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.

Comparative Evaluation of the Efficacy of Stepwise Caries Excavation vs Indirect Pulp Capping in Preserving the Vitality of Deep Carious Lesions in Permanent Teeth of Pediatric Patients: An In Vivo Study.

AIMS AND OBJECTIVES: To comparatively evaluate the clinical efficacy of stepwise caries excavation with indirect pulp capping (IPC) in managing the young permanent teeth in pediatric patients who have deep carious lesions. MATERIALS AND METHODS: Eighty-eight teeth (first/second permanent molars) were included and randomly divided into two groups: group I (stepwise caries excavation) and group II (IPC). For group I, i.e., stepwise caries excavation, in the initial visit, bulk caries removal was done from walls of the cavity, however, soft and infected dentin was left untouched on the pulpal floor. The final excavation was performed after 2 months. The dentin parameters like the color, the consistency, and the humidity of dentin were noted at the first and second visits. A final follow-up to assess the primary outcome, i.e., sustained pulp vitality, was done after 1 year. RESULTS: When both the groups were compared with each other using the Chi-squared test, a highly significant difference was found (p < 0.05) between them. The success rate of stepwise caries excavation (97.3%) was found to be significantly greater than IPC (82.4%). After doing statistical analysis, a significant difference between stepwise excavation at baseline and at re-entry for parameters like the color, the consistency, and the humidity (p < 0.05), where dentin was observed to be darker in color, harder in consistency, and drier to touch at re-entry was found. CONCLUSION: Stepwise caries excavation was considered a safer technique than IPC for preserving the vitality of young permanent teeth. Also, the clinical changes recorded during the re-entry in the case of stepwise caries excavation technique indicated the arrest of the carious process. CLINICAL SIGNIFICANCE: Pulp preservation is of utmost importance especially in the case of young permanent teeth which have open apex to aid in apexogenesis. Failure to do so in maintaining the vitality of pulp before root completion may lead to the unfavorable crown to root ratio resulting in thin dentinal walls which are prone to fracture. HOW TO CITE THIS ARTICLE: Manhas S, Pandit IK, Gugnani N, et al. Comparative Evaluation of the Efficacy of Stepwise Caries Excavation vs Indirect Pulp Capping in Preserving the Vitality of Deep Carious Lesions in Permanent Teeth of Pediatric Patients: An In Vivo Study. Int J Clin Pediatr Dent 2020;13(S-1):S92-S97.

Management of grossly decayed primary anteriors using various intracanal post systems: A clinical study.

PURPOSE: The aim of the present study was to clinically evaluate and compare the efficacy and retention of various types of intracanal posts in the restoration of grossly decayed deciduous anterior teeth. The various posts used were polyethylene post, glass post, and composite post. MATERIALS AND METHODS: A total number of 16 patients with 45 grossly decayed primary anterior teeth were selected. After biomechanical preparation and obturation, patients were randomly divided on the basis of posts to be used into three groups (Group I: Polyethylene post; Group II: Glass post, and Group III: Composite post). Then, space was created in the obturated canal and posts were placed, followed by core build up. RESULTS: After an interval of 12 months, 86.67% of the teeth exhibited complete retention of the post restored with polyethylene post (P > 0.005) and 93.3% of the teeth exhibited complete retention of the post that were restored with glass post (P > 0.005) whereas only 60% of the teeth exhibited complete retention of the post that were restored with composite post (P< 0.005). Only 20% of the teeth exhibited marginal discoloration in both Groups I and III and 13.33% in Group II and this was nonsignificant. CONCLUSION: Both glass post and polyethylene post proved to be effective. Glass post showed the maximum retention and marginal adaptation followed by polyethylene post. Thus, it appears to be of potential interest for use especially in clinical pediatric dentistry.

Efficacy of Different Precooling Agents and Topical Anesthetics on the Pain Perception during Intraoral Injection: A Comparative Clinical Study.

UNLABELLED: Topical anesthesia is widely advocated in pediatric dentistry practice to reduce pain and anxiety produced by administration of local anesthesia. Cryoanesthesia to lessen the injection pain has also been reported to be promising. However, sparse literature reports exist regarding clinical efficacy of these agents. AIM: The purpose of this study was to compare the efficacy of the refrigerant (1,1,1,3,3-pentafluoropropane/1,1,1,2-tetrafluo-roethane), benzocaine and ice on the pain perception during intraoral injection using visual analog scale (VAS) and sound, eye, motor (SEM) scale. STUDY DESIGN: In this Spit-mouth design study, a total of 160 patients between the age group of 5 and 8 years were selected and were randomly divided into two equal groups having 80 patients in each group. RESULTS: Ice cone has shown lower mean scores (p < 0.001) as compared to benzocaine and refrigerant whereas no significant difference was observed between refrigerant and benzocaine (p > 0.05) on both the scales. CONCLUSION: Ice cone had shown significantly higher efficacy as compared to benzocaine and refrigerant. How to cite this article: Lathwal G, Pandit IK, Gugnani N, Gupta M. Efficacy of Different Precooling Agents and Topical Anesthetics on the Pain Perception during Intraoral Injection: A Comparative Clinical Study. Int J Clin Pediatr Dent 2015;8(2):119-122.

Semilunar vestibular technique: A novel procedure for multiple recession coverage (a report of two cases).

The procedures for root coverage have been greatly refined over the past few decades. Still as compared to the other periodontal surgical procedures, predictability of mucogingival procedures remains uncertain which is more in patients who present with multiple recessions or recession complicated with periodontal involvement. Techniques which claim success almost always involve a second surgical site. A novel technique avoiding second surgical site and good predictability for multiple recessions was described by Dr. P.D. Miller in a conference at Pune in 2011. A semilunar vestibular incision technique described by Dr. P.D Miller was performed on two patients who presented with multiple recessions in the maxillary anterior teeth. About 90-100% root coverage was observed when the patients were on a follow-up for 1-year with a significant increase in the vestibular depth. The semilunar vestibular incision technique used in two cases resulted in predictable root coverage with a good color blend, an esthetic marginal morphology and most importantly the avoidance of the second surgical site.

Adhesive bonding to pulp chamber dentin after different irrigation regimens.

AIM: The aim of the present study was to determine the effect of ethylenediaminetetraacetic acid (EDTA) and NaOCl irrigation on the microleakage and interfacial morphology of adhesives bonded to pulp chamber dentin. METHODS: The pulp chamber roof of 72 extracted permanent molars was removed. Samples were equally divided into six groups. Pulp chamber dentin was bonded with either Adper Easy One (group 1), Adper Prompt L-Pop (group 2), or Adper Single Bond 2 (Group 3), after irrigation with either normal saline (groups 1a, 2a, 3a) or 17% EDTA and 5.25% NaOCl (groups 1b, 2b, 3b). Composite resin restorations were placed in the pulp chamber. Ten samples per group were subjected to microleakage test and scanning electron microscopic analysis was done in two samples from each group. Data were statistically analyzed using Mann-Whitney and Kruskal Wallis tests at a significance level of P < 0.05. RESULTS: EDTA and NaOCl irrigation of the pulp chamber significantly reduced microleakage in Adper Easy One. However, it had no significant effect on the microleakage of Adper Prompt L-Pop and Adper Single Bond 2. CONCLUSIONS: EDTA and NaOCl irrigation of the pulp chamber was not deleterious to the bonding of any of the adhesives tested. While this irrigation regimen had no significant effect on the microleakage of Adper Prompt L-Pop and Adper Single Bond 2, it significantly reduced the microleakage scores in Adper Easy One.

Clinical comparison of various esthetic restorative options for coronal build-up of primary anterior teeth.

BACKGROUND: This study was designed to compare the clinical performance of composite, strip crowns, biological restoration, and composite with stainless steel band when used for the coronal build-up of anterior teeth. MATERIALS AND METHODS: A total of 20 patients aged 3-6 years presenting with mutilated primary anterior teeth due to caries or trauma were selected for the study using randomized simple sampling. A total of 52 primary anterior teeth were randomly divided into four equal groups having 13 teeth in each group. Teeth in Group I were restored with composite, in Group II with strip crowns, in Group III with biologic restoration and with stainless steel band reinforced composite in group IV. The restorations were evaluated for color match, retention, surface texture, and anatomic form according to Ryge's Direct (US Public Health Service) evaluation criteria at baseline (immediate postoperative), after 48 h, 3, 6, and 9 months. The data obtained were statistically analyzed using Chi-square test, and level of significance, that is, P value was determined. RESULTS: At baseline, none of the groups showed any color changes. Other than Group III all other groups showed highly significant changes (P < 0.05) in color after 3 months. Loss of retention was seen in both Groups I and IV after 3 months. After 6 months, retention loss was seen in all the groups except Group II, in which loss was seen after 9 months (P > 0.05). Deterioration in surface texture was exhibited maximum by restorations in Group IV followed by Group I at 3 months. Whereas, no surface changes were seen in Group II and III. Only Group I and IV showed discontinuity in anatomic form after 3 months. After 6 months, except in Group II, discontinuity in anatomic form was observed in all the groups. Discontinuity in anatomic form was seen in all the 4 groups after 9 months although the difference was not significant (P > 0.05). CONCLUSION: Biological restoration was found to be most satisfying esthetically owing to color compatibility with the patient's tooth. Thus, it has a great potential to be used as esthetic restorative option in primary anteriors.

Space maintainers in dentistry: past to present.

Early orthodontic interventions are often initiated in the developing dentition to promote favourable developmental changes. Interceptive orthodontic can eliminate or reduce the severity of a developing malocclusion, the complexity of orthodontic treatment, overall treatment time and cost. The safest way to prevent future malocclusions from tooth loss is to place a space maintainer that is effective and durable. An appropriate use of space maintainer is advocated to hold the space until the eruption of permanent teeth. This case report describes the various changing trends in use of space maintainers: conventional band and loop, prefabricated band with custom made loop and glass fibre reinforced composite resins as space maintainers.

An evaluation of various materials and tooth preparation designs used for reattachment of fractured incisors.

BACKGROUND/AIM: The present study was undertaken to evaluate and compare the fracture strength of various restorative materials and designs used in the reattachment of anterior fractured teeth. MATERIALS AND METHOD: Sound human maxillary central incisors were selected for the study. These teeth were fractured using universal testing machine so as to obtain Ellis class II fracture with intact fragment. The fractured fragment was reattached to the tooth using three restorative materials namely, bonding agent, resin luting cement and nano-composite, and designs incorporated were simply bonding the fragment to the tooth and other one included a chamfer along the fractured line. The reattached teeth were again fractured and the mean fracture strength values recorded. RESULTS AND CONCLUSION: A combination of nano-composite (best material) and chamfer preparation (best design) gave the highest mean fracture strength values.