Evaluation of antimicrobial efficacy of ethanolic extract of Cuminium Cyminium as intracanal medicament on common bacteria of endodontic infections: An in vitro study.

Context: Antimicrobial intracanal medicaments play a vital role in successful outcome of any endodontic procedure. One such plant extract Cuminium cyminium, as intracanal medicaments needs to be researched. Aims: The purpose of this study was in vitro assessment of the antibacterial activity of ethanol extract of C. Cyminium in comparison to Calcium hydroxide (Ca[OH]2) as intracanal medicament against the pathogens of endodontic infection, at an interval 1 h, 24 h, 48 h, and 72 h. Settings and Design: The study was conducted in the central research laboratory of our institute. Freshly prepared C. cyminium extract was procured from AYUSH approved laboratory and direct contact test (DCT) was utilized, which is based on turbidometric determination of microbial growth in a 96-well microplate, carrying 6 times for each bacteria. Methodology: Three groups were assigned for each material in a 96 microwell plate for DCT. Bacterial growth kinetics was monitored at intervals of 1 h, 24 h, 48 h, and 72 h using spectrophotometer at 595 nm. The optical density of T2 (Test group), P2 (Positive control), and N2 (Negative control) was considered. Statistical Analysis Used: After compiling the data, based on the normality of data, further statistical analysis was conducted using Kolmogorov-Smirnov test, Paired t-test, and pairwise comparisons by Turkey's multiple post hoc procedures. The level of statistical significance was set at P = 0.05. Results: The comparison of mean optical density values of C. cyminium in comparison with Ca(OH)2 against the microorganisms of endodontic origin showed a statically significant decrease in bacterial viability at the end of 24 h, 48 h, and 72 h. Conclusion: Based on the results of the study, it can be concluded that C. cyminium has significant antibacterial action against endodontic origin, at interval of 24 h, 48 h, and 72 h.

Acceptance of Parents for Behavior Management Technique with Reference to Previous Dental Expertise and Dental Anxiety.

Introduction: Behavior management of pediatric patients may be done by behavioral and pharmacological techniques. Parents play a vital role when making a decision for treatment for the kid. Aim: To evaluate parental acceptance towards behavior management techniques (BMT) at the side of its reference to previous dental expertise and dental anxiety. Materials and methods: A descriptive cross-sectional survey was conducted among forty parents of children between three to twelve years before dental treatment. The statistical analysis was done using the Chi-square test, Student's paired and unpaired t -test. p < 0.05 was considered statistically significant. Data analysis was performed using software package of statistical analysis (SPSS 22.0 version and GraphPad Prism 6.0 version). Results: The most accepted technique was audiovisual technique followed by tell-show-do and anesthesia. The least accepted technique was oral sedation. Parents whose children were treated at the Postgraduate Clinic of Department of Pediatric Dentistry had lower incomes than those from the private practice. 24% preferred general anesthesia compared to active restraint. Conclusion: Audiovisual technique is the most accepted behavior management technique by parents and is an efficient distraction technique for behavior management for anxious pediatric patients. Postgraduate clinic parents had lower incomes than those at the private practice. Parental dental experience and dental anxiety didn't have an effect on the acceptance of any specific behavior management technique. How to cite this article: Shukla H, Kulkarni S, Wasnik MB, et al. Acceptance of Parents for Behavior Management Technique with Reference to Previous Dental Expertise and Dental Anxiety. Int J Clin Pediatr Dent 2021;14(S-2):S193-S198.

Effect of Photoactivation by Ultraviolet Light on Bond Strength of Composite Veneer on Stainless Steel Crowns-An In Vitro Study.

AIM: The aim of this study is to determine the effect of ultraviolet irradiation on the bond strength of composite veneer adhered to the SSCs. MATERIALS AND METHODS: Seventy anterior typhodont teeth (API, New Delhi, India) were randomly divided into two groups (N = 35/group) to be crowned with 70 maxillary left central incisor SSCs, size no. 3 (3MESPE, St. Paul, USA). The crowns were adjusted and cemented with the glass ionomer cement (type I, Ivoclar Vivadent, New York, USA). The labial surfaces of the experimental group were exposed to UV irradiation for 80 minutes using the UV chamber (Easy UV Chamber, India) with 2 UV lamps that produced 30 W of power to induce photoactivation. Standardized composite blocks (Ivoclar Vivadent, Gurgaon, India) of 4 × 4 × 1 mm were fabricated using Teflon molds and light cured for 60 seconds. The samples were fixed in the acrylic resin (NicTone62),with a label bearing the number of each sample. The samples were stored in a dry medium for 24 hours and tested using a universal testing machine. RESULTS: The mean shear bond strength in the non-UV group was 26.03 ± 9.42 MPa, while in the UV group, it was 35.10 ± 14.80 MPa. Thus, there was a statistically significant difference in the mean value of the shear bond strength between the non-UV and UV groups. The shear bond strength in the UV group is much higher as compared with the non-UV group. CONCLUSION: Based on this study's results, the following conclusion can be made: ultraviolet irradiation of pediatric stainless steel crowns was found to significantly increase the shear bond strength of composite resin. CLINICAL SIGNIFICANCE: UV irradiation could provide suitable adhesion of composite resins to stainless SSCs, leading to in-office veneering of SSCs. HOW TO CITE THIS ARTICLE: Sharma A, Kulkarni S, et al. Effect of Photoactivation by Ultraviolet Light on Bond Strength of Composite Veneer on Stainless Steel Crowns-An In Vitro Study. Int J Clin Pediatr Dent 2019;12(1):50-52.

Prevalence of traumatic dental injuries and their relation with predisposing factors among 8-15 years old school children of Indore city, India.

BACKGROUND: Dental injuries result in functional, esthetic and psychological disturbances accompanied by great concern from the child, the parent and the dentist. Oral injuries are fourth most common area of bodily injuries among 7-30 year-old individuals. AIM: a) To assess the prevalence of traumatic dental injuries (TDI) and their relation with predisposing factors among 8-15 years old school children in Indore city, India.b) To collect baseline data as there have been no reported studies of TDI in central India to this date. METHODS: A cross sectional study was carried out among 4000 children of 60 schools in Indore using multistage random sampling method. Examination of permanent incisor teeth was done in accordance with the modified Elli's and Davey Classification using a standard mouth mirror and probe. Subjects who had clinical evidence of trauma were interviewed for details of the injury event by using structured questionnaire. Chi square test was used to analyze the distribution of all the measurement in this study at the statistical significance of 0.05. RESULTS: Among the 4000 children of 60 schools examined, 10.2% experienced TDI. 68.38% boys experienced TDI, which was approximately twice as higher in females being 31.62%. The most commonly affected teeth were maxillary central incisors. A higher number of children with incisal overjet greater than 3 mm had TDI than those with less than 3 mm, although this difference was not statistically significant. Lip closure incompetence was found to be more common in subjects having a TDI. Fall was the most common cause for TDI and place of occurrence was home. Most common type of fracture was class I and most of them were untreated. CONCLUSION: The high level of dental trauma and low percentage of children with trauma seeking treatment stresses the need for increased awareness in Indore population.

Evaluation of Root Canal Filling in Primary Teeth by Volumetric Analysis: In Vitro Study.

PURPOSE: This study was conducted to evaluate the efficacy of various techniques to fill root canals of primary teeth by volumetric analysis using cone beam computed tomography (CBCT) to assess percentage of obturated volume (POV), percentage volume of voids (PVV), and depth-of-fill. METHODOLOGY: Root canals in 40 extracted deciduous maxillary incisors were instrumented with H-files to size 35 and volume of the canal measured using CBCT under "On Demand 3D AppTM Software" (Cybermed Inc. Medical 3D imaging software). The teeth were divided into four groups of 10 samples each and root filled by Lentulo spiral mounted on slow-speed hand-piece, NaviTip System, Bi-directional spiral and Combination method i.e. Lentulo spiral mounted on slow speed hand-piece followed by NaviTip syringe respectively, after that depth-of-fill for each group was checked. Then, the filled canal volume was measured using CBCT under "On Demand 3D AppTM Software". Further, the (POV), (PVV) was calculated. STATISTICAL ANALYSIS: The data were statistically analysed using one-way ANOVA, Turkey post Hoc test and Pearson's Chi-square test. CLINICAL SIGNIFICANCE: Adequate adaptation of root canal filling material decreases the chance of microorganism regrowth, reinfection due to voids creation and minimizes the potential drawback of overfilling like foreign body reaction or deflection of the unerupted permanent tooth. RESULTS: The four groups were comparable in canal volume. The overall percentage of obturated volume was 53%, 59.7%, 40.3% and 75.1%; the overall percentage volume of voids was 48%, 40.3%, 58.6%, 29.5%; optimally filled canals for each group was 80%, 60%, 30% and 90% respectively (p < 0.05). CONCLUSION: The greatest percentage of obturated volume and maximum number of optimally filled canals was obtained in method combining both Lentulo spiral in slow speed hand piece along with NaviTip system. Whereas, voids were the constant finding with all root fillings.How to cite this article: Sijeria P, Bhartia R, Swamy KVN, Kulkarni S, Singla S. Evaluation of Root Canal Filling in Primary Teeth by Volumetric Analysis: In Vitro Study. Int J Clin Pediatr Dent, 2018;11(5):386-392.

Evaluation of different fibers and biodentine as alternates to crown coverage for endodontically treated molars: An in vitro study.

OBJECTIVE: The objective of this study is to evaluate the fracture resistance of newer restorative materials that could serve as an alternate to crown coverage. MATERIALS AND METHODS: Forty extracted human mandibular molar teeth were selected for this study and were divided into four groups (n = 10). All the teeth in the experimental groups (Group 2-4) were subjected to access cavity preparation with roughly 1.5 mm of tooth structure remaining throughout the circumference. Group 1: Intact teeth used as control. Group 2: Access cavities reinforced with biodentine. Group 3: Inner circumference of access cavities reinforced with polyethylene fiber and nano-hybrid composite. Group 4: Access cavities were reinforced with fiber reinforced composite. All the teeth were subjected to fracture resistance using universal testing machine. RESULTS: The results of the study were evaluated statistically using one-way ANOVA and Tukey post hoc test. Group 2 demonstrated the least mean values of fracture resistance and was significantly different from the control and other experimental groups. Statistically significant difference among Groups 1, 3, and 4 was not found. CONCLUSION: Within the limitation of this in vitro study, it can be concluded that fiber reinforced composite and polyethylene fibers with nanohybrid composite could serve as an alternate to crown coverage.

Dentition Status, Treatment Needs and Risk Predictors for Dental Caries among Institutionalised Disabled Individuals in Central India.

INTRODUCTION: Children and adolescents with disabilities appear to have poorer oral health than their non-disabled counterparts. Individuals with disabilities or illnesses receive less oral care than the normal population. OBJECTIVE: To determine the dentition status, treatment needs and risk predictors for dental caries of the institutionalized disabled individuals. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted with pre-tested questionnaire among 330 institutionalised disabled individuals in the age range from 3 to 22 years. The Dentition status and treatment needs were assessed by using WHO Oral health Proforma 1997. ANOVA test, chi-square test and backward conditional logistic regression analysis were performed. RESULTS: The mean DMFT for all the groups was 1.26 and the mean deft was 0.59. Backward conditional logistic regression revealed that only age categories and disability types were significantly associated with dental caries. Individuals who were mentally retarded (OR=1.36) and in the age group of 13-17 y (OR=1.91) were more likely to develop dental caries. CONCLUSION: The findings of the present study showed that overall caries experience was low but the treatment need was high among these institutionalized disabled individuals.

Use of second-generation platelet concentrate (platelet-rich fibrin) and hydroxyapatite in the management of large periapical inflammatory lesion: a computed tomography scan analysis.

Periapical surgery is required when periradicular pathosis associated with endodontically treated teeth cannot be resolved by nonsurgical root canal therapy (retreatment), or when retreatment was unsuccessful, not feasible or contraindicated. Endodontic failures can occur when irritants remain within the confines of the root canal, or when an extraradicular infection cannot be eradicated by orthograde root canal treatment. Foreign-body responses toward filling materials, toward cholesterol crystals or radicular cysts, might prevent complete periapical healing. We present here a case report wherein, combination of platelet-rich fibrin (PRF) and the hydroxyapatite graft was used to achieve faster healing of the large periapical lesion. Healing was observed within 8 months, which were confirmed by computed tomography, following improved bone density. PRF has many advantages over platelet-rich plasma. It provides a physiologic architecture that is very favorable to the healing process, which is obtained due to the slow polymerization process.

Use of platelet-rich fibrin as an autologous biologic rejuvenating media for avulsed teeth - an in vitro study.

AIM: The prognosis of replanted avulsed tooth depends on the existence of viable cells in the periodontal ligament and also on those cells which are able to proliferate on the damaged areas of the root. The purpose of this study was to evaluate the survival of periodontal ligament cells (PDL) when soaked in an autologous biologic rejuvenating media after an extra-oral dry time of 40 min. METHOD: Thirty teeth were selected with intact crown which were advised for Orthodontic extraction having healthy PDL. They were divided into two experimental and two control groups. The positive and negative controls corresponded to 0-min and 1-h dry time, respectively. The experimental teeth were stored dry for 40 min and then immersed in one of the two media, combination of platelet-rich fibrin and platelet poor plasma (PRF+PPP) and PPP for 45 min. The teeth in each group were treated with dispase II and collagenase for 30 min and later centrifuged for 5 min at 50.17 g. The supernatant was removed with sterile micropipette, the cells labelled with 0.4% trypan blue, and the number of viable PDL cells was counted with a haemocytometer, under a light microscope. RESULTS: anova and Mann-Whitney U-test demonstrated statistically significant differences in the viability of PDL cells among experimental groups. CONCLUSION: Within the parameters of this study, a combination of platelet-rich fibrin and PPP demonstrated higher number of viable PDL cells and hence could be a good biologic rejuvenating media for avulsed teeth.

Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: An in vitro study.

INTRODUCTION: Remineralization as a treatment procedure has received much attention from clinicians. The objective of this in vitro study was to find out the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), and tricalcium phosphate fluoride (TCP-F) in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using DIAGNOdent(®) (KaVo) and scanning electron microscope (SEM). MATERIALS AND METHODS: A total of 52 premolars and 24 molars were selected and classified into four groups of 13 premolars and 6 molars in each: I (CPP-ACP), II (CPP-ACPF), III (TCP-F), and IV (artificial saliva). All the samples were assessed using DIAGNOdent at the baseline and after demineralization and remineralization. Ten samples were randomly selected from each group baseline after demineralization and after remineralization for surface evaluation using SEM. RESULTS: Statistical analysis showed that all the experimental groups had a significantly higher amount of remineralization except for group IV. CONCLUSION: All the three experimental groups showed a statistically significant amount of remineralization. However, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus(®)) and TCP-F showed marginally more amount of remineralization than did CPP-ACP (Tooth Mousse(®)). Remineralization efficacy was TCP-F > CPP-ACPF > CPP-ACP.

Efficiency and mechanism of intracellular paclitaxel delivery by novel nanopolymer-based tumor-targeted delivery system, Nanoxel(TM).

INTRODUCTION: An increasing research interest has been directed toward nanoparticle-based drug delivery systems for their advantages. The appropriate amalgamation of pH sensitivity and tumor targeting is a promising strategy to fabricate drug delivery systems with high efficiency, high selectivity and low toxicity. MATERIALS AND METHODS: A novel pH sensitive Cremophor-free paclitaxel formulation, Nanoxel(TM), was developed in which the drug is delivered as nanomicelles using a polymeric carrier that specifically targets tumors. The efficiency and mechanism of intracellular paclitaxel delivery by Nanoxel(TM) was compared with two other commercially available paclitaxel formulations: Abraxane(TM) and Intaxel(TM), using different cell lines representing target cancers [breast, ovary and non-small cell lung carcinoma (NSCLC)] by transmission electron microscopy and quantitative intracellular paclitaxel measurements by high performance liquid chromatography. RESULTS: The data obtained from the present study revealed that the uptake of nanoparticle-based formulations Nanoxel(TM) and Abraxane(TM) is mediated by the process of endocytosis and the uptake of paclitaxel was remarkably superior to Intaxel(TM) in all cell lines tested. Moreover, the intracellular uptake of paclitaxel in Nanoxel(TM)- and Abraxane(TM)-treated groups was comparable. Hence, the nanoparticle-based formulations of paclitaxel (Nanoxel(TM) and Abraxane(TM)) are endowed with higher efficiency to deliver the drug to target cells as compared to the conventional Cremophor-based formulation. CONCLUSION: Nanoxel(TM) appears to be of great promise in tumor targeting and may provide an advantage for paclitaxel delivery into cancer cells.

Use of ribbond and panavia F cement in reattaching fractured tooth fragments of vital maxillary anterior teeth.

Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the reattachment of the fragment. This article presents a novel technique for reattachment of oblique fractured fragment of vital maxillary central and lateral incisor with pulp exposure. Pulp capping was done using mineral trioxide aggregate. Orthodontic extrusion was done to expose the sub gingival fractured site. Polyethylene fiber (ribbond) and panavia F cement were used to reattach the fractured fragment using an internal groove technique to provide high fracture strength to restored tooth. Ribbond fibers can be used to give additional strength to the reattached tooth fragment so that the tooth obtains fracture resistance equal to an intact tooth.

Endodontic treatment in submerged roots: a case report.

Alveolar ridge resorption has long been considered an unavoidable consequence of tooth extraction. While the extent and pattern of resorption is variable among individuals, there is a progressive loss of ridge contour as a result of physiologic bone remodeling. Even today, with best modalities of tooth preservation, there is a group of elderly individuals who do not benefit from modern preventive practices and who now present a dilemma in terms of maintaining the masticatory apparatus necessary for nutrition. Even with excellent dental care, such patients experience abrasion of the natural tooth crowns with age, and embedded roots are left within the alveolar bone. According to old concepts of dental care, extraction of these roots would have been recommended, but today's goal of excellence in endodontics dictates otherwise. We report a case in which vital and non-vital root submergence was carried out to prevent alveolar ridge reduction.

Evaluation of fracture resistance in simulated immature teeth using Resilon and Ribbond as root reinforcements--an in vitro study.

BACKGROUND/AIM: To compare the reinforcement and strengthening ability of resilon, gutta-percha, and ribbond in endodontically treated roots of immature teeth. MATERIAL AND METHODS: Sixty five freshly extracted human maxillary anterior teeth were prepared with a Peeso no. 6 to simulate immature teeth (Cvek's stage 3 root development). After instrumentation, each root was irrigated with sodium hypochlorite and with ethylene diamino tetra acetic acid to remove the smear layer. To simulate single visit apexification technique a 4-5 mm white Pro Root mineral trioxide aggregate plug was placed apically using schilder carrier. The teeth were divided into three experimental groups and one control group. Group I--control group (root canals instrumented but not filled); Group II--backfilled with thermoplastisized gutta-percha using AH plus sealer; Group III--reinforced with Resilon using epiphany sealer; Group IV--reinforced with Ribbond fibers using Panavia F luting cement. A Universal Testing Machine was used to apply a load, at the level of the lingual cementoenamel junction with a chisel-shaped tip The peak load to fracture was recorded and statistical analysis was completed using student's t-test. RESULTS: Values of peak load to fracture were 1320.8, 1604.88, 1620, and 1851 newtons for Group I to Group IV respectively. The results of student's t-test, revealed no significant difference (P > 0.05,) between Group II and Group III. Comparison between Group IV and Group III and between Group IV and Group II revealed highly significant difference (P > 0.001). CONCLUSIONS: Teeth reinforced with Ribbond fibers using Panavia F luting cement showed the highest resistance to fracture. Resilon could not strengthen the roots and showed no statistically significant difference when compared with thermoplastisized gutta-percha in reinforcing immature tooth when tested with universal testing machine in an experimental model of immature tooth.

Single-step apical barrier placement in immature teeth using mineral trioxide aggregate and management of periapical inflammatory lesion using platelet-rich plasma and hydroxyapatite.

We present here a case report of a tooth with an immature root with a large periapical lesion. The open apex was managed by placing an apical barrier using mineral trioxide aggregate, and the periapical lesion was treated surgically. A combination of platelet-rich plasma (PRP) and hydroxyapatite graft (HA) was used to achieve faster healing of the periapical lesion. The case was followed up for 11 months. The indications and advantages of apical barrier placement, periapical surgery, and the role of PRP and HA in postsurgical healing are discussed.

Invasive cervical resorption: a case report.

Invasive cervical resorption (ICR) is a relatively uncommon form of external resorption, which may occur in any tooth in the permanent dentition. Characterized by its cervical location and invasive nature, this resorptive process leads to progressive and usually destructive loss of the tooth structure, the clinical features of which often resemble internal resorption ("pink tooth"). This article describes a case report of ICR and its management. The salient features were a large resorptive defect and localized fibrous in-growth located almost wholly on the cervicolabial aspect of the maxillary incisor crown involving the enamel and dentin.

Microbiological evaluation of various parameters in ophthalmic operating rooms. The need to establish guidelines.

PURPOSE: Postoperative infections can be caused by a contaminated environment, unsterile equipment, contaminated surfaces, and infected personnel as well as contaminated disinfectants. In order to establish guidelines for microbiological monitoring, a detailed microbiological surveillance was carried out in an ophthalmic hospital. METHOD: Over a period of 21 months, we assessed environmental Bacteria Carrying Particle(BCP) load and surface samples weekly (n = 276); the autoclaving system once a month and repeated whenever the process failed (n = 24); the air conditioning filters for fungal growth once in four months (n = 15), and the disinfectant solution for contamination once in two months (n = 10). Additionally, the personnel involved directly in surgery were screened for potential pathogens such as Staphylococcus aureus and beta haemolytic streptococci. RESULT: On 14 (5.07%) occasions the environment in the operating rooms had a significant risk of airborne infections. Sterilisation of instruments in the autoclaves was unsatisfactory on 4 (16.66%) occasions. Samples from the filters of the air-conditioning units yielded potentially pathogenic fungi on 3 (20%) occasions. Personnel sampling revealed that 5 (8.77%) individuals harboured beta haemolytic Streptococci in the throat and 4 (7.01%) harboured S. aureus in the nasal cavity. The samples of disinfectant in use were not contaminated. CONCLUSION: There is a need to standardise microbiological evaluation protocols for operating rooms.