Study of Developmental Defects of Enamel in Young Permanent Maxillary Incisors in 11-13-year-old Indian Children for Occurrence Distribution and Associated Factors.

Purpose: The aim of present study was to assess the frequency, severity, and distribution of developmental defects of tooth enamel and correlate the etiology with the type of defect in 11-13-year-old Indian children. Materials and methods: The present study included examination of permanent maxillary incisors in 500 children in the age-group of 11-13 years to examine the occurrence of distribution of developmental defects of tooth enamel. Materials and methods: Only the buccal surface of four permanent maxillary incisors was examined for enamel defects using modified developmental defects of enamel (DDE) index by Clarkson which recognized three basic types of enamel defects; namely demarcated opacities, diffuse opacities, and hyploplsia. Personnel details, dental history which included dental infection, extraction, trauma, lifetime fluoride, fluoride in water, and medical history were also recorded. Data was coded and analyzed for distribution of developmental defects of tooth enamel by tooth type and gender using Statistical Package for the Social Sciences. Result: Out of 500, 114 (22.8%) children showed defective enamel in permanent maxillary incisors. Of all enamel defects, diffuse opacities were most prevalent with 48.25% occurrence followed by demarcated opacities 38.5%, hypoplasia 10.52%, and any other defects 1.75%. No significant difference was observed in males and females for the occurrence of developmental enamel defects. The occurrence of dental enamel defect significantly correlated with dental history as well as with medical history (Chi-squared statistical test, p-value = 0.001**). Conclusion: (1) High fluoride in water accounts for most prevalent diffuse opacity. (2) Demarcated opacities are associated mainly with positive dental history. (3) Hypoplasia of incisors was found to be least prevalent associated with trauma, periapical infections. How to cite this article: Sheoran N, Garg S, Dhindsa A, et al. Study of Developmental Defects of Enamel in Young Permanent Maxillary Incisors in 11-13-year-old Indian Children for Occurrence Distribution and Associated Factors. Int J Clin Pediatr Dent 2023;16(S-2):S176-S182.

Effect of maternal parenting style on child behaviour and its management strategies in dental office: A pilot study.

AIM: To evaluate the effect of maternal parenting style on child behaviour and consequent management strategies in dental office. MATERIALS AND METHODS: Eighty child-mother pairs were included in the study. Before the start of the treatment, Maternal parenting style was evaluated utilising Primary Caregivers Practices Report, while child behaviour along with his/her perception towards dental treatment were observed using Frankl Behaviour Rating Scale and Sound Eye Motor scale, respectively. Also the behaviour management strategy utilised for the child was noted and its correlation to both parenting style and child behaviour was evaluated. RESULTS: A statistically significant correlation (p-value = 0.00) was observed between the maternal parenting style and child behaviour displayed during dental treatment. Also, a positive correlation (p-value = 0.00) was observed between behaviour displayed by the children and behaviour management strategy used in the dental operatory. CONCLUSION: The clinicians can predict the type of behaviour the child might display and the behaviour management strategy to be utilised for a specific child based on the maternal parenting style.

Applicability of moyer's probability tables in north indian population of 16-18 years old.

AIMS: To determine the applicability of Moyer's probability tables in North Indian population of 16-18 year olds and to formulate a new regression equation for the same group of population. SETTING AND DESIGN: Evaluative Study. METHODS AND MATERIAL: 1000 children aged 16-18 years were selected as sample for the measurement of mesiodistal widths of permanent mandibular incisors, maxillary and mandibular canines and premolars using study models. The recorded values were then subjected to statistical analysis. STATISTICAL ANALYSIS USED: Software Package for Social Sciences (SPSS) software version 22.0. RESULTS: The actual widths of the canine and premolars showed highly significant differences in maxilla and in mandible (P < 0.001), compared to widths predicted by Moyer's probability table at 75th percentile. CONCLUSION: Moyer's mixed dentition analysis was not an accurate method for prediction in North Indian population as it showed overestimation of tooth sizes. Hence, new regression equation has been formulated for the same.

Knowledge regarding avulsion, reimplantation and mouthguards in high school children: Organised sports-related orodental injuries.

PURPOSE: To assess knowledge, awareness and attitude of high school children involved in various sports activities regarding avulsion, reimplantation and mouthguard use. MATERIALS AND METHODS: An interview-based study was conducted among high school children in the age group of 8-16 years (n = 1105). A questionnaire was given to children and parents which included questions based on knowledge of children regarding avulsion, reimplantation, consequences of losing teeth, mouthgards and their usage and preferred media for tooth transportation. The research proposal was submitted to the ethics committee and the study design was approved. Data analysis included descriptive statistics and Statistical Package for the Social Sciences (SPSS) software. RESULTS: Only 37.6% of the children knew that their teeth can be completely knocked out with injury and 20.1% knew that a knocked-out tooth can be replanted. The preferred media for tooth transportation were gauze/cotton (27.2%), handkerchief (17.5%), paper (14%), water (13.8%) and cellophane (1.3%), i.e. 81.3% of the children preferred dry transport media. Among the children playing contact sport, 53.8% did not know about mouthguards and the rest 46.2% knew about it, but most of them never used it. CONCLUSION: Considering the lack of awareness among children, as well as the people around them, there appears to be a crucial need for education of public and to determine dental manpower and dentists to increase awareness.

Split-mouth Randomised Clinical Trial on the Efficacy of GIC Sealant on Occlusal Surfaces of Primary Second Molar.

PURPOSE: To evaluate the clinical performance of high viscosity GIC sealant applied with or without additional light curing in children with early childhood caries (ECC). MATERIALS AND METHODS: A split-mouth clinical trial was conducted in a total of 111 3- to 5-year-old children with ECC. 180 pairs of non-carious primary second molars were selected and divided into two groups: study and control. On the basis of the application technique, selected teeth in the study group were further allotted to group A (sealant application with additional light curing) and group B (sealant application without additional light curing). Caries incidence was observed for 1 year in the anatomical pits and grooves, along with sealant retention and marginal discolouration at various intervals over the 1-year period. RESULTS: Group A (GIC sealant with additional light curing) (44.2%) showed sealant retention similar to that of group B (GIC sealant without additional light curing) (43.0%) (p = 0.885). Caries incidence was significantly higher in the control group (26%) than the sealant groups (1%) (p < 0.001). No marginal discolouration adjacent to the sealant was observed in either anatomical grooves or pits in both sealant groups for the duration of the study. CONCLUSION: Retention and caries prevention by high-viscosity GIC sealant applied with or without additional light curing was found to be similar. At the 12-month assessment, mean dmfs scores and caries incidence in primary second molars were higher in the control than in both study groups.

Comparative Clinical and Microbial Evaluation of Two Endodontic File Systems and Irrigating Solutions in Pediatric Patients.

AIMS: The purpose of the study was to determine the best combination for chemomechanical preparation in primary teeth using two endo file systems (hand and rotary) along with two different irrigants. MATERIALS AND METHODS: Sixty primary molars indicated for pulpectomy, underwent chemomechanical preparation using endo files (H hand files and rotary Protaper files) and root canal irrigating solutions (Smearclear and QMiX). Samples from root canals were collected before and after the chemomechanical preparation of the canal and were cultured for microbial analysis of Enterococcus faecalis. RESULTS: Endodontic irrigating solutions showed significant differences of effectiveness on the growth inhibition of bacterial strain. The present study confirmed that the in vivo antimicrobial efficacy of QMiX solution was statistically significant when compared to the Smearclear solution. CONCLUSION: Based on the antimicrobial efficacy observed in the present study, it may be concluded that QMiX has a great potential than Smearclear as an intracanal irrigation solution in primary teeth and rotary preparation may be considered as more efficient and time-saving mechanical preparatory technique in primary molars.

Prevalence and associated Risk Factors of Severe Early Childhood Caries in 12- to 36-month-old Children of Sirmaur District, Himachal Pradesh, India.

AIM: To assess the prevalence, distribution, and associated risk factors of severe early childhood caries (S-ECC) among 12- to 36-month-old children of district Sirmaur, Himachal Pradesh, India. MATERIALS AND METHODS: The present study was conducted on a random sample of 510 children, both boys and girls, between 12 and 36 months of age randomly selected from various government-sponsored day-care centers, private day-care centers, and vaccination centers. Caries was recorded using World Health Organization criteria. Statistical analysis was done by using chi-square test and Mann-Whitney test. A two-sided p value was calculated for each statistical test. Multiple logistic regressions were done to calculate the risk of S-ECC from independent variables. RESULTS: In the present study, S-ECC was found in 21% of 510, 12 to 36 months old children of Sirmaur district, Himachal Pradesh. The S-ECC was found to be significantly higher in 25 to 36 months old children's age group and was 27.8% in them as compared with 8% in 12 to 24 months old children. CONCLUSION: Providing anticipatory guidance and education to parents is essential for the promotion of optimal oral health of their children. There is a need for moving upstream to propose and implement policies and programs to improve the oral health of the very young, especially in a developing country like India, which lacks much data on S-ECC. HOW TO CITE THIS ARTICLE: Mangla RG, Kapur R, Dhindsa A, Madan M. Prevalence and associated Risk Factors of Severe Early Childhood Caries in 12- to 36-month-old Children of Sirmaur District, Himachal Pradesh, India. Int J Clin Pediatr Dent 2017;10(2):183-187.

Oral Subcutaneous Midline Leiomyomatous Hamartoma Presenting as Congenital Incisive Papilla Overgrowth in a Toddler.

Congenital soft-tissue tumors of oral cavity are mostly hyperplastic and benign in nature. This article presents an unusual case of congenital subcutaneous hamartoma of incisive papilla in a 2-year-old female child causing feeding and breathing difficulty. Total excisional biopsy was done under local anesthesia. Histopathology of tissue in reticulin-stained slide showed the presence of immature muscle fibers whereas Masson's trichrome stain revealed collagen fibers and smooth muscles confirming the diagnosis of oral midline subcutaneous smooth muscle (leiomyomatous) hamartoma of incisive papilla. It is important for dental professionals to be aware of this oral lesion present from birth mimicking overgrowth of incisive papilla, by its presentation, differential diagnosis, histopathology, and management.

In Vivo Effect of Calcium Hydroxide and Resin-modified Glass Ionomer Cement on Carious Dentin in Young Permanent Molars: An Ultrastructural and Macroscopic Study.

PURPOSE: The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of calcium hydroxide cement (CH) and resin-modified glass ionomer cement (RMGIC) compared with gutta percha (control) as a lining material on carious dentin after partial caries removal and sealing. METHODS: Twenty-seven permanent molars with deep carious lesions underwent partial caries removal with the application of CH, RMGIC, or gutta percha (control) and were then sealed for three months. After a partial caries removal and sealing period, the dentin was macroscopically assessed (for color, consistency, and humidity) and further analyzed by scanning electron microscope to assess the ultrastructural changes in dentin (lumen size, mineralization of tubules, occlusion of tubules by cements, and bacterial ingress). The effect of treatment in each group was statistically analyzed. RESULTS: Dentin darkening and hardening were observed after the sealing period in all groups. However, there was no difference in the color after treatment among the three groups. It was observed that RMGIC showed a significant reduction in the size of the lumen compared to CH and the control. CONCLUSION: Partial caries removal and sealing resulted in dentin hardening, darkening, and dentin remineralization, irrespective of the dentin protection used.

Transmission of mutans streptococci in mother-child pairs.

BACKGROUND & OBJECTIVES: Dental caries is an infectious, transmissible disease. Maternal transfer of mutans streptococci (MS) has been a subject of research. The aim of this study was to evaluate the transmission of MS from mother to children through genetic analysis. METHODS: Thirty mother-child pairs were included and divided into three groups according to the age of the children. Saliva samples were collected and MS colonies from each mother-child pair were isolated. After inoculation and incubation, MS colonies were submitted to amplification technique by polymerase chain reaction (PCR) for identification and arbitrarily primed PCRs (AP-PCRs) to determine various MS genotypes. RESULTS: From birth to six months of age, 30 per cent of children exhibited MS colonization, and by the age of 30 months, 100 per cent harboured the bacteria (P < 0.001). Factors associated with MS colonization were eruption of teeth (P < 0.001), feeding habits with mean colony count being significantly lower in breast-fed as compared to bottle-fed children (P < 0.001) and a significant association between mean MS count of child and mother's practice of sharing spoon with child (P < 0.001). The AP-PCR fingerprinting profile analysis showed 17 MS groups (clusters) containing identical or highly related isolates in mother-child pairs with a high level of similarity (77.27 %). INTERPRETATION & CONCLUSIONS: The presence of matching MS genotypes suggested vertical transmission from mothers to children. Feeding habits, gum cleaning and number of erupted teeth in children had significant effect on MS colonization. There is a need to develop strategies to present MS colonization in children.

Plaque removal efficacy of Colgate 360 toothbrush: A clinical study.

AIM: The aim of this clinical study was to confirm the plaque removal efficacy of the Colgate 360 Whole Mouth Clean Toothbrush. STUDY DESIGN: This was a single-center, monadic, case-controlled study with the 7 days duration. MATERIALS AND METHODS: A total of eighty participants (56 male and 24 female) aged between 18 and 45 years with a minimum of 20 permanent teeth (excluding the third molars) without any prosthetic crowns and an initial plaque score of minimum 1.5 as determined by Modified Quigley-Hein Plaque Index (1970) participated in the study. There were two dropouts during the study duration, one male and one female. The participants were instructed to brush for 1 min, after which plaque index was recorded again. They were then instructed to brush their teeth twice a day for 1 min with the assigned toothbrush (Colgate 360 Whole Mouth Clean Toothbrush) and a commercially available fluoride toothpaste for the next 7 days. On the 7(th) day, all the participants were recalled for follow-up and plaque examination. The plaque index scores (pre- and post-brushing) were recorded, tabulated, and analyzed statistically. RESULTS: The mean plaque indices reduced after brushing both on day 1 and day 7. There was also a reduction in mean plaque indices from day 1 to day 7. All these reductions were statistically significant (P < 0.001). The reduction in plaque scores was independent of the gender of the participants however female participants showed lower scores as compared to male participants (P < 0.001). CONCLUSION: The present study demonstrated a significant reduction in plaque scores with the use of Colgate 360 Whole Mouth Clean Soft Toothbrush throughout the study period. Continued use resulted in a further significant reduction in plaque scores irrespective of the gender of participants.

Assessment of White Spot Lesions and In-Vivo Evaluation of the Effect of CPP-ACP on White Spot Lesions in Permanent Molars of Children.

INTRODUCTION: As hindrance of remineralisation process occurs during orthodontic therapy resulting in decalcification of enamel because number of plaque retention sites increases due to banding and bonding of appliances to teeth. AIM: The present analytic study was undertaken to assess the occurrence of white spot lesions in permanent molars of children with and without orthodontic therapy and to evaluate the effect of Casein PhosphoPeptide-Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions in post-orthodontic patients in a given period of time. MATERIALS AND METHODS: The study comprised of examination of 679 first permanent molars which were examined to assess the occurrence of smooth surface white spot lesions in children of 8 to 16 years age group. Group I comprised subjects without any orthodontic treatment and Group II comprised of subjects who had undergone orthodontic therapy. The sample size was calculated using the epi-info6 computer package. Treatment group included 20 post-orthodontic patients examined with at least one white spot lesion within the enamel who received remineralizing cream (GC Tooth Mousse, Recaldent, GC Corporation.) i.e., CPP-ACP cream two times a day for 12 consecutive weeks. Computerized image analysis method was taken to evaluate white spot lesions. These frequency and percentages were compared with chi-square test. For comparison of numeric data, paired t-test was used. RESULTS: Of the total 278 (49.6%) first permanent molars showed occurrence of smooth surface white spot lesions out of 560 in Group I and 107 (89.9%) first permanent molars showed presence of white spot lesions out of 119 debanded first permanent molars of children examined in Group II. CPP-ACP therapy group showed reduction in severity of codes which was found to be highly significant after 12 weeks and eight weeks on gingival-third, p-value (<0.001) and significant after eight weeks and four weeks on middle-third according to ICDAS II criteria and computerized image analysis. CONCLUSION: CPP-ACP therapy minimum for 12 weeks is highly recommended as post-orthodontic treatment need in management of smooth surface white spot lesions on teeth undergoing fixed orthodontic therapy according to the present study.

Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study.

BACKGROUND: To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)2) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. MATERIALS AND METHODS: The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). RESULTS: In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)2 group. CONCLUSION: MTA and Ca(OH)2, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.

Correlation between dental caries experience and mutans streptococci counts by microbial and molecular (polymerase chain reaction) assay using saliva as microbial risk indicator.

BACKGROUND: The aim of this study was to assess the relationships of quantitative salivary levels of mutans streptococci (MS) in children, aged 3-6 years and 12-15 years, exhibiting variable patterns of caries activity, and to compare the association of MS in saliva using microbial and molecular (polymerase chain reaction [PCR]) assay. MATERIALS AND METHODS: In this cross-sectional observational study, eighty children were included, forty children each in Group I (3-6 years) and Group II (12-15 years). Children were further divided into two subgroups (Group IC, INC and Group IIC, IINC) based on their dental caries status. Saliva samples were collected and plated onto Mitis Salivarius-Bacitracin agar plates. After detection of MS, DNA was isolated and purified, and MS were evaluated using the PCR and AP-PCR. RESULTS: Of the selected 80 children, 42 were male and 38 were female. In Group IC, the mean colony count was 2.27 ± 0.54 × 105 CFU/ml, and in Group INC, the mean colony was found to be 1.61 ± 0.54 × 105 CFU/ml. In Group II, where mean colony count of 3.31 ± 0.85 × 105 CFU/ml and 2.44 ± 0.54 × 105 CFU/ml was observed in Group IIC and Group IINC, respectively. CONCLUSION: The mean colony count increased with increasing age and was also more in children with dental caries. Based on the matrices generated by the PCR analysis using coefficient slipped-strand mispairing, wide range of genetic diversity was seen in cases of children with and without clinically detectable caries.

A study of sports related occurrence of traumatic orodental injuries and associated risk factors in high school students in north India.

BACKGROUND: Oral and dental injuries contribute to a major part of sports related injuries in children. Trauma occurring in developing years disrupts normal social functioning and brings about a major impact on quality of life due to their cumulative effect. OBJECTIVES: To assess the prevalence and causes of various sports related traumatic orodental injuries among 8 to 16 year school students along with identifying the associated risk factors in North India. PATIENTS AND METHODS: A cross sectional study consisting of high school students of different organized sports teams aged 8-16 years was carried out in geographical area of north India. The students were selected by multistage cluster sampling methodology. 1105 students from 19 school teams (sports teams) and sports academies participated in study through structured interview and clinical examination in different sports situations. RESULTS: 30.3% (n = 335) of students suffered from orodental injuries. A higher number of girls had injury (32%) than boys (29%), though the difference was not significant. Most of the students suffered from soft tissue injuries (48%) followed by tooth fractures (43%). Maximum numbers of injuries were reported in high velocity (44.1%) and medium intensity sports (46.6%) (P < 0.001) Maximum injuries occurred in basketball (50%) and lowest in the field of badminton (6.1%) (P < 0.05). Amateurs (52%) suffered the most from injuries as per level of coaching. Only 6% of boys and 2% of girls used mouthguards. CONCLUSIONS: The result of the present study confirmed that students participating in different organized sports at high school level are at a very high risk of getting orodental injury. Hence knowledge and education regarding prevention of traumatic injuries is of paramount importance.

Esthetic management of developmental enamel opacities in young permanent maxillary incisors with two microabrasion techniques--a split mouth study.

PURPOSE: This study evaluated the effectiveness of two microabrasion materials for the removal of developmental enamel opacities in young permanent maxillary incisors. MATERIALS AND METHODS: Using a split-mouth study design, 37% phosphoric acid and 18% hydrochloric acid were used for removal of visually unesthetic developmental enamel opacities of young permanent maxillary anterior teeth from 25 subjects (11-13 years old) by two microabrasion techniques for 10 and 5 seconds respectively. This procedure was repeated four to six times during each clinical appointment. The subjects were evaluated about their satisfaction with the treatment. Two blinded evaluators appraised both sides of the mouth using visual analog scale. The records were analyzed using Wilcoxon test. RESULTS: The majority of the subjects (approximately 97%) reported satisfaction at the end of the treatment (p = 0.001**). Statistical significant reduction in enamel opacities was observed by evaluators immediately after microabrasion technique in group 1 (81.75%) and in group 2 (81.4%) (p < 0.002). Reduction was increased to 97.2% in group 1 and 96.7% in group 2 after 1 month. CONCLUSIONS: Both microabrasion techniques showed comparative highly significant successful results in esthetic management of enamel opacities clinically and in terms of subject's satisfaction. CLINICAL SIGNIFICANCE: Developmental enamel defects like diffuse opacities due to high-fluoride content in water and demarcated opacities associated with positive dental history and are commonly seen in young permanent maxillary incisors of both boys and girls in their developing years. They are aware of unesthetic appearance of these newly erupted permanent anterior teeth and become highly motivated when informed about minimally invasive, patient friendly, cost-effective, and safe treatment like microabrasion for esthetic improvement. Both noninvasive microabrasion techniques using 37% phosphoric acid (group 1) and 18% hydrochloric acid (group 2) show comparatively high success results in treating enamel defects successfully to the subject's satisfaction along with their parents.

Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly.

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible. Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Comparative evaluation of the effectiveness of electronic dental anesthesia with 2% lignocaine in various minor pediatric dental procedures: A clinical study.

One of the most distressing aspects of dentistry for pediatric patients is the fear and anxiety caused by the dental environment, particularly the dental injection. The application and induction of local anesthetics has always been a difficult task, and this demands an alternative method that is convenient and effective. Electronic dental anesthesia, based on the principal of transcutaneous electric nerve stimulation (TENS), promises to be a viable mode of pain control during various pediatric clinical procedures. Therefore, the aim of the present study was to evaluate the effectiveness of TENS and to compare its efficacy with 2% lignocaine during various minor pediatric dental procedures. Pain, comfort and effectiveness of both the anesthetics were evaluated using various scales and no significant difference was observed between 2% lignocaine and TENS in the various pain scales, while TENS was perceived to be significantly effective in comfort and efficacy as judged by the operator and quite comfortable as judged by the patient himself/herself.