Comparative evaluation of the predictive value of cariogram and informal caries risk assessment among school-going children in the age group of 8-9 years of Yamuna Nagar District, Haryana.

AIM: This longitudinal, observational study was conducted in the schools of Yamunanagar, Haryana, to evaluate and compare the predictive value of formal type of caries risk assessment using reduced Cariogram software, including only seven factors and informal type among 8-9 years' school-going children. METHODS: A.total of 111 school-going children were included in the study. Risk profile for each child was created using cariogram as well as informal factors. The same children were scheduled for re-examination at an interval of 9 and 18 months. The caries status was recorded again using the Collapsed International Caries Detection and Assessment System (ICDAS) concept. STATISTICAL ANALYSIS: The precoded data were transferred to the computer and analyzed using the SPSS software (version 17.0). Data were analyzed for the identification of children with lesion progression and numbers of lesions progressing using the Transition Scoring System. RESULTS: Cariogram being a multifactorial model gives significant individual weightage to each etiological factor causing dental caries as compared to informal caries risk assessment which though easy to implement yet unstructured unlike cariogram and thus does not guarantee consistent implementation. CONCLUSION: Cariogram is a perfect option for patient motivation and supports the clinician in decision making for planning preventive strategies for the patients. Along with this, a combination of the factors for informal caries risk assessment can help in making a simple yet multifactorial model which can be applied in daily practice.

Acidogenic Potential of Packaged Fruit Juices and its Effect on Plaque and Salivary pH.

AIM: The aim of this study was to analyze the acidogenic potential of the various commercially available fruit juices and to evaluate the salivary and plaque pH changes before and after consumption of the fruit juices that were kept at various temperatures. MATERIALS AND METHODS: Baseline plaque and salivary pH were measured for 30 volunteers, and the test was conducted for 4 consecutive days on which juices with a known pH was consumed, which were kept at varying temperatures. The resulting changes in the plaque and salivary pH were measured after 1, 5, 15, and 30 minutes of the consumption of the fruit juices using a portable standard digital pH meter. RESULTS: Among the three juices compared, grape juice was found to be more acidic compared to the orange juice and pineapple juice. The pH fall was maximum after consumption of grape juice followed by orange and pineapple juice, respectively. The consumption of ice candy caused a greater fall in pH followed by the refrigerated juice and the juices that were kept at room temperature, respectively. CONCLUSION: Parents are unaware of the harmful effects of endogenous acids in the fruit juices and their effect on the teeth. We, as primary dental care providers, should take initiatives to provide adequate knowledge and information regarding this new trend of consuming frozen fruit juices and must strongly discourage this form of consumption as a frequent habit. CLINICAL SIGNIFICANCE: Though many presume that the readily available fruit juices are healthy, frequent consumption of these fruit juices causes acid dissolution of enamel as most of these juices have a pH below the critical level. Hence the present study was conducted to evaluate the erosive potential of the various commercial fruit juices. As with increased awareness by both the dentists and the parents, the problem of fruit-juice-induced tooth loss may be reduced. HOW TO CITE THIS ARTICLE: Mehta LK, Hegde A, et al. Acidogenic Potential of Packaged Fruit Juices and its Effect on Plaque and Salivary pH. Int J Clin Pediatr Dent 2019;12(4):312-317.

Evaluation of Predictability of Suitable Implant Lengths as related to Accurate Treatment Planning using Recent Roentgenographic Measures: A Key to Success.

BACKGROUND AND AIM: Selection of suitable length of dental implants is very subjective and largely depends on clinical evidences and operator's expertise. The present study was aimed to assess the role of cone beam computed tomography (CBCT) and cephalograms as far as the selection of right implant length is concerned. MATERIALS AND METHODS: The study includes 220 patients for whom radiographic and follow-up records were obtained. There were 105 males and 115 females in the age range of 22 to 58 years. A total of 98 implant sites in different edentulous areas were studied. Length of implant was predicted at treatment planning and compared with finally placed implant at surgical stages. It also includes the in-depth exploration of (1) number of implants placed per patient, (2) implant per edentulous areas, (3) implant location, and (4) implant region. For prediction of implant lengths, CBCT results were obtained and compared with cephalometric findings. Accuracies of implant lengths as planned by CBCT and cephalometric images were also studied at treatment planning and surgical stages. Statistical analysis and results: Upon statistical comparisons, we found that larger implant lengths chosen at treatment planning stage did not change in 65.5% of patients. In addition, the smaller length implants were just about the same as that with larger dimensions. The CBCT results were satisfactory (up to 98.5%). Cephalometry was performed well in this prediction, especially in posterior mandible (87.9%). However, its performance in anterior maxillary region was not satisfactory (69.6%). Intergroup comparisons of CBCT and cephalometric results at different regions were significant (p < 0.001). CONCLUSION: Our study results show insignificant changes in the length of implants that was exactly planned using CBCT scans. Therefore, accurate prediction of implant lengths can be done using CBCT scans as they have superior and advanced tools that facilitate presurgical decision-making. Lateral cephalometric evaluation has been shown as an imperative radiographic tool for determining implant lengths as it confirmed the significance bone resorption on the selection of implant length at different sites. CLINICAL SIGNIFICANCE: The CBCT and lateral cephalogram offer excellent anatomical details that can be judiciously applied for treatment planning and other clinical decision-making, including selection of correct implant length. Our study advocates thorough cephalometric evaluations of mandible wherein implants are to be placed for implant-supported overdentures.

Biofilm in endodontics: A review.

Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms' formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.

An Ultrastructural Study of Melanocytes and Mast Cells in the Depigmented Skin in Vitiligo.

In the depigmented patch of ten vitiligo patients a few melanocytes were seen. Coagulation, fatty degeneration, focal aggregation of melanosomes and vacuolation were some of the changes seen in their cytoplasm. Many indeterminate cells were also observed. These resembled Langerhans cells morphologically but were without Birbeck granules. Basement membrane architect was lost. In the dermis mast cells and plasma like cells were seen. Collagenised nerves and blood vessels with reactive endothelial cells were the salient features.

Evolution of nasal mucosal lesions in leprosy (histological study)

Four stages of nasal pathology in tuberculoid leprosy is described. In every atrophic rhinitis case nasal biopsy is advocated. Rhinoscopic examination should be done in family contacts and early cases of leprosy.