In Vitro Evaluation of Reliability and Validity of International Caries Detection and Assessment System II Coding for Occlusal Caries using Magnification.

Aim: To check the reliability and validity of International Caries Detection and Assessment System (ICDAS) II coding in occlusal caries detection under unaided visual and enhanced visual examination. Materials and methods: This study included 100 extracted premolars and molars. Two examiners independently scored occlusal caries using ICDAS II criteria without magnification and under 6x magnification in the dental operating microscope. The examination was repeated after one month to check the intraexaminer reliability. The examined samples were sectioned and the carious lesions were scored using Ekstrand-Ricketts-Kidd (ERK) histological criteria under 20x magnification in stereomicroscope. The ICDAS II scores given by the examiners were compared with the histological scores. Results: The κ values for interexaminer reproducibility of unaided and enhanced visual examinations were 0.695 and 0.626, respectively (substantial agreement), and 0.984 (almost perfect agreement) for histological examination. Intraexaminer reproducibility for unaided and enhanced visual examinations were 0.835 and 0.910, respectively (almost perfect agreement). Spearman's correlation coefficients of ICDAS II unaided visual and enhanced visual examinations to ERK histological scores were 0.724 and 0.689, respectively, which infers that there is a strong correlation between unaided visual and histological examination and a moderate correlation between enhanced visual and histological examination. For unaided visual examination, specificity is 100% and sensitivity is 92%, whereas for enhanced visual examination, specificity is 50%, and sensitivity is 100%. Conclusion: Unaided visual examination demonstrated good reliability and validity for ICDAS II coding, whereas enhanced visual examination exhibited good reliability but relatively lower validity. Clinical significance: This study reveals that magnification did not have any added benefits in occlusal caries diagnosis using ICDAS II coding compared to unaided visual examination. The use of magnification did not improve the validity and led to a drop in the specificity, which indicates higher chances of false positive results. How to cite this article: SasiRekha G, Chandrasekhar R, Vinay C, et al.In Vitro Evaluation of Reliability and Validity of International Caries Detection and Assessment System II Coding for Occlusal Caries using Magnification. Int J Clin Pediatr Dent 2023;16(S-2):S138-S141.

Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation.

Aim: To evaluate the effectiveness of laser-activated irrigation (LAI) and ultrasonic irrigation (UI) in the removal of calcium hydroxide [Ca(OH)2] and modified triple antibiotic paste (MTAP) from the root canals. Materials and methods: Root canals of freshly extracted human permanent maxillary incisors (n = 80) were prepared. The root canals of half sample (n = 40) were filled with Ca(OH)2 and the other half (n = 40) with MTAP, in which propylene glycol was used as a vehicle. After 14 days, roots were randomly assigned to four groups (n = 20) according to the irrigation technique used-group I [Ca(OH)2 with UI], group II (MTAP with UI), group III [Ca(OH)2 with LAI], group IV (MTAP with LAI). The roots were sectioned, and the intracanal medicament residues were evaluated at 25× magnification under stereomicroscope using 4-grade scoring system. Statistical analysis: One-way analysis of variance (ANOVA) and post hoc Tukey tests were performed. Results: Laser-activated irrigation (LAI) was found to be superior compared to UI. Ca(OH)2 was better removed compared to MTAP with either of the irrigation techniques. A statistically significant difference was found between the Ca(OH)2 with LAI and MTAP with UI groups in all the regions, that is, coronal, middle, and apical thirds. Conclusion: Laser-activated irrigation (LAI) was superior to UI in removing Ca(OH)2 and MTAP. Ca(OH)2 was better removed than MTAP, irrespective of the technique used. However, none of the irrigation techniques could completely remove the intracanal medicament from the root canals. How to cite this article: Swathi P, Uloopi KS, Vinay C, et al. Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation. Int J Clin Pediatr Dent 2023;16(S-1):S1-S5.

Impact of Parenting Style on Child's Behavior and Caries Experience in 3-6-year-old Children: A Cross-sectional Study.

Aim: The aim of the study is to evaluate the impact of parenting style on a child's behavior and caries experience in 3-6-year-old children. Materials and methods: This cross-sectional study included 1,216 parent-child pairs of 3-6-year-old preschool children. Parenting style was determined using Parenting Style and Dimensions Questionnaire (PSDQ). Child behavior was assessed using Frankl's behavior rating scale, and caries experience was recorded using the decayed, extracted and filled deciduous teeth surfaces index. Results: Out of the 1,216 parents, the authoritative parenting style is seen in 70%, authoritarian in 20%, and permissive parenting style in 9.5%. Children with a permissive type of parenting style have shown more negative behavior. Children of authoritative parents had 4.1 times higher odds of exhibiting definitely positive behavior, which is statistically significant (p = 0.004). Children of positive child behavior had 2.4 times higher odds of avoiding caries which is statistically significant (p = 0.0001). Children of authoritarian parents had 1.45 times higher odds of exhibiting caries than children of permissive parents; however, this difference is not statistically significant. Conclusion: Children of authoritative parents demonstrated low caries experience and desirable behavior in the dental office. On the contrary, children of permissive parents exhibited undesirable dental behavior, and children of authoritarian parents had high caries experience. Clinical significance: Twenty-first-century parents are less controlling and are more permissive leading to problematic child behavior in the dental office. Parenting styles have an impact on the effectiveness of behavior management as well as dental treatment. Pediatric dentists should identify different parenting styles and anticipate the child's behavior. This study emphasizes the effect of different parenting styles on a child's behavior and dental caries experience. How to cite this article: Shalini K, Uloopi KS, Vinay C, et al. Impact of Parenting Style on Child's Behavior and Caries Experience in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):276-279.

Perspectives of Indian dental residents on novel online practical examination during COVID-19: A cross-sectional study.

PURPOSE: This cross-sectional study aimed to assess the graduating dental residents' perspectives on the online clinical examination format. METHODS: The questionnaire used to assess the perspectives was developed via a focus group discussion and was validated for face and content validity, readability testing, and pilot testing for the online version. This self-administered, online questionnaire integrated 15 Likert-scale-based multiple choice questions and one open-ended question. It was distributed to the residents across 16 dental schools after the clinical examination was completed. The perspectives regarding examination preparation, the ability to transition to online mode, and the performance in the examination were assessed. Descriptive statistical analysis (counts and percentages) was performed. RESULTS: A total of 256 subjects participated in the study by returning the online survey. In the preparation phase, 70.7% (n = 181) residents reported anxiety and 56.1% (n = 144) reported stress. During the examinations, only 13.6% (n = 35) of the participants reported difficulty with internet speed. The majority, 64.6% (n = 165) of the participants reported that the absence of an external examiner face-to-face reduced anxiety. The compiled answers to the open-ended question revealed that residents expressed inconvenience in digitizing the academic logbooks and clinical work. The poor quality of sound and images affected the display of skills. CONCLUSIONS: The study revealed a moderate level of acceptance for the novel online practical examination method. The residents reported stress before and during the examination due to the sudden transition to an online examination. The online practical examination with modifications might be a viable alternative to the in-person clinical examination.

Faculty perception on clinical shadowing: A concurrent mixed methods study.

PURPOSE: This mixed methods study aims to investigate faculty members' perceptions of early clinical exposure through clinical shadowing program (CSP) at one academic dental institution. METHODS: After ethical approval was received, concurrent data collection using quantitative and qualitative methods was integrated for this study design. For the quantitative data, a validated instrument (Likert scale) was distributed to all basic and clinical science faculty members regarding the CSP. Qualitative semi-structured interviews of basic and clinical science faculty members were conducted to explore their perceptions of the CSP. Descriptive statistics were completed for the quantitative data, and thematic analysis was carried out for the transcribed interviews. RESULTS: Faculty members from basic and clinical sciences participated in this mixed methods study, 97% (n = 74) participants in the quantitative and 12 participants in the qualitative. The majority of faculty (67%; n = 44) strongly agreed that CSP helps predoctoral students in the application of basic science knowledge to clinical practice. All basic science respondents (n = 10; 100%) and many clinical science faculty (60%; n = 35) strongly agreed that CSP requires coordination between basic and clinical science educators (p = 0.042). Some faculty suggested the inclusion of training for educators on the program and regular periodic student assessments of the program's effectiveness. CONCLUSION: The current study reported positive faculty perception toward the proposed method of integration. Furthermore, opportunities to foster coordination between basic and clinical science educators may be provided by administrators to strengthen the existing CSP framework.

Effectiveness of Distraction with Virtual Reality Eyewear in Managing 6-11-year-old Children with Hearing Impairment during Dental Treatment: A Randomized Controlled Trial.

Aim: To assess the effectiveness of distraction with virtual reality (VR) eyewear along with modified tell-show-do (MTSD) on anxiety levels of 6-11-year-old children with hearing impairment (HI) during the noninvasive dental procedure. Materials and methods: The randomized controlled trial included 40 children with HI aged 6-11 years requiring oral prophylaxis. The children were randomly allocated into two groups. Oral prophylaxis was carried out in both groups, where in group I (VR + MTSD, n = 20), distraction with VR eyewear was performed along with MTSD, and in group II (MTSD, n = 20), MTSD alone was used. Pre and postoperative anxiety levels were assessed using facial image scale (FIS) (subjective) and pulse rate (PR) (objective) measures. Paired t-test and unpaired t-test were used to analyze the obtained data. Results: Postoperative (post-op) PR readings in the VR + MTSD group were reduced by 6.95, whereas it was increased in the MTSD group by 8.55, and the difference was statistically significant (p = 0.001). Post-op FIS scores were found to be reduced in the VR + MTSD group by 2.15, whereas it was increased in the MTSD group by 0.10, and the difference was statistically significant (p = 0.033). Conclusion: Distraction using VR eyewear along with MTSD is effective in reducing anxiety levels in 6-11-year-old children with HI during noninvasive dental procedures. Clinical significance: Hearing-impaired children are usually anxious about the unknown and have unmet oral health needs due to communication barriers. This study provides evidence that the distraction using VR eyewear along with MTSD is effective in reducing anxiety levels in children with HI. How to cite this article: Varshitha K, Uloopi KS, Vinay C, et al. Effectiveness of Distraction with Virtual Reality Eyewear in Managing 6-11-year-old Children with Hearing Impairment during Dental Treatment: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(6):820-823.

Clinical Evaluation of the Retention of Self-adhering Flowable Composite as Fissure Sealant in 6-9-year-old Children: A Randomized Controlled Trial.

Aim: To evaluate the retention rate of self-adhering flowable composite as fissure sealant in comparison with the unfilled resin sealant on first permanent molars of 6-9-year-old children. Materials and methods: A 2-arm, split-mouth randomized controlled trial included 100 children of age 6-9 years with completely erupted mandibular first permanent molars. A total of 200 teeth were randomly divided into two groups, group I: self-adhering flowable composite; group II: unfilled resin sealant. Sealants were placed on the mandibular first permanent molars and the children were recalled at 6, 12, and 18 months intervals to evaluate the retention rate. Chi-square test was used to analyze the data. Results: Self-adhering flowable composite has shown a complete retention rate of 67%, 47%, and 46% at 6, 12, and 18-month intervals, respectively, whereas unfilled resin sealant has shown 41%, 8%, and 5% retention rate at 6, 12, and 18-month intervals, respectively. The difference in the complete sealant retention rates between the groups is found to be statistically highly significant at all the follow-up intervals (p = 0.0004, 0.0001, and 0.0001 at 6, 12, and 18-month intervals, respectively). In both groups, maximum sealant loss occurred between 6 and 12-month intervals. Retention rates were higher at 6 months intervals which were significantly reduced over 18 months intervals. Conclusion: Self-adhering flowable composite has shown a higher retention rate compared to unfilled resin sealant at all the time intervals. The retention rate of both materials decreased with time. However, the loss of sealant was more with unfilled resin sealant. Clinical significance: In pediatric dental practice, the elimination of a step in restorative dentistry protocol makes a big difference as time is a critical factor in obtaining children's cooperation. The use of self-adhering materials eliminates the step of bonding agent application, which simplifies the restorative protocol and makes the clinical practice effective. Therefore, these self-adhering flowable composite resin materials can be considered fissure sealants in routine clinical practice. How to cite this article: Bhuvaneswari P, Vinay C, Uloopi KS, et al. Clinical Evaluation of the Retention of Self-adhering Flowable Composite as Fissure Sealant in 6-9-year-old Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(3):322-326.

Time and Eruption Sequence of Permanent Teeth in Hyderabad Children: A Descriptive Cross-sectional Study.

CONTEXT: Eruption of teeth is influenced by various factors. Very few studies were carried out in the past on the eruption time of teeth in the Indian population. AIM: The aim of the study is to determine the time and sequence, gender differences, pattern of symmetry in the eruption of permanent teeth in Hyderabad children. MATERIALS AND METHODS: In this cross-sectional study, 1654 schoolchildren (806 girls and 848 boys) in the age group of 5 to 15 years from Hyderabad were examined for the status of eruption of permanent teeth. STATISTICAL ANALYSIS USED: Results were subjected to probit's regression analysis. The average age at eruption of permanent teeth, excluding third molars, was given as the mean [± standard deviation (SD)] in months for each gender. A table of percentiles of the eruption time was also determined. RESULTS: Unlike most of the earlier studies which showed that girls are ahead of boys in permanent teeth emergence, no such pattern was observed. No significant difference was found in the eruption of permanent teeth in right and left arches. Eruption of all the mandibular teeth, with the exception of right first premolar (44) in both the genders, was earlier than their maxillary counterparts. There was overall delay in the eruption of permanent teeth and significant delay in the eruption of lower canines in both genders. CONCLUSION: The significant delay in the eruption of permanent mandibular canines is relevant for orthodontic treatment planning.How to cite this article: Chaitanya P, Reddy JS, Suhasini K, Chandrika IH, Praveen D. Time and Eruption Sequence of Permanent Teeth in Hyderabad Children: A Descriptive Cross-sectional Study. Int J Clin Pediatr Dent 2018;11(4):330-337.

Squamous Papilloma on Hard Palate: Case Report and Literature Review.

Most of the lesions in the oral cavity have papillary appearance. Oral squamous papilloma (SP) is one such type, which is a benign proliferation of the stratified squamous epithelium and presents as papillary or verrucous exophytic mass induced by human papillomavirus (HPV). Most of the oral mucosal lesions are often asymptomatic and have small progression. The common sites of occurrence include tongue, soft palate, and uvula. Squamous papilloma arising on hard palate is described in this article. Surgical excision of the lesion was done and sent for histopathological analyses that confirmed the clinical diagnosis. In larynx and trachea, malignant transformation of papillomas has been reported. The potentially malignant nature of SP if present needs to be explored. How to cite this article: Chaitanya P, Martha S, Punithvathy R, Reddy M. Squamous Papilloma on Hard Palate: Case Report and Literature Review. Int J Clin Pediatr Dent 2018;11(3):244-246.