Bite force evaluation at maximal intercuspal position: An in vivo comparative study between stainless steel and zirconia crowns on primary molar teeth.

Objective: The objective of this study was to clinically evaluate and compare the mean bite force changes at maximum intercuspal position, along with parental satisfaction following full crown restoration using stainless steel crown/zirconia crown on primary molar teeth using digital occlusal analysis system T-Scan III (Tekscan Corp, Boston, Mass., USA). Materials and Methods: Thirty-six primary molars of children aged 6-9 years with pulpal involvement were selected for the study. The selected teeth were allocated to either of the two groups using simple random sampling technique: Group A = stainless steel crowned teeth and Group B = zirconia crowned teeth. The mean bite force was recorded before the placement of the crown, after the placement of the crown, and after 1 month-follow-up. The inter-group and intra-group comparison was done among the groups. After the placement of the crown, parents were asked to fill out a questionnaire for assessing parental satisfaction. Results: A significant result in the bite force on crowned tooth, vertical dimension was seen from baseline to 1-month follow-up between the SSC and zirconia groups. In the zirconia crown group, the mean bite force was more compared to the stainless steel crown group. Parents' satisfaction was higher with zirconia crown in terms of color and esthetics. Conclusion: SSC is more acceptable than zirconia crown since occlusal re-equilibration was attained better in SSC as compared to zirconia crown.

Clinical Evaluation of Maneuverability and Durability of Titanium Nitride-coated Preformed Crown on Primary Molar Teeth: A Randomized Controlled Trial.

Background: The management of multisurface carious primary molar is challenging. Currently, the ideal choice for the management of extensive multi-surface carious primary molar is the placement of a preformed stainlesssteel crown (SSC)/preformed zirconia crown. Unfortunately, conventional preformed SSCs are frequently refused by parents for esthetic reasons, while the preformed zirconia crown has its own disadvantages like high cost and excessive tooth preparation. Aim: To evaluate the maneuverability and durability of titanium nitride-coated crowns on primary molar teeth and to assess the child-parent satisfaction of titanium nitride-coated gold-colored preformed crowns over metal-colored preformed SSC on primary molar teeth. Materials and methods: Randomized controlled trial conducted on children between the age-groups of 6- and 9-year-old children. Group I for titanium nitride-coated preformed crown and group II for preformed SSC (control group) were allotted with a simple random technique. The maneuverability of the titanium nitride-coated crowns was evaluated in comparison with preformed SSC in terms of the level of difficulty while trimming, contouring, crimping, and wearing out of titanium nitride coating while manipulating. Participants of group I were recalled for follow-up in the 1st, 6th, and 12th months to evaluate the durability of the titanium nitride coating on the preformed crowns. Results: There were no failures at the 12-month follow-up in terms of the durability of the titanium nitride coating, and there was no significant difference seen in terms of the maneuverability of both crowns. Overall, child-parent satisfaction was good with gold-colored titanium nitride-coated crowns. Conclusion: The study concluded that titanium nitride-coated gold crowns could be a boon to pediatric dentistry and serve as an alternative to metal-colored SSCs. How to cite this article: Vundela RR, Gupta N, Balamurugan S, et al. Clinical Evaluation of Maneuverability and Durability of Titanium Nitride-coated Preformed Crown on Primary Molar Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(S-3):S263-S267.

Evaluation of Caries Removal Efficacy Using BRIX 3000 and Atraumatic Restorative Treatment in Primary Molars: A Clinical Comparative Study.

AIM: The aim of the present study was to compare and evaluate the efficacy of two minimally invasive methods in the removal of infected carious dentin in primary molars. MATERIALS AND METHODS: Eighty primary molars with class I occlusal caries involving dentin were selected and allocated to either of the two groups using convenient sampling. Group A (n = 40) caries were excavated using BRIX 3000 and in Group B (n = 40) atraumatic restorative treatment (ART) caries were excavated using hand instruments only. In both groups, caries removal efficacy was evaluated clinically using caries detection dye (Sable and Sleek), and the patient's discomfort level was noted using the Wong-Baker faces pain rating scale (WBFPS). RESULTS: The results indicated that BRIX 3000 was effective in the removal of caries from primary molars with a significant difference. While there was no statistically significant difference seen in pain perception on caries excavation using both the methods. Although, a mild discomfort was noted in Group B. CONCLUSION: Comparing the two minimally invasive techniques, the new chemomechanical solution (BRIX 3000) was an effective method for the removal of caries from primary molars. So, it can be considered an alternative to the conventional caries removal method in treating pediatric dental patients. CLINICAL SIGNIFICANCE: BRIX 3000 gel is effective in the removal of caries in children who are anxious and apprehensive as it is a noninvasive method of treatment in the pediatric age group.

Evaluation of Microleakage of Different Types of Pit and Fissure Sealants: An In Vitro Comparative Study.

Aim: Compare and evaluate the microleakage of different types of pit and fissure sealants, 3M ESPE Clinpro, GC Fuji Triage Capsule, and 3M ESPE Filtek Z350 XT. Materials and methods: A total of 54 freshly extracted maxillary and mandibular premolar teeth were used and randomly divided into three groups of 18 teeth each, and the following pit and fissure sealants were used: group I-Clinpro, group II-GC Fuji Triage Capsule, and group III-Filtek Z350 XT. Samples underwent thermocycling at 5° and 55°C with a dwell time of 10 seconds for 250 cycles. The apices of the teeth were sealed with impression compound, and two coats of fingernail polish were applied and immersed in 5% methylene blue dye for 24 hours and then sectioned. The sectioned specimens were then analyzed at 4× magnification under a stereomicroscope for dye penetration and were evaluated based on Williams and Winters' criteria. Results: The data were collected for statistical analysis. Descriptive statistics included mean, standard deviation (SD), frequency, and percentage. Inferential statistics included the Chi-squared test and one-way analysis of variance (ANOVA), followed by the post hoc Tukey's test. The level of significance was set at 0.05 at a 95% confidence interval, and the results revealed that the mean difference of the sealants was GC Fuji Triage (2.1667), Clinpro (0.7778), and Filtek Z350 XT (0.1667). Conclusion: Filtek Z350 XT exhibited the least microleakage when compared to Clinpro and GC Fuji Triage, with their mean difference statistically significant. Hence, Filtek Z350 XT can be a promising sealant and a restorative material. How to cite this article: Prabahar T, Chowdhary N, Konkappa KN, et al. Evaluation of Microleakage of Different Types of Pit and Fissure Sealants: An In Vitro Comparative Study. Int J Clin Pediatr Dent 2022;15(5):535-540.

Estimation of Copper Levels in Saliva and Its Relation to Dental Caries and Hemoglobin Levels.

CONTEXT: A very small quantity of trace elements will be present in saliva. Salivary composition influences caries inhibition and promotion based on the different organic, inorganic, and trace elements. AIM AND OBJECTIVE: To evaluate the levels of copper in saliva in children with caries-active and caries-free group and to associate copper levels of saliva with hemoglobin (Hb) levels of blood. MATERIALS AND METHODS: Sixty subjects between the ages of 6 and 14 years were divided into group I-caries-free and group II-caries-active. The caries-active group was further subdivided into group IIa (deft/DMFT < 3) and group IIb (deft/DMFT > 3). To maintain the uniformity of salivary composition, unstimulated saliva (5 mL) was collected in noontime before food from all the participants. The copper levels were estimated by atomic absorption spectrophotometry. Hemoglobin levels in the blood and their relation with copper levels in saliva were estimated. STATISTICAL ANALYSIS: The results thus obtained were analyzed by t-test and Karl Pearson's correlation coefficient. It was considered significant if the "p" value is 0.05 or less. RESULTS: Copper levels were higher in group II showing statistically highly significant results compared with that of group I with p ≤ 0.00001. The results were no significant with respect to Hb scores among the groups. CONCLUSION: A definite positive correlation is seen with dental caries and levels of copper in saliva. Hence, the amount of copper in saliva can be considered as a caries risk assessment tool. HOW TO CITE THIS ARTICLE: Reddy VR, Devakar S, Chowdhary N, et al. Estimation of Copper Levels in Saliva and Its Relation to Dental Caries and Hemoglobin Levels. Int J Clin Pediatr Dent 2021;14(2):235-237.

Remineralization efficacy of nonfluoride versus herbal-based pediatric dentifrice in demineralized primary teeth.

BACKGROUND: Dental caries is one of the most prevalent posteruptive bacterial infections worldwide, characterized by a progressive demineralization process that affects the mineralized dental tissues. Although the decline of dental caries prevalence can be attributed to the widespread use of dentifrices that contain fluoride, yet there is a need for an advanced alternative nonfluoride remineralizing dentifrice. Yet, there is a need for an advanced alternative nonfluoride remineralizing dentifrice. AIM: The aim of this study was to evaluate and compare the remineralizing effect of nonfluoride-based and herbal-based pediatric dentifrice in demineralized primary teeth with an ideal in vitro method of pH cycling and evaluating the values under Polarized Light Microscope (Olympus BX43) using image analysis software (ProgRes, Speed XT core3). MATERIALS AND METHODS: A total of 30 tooth samples were collected and placed in the demineralizing solution for 96 h to produce a demineralized lesion of approximately 100 µm, and then cut longitudinally into 60 sections that were randomly assigned to two groups with 27 samples each, Group A - nonfluoride-based dentifrice (Mee Mee®), Group B - herbal-based dentifrice (Mamaearth™), after which they were subjected to pH cycling for 7 days along with dentifrice slurry preparation. The sections were evaluated under the polarizing light microscopy for remineralizing efficacy. The lesion depth was measured and tabulated to be sent for statistical analysis. RESULTS: The mean demineralization value for nonfluoride and herbal-based dentifrice groups were 7.8730 µm and 28.3174 µm, respectively. Hence, it can be inferred that since lesion depth measured was lesser in nonfluoride than herbal-based dentifrice, remineralization has occurred in the nonfluoride-based dentifrice group. CONCLUSION: Nonfluoride-based dentifrice showed significant results in remineralizing the demineralized lesion, while herbal-based dentifrice showed poor efficiency in remineralizing the demineralized lesion.

Comparative Evaluation of Occlusal Bite Force in Relation to the Muscle Activity in the Mixed Dentition Children of Age Group 9-12 Years: A T-scan Analysis.

AIM AND OBJECTIVE: Compare and evaluate the muscle activity and the occlusal force between the mixed dentition boys and girls of 9-12 years. MATERIALS AND METHODS: The study included 15 boys and 15 girls. The occlusal force and activity of the masseter and temporalis muscle were measured with a T-scan device using a sensor, a module to transmit the signals to a computer and the complete data of the bite force and muscle activity with the EMG recordings and data were collected and evaluated. RESULTS: Relative occlusal force in the primary and permanent molars between the boys and girls showed no significant difference on the left side compared to the right. The electromyography values of masseter and temporalis in boys and girls showed a significant difference in which (TAR and MMR), (TAR and MML), (TAL and MMR), and (TAL and MML) are significant. The overall paired sample statistics showed higher muscle activity in masseter. CONCLUSION: T-scan analysis has proved to be a dependable method for the evaluation of occlusal bite force with the muscle activity interpretation using EMG. This study concluded that there is a difference in the occlusal pattern and muscle activity in the mixed dentition that showed the maximum force was on the permanent molars and the symmetry of EMGs activity in children was on the right masseter comparatively with higher bite values in boys compared to girls. CLINICAL SIGNIFICANCE: T-scan is a computerized analysis system that helps in the proper assessment of the patient's occlusion and assists in the proper treatment planning and diagnosis accurately without much effort. HOW TO CITE THIS ARTICLE: Prabahar T, Gupta N, Chowdhary NR, et al. Comparative Evaluation of Occlusal Bite Force in Relation to the Muscle Activity in the Mixed Dentition Children of Age Group 9-12 Years: A T-scan Analysis. Int J Clin Pediatr Dent 2021;14(S-1):S29-S34.

Use of Restorative Full Crowns Made with Zirconia in Children: A Systematic Review.

AIM AND OBJECTIVE: The purpose of this systematic review is to analyze the suitability of the zirconia crowns for restoration of damaged primary teeth in children. BACKGROUND: This systematic review has been conducted in line with the preferred reporting items for systematic reviews (which is also called as PRISMA) guidelines. A search for the relevant articles of zirconia crowns in deciduous teeth has been made in electronic database of PubMed and a study design (meta-analysis), i.e., PICOS framework. The words used in the search are "zirconia crowns" and "primary molars," "zirconia crowns" and "primary incisors," "zirconia crowns" and "children," "zirconia crowns" and "primary teeth." REVIEW RESULTS: The database search showed 44 studies of which 20 articles were excluded as they were irrelevant, duplicates, and data were not available. In the present systematic review, the remaining 24 articles were included. CONCLUSION: Zirconia crowns have been proved with better results than other crowns in terms of gingival and periodontal health, esthetics, and crown fractures. However, the quantity of tooth preparation and the wear of antagonist tooth are reported to be more in case of zirconia crowns. Future randomized control studies should be carried out in primary teeth due to less number of randomized studies on this topic. CLINICAL SIGNIFICANCE: Zirconia crowns are now widely used in dentistry and there is an increase in the number of studies, so a systematic review evaluating and comparing results is warranted. HOW TO CITE THIS ARTICLE: Ajayakumar LP, Chowdhary N, Reddy VR, et al. Use of Restorative Full Crowns Made with Zirconia in Children: A Systematic Review. Int J Clin Pediatr Dent 2020;13(5):551-558.

Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study.

Composite restorations are popular because of their superior esthetics and acceptable clinical performance. But shrinkage is still a drawback. Polymerization shrinkage results in volumetric contraction, leading to deformation of the cusps, microleakage, decrease of marginal adaptation, enamel micro-cracks and postoperative sensitivity. A new class of ring opening resin composite based on silorane chemistry has been introduced with claims of less than 1% shrinkage during polymerization. The present study was conducted to evaluate and compare the ability of low shrink silorane based material, a packable composite and a compomer to resist microleakage in class II restorations on primary molars and evaluate marginal ridge fracture resistance of these materials. Sixty human primary molars were selected. Class II cavities were prepared and the teeth were divided into three groups of twenty each. Groups were as follows group I: low shrink composite resin (Filtek P90). Group II: packable composite (Filtek P60) and Group III: compomer (Compoglass F). Half of the teeth were used for microleakage and the rest for marginal ridge fracture resistance. For microleakage testing, dye penetration method was used with 1% methylene blue dye. Followed by evaluation and grading under stereomicroscope at 10* magnification. Fracture resistance was tested with universal testing machine. It was concluded that low shrink silorane based composite resin showed the least amount of microleakage, whereas compomer showed the highest microleakage. Packable composite resisted fracture of marginal ridge better than other composite resins. Marginal ridge fracture resistance of packable composite was comparable to the intact side. How to cite this article: Yeolekar TS, Chowdhary NR, Mukunda KS, Kiran NK. Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study. Int J Clin Pediatr Dent 2015;8(2):108-113.

Retention of resin-based filled and unfilled pit and fissure sealants: A comparative clinical study.

BACKGROUND AND OBJECTIVES: The most caries-susceptible period of a permanent first molar tooth is the eruption phase, during which the enamel is not fully matured and it is usually difficult for the child to clean the erupting tooth surfaces. Sealing occlusal pits and fissures with resin-based pit and fissure sealants is a proven method to prevent occlusal caries. The difference in the viscosity of the sealants differs in the penetration into pit and fissures and abrasive wear resistance property due to the addition of filler particles. The present study was conducted to evaluate and compare the retention of the resin-based filled (Helioseal F, Ivoclar Vivadent) and unfilled (Clinpro, 3M ESPE) pit and fissure sealants, which is important for their effectiveness. MATERIALS AND METHODS: Fifty-six children between the age group of 6 and 9 years, with all four newly erupted permanent first molars were selected. Sealants were applied randomly using split mouth design technique on permanent first molars. Evaluation of sealant retention was performed at regular intervals over 12 months, using Simonsen's criteria at 2(nd), 4(th), 6(th), 8(th), 10(th) and 12(th) month. The results were subjected to statistical analysis. RESULTS: At the end of our study period (12(th) month), 53.57% showed complete retention, 37.50% showed partial retention, and 8.83% showed complete missing of resin-based filled (Helioseal F) pit and fissure sealant. And, 64.29% showed complete retention, 32.14% showed partial retention, and 3.57% showed complete missing of resin-based unfilled (Clinpro) pit and fissure sealant. This difference in retention rates between filled and unfilled pit and fissure sealants was not statistically significant. CONCLUSION: The difference in retention rates between Helioseal F and Clinpro was not statistically significant, but Clinpro (unfilled) sealant showed slightly higher retention rates and clinically better performance than Helioseal F (filled).

Early detection of congenital syphilis.

Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson's teeth.

Need of implant dentistry at undergraduate dental curriculum in Indian dental colleges.

Edentulism is the major problem in the developing countries, and is widely spread in the current population, although the prevalence is declining and incidence of tooth loss is decreasing in the developed nations. The prevalence of edentulism in India varies from 60% to 69% of 25 years and above age group. It is obvious that the number of lost teeth increases with age leading to an increase in prevalence of partially edentulous patients. From a biological point of view, the replacement of a single missing tooth with an implant rather than a three-unit fixed partial denture, and the implant-supported complete denture has been proved more efficient in improving the mastication and maintaining the bone for a longer time and also more cost-effective treatment. Many dental schools throughout Europe and America have to a various extent introduced implant dentistry as part of the compulsory undergraduate curriculum. Thus, it becomes more essential to introduce implant dentistry at undergraduate level in Indian dental schools to manage the higher percentage of edentulism.

An unusual sucking habit in a child.

Presence of oral habit in 3-6 year old children is an important finding in the clinical examination. An oral habit is no longer considered as normal for children near the end of this age group. In pre-school children, digit and dummy sucking is a predominant habit, and girls are found to have a higher level of sucking habit then boys do. Here is a case report of a unique sucking habit, which if not stopped, will lead to dental problem in the child.