Comparative Evaluation on the Effect of Different Remineralizing Agents on Enamel-Bracket Shear Bond Strength: An In Vitro Study.

AIM:  This study aimed to compare the effects of applying various remineralizing agents before and after acid etching on the enamel-bracket shear bond strength (SBS) in vitro. These agents included silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 5% sodium fluoride (5% NaF). MATERIALS AND METHODS: All the selected teeth were divided equally into six subgroups depending on before and after acid etching and one separate control group for the in vitro study design. Eighty-four extracted premolar teeth (12 teeth in each group x seven groups, including the control group). Before acid etching, teeth in groups A1, B1, and C1 were given SDF, CPP-ACP paste, and 5% NaF, respectively. Following acid etching, all of the teeth in Groups A2, B2, and C2 received the same preventative treatments. After that, the SBS of the bonded brackets to the enamel was evaluated. RESULTS: The CPP-ACP group, control group, and SDF group had the highest values for SBS prior to acid etching.The 5% NaF group had the weakest bonds, and the difference between the groups was statistically significant. The CPP-ACP group had the highest SBS following acid etching, followed by the 5% NaF group. The least bond strength was seen in the SDF group, and the difference between the three groups was significant. CONCLUSION: When it comes to bonding orthodontic brackets, the CPP-ACP pretreatment is superior to fluoride pretreatment in terms of effectiveness. The use of these remineralizing agents resulted in favorable values that did not have any effect on the SBS and were therefore safe to use with orthodontic brackets.

Evaluation of Eruption Pattern and Caries Occurrence among Children Affected with Fluorosis.

AIM: The aim of this study was to evaluate eruption pattern and occurrence of caries in children affected with fluorosis. MATERIALS AND METHODS: One hundred and fifty subjects (75 each with/without fluorosis) with age group of 7-8 years were selected. Dental fluorosis assessed on the buccal surfaces of the permanent incisors and molars and scored using the Thylstrup and Fejerskov index. The tooth were scored as emerged when at least one cusp of the tooth was visible in the mouth. Caries attack rate in primary and permanent teeth were estimated using DMFS and defs index in fluorosis patient. The findings were subjected to statistical analysis. The data were analyzed using Student "t" test and ANOVA "F" test. RESULTS: There was statistically highly significant difference found in the incidence of occlusal, mesioproximal, and distoproximal caries between fluorotic and nonfluorotic patients (p < 0.001). The result of present study showed a nonsignificant association between fluoride exposure parameter and median emergence ages of permanent incisors and molar teeth. On the other hand, caries occurrence shows a significant association with fluorosis. CONCLUSION: In this study, a significant positive correlation exists in the prevalence of caries and fluorosis. It is concluded that occlusal and proximal caries are less pronounced in fluorosis patients. CLINICAL SIGNIFICANCE: Dental caries is a public health problem. In this study, we study the fluoride effect since the predominant cariostatic effect of fluoride is beneficial in extensive caries reduction without a concomitant risk of dental fluorosis. How to cite this article: Trivedi S, Trivedi A, Banda NR, et al. Evaluation of Eruption Pattern and Caries Occurrence among Children Affected with Fluorosis. J Contemp Dent Pract 2019;20(10):1217-1222.

In Vivo Evaluation of Customized Pulse Oximeter and Sensitivity Pulp Tests for Assessment Of Pulp Vitality.

OBJECTIVE: The purpose of this study was to test a customized pulse oximeter (CPO) for evaluation of pulp vitality in primary and permanent teeth against clinical diagnosis (vital and untreated non-vital) in order to expand its clinical use for pulp preservation. STUDY DESIGN: CPO was evaluated on intact primary and permanent central or lateral incisor (CI, LI) teeth-vital (group 1, 20n each); untreated non-vital (group 2, 10n each) and; root filled non-vital (group 3, 10n each) of children 4-12 years according to inclusion/ exclusion criteria. For each patient CPO was first applied on finger followed by vitality tests in following sequence-electrical, pulse oximetry and thermal tests. RESULTS: Mean oxygen saturation (%SpO2) in permanent and primary-vital teeth was 88.78% & 87.77% respectively; non-vital teeth was 74.67% & 75.00% respectively; and in all root filled teeth was 0%. Tooth and finger oxygen saturation values showed strong positive relationship in vital primary or permanent teeth and; no correlation in untreated non-vital primary or permanent teeth. The accuracy rate of thermal pulp test and pulse oximetry was 100% and for electrical pulp test it was 90% for permanent and 86.67% for primary teeth. CONCLUSION: The CPO tested in this study proved to be a valuable adjunct for diagnosing pulp vitality by objective means.

Evaluation of total antioxidant level of saliva in modulation of caries occurrence and progression in children.

CONTEXT: Recent studies have implicated a direct relation between dental caries and salivary total antioxidant level (TAL), which can be suggested as an indicator (either harmful or protective) for susceptibility of individuals for dental caries. AIM: To evaluate the total antioxidant level (TAL) in unstimulated saliva of children, and to correlate the TAL with caries experience and BMI (body mass index). SETTINGS AND DESIGN: 60 children, aged 6-12 yrs, were randomly selected for the study. Two groups were made (study group n=30 and control group n=30), and subdivisions based on gender were made out of both groups [male (n=15) and female (n=15)]. In control group, subjects with no dental caries and study group, subjects having decayed teeth score ≥4 were included. STATISTICAL ANALYSIS: Data analysis was done using Statistical Package for Social Sciences (SPSS V. 21). Shapiro - Wilks test showed that TAL (absorbance) did not follow normal distribution. Hence, for comparison between cases and control for TAL non-parametric test namely Mann- Whitney U test was applied. RESULTS: Statistically significant strong positive correlation was seen between age and TAL (P< 0.05).

Does Taste Perception Effect Body Mass Index in Preschool Children?

INTRODUCTION: Eating trends established early in life leads to chronic life style disorders such as obesity, which is hard to overcome as child comes of age. Energy expenditure is less but caloric intake is high leading to disparity of energy balance in turn leading to obesity. Obesity is the outcome of a disparity between energy expenditure and caloric intake. Genes play a role in establishing eating habits, which is termed as genetic sensitivity to taste. AIM: To determine taste perception effect on body mass index (BMI) in preschool central Indian urban children. MATERIALS AND METHODS: A total of 500 children of 3-6 years were selected and genetic taste perception was assessed using PROP sensitivity test. Anthropometric measurements were recorded to obtain BMI value. Categorical variables were analysed using Pearson's Chi square test. RESULTS: Non tasters were mostly in overweight category i.e. 73.30% where as more number of tasters i.e. 59.70% were in underweight category. A significant correlation is seen between BMI and taste perception. No statistically significant correlation was seen between oral hygiene and taste perception. Females were predominant in both the tasters and non tasters categories. CONCLUSION: Taste perception showed significant relationship with BMI of children between 3-6-year-old children.

Vacuum formed splints: Novel method for managing oro-facial trauma.

OBJECTIVE: Trauma to the oro-facial structures in children is different from trauma in adults. There are several points of differentiation between the two, the most important being growth. AIM: The purpose of this paper is to present the advantages of a vacuum-formed splint which was chosen as a practical and effective conservative treatment approach for the management of maxillofacial trauma. CASE REPORT: A 9-year old boy reported to the department of pediatric and preventive dentistry with right mandibular parasymphyseal fracture. The trauma presented with the unique challenge to save and support the unerupted and developing tooth buds. Therefore, a vacuum-formed splint was fabricated and cemented in place for the next 4 weeks. CONCLUSION: The splinting method used for stabilization of the injured teeth is an important issue in trauma therapy to support the periodontal healing. Pediatric maxillofacial traumas require different clinical treatment strategies compared with fractures of the adult population.

Clinical management of a complicated crown-root fracture using autogenous tooth fragment: A biological restorative approach.

Trauma resulting in crown-root fracture is one of the most challenging fracture types. However, biologic width involvement should be carefully evaluated. Reattachment of tooth fragment to a fractured tooth remains as the treatment of choice because of its simplicity, natural esthetics, and conservation of tooth structure. The reattachment procedure using composite resin should be considered if the subgingival fracture can be exposed to provide isolation. This report presents a case of complicated crown-root fracture of permanent maxillay left central incisor, involving the biologic width in a 10-year-old girl. The traumatized tooth was treated endodontically. Access to the subgingival margins was gained by orthodontic extrusion followed by gingivectomy. The fractured fragment was reattached using bonding system and composite resin.

Maxillary adenomatoid odontogenic tumour.

An adenomatoid odontogenic tumour (AOT) is a benign, slow-growing, relatively rare oral tumour, which accounts for about 3-7% of all odontogenic tumours as reported in the literature. It is an unusual benign neoplasm which shares clinical and radiographical characteristics with odontogenic cystic lesions denoting a distinct behaviour. The three variants-follicular, extrafollicular and peripheral-present with identical histological findings. This report describes a patient with an AOT in the anterior maxilla. Radiographically, the lesion was characterised by a well circumscribed unilocular radiolucent area displacing left maxillary lateral incisor, canine and first premolars. The final diagnosis was AOT. The lesion was enucleated under local anaesthesia. The patient was followed-up for one year. This paper also provides a refresher for general dental practitioners about various diagnostic aspects of this tumour and highlights the controversies regarding its origin and management in the light of recent findings.

Accessory tragus: a dentist's perspective.

Accessory tragus (AT) also referred as preauricular tag is a rudimentary tag of ear tissue This paper presents two specific cases: one hereditary and another sporadic case of AT. A general clinical description of AT, its associated syndromes, embryology aetiopathogenesis and management is discussed. A dentist can play an important role in spotting the AT during their head and neck examination. The presence of this defect can be correlated to other congenital defects of first branchial arch. On recognising its occurrence, the dentist can refer to a specialist for thorough investigation management. A dentist can play a vital role in encouraging and counselling the parents for the correction of such defects as it improves the aesthetics of the face. Usually, children with these defects are often targets of teasing by peers.

Peripheral cementifying fibroma: a clinical diagnostic dilemma.

The peripheral ossifying fibroma (POF) is a reactive gingival overgrowth occurring frequently in the anterior maxilla. It originates in the cells of the periodontal ligament and is more common in children and young adults. In the current article a case of gingival over growth, which was thought to be puberty-induced gingivitis was seen in the lower anterior maxillary gingiva. Histology of the excised tissue showed cellular, fibrous connective tissue stroma with calcified osseous calcifications indicative of POF. The definitive diagnosis is established only by histological examination, which revealed the presence of highly cellular connective tissue with focal calcifications. Surgery is the treatment of choice, though the recurrence rate can reach 20% in case of POF. After histological confirmation the recall and clinical evaluation protocol of POF varies due to its increased recurrence rate, which the general dentist should be aware of.

Infected mesenteric cyst.

Mesenteric cyst is a rare condition. Presentation with non-typhoid spontaneous infection in an unusual area makes it even more a rare situation with mesenteric cyst. Its diagnosis is mainly based on the imaging modalities. However, there are difficulties in diagnosis when it is present in an uncommon area and rare known complications. Mesenteric cyst can present with few uncommon emergency conditions which pose difficulties in diagnosis as well as treatment options as mentioned in this case.

A rare occurrence and management of familial schwannomatosis.

We are presenting a familial schwannomatosis without the features of neurofibromatosis (NF). We retrospectively reviewed the hospital charts, radiology films, operative notes and pathology slides of the patient. There was a family history of schwannomatosis. The patient had contrast-enhanced MRI, which was negative for vestibular schwannomas. The patient underwent surgical excision of symptomatic lesions. Histopathology confirmed these lesions as schwannomas consisting of areas of Antoni A and B, and immunohistochemical study was positive for S-100 protein. We recommend surgery for symptomatic lesions. Asymptomatic tumours can be monitored. Regular follow-up is essential as they may develop fresh lesions at any time. The relevant literature is discussed.

A rare occurrence of peripheral ossifying fibroma in the first decade of life and its management.

Localised growths are commonly seen on the gingiva. Many of these enlargements are considered to be reactive rather than neoplastic in nature. Clinically, differentiating one from the other as a specific entity is often not possible. Clinical knowledge and histopathological examination is needed to positively identify the lesion. The peripheral ossifying fibroma is one such lesion. We report a rare case in a 10-year-old female patient with a peripheral ossifying fibroma in the mandible exhibiting a significant increase in size within a short duration of 6 months.

Biological restoration in a young patient with a complicated crown root fracture with an autogenous tooth fragment.

Crown-root fractures are one of the most challenging trauma cases to treat. Reattachment of tooth fragment to a fractured tooth being a simple procedure conserves the tooth structure, maintains the natural esthetics value and is thus considered as a favorable treatment option. The reattachment procedure using composite resin should be considered if the subgingival fracture can be exposed to provide isolation after a careful evaluation of the biologic width involvement. This case report presents a complicated crown-root fracture of permanent maxillary left central incisor, involving the biologic width in an 11-year-old boy. The traumatized tooth was treated endodontically and reinforced by using glass fiber-post. Access to the subgingival margins was gained by electro surgery. The fractured fragment was reattached using bonding system and composite resin.

Management of a xeroderma pigmentosum case with oral findings in a dental setup.

Xeroderma pigmentosum (XP) is heterogeneous group of disorder transmitted as autosomal recessive trait. It is characterised by photosensitivity, freckled pigmentation and premature skin ageing and malignant tumour development. The manifestations are due to a cellular hypersensitivity to ultraviolet light resulting from a defect in DNA repair. Multiple cutaneous neoplasms develop at a young age in persons with XP. Two important causes of mortality are metastatic malignant melanoma and squamous cell carcinoma (SCC). We report a case of XP in a 22 year-old male patient who developed SCC of lower lip with in a short period of 1 month.

Odontomas--silent tormentors of teeth eruption, shedding and occlusion.

Odontomas are the most common odontogenic tumours of the jaws, characterised by their slow growth and non-aggressive behaviour. They usually remain asymptomatic, and are diagnosed on routine radiographs. Clinically, they are often associated with delayed eruption or impaction of permanent teeth and retained primary teeth. The purpose of this paper is to review the literature and report two cases of odontomas. In the first case, a compound odontoma was associated with an unerupted maxillary permanent right central incisor, in an 11-year-old boy. In the second case, a 12-year-old girl had retained mandibular primary left central incisor and its unerupted successor was associated with a compound odontoma, a site considered rare for compound odontoma to occur. The clinical features, diagnosis and treatment of these cases have been discussed.

Management of traumatic bone cyst in a 3-year-old child: a rare case report.

The following case report describes a case of traumatic bone cyst (TBC) with classical clinical features occurring as a rare combination in a very young female patient with a traumatic etiology and its management using acrylic splint postsurgery. How to cite this article: Banda NR, Nayak UA, Vishwanath KH, Sharma DS, Khandelwal V. Management of Traumatic Bone Cyst in a 3-Year-Old Child: A Rare Case Report. Int J Clin Pediatr Dent 2012;5(3):213-216.

Evaluation of primary tooth enamel surface morphology and microhardness after Nd:YAG laser irradiation and APF gel treatment--an in vitro study.

OBJECTIVE: Laser irradiation and fluoride has been used as a preventive tool to combat dental caries in permanent teeth, but little has been done for primary teeth which are more prone to caries. The purpose of this study was to evaluate microhardness alterations in the primary tooth enamel after Nd-YAG laser irradiation alone and combined with topical fluoride treatment either before or after Nd-YAG laser irradiation. METHOD: Ten primary molars were sectioned and assigned randomly to: control group, Nd-YAG laser irradiation, Nd-YAG lasing before APF and APF followed by Nd-YAG lasing. The groups were evaluated for microhardness. Surface morphological changes were observed using SEM. RESULTS: Statistical comparisons were performed. The control group's SEM showed a relatively smooth enamel surface and lasing group had fine cracks and porosities. In the lasing + fluoride group a homogenous confluent surface was seen. In the fluoride + lasing group an irregular contour with marked crack propagation was noted. There was a significant increase in the microhardness of the treatment groups. CONCLUSION: Nd-YAG laser irradiation and combined APF treatment of the primary tooth enamel gave morphologically hardened enamel surface which can be a protective barrier against a cariogenic attack.

Management of Developing Anterior Malocclusion due to SupernumeraryTooth with Preventive and Intercep-tive Approach: A 1½ Year Case Study.

Variety of clinical complications occurs due to the presence of supernumerary teeth, especially mesiodens. It may result in impaction of one or both central incisors which in turn may lead to a variety of malocclusions. Timely intervention not only prevents malocclusion but also the time taken for corrective orthodontics. A complete case report of developing mesiodens' tooth germ resulting in malocclusion including treatment in 1½ year period is presented.