Estimation and Association of Total Protein Concentration with Early Childhood Caries in 3-6-year-old Children: A Randomized Clinical Trial.

Background and objective: Caries is a common problem witnessed in children, early childhood caries (ECC) is the most predominant chronic disease which not only leads to distress and pain but also poor quality of life, thus affecting the overall well-being of children. Salivary protein plays a vital part in monitoring health status or disease. It was stated that the salivary proteins could regulate the equilibrium of oral health, preserve a stable ecosystem, and constrain the growth of cariogenic bacteria. Aim: The aim of this study is to estimate the total protein concentration in saliva and its correlation to ECC. Materials and methods: A total of 20 patients with ECC in the age-group of 3-6 years were selected as the experimental group and 20 patients without caries for the control group. Unstimulated saliva samples were collected and subjected to spectrophotometry. The data obtained was subjected to statistical analysis. Independent student's t-test was used for the comparison of mean salivary pH between the caries group and the control group. Mann-Whitney test was used for a comparison of salivary total protein concentrations between the two groups. Results: The mean pH of the carious group showed a statistically significant slightly lower value than that of the noncarious group. On the contrary, the mean total protein concentration of the carious group presented a statistically significant higher value than that of the noncarious group. Age-wise comparison of mean salivary proteins in the carious group and the noncarious group showed an increase in the protein concentration in the children aged 4 years or younger. Conclusion: Based on the results of this study, it can be concluded that there is a strong association between the total protein concentration in saliva and ECC. There exists a significant increase in the total protein concentration in children with ECC. As age increases, total protein concentration decreases with age. Clinical significance: Total protein concentration and particular protein estimation and quantification help us in assessing the risk of caries in children at the earliest and prevention of caries through preventive measures. Estimation of total salivary protein concentration in children can be a marker for ECC in children. How to cite this article: Thimmegowda U, Pai S, Chikkanarasaiah N, et al. Estimation and Association of Total Protein Concentration with Early Childhood Caries in 3-6-year-old Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(1):36-40.

Global Developmental Delay in Children with Full Mouth Rehabilitation: A Case Series.

Global developmental delay (GDD) is a chronic neurological disturbance that includes defects in one or more developmental domains. Although some diagnosed delays are benign, certain presentations are more worrisome. The developmental domains can be motor, cognitive, daily activities, speech or language, and social or personal development. The etiology of GDD can be prenatal, perinatal, or postnatal. It can be diagnosed early in childhood as the delay or absence of one or more developmental milestones. Hence the role of pediatric dentists and pediatricians becomes more crucial in identifying this condition. How to cite this article: Thimmegowda U, Chikkanarasaiah N, P A, et al. Global Developmental Delay in Children with Full Mouth Rehabilitation: A Case Series. Int J Clin Pediatr Dent 2023;16(3):522-527.

Identification and Correlation of Streptococcus mutans and Streptococcus sanguinis in Caries-active and Caries-free Children: A PCR Study.

Aim and objectives: Dental caries is currently considered an ecological imbalance within the oral biofilm leading to the dissolution of the tooth's hard tissues. It has been traditionally thought that two species belonging to the Streptococci group, Streptococcus mutans (SM) and Streptococcus sanguinis (SS), are the etiologically responsible for the onset of dental decay. Materials and methods: The present in vivo study was conducted on 40 children with caries-active (CA) and caries-free (CF). They were allocated into two groups, group I (CA) = 20 and group II (CF) = 20. The whole saliva was collected into the vials with buffer solution and was stored in cold storage. Polymerase chain reaction (PCR) was done to identify and correlate SM and SS in CA and CF children. Results: Comparison of mean SM level between CA and CF groups showed a statistically significant result at p = 0.001. Spearman's correlation between caries score and SM showed a strong correlation of 0.77 between caries score and SM, which was statistically significant at p = 0.001. Similarly, SS and caries scores showed a weak correlation of 0.22. Simple linear regression analysis to SM and caries score showed a significant increase of 4.74 units for 1 score increase in caries score, which is statistically significant. Conclusion: The presence of SM levels in children with caries is significant, whereas, in CF children, SS levels are present in increased levels. A strong correlation was seen between caries scores and SM. The simple linear regression analysis predicts a statistically significant increase by 4.74 units per increase of 1 score of caries at p < 0.001. As caries increase, SM count increases, but SS count decreases; as SS count increases, there is a reduction in SM counts. How to cite this article: Thimmegowda U, Belagatta V, Chikkanarasaiah N, et al. Identification and Correlation of Streptococcus mutans and Streptococcus sanguinis in Caries-active and Caries-free Children: A PCR Study. Int J Clin Pediatr Dent 2023;16(1):9-15.

Shear Bond Strength of Glass Ionomer Cement to Er, Cr:YSGG Laser-irradiated Dentin in Primary Teeth: An In Vitro Study.

Background: The clinical success of restorative materials depends upon a good adhesion with the dentinal surface to resist various dislodging forces acting within the oral cavity. Shear bond strength is the resistance to forces that slides restorative material past tooth structure. The Er, Cr:YSGG pulsed laser irradiation may be used to prepare enamel, dentin, cementum, and bone effectively and cleanly without leaving a smear layer. Aim: To compare the shear bond strength of GIC to dentin treated with conventional cavity conditioning and laser irradiation methods. Methodology: Thirty samples of noncarious human primary molars which get exfoliated either due to physiologic reasons or extracted due to any therapeutic reasons were collected for the study. Occlusal enamel was removed and teeth were then embedded in self-cured acrylic mold. All the prepared specimens were disinfected with Chloramine T solution and stored in distilled water for 24 hours at room temperature and teeth were randomly divided into the following groups; group 1: conventional cavity conditioning and type IX GIC restoration, group 2: Er, Cr:YSGG conditioning and type IX GIC restoration. Specimens were then subjected to thermocycling and shear bond strength was evaluated using the Lloyd testing machine. Statistical analysis: One-way ANOVA test followed by Tukey's HSD post hoc analysis was used to compare mean shear bond strength between two study groups. The level of significance [p-value] were set at p < 0.05. Result: Conditioning the dentin surface with Er, Cr:YSGG laser can increase the shear bond strength of glass ionomer restoration than conventional cavity conditioning. How to cite this article: Chikkanarasaiah N, P H. Shear Bond Strength of Glass Ionomer Cement to Er, Cr:YSGG Laser-irradiated Dentin in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):199-203.

A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population.

Aim: To determine the location of mandibular foramen (MF) and mental foramen (MeF) in 8-18-year-old children using cone beam computed tomography (CBCT). Materials and methods: Hundred CBCT images of children (8-18 years) were evaluated to determine the shortest distance from MF to the anterior border of ramus (A), posterior border of ramus (P) and inferior border of the mandible (MI), most superior point of the curvature of mandibular notch (MN), occlusal plane of the mandibular permanent molars (O), and the distance from MeF to lower border of mandible (BM) and to the alveolar crest (AC). Results: There was a statistical increase in A-MF, P-MF, MI-MF, MN-MF, and O-MF values with age. MF was found to be 3.53 mm below the occlusal plane in 8-11-year-old children, and it reaches the occlusal plane by 12-14 years of age, and it moves posterior-superiorly 3.58 mm above the occlusal plane in 15-18-year-old individuals. AC-MeF value decreases whereas the BM-MeF value increases with age and there was a significant difference based on sex. Conclusion: The location of the MF is just posterior to the middle of the ramus, it reaches the level of the occlusal plane by the age of 12-14 years, and MF and MeF are shifting posterior-superiorly with increasing age. Clinical significance: The awareness of localization of MF and MeF is of greater importance when administering regional anesthesia in mandible, especially in children. Its position varies according to gender and age, especially during growth spurts. Failure to achieve proper nerve block leading to repeated injection of the local anesthetic solution will not only pose a behavior problem in children but can also lead to systemic toxic level of anesthetic solution being administered. Its accurate position enables more effective local anesthesia and improves child cooperation, minimizing the risk of complications. How to cite this article: Vathariparambath N, Krishnamurthy NH, Chikkanarasaiah N. A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population. Int J Clin Pediatr Dent 2022;15(4):422-427.

Fragile and Brittle Bone Disease or Osteogenesis Imperfecta: A Case Report.

AIM AND OBJECTIVE: The aim and objective of this report is to describe the dental management of 11-year-old patient with type III osteogenesis imperfecta (OI). BACKGROUND: Osteogenesis imperfecta or brittle bone disease is caused by mutations in the collegen type I gene which is a heterogeneous rare connective tissue disorder. Dentinogenesis imperfecta, hearing impairment, scoliosis, sclera is blue, hyperlaxity of ligaments, and fragile skin are other common features. Individuals having positive family history suggest a straightforward diagnosis of OI but can be difficult in the absence of affected family. CASE DESCRIPTION: We report a case of 11-year-old boy, with a chief complaint of pain and swelling on the lower left back tooth region which was associated with extraoral draining sinus. His medical history revealed multiple fractures sustained during routine handling. On examination, the child was pale, dyspneic, with rhizomelic dwarfism, and relative macrocephaly with frontal bossing. On the grounds of history taken, clinical examination and respective investigations carried out, we came to a conclusion of osteogenesis imperfect type III. As the child needs a special care, we planned for a conservative treatment approach. CONCLUSION: The craniofacial abnormalities in OI-III affected person's impact on their dentofacial appearance and masticatory function. A detailed dental and craniofacial investigation is necessary in affected persons in order to identify any primary or secondary abnormalities. As soon as the deciduous teeth erupt, patients with OI should be evaluated with adequate dental treatment and oral hygiene instructions in order to reduce the need for extensive treatment. CLINICAL SIGNIFICANCE: Although oral manifestations are seldom seen, dentist should be extremely alert while managing this fragile bone disease. Early diagnosis, increased awareness, and effective treatment plan will reduce the effects of this debilitating disease. An ounce of prevention is worth a pound of cure, especially when something has no cure. HOW TO CITE THIS ARTICLE: Krishnamurthy NH, Chikkanarasaiah N, Nanjappa A, et al. Fragile and Brittle Bone Disease or Osteogenesis Imperfecta: A Case Report. Int J Clin Pediatr Dent 2020;13(4):425-428.

Effect of Full-Mouth Rehabilitation on Streptococcus mutans and Streptococcus sobrinus Levels in Children with Severe Early Childhood Caries.

Purpose: To investigate the effect of full-mouth rehabilitation on the levels of Streptococcus mutans and Streptococcus sobrinus in plaque samples of children suffering from severe early childhood caries using the quantitative reverse transcription polymerase chain reaction method.
Methods: A dental examination was performed to determine the decayed, missing, and filled primary teeth and surfaces (dmft and dmfs, respectively) in three- to five-year-old children using the World Health Organization's caries diagnostic criteria. Supragingival plaque samples were collected from all tooth surfaces with a sterile universal scaler at baseline and six months after full-mouth rehabilitation. The Wilcoxon signed-rank test was used to compare the mean values of dmft and dmfs scores and the mean values of S. mutans and S. sobrinus levels between the pre- and post-treatment period.
Results: At six months, the mean relative quantification values of S. mutans and S. sobrinus showed significant reductions (P > 0.05) in the post-treatment samples but the mean dmft scores remained the same.
Conclusion: Full-mouth rehabilitation is effective in reducing levels of S. mutans and S. sobrinus, thus diminishing the cariogenic challenge in the oral cavity.

Digital occlusal analysis of vertical dimension and maximum intercuspal position after placement of stainless steel crown using hall technique in children.

BACKGROUND: The stainless steel crowns (SSCs) placed using the Hall technique disrupt the occlusion, but stabilization appears to occur within a short period post-placement. Negligible understanding and comprehension is presently handy about the changes in overbite and bite force after placement of stainless steel crown using the Hall technique in children. AIM/HYPOTHESIS: To evaluate the digital occlusal analysis of vertical dimension and maximum intercuspal position to understand the changes in overbite and bite force after placement of stainless steel crown using the Hall technique. DESIGN: Twenty children who needed treatment for the carious tooth with decay extending to enamel and dentin and multisurface caries were managed using the Hall technique. Following that, overbite measurement for vertical dimension was carried out clinically using digital vernier calipers. Later, the T-Scan III was used for measuring occlusal load at the maximum intercuspal position. The bite force and occlusal premature contacts were digitally analysed and recorded pre-operatively, immediately after placement of SSC and after 1 month follow-up period. RESULTS: A significant result in the vertical dimension, bite force on crowned tooth, and significant reduction in the prematurities were seen from baseline to one-month follow-up. CONCLUSION: There was an occlusal re-equilibration attained after 1 month.

Genotoxic effects of X-rays in buccal mucosal cells in children subjected to dental radiographs.

OBJECTIVES/AIMS: Bitewing and digital dental panoramic radiographs have become important adjuvants for successful dental practice in pediatric dentistry. Both methods lead to genetic changes in the oral buccal epithelium that have not yet been satisfactorily explored. The aim of the present study was to evaluate the genotoxic effects induced by X-ray radiation from bitewing and panoramic dental radiography in exfoliated buccal epithelial cells of children, using the Buccal Micronucleus Cytome assay. MATERIALS AND METHODS: Children (n=40) who met the inclusion criteria and provided signed informed consent were included in the study. Children were selected for undergoing bitewing radiographs (group 1; n=20) or digital dental panoramic radiographs (group 2; n=20). Exfoliated buccal mucosal cells were obtained by scraping the right/left buccal mucosa with a wooden spatula immediately before the X-ray exposure and 10±2 days after exposure. RESULTS: The frequency of micronuclei increases significantly post exposure to both bitewing and digital dental panoramic radiography in children, but the frequency was higher in bitewing radiographs. CONCLUSION: It was concluded that the frequency of micronuclei increases post exposure to both bitewing and digital panoramic radiographs. Increased radiation exposure results in an increase in micronuclei frequency.

The effect of Propolis and Xylitol chewing gums on salivary Streptococcus mutans count: a clinical trial.

BACKGROUND: Streptococcus mutans is one of the most common cariogenic microorganisms. Use of natural anticariogenic agents, such as Xylitol has been well-established in the literature. On the other hand, there is a scarcity of studies that have reported the antimicrobial potential of Propolis as an anticariogenic chewing agent; hence, the present study was designed. AIMS: To evaluate and compare the anticariogenic action of two commercial chewing gums Propolis and Xylitol on the salivary S. mutans count in a group of children from Bengaluru city. SETTINGS AND DESIGN: Clinical setting and experimental design. MATERIALS AND METHODS: Thirty healthy children aged 8-11 years with decayed, missing, and filled teeth (dmft)/DMFT index score≥3 were included in the study. Before the test, unstimulated saliva was collected. Children divided into Group I and II were given Propolis and Xylitol chewing gums respectively; to chew for 15 min. Saliva samples were then collected at 15 min (just after spitting) and after 1 h. The amount of S. mutans in saliva was evaluated using a selective media (MSAB). In addition, compliance of the two chewing gums among the children was tested with a questionnaire. STATISTICAL ANALYSIS USED: Student's t-test. RESULTS: Six samples out of 30 were excluded due to no growth. The total number of bacterial colonies was significantly reduced when compared to baseline in both the groups. Propolis gum showed statistically significant reduction in the number of colonies as compared to Xylitol. Xylitol gum was more preferred than Propolis gum by the children. CONCLUSIONS: Propolis chewing gum can be used as an anticariogenic agent in children.