Isolation of Scardovia wiggsiae using real-time polymerase chain reaction from the saliva of children with early childhood caries.

AIM: This study aimed to quantitatively assess the levels of Scardovia wiggsiae in caries-free and early childhood caries (ECC)- and severe ECC (SECC)-affected children using real-time polymerase chain reaction (RT-PCR). METHODS: Forty-five children aged <71 months were randomly recruited from the Outpatient Clinic at the Department of Pedodontics and Preventive Dentistry at Subharti Dental College and Hospital, Meerut, India. Fifteen children suffering from ECC, 15 with SECC, and 15 children without ECC were enrolled in the study. About 1-2 mL of unstimulated saliva was collected and subjected to microbial analysis using RT-PCR. RESULTS: The SECC group (n = 15) was found to have significantly higher mean relative 16s rRNA expression of S. wiggsiae (3.67) than both ECC (n = 15) and controls (n = 15) (1.69 and 0.85, respectively). S. wiggsiae was detected in 86.7% of the SECC and 60% ECC group and was detected negligibly in the control (caries free) group. The correlation of decayed, missing, or filled surface levels with 16s rRNA levels showed significant positive correlation with 16S rRNA in both ECC and SECC patients. CONCLUSION: Salivary levels of S. wiggsiae were significantly associated with ECC in children. S. wiggsiae represents a new frontier in the microbial etiology of ECC. This may lead to the development of new antimicrobial agents targeted to this organism and improve the treatment of ECC.

Bilateral Maxillary Paramolars in an Adolescent.

Paramolars are relatively uncommon supernumerary molars. Limited cases of bilateral maxillary or mandibular paramolars have been reported. This case report describes bilateral maxillary premolars and their management in a 15-year-old girl, whose chief complaint was food lodgment in these regions. After a diagnosis of bilateral maxillary premolars was made and confirmed by orthopantomogram, both of the paramolars were extracted.

How efficacious are Neem, Tulsi, Guduchi extracts and chlorhexidine as intracanal disinfectants? A comparative ex vivo study.

INTRODUCTION: In endodontics, despite careful instrumentation and antimicrobial irrigation, root canals still harbor cultivable microorganisms. Such cases require intra canal medicament that eliminates the microbial inhabitants from the canals. Recent trend advocates the use of herbal extracts due to easy availability, cost-effectiveness, low toxicity, and lack of microbial resistance. Hence, in the present study, Neem, Tulsi, and Guduchi extracts were used as intracanal medicaments. AIM: This study aimed to evaluate and compare the antibacterial efficacy of Neem, Tulsi, Guduchi extracts, and chlorhexidine against Enterococcus faecalis, when used as intracanal medicaments. MATERIALS AND METHODS: One hundred and twenty-five extracted human teeth, inoculated with E. faecalis, were divided into four experimental groups and a control group (n = 25 in each group). The experimental groups were treated with chlorhexidine, Neem, Tulsi, and Guduchi extracts and their antibacterial property was evaluated by estimating microbial counting (CFU/ml). RESULTS: The reduction in bacterial count for chlorhexidine, Neem, Tulsi, and Guduchi groups was 60.76%, 51.98%, 37.73%, and 34.93%, respectively. Statistically significant difference in reduction of bacterial count was observed in all the groups, when compared with the control group. CONCLUSION: Among all the herbal extracts, Neem was found to be the most potent medicament followed by Tulsi and Guduchi. However, chlorhexidine was found to be at epic.

Non suicidal self injury resulting in dental trauma in an adolescent.

BACKGROUND/AIM: Non-suicidal self injury may be a possible etiologic factor for dental trauma in adolescents. The aim of this case report is to present a case of non-suicidal self injury resulting in dental trauma in a 16 year old adolescent boy. CASE REPORT: This report illustrates a case of non-suicidal self injury in a 16 year old healthy boy with resultant trauma to the maxillary central incisors and the left lateral incisor (teeth 11, 21, and 22). Three tests were applied; Wechsler Abbreviated Scale of Intelligence™ (WASI), Inventory of Statements about Self Injury (ISAS), and UPPS Impulsive Behavior Scale (UPPS); to assess the patient's intellectual and behavioral functioning. Dental treatment was rendered in the form of composite restorations on teeth 11, 21, and 22. RESULTS AND DISCUSSION: The patient had a general intelligence quotient (IQ) of 92 (SD = 10.9), verbal score of 86.6 (SD = 14.6), and performance IQ of 93.4 (SD = 23.66) which implied that the intelligence levels were well within the normal range. The patient demonstrated self hitting behavior and predominantly intrapersonal functions of his NSSI on testing with the ISAS scale and elevated urgency scores on the UPPS scale. The total UPPS score was 115.9 and urgency score was 35.9. NSSI was an outlet for negative emotions and to release self directed anger. This resulted in dental trauma to teeth 11, 21, and 22. CONCLUSION: NSSI may be an etiologic or risk factor for dental trauma in intellectually normal adolescents as seen in the present case. Self hitting, intrapersonal factors or self directed factors and impulsivity are more likely to predispose an adolescent toward performance of such behavior.

Alterations in the mechanical properties of the extracted human teeth to be used as biological restorations on storing them in different storage media: an in vitro study.

BACKGROUND: Total or partial loss of tooth structure occured due to caries or trauma. The decayed or fractured tooth is restored with appropriate restorative materials. A range of restorative materials are available in the market today, but each of them has one or the other drawbacks, viz. color mismatch, variable wear resistance, and strength. Therefore, there has always been a quest to use a restorative material which has properties as close to natural tooth as possible. Extracted human teeth have been tried as restorative materials with good success rate, but their storage has been a problem due to change in physical properties. AIMS AND OBJECTIVES: To evaluate the changes in the mechanical properties of the extracted human teeth to be used as biological restoration upon storing them in different storage media and to compare their effectiveness. MATERIAL AND METHODOLOGY: Five hundred and twenty extracted human teeth (samples) included in the study were equally distributed and randomly stored in different storage media (saline, artificial saliva, ORS, coconut water, and eye solution), and their mechanical properties were checked at different time intervals (7, 14, and 30 days) using universal testing machine and Vickers hardness test. RESULT AND CONCLUSION: None of the storage media used in the study significantly altered mechanical properties of the stored extracted human teeth except the hardness which was substantially reduced after storing for 30 days. Of the 4 media tested, eye solution was found to be the best, while artificial saliva was found to be least effective as storage media. It was also concluded that storage time of the extracted teeth to be used as biological restorations should not exceed more than 3-4 weeks as beyond this time, mechanical properties namely hardness get altered significantly.

Obsessive compulsive disorder in dental setting.

Globally, 20% of children and adolescents suffer from a disabling psychologic illness. Among these, Obsessive Compulsive Disorder (OCD) is listed by the World Health Organization (WHO) as one of the 10 most disabling conditions, with prevalence rates of OCD in children ranging between 1 to 3%. Pediatric dentists are in a unique position to diagnose psychological problems in children and adolescents due to their ongoing relationship with children and their parents that starts at a very early age. Timely diagnosis of psychological illness can result in early intervention as well as better patient management for the dentist too. The purpose of this case report is to highlight a case of OCD in an adolescent girl diagnosed in a dental setting.

Pediatric oral lichen planus: review and case report.

Oral Lichen Planus (OLP) is one of the most common dermatologic diseases occurring in the mouth with an overall prevalence of 0.5 - 2.2%. Childhood OLP is rare and follows an atypical course. OLP typically presents clinically as bilateral, symmetrical, flat- topped polygonal papules and plaques that may be symptomatic or asymptomatic. The aim of this article is to present a brief review of OLP with a case report of a 7 year old girl with OLP.

A Comparative Evaluation of the Effect of Bonding Agent on the Tensile Bond Strength of Two Pit and Fissure Sealants Using Invasive and Non-invasive Techniques: An in-vitro Study.

BACKGROUND: Newer technologies and the development of pit and fissure sealants have shifted the treatment philosophy from 'drill and fill' to that of 'seal and heal'. AIMS: The purpose of this in-vitro study was to evaluate the effects of bonding agents on the tensile bond strengths of two pit and fissure sealants by using invasive and non-invasive techniques. STUDY DESIGN AND METHODS: One hundred and twenty bicuspids were collected and teeth were divided into two groups: Group-I (Clinpro) and Group-II (Conseal f) with 60 teeth in each group. For evaluating tensile bond strengths, occlusal surfaces of all the teeth were flattened by reducing buccal and lingual cusps without disturbing fissures. Standardised polyvinyl tube was bonded to occlusal surfaces with respective materials. Sealants were applied, with or without bonding agents, in increments and they were light cured. Tensile bond strengths were determined by using Universal Testing Machine. STATISTICAL ANALYSIS: Data were then statistically analysed by using Student t-test for comparison. RESULTS: A statistically significant difference was found in tensile bond strength in invasive with bonding agent group than in non-invasive with bonding agent group. CONCLUSION: This study revealed that invasive techniques increase the tensile bond strengths of sealants as compared to non- invasive techniques and that the use of a bonding agent as an intermediate layer between the tooth and fissure sealant is beneficial for increasing the bond strength.

A study of root canal morphology of human primary incisors and molars using cone beam computerized tomography: an in vitro study.

BACKGROUND: Variations in morphology of root canals in primary teeth usually leads to complications during and after endodontic therapy. To improve the success in endodontics, a thorough knowledge of the root canal morphology is essential. AIM: The aim of this study was to assess the variation in number and morphology of the root canals of primary incisors and molars and to study the applicability of cone beam computerized tomography (CBCT) in assessing the same. SETTINGS AND DESIGN: A total of 60 primary molars and incisors with full root length were collected and various parameters such as the number of roots, number of canals, diameter of root canal at cementoenamel junction and middle-third, length and angulations of roots of primary molars and incisors were studied using CBCT. STATISTICAL ANALYSIS USED: The observations were put to descriptive statistics to find out the frequency, mean, standard deviation and range for all four subgroups. Further, unpaired t-test was used to compare these parameters between subgroups and analysis of variance test was implemented to evaluate the parameters within the subgroups. RESULTS AND CONCLUSION: The CBCT showed the presence of bifurcation of root canal at middle third in 13% of mandibular incisors while 20% of mandibular molars had two canals in distal root. The diameter of distobuccal root canal of maxillary molars and mesiolingual canal of mandibular molars was found to be minimum. CBCT is a relatively new and effective technology, which provides an auxiliary imaging modality to supplement conventional radiography for assessing the variation in root canal morphology of primary teeth.

Antimicrobial Efficacy of Endodontic Irrigants against Enterococcus Faecalis and Escherichia Coli: An in vitro study.

AIM: To evaluate the relative antimicrobial efficacy of five different commonly used antimicrobial agents with regard to reduction in the number of Enterococcus faecalis and Escherichia coli as compared to normal saline. An agar disk diffusion in vitro method was used to test the efficacy of the root canal irrigants against these two microorganisms. The root canal irrigants used were: 5.25% sodium hypochlorite (NaOCl), 10% citric acid, 17% ethylene diamine tetraacetic acid (EDTA), 3% hydrogen peroxide (H2O2), 0.2% cetrimide and normal saline (as control). MATERIALS AND METHODS: The sample size consisted of 120 agar plates, divided into two groups: groups I and II. Group I consisted of 60 blood agar plates for assessment of E. faecalis and group II consisted of 60 MacConkey agar plates for assessment of E. coli. On each agar plate, 6 circular cellulose nitrate paper disks were placed, on which the inoculum of the respective microorganism was poured with a micropipette. After incubation, these paper disks were removed and put in test tubes containing the particular root canal irrigants, and were vortexed for 60 seconds.The microbial count was then assessed using a microbial colony counter. RESULTS: RESULTS showed that in the group I (E. faecalis), maximum reduction was achieved with cetrimide, followed by NaOCl, H2O2, citric acid and then EDTA. In group II (E. coli), maximum reduction was achieved with NaOCl, followed by cetrimide, H2O2, citric acid and then EDTA. How to cite this article: Kaushik N, Rehani U, Agarwal A, Kaushik M, Adlakha V. Antimicrobial Efficacy of Endodontic Irrigants against Enterococcus Faecalis and Escherichia Coli: An in vitro study. Int J Clin Pediatr Dent 2013;6(2):178-182.

Surgical Repositioning of a Dilacerated Impacted Incisor.

Dilaceration is one of the most common complications of trauma to deciduous dentition. The possible causes of dilaceration are trauma and developmental disturbances, while some authors suggest an association with some developmental syndromes. Dilaceration can be seen in both the permanent and deciduous dentition. The present case report describes surgical repositioning of a dilacerated impacted maxillary central incisor in a 9-year-old boy.

Mandibular fracture in an 18-month-old child.

Facial trauma in a child can be a greatly distressing experience for the parents as well as the child, causing uncontrollable crying in the child and panic and fear in the parents. Facial injuries in children are less common than in adults. This case report describes the management of symphysial fracture of the mandible in an 18-month-old girl. The fracture was reduced under general anesthesia and then stabilized with an acrylic cap splint, utilizing circummandibular wiring.

Oral health in children guidelines for pediatricians.

Dental caries in the primary dentition can have significant damaging effects on a childs growth due to impairment of oral functions. Since the first encounter of a child to a medical environment is often through pediatricians and medical practitioners, it is important that they be aware of the prevention of oral disease that begins early in life. The aim of this article is to diminish the existing ambiguity among pediatricians and medical practitioners regarding oral disease and its prevention.

Prosthetic Rehabilitation in Marble Bone Disease.

Osteopetrosis is a rare metabolic disease.(1) Dental abnormalities may be attributed to the pathological changes in osteopetrosis. Patients with osteopetrosis are especially susceptible to osteomyelitis of mandible.(1) A 13-year-old girl presented with complaint of jaw swelling on left side. The radiograph of left mandible (lateral oblique view) showed small sequestrum with irregularity and erosions of the man-dibular cortical margins. This case report aims at diagnosis and treatment of osteopetrosis with superadded mandibular osteomyelitis-a are entity.

A comparative evaluation of hydroxyapatite crystals and glutaraldehyde as agents for pulpotomy in deciduous molars.

PURPOSE: To evaluate and compare clinically and radiographically use of hydroxyapatite crystals and 2% glutaraldehyde as a pulpotomy agent. METHOD: Thirty deciduous molars were treated with pulpotomy using hydroxyapatite crystals and 2% glutaraldehyde. RESULTS: Clinical and radiographic findings were observed at three months and six months. The success rate was found to be 100% clinically and 80.33% radiographically in the hydroxyapatite crystals group and 100% clinically and radiographically in the glutaraldehyde group. CLINICAL SIGNIFICANCE: The results of this study revealed that hydroxyapatite crystals is a potential pulpotomy agent for deciduous molars.

Orofacial cat bite: a case report.

The article describes an unusual case of a 7 years old male child presenting with orofacial cat bite injury that occurred in infancy. This resulted in loss of deciduous and permanent tooth buds and consequently hampered alveolar growth. The patient was given a removable partial denture to restore function and aesthetics. The article highlights the importance of complete history, diagnosis and management of such injuries in children.

Comparative analysis of the amount of plaque formation and associated gingival inflammation in deciduous, mixed and permanent dentition.

Periodontal diseases in children and adolescents comprise mainly of gingivitis. Gingivitis is an inflammation involving the gingival tissues next to the teeth. Marginal gingivitis is the most common form of periodontal disease and starts in early childhood. However, severe gingivitis is relatively uncommon in children, although a large population has a mild, reversible type of gingivitis. The major etiologic factors associated with gingivitis and more significantly periodontal diseases are uncalcified and calcified bacterial plaque. The gingival tissues in children are different from those in adults. Due to these differences in the structure between the gingival tissues of the child and the adult, even the clinical features and disease manifestations differ according to the age of an individual. It has been observed in earlier studies that children with a deciduous dentition seem to respond to plaque formation with less gingivitis than adults with a permanent dentition. Thus, in this study, the occurrence of gingivitis in response to plaque was studied and compared in the deciduous, mixed and permanent dentitions.