Green synthesis, characterization, and antibacterial activity of Citrus lanatus based silver nanoparticles.

Due to their enhanced and unique physicochemical characteristics, such as their minimal dimensions, large surface area compared to their mass and increased reactivity, nanomaterials hold promise in the field of antibacterial therapy. The aim of this study is to evaluate the method for Green Synthesis, Characterization of Citrus lanatus pulp, rind, and seed-based Silver Nanoparticles, and study its antibacterial activity against common oral microorganisms. Green synthesis of nanoparticles was formulated using the extract from the rind, seed, and pulp of Citrullus lanatus and silver nitrate extract. The extract was stirred in a magnetic stirrer for 24 hours, and centrifugation was done at 8000 rpm for 10 minutes. The synthesized nanoparticles were characterized and utilized for the antibacterial study. The characterization was done using UV-visible light spectroscopy, and antibacterial activity was assessed using the well diffusion method and measuring the zone of inhibition. The nanoparticles synthesized were characterized using UV-visible spectroscopy, and the spectroscopic analysis confirmed the formation of silver particles in this study. At 450 nm, a sharp peak was observed, which correlated to the SPR band of the particles. The results showed that the zone of inhibition assessed was comparable to the standard. From this study it can be concluded that silver nanoparticles (AgNPs) produced by green synthesis from Citrullus lanatus showed significant antibacterial potential against common oral microflora.

Green Synthesis of Titanium Oxide Nanoparticles With Rosemary and Ginger and Their Bactericidal Action Against Staphylococcus aureus.

INTRODUCTION: Titanium oxide (TiO2) nanoparticles (NPs) have significantly proved to be highly useful in restorative materials, dental adhesives, sealants, cements, and other dental applications to prevent microbial colonization and reduce the risk of infections. The present study was aimed at developing a dental material with antibacterial properties by combining titanium oxide NPs using ginger and rosemary extracts. MATERIALS AND METHODS: The formulation was prepared using rosemary and ginger, mediated by TiO2 NPs. The preparation was then introduced into the wells of a microplate consisting of cultured Staphylococcus aureus and was kept for incubation for four hours. To record the minimum inhibitory concentration, the test solution was added into Kimble tubes consisting of Muller-Hinton broth. The results obtained were statistically analyzed using one-way ANOVA. RESULT: Increasing concentration led to decreased optical density, indicating bactericidal effects. Significantly lower optical density values were observed in decreasing order among the test samples (25, 50, and 100 µL) compared to control and antibiotic groups against Streptococcus, highlighting the potent antibacterial and antibiofilm properties of the greenly generated combination of titanium oxide NPs with herbs. This was also confirmed by moderate minimum inhibitory concentration at 100 µL. CONCLUSION: The present study suggests that there is a bactericidal process at play, leading to a reduction in the overall bacterial count. It can be concluded that the ginger and rosemary-mediated titanium oxide NPs serve as potential antibacterial agents against S. aureus. This study can be used as a preliminary study, and further studies can be conducted to use this formulation in the field of medicine.

Antibacterial, antioxidant and anti-inflammatory activity zinc-titanium dioxide nanocomposite.

The current study concentrated on the green synthesis of Zinc-titanium dioxide nano-composite (Zn-TiO2 NC) through the use of lemon extract, optimizing the different experimental factors required for the formation and stability of nanocomposite. The preparation of nanocomposite was confirmed by the observation of the colour change and the surface plasmon resonance band was found at 380 nm, utilizing UV-Visible analysis. The TEM analysis, the morphological features of the prepared nanocomposite was identified to be spherical shape with mean particle size of 25 nm. In addition, the antibacterial, antioxidant, and anti-inflammatory activity of this nano-composite were also investigated. The biosynthesized nanocomposite showed excellent antibacterial activity against S. mitis and S. mutans. The obtained results indicate that the antioxidant and anti-inflammatory activity of this nanocomposite is significant. This bioactive nanocomposite can be used as an effective antibacterial, antioxidant and anti-inflammatory agent in biomedical and pharmacological fields for future applications.

Application of nanoparticles in Dentistry.

Nanoparticles(NPs) are of particle sizes lesser than 100nm and are insoluble the field which deal with the handling of these particles is coined as "Nanotechnology" as their particle size is smaller, they can penetrate easily therefore they are applied in various medical fields, drug delivery and in dentistry as they have antimicrobial property, reduces friction, anti-inflammatory and antioxidant property. Many studies have been done to evaluate its application and its cytotoxicity by varying its concentration and various studies have been done to evaluate its physical property. Therefore, it is of interest to describe concepts of nanoparticles, mode of action, tissue reaction and its application in orthodontics.

Dental caries as a source of Helicobacter pylori infection in children: An RT-PCR study.

BACKGROUND: Findings on the presence of Helicobacter pylori in the oral cavity are conflicting. This bacterium can occur either transiently in the oral cavity or, in some situations, pose a threat to oral/gastric tissues. AIM: We investigated the presence of H. pylori in deep carious lesions of children and assessed its association with dental status and caries severity. DESIGN: This cross-sectional study involved 20 children aged 3-6 years attending the paediatric outpatient clinic. Demographic and oral hygiene-related data were obtained from parents/caregivers. Caries status and severity were assessed using the DMFT and ICDAS II indices respectively. Dentine samples were collected and stored in phosphate-buffered saline solution. These samples were assessed for H. pylori using reverse transcription polymerase chain reaction. DMFT and ICDAS II scores were compared between children with and without H. pylori. RESULTS AND CONCLUSION: H. pylori was detected in 70% of children with severe carious lesions (95% confidence interval: 46%-88%). The mean DMFT score was significantly higher in the group with H. pylori than in the group without (p = .001). The prevalence of H. pylori was greater in those with ICDAS II code 6 than in those with ICDAS II code 5 caries. Cavitated carious lesions can serve as a reservoir for H. pylori. Its presence was associated with higher caries status and caries severity (ICDAS II code 6). The presence of H. pylori in such cavities may tip the balance of plaque ecosystem in favour of Streptococcus mutans, the main bacterial source in dental caries.

Comparison of obturation quality, instrumentation time and post-operative pain using manual K-files and pediatric rotary files in primary molars ­ a double blinded randomised clinical trial / Comparação da qualidade de obturação, tempo de instrumentação e dor pós-operatória usando Limas manuais K e Limas rotativas pediátricas em molares decíduos ­ um estudo clínico randomizado duplo-cego

Objective: to compare the quality of obturation, instrumentation time and post-operative pain after pulpectomy in primary molars using manual K-files, Kedo-S and Kedo-S Square rotary file systems. Material and Methods: a double blinded randomized control trial was conducted in 45 children, who were indicated for pulpectomy in any one of the primary mandibular molars. The canal preparation was done using either hand K-files, Kedo-S files, or Kedo-S Square files based on the groups assigned. The time taken for instrumentation was recorded using a stopwatch. The quality of obturation was evaluated using post-operative radiograph and post-operative pain was assessed with modified Wong-Baker Faces Pain scale. Results: instrumentation time was minimum in rotary Kedo-S Square files (53.23 ± 9.60 seconds) followed by Kedo-S files (82.70 ± 11.86 seconds). The preparation time was maximum with manual K-files (121.43 ± 20.18 seconds). Kedo-S square files provided a higher number of optimally filled canals (66.4%). All the three instrumentations equally showed the tendency to produce voids in the obturation. Rotary files Kedo-S Square followed by Kedo-S showed less post-operative pain compared to K-files. Conclusion: the use of pediatric rotary instruments for canal preparation during pulpectomy will result in better quality of obturation in reduced time with least post-operative pain (AU)

Objetivo: comparar a qualidade de obturação, tempo de instrumentação e dor pós-operatória após pulpectomia em molares decíduos usando limas manuais K, limas rotatórias Kedo-S e limas rotatórias Kedo-S Square. Material e Métodos: um estudo clínico randomizado duplo-cego foi conduzido com 45 crianças que foram submetidas à pulpectomia de algum molar decíduo indicado. A preparação do canal foi feita usando limas manuais K, ou limas Kedo-S, ou ainda Limas Kedo-S Square, com base nos grupos que foram selecionados. O tempo para a instrumentação foi registrado com um cronômetro. A qualidade de obturação foi avaliada por meio de uma radiografia após o procedimento e a dor pós-operatória foi avaliada com a escala de dor Wong-Baker Faces modificada. Resultados: o tempo de instrumentação foi mínimo para as limas rotatórias Kedo-S Square (53,23 ± 9,60 segundos) seguido pelas limas Kedo-S (82,70 ± 11,86 segundos). O tempo de preparação foi maior com as limas manuais K (121,43 ± 20,18 segundos). As limas Kedo-S Square promoveram um maior número de canais otimamente obturados (66,4%). Todas as três instrumentações mostraram igualmente a tendência em seproduzir vazios na obturação. As limas rotatórias Kedo-S Square seguidas pelas limas Kedo-S produziram menos dor pós-operatória comparadas às limas manuais K. Conclusão: o uso de instrumentos rotatórios pediátricos para a preparação do canal durante a pulpectomia resultará em melhor qualidade de obturação em tempo reduzido e com menos dor pós-operatória. (AU)

Average time in between appointments for multivisit pulpectomy in patients reported to a university dental hospital.

Complete removal of the infected coronal and radicular pulp tissue along with obturation of the canal space with suitable medication is defined as pulpectomy. The most common indication for pulpectomy is a tooth with irreversible pulpitis which shows symptoms of nocturnal pain and abscess. To determine the average time in appointments for multivisit pulpectomy in patients reported to a university dental hospital. It is planned as a retrospective analysis of the case records of patients who were treated as two visit pulpectomy procedures in a university dental hospital, India. The study concluded that in the majority of the situations the average time in between appointments for multivisit pulpectomy was found to be within 1 week.

Prevalence of pain following single-visit pulpectomy with stainless steel crown done by postgraduate students in a university sitting.

Pain is usually a very unpleasant experience, it can be felt by any age group whose sensory and cognitive components have been developed. Children tend to experience pain in around 65% of dental procedures. It can affect daily activities, and in many situations, it can lead to crisis. Since it is a developing child, the concept of pain can influence adversely in the mind of the child. The clinical records of all pulpectomy cases during the period between January 1, 2020, and January 1, 2021, were analyzed. Gender and age of the patients were also included in the study. The majority of children in our study group were males; children who had a proper abscess of any kind of symptoms tend to have a higher incidence of postoperative pain compared to children with the least symptoms. The study identified that children experienced less pain following multi-visit pulpectomy when compared with single visits during the 1st 3 days. In children who were treated with both single-visit pulpectomy and stainless steel crown experienced no difference in pain perception in the first 3 days of appointment.

Transpapillary Injection Technique as a Substitute for Palatal Infiltration: A Split-mouth Randomized Clinical Trial.

AIM AND OBJECTIVE: To assess and compare the degree of pain during local anesthesia administration and to evaluate the efficacy of transpapillary injection as a substitute for palatal injection in simple maxillary tooth extractions. MATERIALS AND METHODS: A split-mouth study was conducted among children aged 7-11 years who required bilateral extraction of maxillary molars. The individuals were subjected to conventional buccal and palatal infiltration for the first extraction. The transpapillary injection was administered for the subsequent extraction in place of palatal administration. 2% lignocaine with 1:100,000 adrenaline was used for both techniques. Faces pain score scale and visual analog scale were utilized to record pain during injection administration and during the extraction process. A p < 0.05 was considered to be statistically significant. RESULTS: The difference in pain scores was observed during injection administration and was found to be statistically significant (p < 0.05) whereas pain scores for extraction were insignificant (p > 0.05). CONCLUSION: The transpapillary injection technique was efficacious in eliminating the pain of the palatal injection technique for maxillary extractions. CLINICAL SIGNIFICANCE: Owing to the results of this study, the transpapillary injection technique can be used as a distinguished substitute for conventional palatal infiltration, thereby lessening the level of distress experienced by a pediatric patient during local anesthesia administration. HOW TO CITE THIS ARTICLE: Sruthi MA, Ramakrishnan M. Transpapillary Injection Technique as a Substitute for Palatal Infiltration: A Split-mouth Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(5):640-643.

Comparative Evaluation of Two Different Topical Anesthetic Agents in Controlling Pain during Intraoral Local Anesthetic Administration in Children: A Split-mouth Triple-blinded Randomized Clinical Trial.

AIM: To compare the efficacy of lignocaine and benzocaine when applied as a topical anesthetic before intraoral local anesthetic administration in children. MATERIALS AND METHODS: Forty-four patients aged between 4 years and 10 years indicated for pulp therapy of primary teeth under inferior alveolar nerve block were selected for this study. The participants were randomly allocated into two groups of 22 each. Group I (lignocaine gel) and group II (benzocaine gel) were applied before inferior alveolar nerve block. The pain scale was assessed by a trained examiner using the visual analog scale (VAS) and sound eye motor scale. RESULTS: Lignocaine when used as a topical anesthetic agent showed lower mean scores under both the pain scales when compared with benzocaine but the results were statistically insignificant. CONCLUSION: Lignocaine and benzocaine are equally effective when applied as a topical anesthetic agent. But lignocaine was more preferred in taste when compared with benzocaine. HOW TO CITE THIS ARTICLE: Kotian N, Mani G, Ramakrishnan M. Comparative Evaluation of Two Different Topical Anesthetic Agents in Controlling Pain during Intraoral Local Anesthetic Administration in Children: A Split-mouth Triple-blinded Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(2):180-182.

A short review on the root canal configuration of primary maxillary molars.

It is of interest to compile available information on the root canal morphology of primary maxillary molars from known literature. The literature resources used to collect data include Medline/PubMed, The Cochrane Central Register of Clinical Trials, SIGLE and Science Direct. Data consists of type of population, number of teeth per study, number of root canals, canal length and type of root canal configuration. We used data from a total of 13 studies (951 primary maxillary molars). Maxillary molars (1st and 2nd) are dominant for two roots variant. The first molar the mean root length ranges from 7.9mm - 8.1mm. The second molar ranges from 7.2mm-8.5mm. Type I (explain in a phrase) canal morphology is the common variant in both the molars. Data shows that Root Canal morphology shows variations with the diagnostic aid (example micro CT) used and in different ethnic populations.

Single visit versus multiple visit root canal.

Single visit endodontics offers many advantages over multi visit treatment. Therefore, it is of interest to assess the preference of single visit over multiple visit root canals. We used 86,000 patient records and selected 9017 records matching the inclusion criteria for the analysis using statistical tools (Chi square test at p value <0.05). Data shows that people between 26 to 45 years are often affected with dental caries. Available data is biased towards multi visits rather than single visit regardless number of canals.

Requirement of Osteoplasty in Dental Implant Surgery-A Retrospective Analysis.

Osteoplasty is a surgical procedure for reshaping or recontouring bone. As dental implants are the most commonly preferred treatment for prosthetic rehabilitation, adequate bone height and width are important prerequisites for a successful implant. There is continuous resorption of the alveolar crestal region after extraction of the tooth, which may form sharp edges or sharp bony margins. Osteoplasty is required in such cases to remove the sharp bony margins and flatten the alveolar bone so as to provide increased stability of the implant in the socket. The aim of this retrospective, university-based study was to assess the requirement of osteoplasty in dental implant surgery. Data of patients who underwent implant surgery were collected. A total of 554 patients (331 males and 223 females) with 1,044 implant sites were included. The data were further sorted with respect to age, gender, implant site, and requirement of osteoplasty, and analyzed using SPSS software. The mean age of the patients was 42.70 ± 13.03. A chi-square test assessed association and correlation. The requirement of osteoplasty was higher in the mandibular posterior region (42.2%) than in any other clinical site. In comparison with gender, the requirement was significantly higher in males than in females.

Coherent Epitaxial Semiconductor-Ferromagnetic Insulator InAs/EuS Interfaces: Band Alignment and Magnetic Structure.

Hybrid semiconductor-ferromagnetic insulator heterostructures are interesting due to their tunable electronic transport, self-sustained stray field, and local proximitized magnetic exchange. In this work, we present lattice-matched hybrid epitaxy of semiconductor-ferromagnetic insulator InAs/EuS heterostructures and analyze the atomic-scale structure and their electronic and magnetic characteristics. The Fermi level at the InAs/EuS interface is found to be close to the InAs conduction band and in the band gap of EuS, thus preserving the semiconducting properties. Both neutron and X-ray reflectivity measurements show that the overall ferromagnetic component is mainly localized in the EuS thin film with a suppression of the Eu moment in the EuS layer nearest the InAs and magnetic moments outside the detection limits on the pure InAs side. This work presents a step toward realizing defect-free semiconductor-ferromagnetic insulator epitaxial hybrids for spin-lifted quantum and spintronic applications without external magnetic fields.

Interventions in management of dental fluorosis, an endemic disease: A systematic review.

OBJECTIVE: Mottling and pitting of enamel due to excess fluoride consumption may affect one's self-esteem due to unaesthetic appearance and also in turn can affect the quality of life. This present study was conducted to assess various treatment approaches available for patients with dental fluorosis. MATERIALS AND METHODS: Literatures were searched from August 1998 to August 2019 for articles in the management of dental fluorosis. The databases used were National Center for Biotechnology Information (NCBI) and Google Scholar. In NCBI, the filters were modified to randomized controlled trial, clinical trial, human trial, and free full-text articles. The following queries were used in order to search for the article: treatment for dental fluorosis, intervention of dental fluorosis, and management of dental fluorosis. RESULTS: All the five studies selected after screening were randomized controlled trials. Total number of patients included in this study were 304 with the mean age of 17.7 years old. They were treated with microabrasion, bleaching, resin infiltration or combination of microabrasion with bleaching, and resin infiltration with bleaching. Microabrasion resulted in less esthetic improvement compared with bleaching. Meanwhile, resin infiltration showed a greater improvement in esthetics in comparison to bleaching. Resin infiltration with additional infiltration time and combination of resin infiltration with bleaching are the best treatment options. CONCLUSION: Based on this systematic review, resin infiltration with increased infiltration time is the best treatment approach in treating dental fluorosis.

Association between Early Childhood Caries and Quality of Life: Early Childhood Oral Health Impact Scale and Pufa Index.

Early Childhood Caries (ECC) are one of the major oral diseases affecting children. ECC adversely affects the children's as well as their parent/caregivers quality of life. The present study aims to assess the quality of life in children with Early Childhood Caries aged 6-72 months using the Early Childhood Oral Health Impact Scale. It also aims to compare the quality of life between children with pufa scores of > 0 and a pufa score = 0. A total of 238 children aged 6 months to 72 months with ECC and their parent/caregiver were included in the present study. Oral examinations of the children were performed by the principal examiner using the defs and pufa index, which was followed by a personal interview of the 13 items in the Early Childhood Oral Health Impact scale among the 238 parents/caregivers. The results showed that, overall, Early Childhood Caries have a negative impact on children's quality of life, as assessed by the parent/caregiver. The overall Early Childhood Oral Health Impact scale score ranged from 0-32 (mean ± SD, 14.12 ± 6.72). Children with a pufa score > 0 (mean ± SD, 16.14 ± 6.27, p < 0.001) have significantly lower quality of life than children with pufa score = 0 (mean ± SD, 9.07 ± 4.94, p < 0.001). Early Childhood Caries had a negative impact on the quality of life of children aged 6-72 months. Children with a pufa score of "0" had better oral health-related quality of life than children with a pufa score > 0.

Survival rate of different fixed posterior space maintainers used in Paediatric Dentistry - A systematic review.

PURPOSE: Space Maintainers have long been used for the management of space loss in primary and mixed dentition, but there is a need to have an evidence based approach when selecting the most appropriate space maintainer for space management in children. This systematic review aimed to assess the survival rate of space maintainers in children. METHODS: A systematic literature search was conducted until October 2017 using PubMed, Scopus, and The Cochrane Central Register of Controlled Trials databases to identify peer- reviewed papers published in English. Search keywords and MeSH headings include "primary dentition" and "Fixed Space maintainers". The inclusion criteria were clinical studies conducted in children less than 12 years of age, who required unilateral or bilateral fixed space maintainer. Retrieved papers were evaluated by four reviewers independently to assess suitability for inclusion in the systematic review and the final decision was made by consensus. Qualities of the included studies were assessed using Quality of Reporting of Observational Longitudinal Research by Oxford Academics and data were extracted for analysis. RESULTS: The search identified a total of 39 papers for screening after removal of duplicate articles. Among the retrieved studies, 23 papers did not satisfy the study inclusion criteria. Consequently, 16 full text articles were retrieved and reviewed. Finally, those 11 papers which fulfilled all the inclusion criteria were selected and reviewed systematically. Most of the clinical trials were assessed as having moderate and low risk of bias. CONCLUSION: There is a wide variation in the survival rate of metal based and resin based space maintainers and also within the metal based space maintainers. There is an inadequate evidence to recommend one best fixed space maintainer due to lack of properly designed studies. Hence, clinical trial comparing different types of metal based space maintainer and resin based space maintainer with longer duration of follow-up must be performed to evaluate its survival rate.

Evaluation of knowledge and attitude of parents about the importance of maintaining primary dentition - A cross-sectional study.

INTRODUCTION: Dental caries is very common in primary dentition because of improper oral hygiene and increased intake of sucrose. Grossly decayed primary teeth require extraction. The space created by extracted teeth should be replaced by primary dentition to avoid migration of adjacent teeth into the space and to prevent the eruption of permanent tooth. Different appliances are used to maintain the space post extraction of the primary tooth to preserve the space for the eruption of the permanent tooth in a sequential manner. AIM: Evaluate the attitude and knowledge of parents toward the importance of maintaining primary dentition in their children. METHODS: A survey was conducted among randomly selected 100 parents having children between the ages of 2 and 16 years from the general population of Chennai, India. A questionnaire was created was distributed. The data were later collected and statistical analysis was performed. RESULTS: Hundred percent awareness was seen among parents regarding maintenance of oral hygiene in children. Only 65% parents reported visiting dentists only when the child complains of pain. Eighty-nine percent of the parents were aware of the harmful effects of thumb sucking habits. However, only a minimum percent parents thought that treating primary teeth was not very important as it would shed off. CONCLUSION: Even though parents were aware that primary teeth have to be managed properly, they were not aware of the various treatment modalities available for treating spaces after extraction of primary teeth and caries management. An increase in the knowledge will encourage parents to provide better oral health to their children.

Management of Crown-Root Fracture in Primary Canine by Surgical Extrusion: A Case Report with 1-Year Follow-Up.

Complicated crown-root fractures of primary teeth often present with a greater challenge to the pediatric dentist. Extraction of the involved tooth is the routine treatment indicated. But, early loss of this primary tooth may lead to esthetic and psychological problems and also causes a detrimental effect on the development of occlusion and the alveolar bone. The present case report described the management of crown-root fracture in a primary canine by surgical extrusion and showed a satisfactory prognosis at one-year follow-up.

Management of foreign body ingestion in children with cerebral palsy: Need for proper trauma management protocol.

Cerebral palsy (CP) is described as a group of permanent, nonprogressive movement disorders that cause physical disability in development and further affecting body movement and muscle coordination. The condition develops when certain abnormalities persist inside the developing brain that ultimately disrupts the brain's ability to control movement and maintain posture and balance. Patients with CP are more susceptible to dental trauma due to the lack of muscle coordination and unexpected involuntary movements. The present case series highlights the need for emergency protocol management when these patients report with dental trauma and complications which can happen in dental office. The first case report is about ingestion of permanent incisor following trauma which was diagnosed incidentally in the abdominal radiograph, and the second case is reported to be accidental ingestion of head of dental mouth mirror during the routine oral examination. These two case reports emphasize the need for more comprehensive trauma management protocol in these children.