Comparative Evaluation of Antimicrobial Efficacy of Fluoride-Based and Self-Assembling Peptide P11-4-based Tooth Remineralization Agents on Streptococcus mutans: A Microbiological Study.

Background: Dental caries is a biofilm-related oral disease that continues to afflict the majority of the world's population. The disease results from an interaction between specific bacteria and dietary constituents within a biofilm known as dental plaque. Among the cariogenic microorganisms, Streptococcus mutans (S. mutans) plays pivotal role in caries-inducing processes. Objectives: Evaluate and compare the antimicrobial efficacy of self-assembling peptide P11-4-based tooth remineralization agents on S. mutans. Materials and Methods: An in vitro microbiological study. The antibacterial efficacy of self-assembling peptide P11-4 gel (Group 1), fluoride enhanced hydroxyapatite gel (Group 2), acidulated phosphate fluoride gel (Group 3), chlorhexidine gluconate gel 1.0% w/w (Group 4; positive control), and normal saline (Group 5; negative control) was performed using time-kill assay over a period of 24 h and the number of S. mutans colony-forming units (CFUs) were calculated. Statistical Analysis: Statistical analysis was done using Kruskal-Wallis test and Mann-Whitney post hoc Test. The level of significance was set at P < 0.05. Results: Group 1 showed mean CFUs (× 103) of 841.33 ± 3.51, Group 2 showed 10035.33 ± 60.68, Group 3 showed 1058.00 ± 56.96, Group 4 showed 0.00 ± 0.00, and Group 5 showed mean CFUs with 15226.67 ± 96.67. The difference in the mean CFUs (× 103) between different groups was statistically significant at P < 0.001. Conclusion: The self-assembling peptide P11-4-based tooth remineralization agent exhibited an inhibitory influence on S. mutans and hence formation of cariogenic bacteria dominant biofilm can thus be affected by its application.

Comparison of Remineralization Potential of Casein Phosphopeptide: Amorphous Calcium Phosphate, Nano-hydroxyapatite and Calcium Sucrose Phosphate on Artificial Enamel Lesions: An In Vitro Study.

Aim and objective: To evaluate and compare the remineralization potential of CPP-ACP, nano-hydroxyapatite, and calcium sucrose phosphate toothpaste on artificial enamel caries lesions by means of microhardness testing. Materials and methods: Twenty sound human primary molars, extracted for therapeutic reasons were selected for this study. From each tooth, two enamel specimens were prepared and embedded in acrylic resin blocks, and each block contains five tooth samples. After polishing, the baseline hardness of the enamel surface (KHN) was determined by Knoop microhardness testing. Then the specimens were randomly assigned into four groups (n = 10), according to the remineralizing agent used: group I: Control, group II: GC Tooth MousseTM (CCP-ACP), group III: AcclaimTM (nano-HAP), and group IV: EnaFix (CaSP). The specimens were then immersed in a demineralizing solution and post-lesion KHN values were obtained as baseline measurements. Later remineralizing agent was applied and after 7 days of remineralization, posttreatment KHN tests were conducted. Results: Data were analyzed using paired t- test, analysis of variance, and Tukey HSD test. Mean enamel surface microhardness (KHN) values after remineralization shows that group IV (EnaFixTM) had maximum hardness number (114.71 ± 12.27) followed by group III (Acclaim) (85.14 ± 22.82) and group II (GC Tooth Mousse) (56.42 ± 19.90). The difference was statistically significant (p < 0.001). Similarly the %SMHR was also highest in group IV (EnaFix), followed by group III (Acclaim) and group II (GC Tooth Mousse). Conclusion: EnaFix (calcium sucrose phosphate) shows a maximum increase in the enamel surface microhardness followed by Acclaim (nano-HAP) and GC Tooth Mousse. Clinical significance: Calcium Sucrose Phosphate in toothpaste strengthened the enamel more than nano hydroxyapatite and CPP-ACP, and can be an alternative to the use of fluoride toothpaste in children. How to cite this article: Sebastian R, Paul ST, Azher U, et al. Comparison of Remineralization Potential of Casein Phosphopeptide: Amorphous Calcium Phosphate Nano-hydroxyapatite and Calcium Sucrose Phosphate on Artificial Enamel Lesions: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(1):69-73.

Antimicrobial Efficacy of Commercially Available Low-fluoride and Fluoride-free Dentifrices for Children.

AIM AND OBJECTIVE: The objective of this study was to evaluate and compare the antimicrobial efficacy of low-fluoride and fluoride-free dentifrices against Streptococcus mutans. MATERIALS AND METHODS: The antimicrobial efficacy of four commercially available low-fluoride child formula dentifrices and four fluoride-free dentifrices against S. mutans was determined using the agar diffusion test. Fifty microliters of various dilutions (1:1, 1:2, 1:4) of each dentifrice were inoculated on the assigned plates under aseptic conditions. Saline was taken as negative control and 0.2% chlorhexidine was considered as a positive control. The plates were incubated at 37°C for 24 hours and the zone of inhibition around the wells was measured. RESULTS: All the tested low-fluoride dentifrices showed varying degrees of antimicrobial activity against S. mutans with F2 (Pediflor®) and F4 (Cheerio™) showing greater zones of inhibition when compared to F1 (Colgate®kids) and F3 (Kidodent). When the mean zones of inhibition produced by non-fluoridated dentifrices were compared with that of fluoridated dentifrices, no statistically significant difference was noted between NF1, NF3, NF4, and F2, F4. The antibacterial activity of F1 and F3 was significantly lower when compared to others. However, no antibacterial activity was noted with NF2. CONCLUSION: Both low-fluoride and fluoride-free formulations tested in the study exhibited antimicrobial activity against S. mutans. In very young children where the risk of fluorosis is of concern, fluoride-free formulations can be considered as safe alternatives to fluoride formulations. CLINICAL SIGNIFICANCE: Several dentifrices, both fluoride-free and low-fluoride formulations, are being aggressively marketed for young children. Though these toothpastes are being very commonly used by young parents for their infants and toddlers, there is very little published literature available on their antimicrobial activity and this study focuses on addressing this. HOW TO CITE THIS ARTICLE: Reddy D, Selvan A, Paul ST, et al. Antimicrobial Efficacy of Commercially Available Low-fluoride and Fluoride-free Dentifrices for Children. Int J Clin Pediatr Dent 2021;14(2):183-186.

Effectiveness of Bubble Breath Play Therapy in the Dental Management of Anxious Children: A Pilot Study.

Play is an inseparable part of childhood and can act as a mode through which children can be desensitized toward dental treatment. AIM: To assess and compare the efficacy of bubble breath play therapy (BBPT) and tell-show-do (TSD) technique in the dental management of anxious/fearful children. MATERIALS AND METHODS: Forty-eight children aged 6-8 years were randomly divided into group I: BBPT and group II: TSD. The effectiveness of the BBPT and TSD technique in reducing anxiety/fear in children was assessed pretreatment, during, and posttreatment evaluation of the child's anxiety levels using finger pulse oximeter and Venham's anxiety and behavior rating scale. All children underwent rotary restorative treatment. RESULTS: The mean pulse rate in the BBPT and TSD group was 106.96 mm Hg and 102.25 mm Hg, respectively, at baseline. A decrease in the pulse rate was observed in both the groups after the application of behavior modification strategies. However, after the dental treatment, the mean pulse rate slightly increased in the BBPT group, while it showed a further improvement in the TSD group. CONCLUSION: The BBPT acts as a distraction and can be considered to enhance rapport between the dentist and children during dental treatment. CLINICAL SIGNIFICANCE: Application of appropriate strategies to allay dental fear in children is essential to provide quality dental treatment and build a positive attitude toward oral health.

Oral health status of children with acute lymphoblastic leukemia undergoing chemotherapy.

OBJECTIVE: The aim of this study was to evaluate the oral health status of children with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. STUDY DESIGN: A total of 94 patients of both sexes in the age group of 2-14 years who were diagnosed with acute lymphoblastic leukemia were selected for the study. The oral cavity was examined for dental caries using def-t and DMF-T indices, gingival status was evaluated by using the modified gingival index, and the WHO oral toxicity scale was used to record oral mucositis. RESULTS: Statistical analysis was done by using Kruskal-Wallis and Mann-Whitney tests. Both DMF-T and def-t were highest in children during the maintenance phase of the chemotherapy followed by the induction therapy with radiotherapy (I 2 ) and induction therapy (I 1 ) phases. The prevalence of gingival inflammation was highest in the maintenance phase of the chemotherapy followed by the induction therapy with radiotherapy (I 2 ) and Induction therapy (I 1 ) phases. Signs and severity of oral mucositis were highest in children undergoing induction therapy with radiotherapy (I 2 ). CONCLUSION: Good oral care is essential to maintain healthy oral cavity in children with acute lymphoblastic leukemia, as improvement in oral conditions may diminish their sufferings and prevent the spread of serious infections from oral cavity.

Clinical Evaluation of Resin Composite and Resin Modified Glass Ionomer in Class III Restorations of Primary Maxillary Incisors: A Comparative In Vivo Study.

UNLABELLED: Restoration of primary teeth continues to be an important facet of restorative dentistry. In comparison to restorations in permanent dentition, the longevity of those in primary teeth is significantly different for all materials. This makes the assessment of these fillings as a separate group meaningful. As there is lack of supporting clinical data with regard to the restoration of primary incisors, it would be judicious to consider why this is so and determine if studies can be designed to gain new information. The purpose of this study was therefore to evaluate and compare the clinical efficacy of composite resins and resin-modified glass ionomer cement restorations of primary incisors, over a period of one year. METHODS: The study group consisted of 40 patients (3½- 5 ½ years of age) with at least one pair of similar sized lesions in the middle1/3 of the same proximal surface of contralateral primary maxillary incisors. Composite resin and resinmodified glass ionomer cement restorations were placed in primary maxillary incisors using split-mouth design. The restorations were evaluated at different intervals of 3,6,9, months and 1 year using Ryge's criteria. Data obtained was analyzed using Mann-Whitney test. RESULTS: The results revealed no statistical significance in the difference of clinical characteristics between the two restorative materials. INTERPRETATION AND CONCLUSION: (1) Resin-modified glass ionomer cement and composite resin restorative materials showed acceptable clinical performance after 1 year in primary teeth. (2) Resin-modified glass ionomer cement and composite resin restorative materials functioned well as class III restorative materials in primary teeth.

A compound composite odontoma associated with unerupted permanent incisor: a case report.

Odontomas are the most common type of odontogenic tumors and are generally asymptomatic. Frequently they interfere with the eruption of the teeth. This is the case report of a compound composite odontoma in an 11 years old girl, which resulted in failure of eruption of the permanent maxillary right central incisor while the contralateral tooth had erupted. A calcified mass was seen in the radiograph and was provisionally diagnosed as odontoma following which the odontoma was enucleated. Routine follow-up was done for 1½ years and no recurrence was seen.