: In primary teeth, working length determination is complicated due to its continuous alteration in dimension, shape, and root apex position. Accurate working length determination is essential to achieve the optimal cleaning and disinfection of the canal. Despite the use of conventional radiographic method, newer methods are available to increase the accuracy of WL determination. This study aims to compare electronic apex locator (EAL) with radiographic method of WL determination and to evaluate its accuracy using cone-beam computed tomography (CBCT). Materials and methods: Sixty root canals from 34 extracted primary teeth were included. Occlusal surfaces were flattened and access opening done for all the samples. Teeth were subjected to working length determination by conventional radiograph and EAL. Samples were then mounted on a U-shaped wax and subjected to CBCT. Results were recorded and statistically analyzed using ANOVA and ICC for quantitative data. Result: The mean measurement of radiographic, EAL and CBCT methods are 11.708, 11.200, and 10.895, respectively. Mean measurements demonstrated significant difference (p < 0.05) between three methods. ICC demonstrated high correlation between EAL and CBCT with Cronbach's α value of 0.962 and moderate correlation were observed between radiographic method and CBCT (0.706) and EAL and radiographic method (0.763). EAL demonstrated 87% accuracy whereas radiographic method demonstrated 63% accuracy to the actual length as evaluated by CBCT. Conclusion: EAL is more accurate than conventional radiographic method as evaluated by CBCT. How to cite this article: Shibin J, GS P, M S, et al. Evaluation of the Working Length Determination Accuracy by Cone-beam Computed Tomography in Primary Teeth. Int J Clin Pediatr Dent 2022;15(S-1):S92-S96.

Prevalence, Etiology, and Risk Factors of Traumatic Dental Injuries in Children with Special Needs of Puducherry.

Background/aim: Dental trauma draws attention in special children due to its risks and consequences. The aim of this study was to estimate the prevalence, etiology, and risk factors of traumatic dental injuries in children with special healthcare needs of Puducherry. Materials and methods: A cross-sectional survey among 121 special children aged 4-18 years was carried out in Puducherry. The children were examined for the presence of traumatic dental injuries (TDI) and associated risk factors for the occurrence of trauma and classified according to the WHO epidemiological field survey classification. Results: Prevalence of TDI was 40.5%. The majority of them were restricted to enamel fractures and the most commonly affected were permanent maxillary central incisors. The most common cause of injury was ˝falling over˝ and home was the frequent place of injury to occur. The risk factors associated with TDI were mesoprosopic facial form, convex facial profile, increased overjet, Angles Class II molar relationship, posterior facial divergence, and incompetent lips which were statistically significant. Conclusion: The study concludes the prevalence of TDI is more prevalent in CSHCN, thereby it is necessary to create awareness, health education, and periodic screening for efficient treatment. How to cite this article: Martin AG, GS Prathima, Sanguida A, et al. Prevalence, Etiology, and Risk Factors of Traumatic Dental Injuries in Children with Special Needs of Puducherry. Int J Clin Pediatr Dent 2022;15(1):104-108.

Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry.

Aim: Child abuse and neglect (CAN) is a major threat to the health and well-being of children throughout the world. Apart from healthcare professionals, teachers also play an important role in recognizing and reporting child abuse as they are in a better position to observe the behavioral changes in children as they spend substantially more time at school. The aim of this study was to evaluate the effectiveness of a video tutorial program in improving the knowledge of school teachers on CAN. Materials and results: A cross-sectional questionnaire-based study was conducted among the 79 school teachers of Puducherry. At baseline, a prevalidated questionnaire was used to assess the knowledge of the school teachers on CAN. After the intervention, the same prevalidated questionnaire was repeated. The mean knowledge score of teachers before intervention was 9.13. After video intervention knowledge score was improved to 14.46 (p < 0.05). Conclusion: The study showed that a knowledge deficit exists among teachers regarding CAN, and the video tutorial program was found to be effective in improving the knowledge of school teachers. The government, as well as the schools should take the initiative to create awareness among teachers. How to cite this article: Shivashankarappa PG, Pitchiah PA, Adimoulame S. Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry. Int J Clin Pediatr Dent 2022;15(5):575-578.

Anxiety Rating Scale for Speech and Hearing-impaired Children.

Background: It has been observed that children with special healthcare needs exhibit higher dental anxiety levels because of various barriers. In the literature, there is no anxiety assessment scale for speech and hearing-impaired children. A new concept of pictorial representation of common emotions observed during dental treatment was used to design an innovative scale, thereby helping to improve communication and in bringing out positive behavior among the children. This study aimed to assess and validate the efficacy of an anxiety rating scale for speech and hearing-impaired children. Materials and methods: A total of 36-12-year-old children with speech and hearing impairments from a special school were selected for this study. The pretreatment anxiety score among the children was assessed using the pictorial anxiety rating scale. Results: The anxiety rating scale was well accepted by speech and hearing-impaired children. It was well-supported by expert opinions and equal distribution of anxiety scores. Conclusion: The pictorial scale is a valid anxiety assessment scale for measuring dental anxiety among speech and hearing-impaired children. It can be used independently to assess dental anxiety in clinical settings and epidemiological studies as well. How to cite this article: Shivashankarappa PG, Kaur J, Adimoulame S. Anxiety Rating Scale for Speech and Hearing-impaired Children. Int J Clin Pediatr Dent 2022;15(6):704-706.

Effects of Xylitol and CPP-ACP Chewing Gum on Salivary Properties of Children with Molar Incisor Hypomineralization.

AIM: To compare the efficacy of chewing gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and xylitol on salivary characteristics in 8-10 years old children with molar incisor hypomineralization. MATERIALS AND METHODS: A randomized controlled trial using CPP-ACP chewing gums (group I) and xylitol chewing gums (group II) was conducted among 32 children affected with mild molarincisor hypomineralization (MIH). Salivary flow rate, pH and buffering capacity were measured using saliva check kit (GC America). Data obtained were tabulated and subjected to statistical analysis using SPSS software version 20. Descriptive statistics-mean, standard deviation, 95% confidence interval. Inferential statistics-independent t tests were used. RESULTS: A significant increase in mean salivary pH, flow rate and buffering action was observed from baseline to immediately after spitting the chewing gum in both the study groups (p 0.05). CONCLUSION: Casein phosphopeptide-amorphous calcium phosphate containing chewing gums improve salivary characteristics in MIH-affected children. CLINICAL SIGNIFICANCE: Xylitol and CPP-ACP chewing gums are recommended in MIH children with early demarcated opacities as it improves the salivary properties in those children and prevents further complications. HOW TO CITE THIS ARTICLE: Prathima GS, Narmatha M, Selvabalaji A, et al. Effects of Xylitol and CPP-ACP Chewing Gum on Salivary Properties of Children with Molar Incisor Hypomineralization. Int J Clin Pediatr Dent 2021;14(3):412-415.

Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial.

AIM: The aim of the study was to assess the remineralizing efficacy of fluoride and its combination varnishes on white spot lesion (WSL) in children with early childhood caries (ECC). MATERIALS AND METHODS: Sixty children with active WSL on primary maxillary anterior teeth were randomly selected. At baseline, the WSL activity was evaluated using ICDAS II [lesion activity assessment (LAA)] and its dimensions through photographic method. They were allocated to group I (GI) (5% NaF), group II (GII) [5% NaF with amorphous calcium phosphate (ACP)], and group III (GIII) [5% NaF with casein phosphopeptides - amorphous calcium phosphate (CPP -ACP)]. First, oral hygiene instructions and diet counseling were given followed by application of fluoride varnishes in their respective groups. The same parameters were recorded at follow-up of 2, 4, 12, and 24 weeks intervals. Data were collected and subjected to statistical analysis using Friedman Chi-square and Mann-Whitney tests. RESULTS: Overall, the active WSL changed to inactive over a period of 24 weeks in GI was 90%, GII was 95%, and 100% in GIII. There was a significant reduction in dimension of WSL in GI from 4.119 to 2.525 (p = 0.0001). Likewise, there was a significant reduction in dimension of WSL in GII and GIII from 4.586 to 3.258 and 4.696 to 1.2155, respectively (p = 0.0001, p = 0.0001). Comparatively, group III (MI varnish) showed statistically significant reduction in the dimension of WSL from baseline to 24 weeks (p = 0.002). But the results were statistically insignificant with change of active lesions to its inactivity (p = 0.349). CONCLUSION: Fluoride varnish with CPP-ACP was found to be an effective preventive strategy in reversing WSL in children with ECC. CLINICAL RELEVANCE: These combination varnishes could prove to be a promising preventive measure for pediatric dentists in reversing white spot lesions of ECC. CLINICAL TRIAL REGISTRY: NCT03360266. HOW TO CITE THIS ARTICLE: Radha S, Kayalvizhi G, Adimoulame S, et al. Comparative Evaluation of the Remineralizing Efficacy of Fluoride Varnish and its Combination Varnishes on White Spot Lesions in Children with ECC: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13(4):311-317.

Yoga therapy as an adjunct to traditional tooth brushing training methods in children with autism spectrum disorder.

AIM: To evaluate if yoga could be an adjunct to regular training methods in training brushing skill to children with autism spectrum disorder (ASD). METHODS: Seventy-two children with ASD aged 7-15 years were selected and divided into two groups (N = 36). Children in Group I received visual pedagogy and video modeling and children in Group II received visual pedagogy and video modeling with yoga. Plaque and gingival indices (PI and GI) were recorded at baseline and at the end of first, second, third, and sixth month. The scores were summarized as mean and standard deviation and inter-group comparison was done using independent t-test. RESULTS: Inter-group comparison of mean plaque and gingival indices scores were statistically significant at second month (P = .039 for PI and P = .009 for GI). The scores were statistically significant even at third month (P = .001 for PI and P = .002 for GI) and sixth month (P = .001 PI and GI), with children in Group II demonstrating better oral hygiene. CONCLUSION: Yoga training can be used as an adjunct to enhance tooth brushing learning capabilities of children with ASD in addition to visual modeling and pedagogy.

Dens evaginatus in proximal surface of mandibular premolar: a rare presentation.

Dens evaginatus is a developmental anomaly that is characterized by occurrence of an extra cusp-like structure projecting from the crown portion of the tooth. Unusual extension of enamel has been found in posterior teeth as enamel pearl or as cervical enamel extensions from the cementoenamel junction or at the furcation areas. We hitherto report a case of extra enamel formation from the proximal surface of the crown in a mandibular premolar, a finding that has previously not been reported.