The Influence of the Tongue on the Development of Dental Malocclusion.

The tongue supports the upper dental arch and encourages healthy dental arch development when it rests against the roof of the mouth. On the other hand, over time, malocclusion can result from incorrect tongue position, such as lying low in the mouth or thrusting forward during swallowing or speaking. As a muscular organ, the tongue applies forces to the jaws and teeth that may help with malocclusion or hinder it from aligning properly. The dentition and jaws grow and align according to the way the tongue, teeth, and surrounding structures interact. The tongue's morphogenetic function includes forming the arches and having an important impact on the maxillary complex's development. The tongue frequently assumes a balancing and compensatory function in subsequent phases, functioning more or less like a natural orthodontic bite. In adults, the tongue is able to compensate for problems like open bites, teeth that are out of alignment, or differences in the occlusal and sagittal planes of the spine. In this context, the tongue's ability to sustain occlusion during malocclusion can be considered a compensatory response. This is comparable to how lingual dysfunction may contribute to malocclusion or act as a potential source of recurring orthodontic instability. In order to diagnose and treat orthodontic issues, dental professionals must know the connection between tongue position and dental malocclusion. Malocclusion can be prevented or minimized with early intervention, such as myofunctional therapy to correct tongue position and habits, improving dental health and well-being overall.

Unlocking Hidden Teeth: A Pediatric Case of Surgical Exposure of Maxillary Central Incisors.

Failure in the eruption of the maxillary incisor necessitates a precise diagnosis and treatment regimen. Impaction can have a number of causes such as physical obstacles in the eruption path, discrepancy in the length of the dental arch, and tooth anomaly. Delayed eruption of anterior teeth can result in a number of issues such as malocclusion and psychological discomfort. In many cases, if the intervention is not done at an early stage, complex orthodontic intervention is required after surgical exposure to enable appropriate eruption. This case report is of a nine-year-old child with unerupted maxillary central incisors. The child was treated surgically for incisor exposure under general anesthesia (GA). Both functional and aesthetic considerations made this surgical procedure necessary. GA was administered due to the negative behavior of the child in a dental setting. Hence, it ensured patient comfort and cooperation. Follow-up examinations showed satisfactory progress in the eruption of the teeth with no complications.

Generalized Non-syndromic Hypertaurodontism With Delayed Eruption: A Case Report.

Taurodontism is a rare dental anomaly defined by a change in tooth shape due to Hertwig's epithelial sheath not folding inward at the right horizontal level. It has a larger pulp chamber and a pulpal floor that is shifted apically, and the cementoenamel junction (CEJ) is not constricted. This condition is more frequently observed in permanent teeth than in primary teeth and can occur in a bilateral or unilateral manner, affecting any quadrant or group of teeth. This brief case report discusses a 14-year-old female patient who presented with complaints of decayed teeth in the lower right and left posterior regions of the jaw. Radiographic examination revealed the presence of non-syndromic taurodontism in both the deciduous teeth and their permanent successors. Dental management included oral prophylaxis, application of pit and fissure sealants, indirect pulp capping, and restoration with glass ionomer cement for the affected teeth.

Passive Root Coverage Through Creeping Attachment of the Gingiva Before and After Scaling and Root Planning Therapy in the Mandibular Anterior Teeth: A Clinical Study.

Introduction Root coverage is one of the most imperative procedures in periodontal therapy. The demands from patients for aesthetics and sensitivity are some of the complaints in root exposure cases. Creeping attachment is a passive apical migration of the marginal gingiva and can be proposed as a noteworthy root coverage technique. The purpose of this study was to evaluate the position of the marginal gingiva and quantify the creeping attachment before and after the scaling and root planning (SRP) procedure. Materials and methods The present study was based on a single-centre clinical trial in which 30 sites from 10 patients were selected. Patients with Miller's class I gingival recession were selected. The plaque index, gingival biotype, and gingival margin position were measured at baseline and then at 10 and 21 days after SRP. The gingival biotype was measured with an endodontic file with a stopper and a digital vernier calliper. The gingival margin position was measured from the incisal surface of the tooth to the marginal gingiva with the help of a University of North Carolina (UNC) 15 periodontal probe. After recording the clinical parameters, a thorough SRP was performed using an ultrasonic scaler and manual instruments. Results The results were compared clinically at baseline and after 10 days and 21 days postoperatively. Statistical analysis was conducted for pre-SRP and post-SRP findings using the IBM SPSS Statistics for Windows, Version 19 (Released 2010; IBM Corp., Armonk, New York) software. A statistically significant improvement was seen in all the clinical parameters at baseline, at 10 days, and at 21 days postoperatively after the procedure (P < 0.01). Conclusion The position of the gingival margin was shifted towards the crown, and the creeping attachment was significantly observed from baseline to 10 and 21 days. Clinical significance Creeping attachment after the SRP procedure can be considered a significant root coverage technique. The genetic memory of the gingiva may play an important role in achieving root coverage. Once local irritants are removed, the gingiva attempts to regain its original position. In addition, the gingival phenotype plays an important role in gingival marginal positioning after basic therapy and root coverage procedures.

Clear Aligners in Pediatric Dentistry: A Scoping Review.

Today not just adults but also children are affected by their looks and appearance. Their facial and dental appearance primarily influence how they present themselves in the outside world. Poor esthetic appearance at any age, especially when it comes to children, affects their psychological status. In earlier times, correction of dentition used to be done with crude methods, after which came the concept of braces, which were fixed on the labial surfaces. Even with these, the patients are equally concerned with their looks throughout the treatment, and thus neither adults nor children are eager to use the standard metallic-looking orthodontic gear. To tackle this problem, researchers have developed several solutions, and clear aligners are the modern and aesthetic answer. For effective tooth movement into the desired position, thin, transparent, plastic aligners known as invisible aligners are used, which are created using the computer-aided design/computer-aided manufacturing (CAD-CAM) technology. These aligners are analogous to the splints that cover the clinical crowns as well as the marginal gingiva. The treatment requires proper patient motivation as there can be poor compliance by patients. However, it can offer greater dental hygiene, comfort, and an excellent aesthetic experience during treatment. This review highlights the history of fabrication of clear aligners, examining the efficacy, advantages, and disadvantages of transparent aligners for pediatric patients and also dentists. It weighs aspects like aesthetic appeal, comfort, oral hygiene, treatment predictability, and practice efficiency when comparing transparent aligners, like Invisalign, to conventional orthodontic treatments. It also ascertains the applicability and worth of clear aligners in contemporary orthodontic practice, while examining patient happiness, compliance, and overall treatment results.

The Impact of Rubber Dam Association With Physiological Stress Parameters on Children of 7-10 Years Undergoing Pit and Fissure Sealant Treatment: An In-Vivo Study.

Introduction Anxiety is an emotion representing apprehension towards an unknown stimulus or situation. Rubber dam application during dental procedures in children makes the treatment more comfortable and acceptable as it gives them a psychological feeling that treatment is being carried out outside the oral cavity. The prime objective of this study was to evaluate and compare physiological parameters, which include pulse rate, arterial oxygen saturation level, blood pressure, and respiratory rate before and after rubber dam isolation. Material and methods The study consisted of 30 children patients of 7-10 years, comprised of 14 females and 16 males with a mean age of 8.15 ± 0.93 years. The study was a 'split mouth' clinical design study, where 60 sites in 30 patients (two sites in each patient) were used. The selected sites were divided into two groups by a convenience sampling method and were categorized as Group-I (control group - 30 sites were treated with pit and fissure sealants under cotton roll and saliva ejectors on mandibular right permanent first molar) and Group-II (study group - 30 sites were treated with pit and fissure sealants underrubber dam isolation on mandibular left permanent first molar). Results Rubber dam application reduced different physiological parameters of stress such as pulse rate, systolic and diastolic blood pressure, and respiratory rate at different intervals from the baseline values. Rubber dam and cotton roll applications have no significant effects on oxygen saturation levels at different intervals in healthy individuals. From statistical analysis, it was evident that a statistically significant difference was evident between the control and experimental groups (P value < 0.005). Conclusion It is confirmed in this study that rubber dam reduces different physiologic parameters of stress. After the application of the rubber dam, children's pulse rate, systolic and diastolic blood pressure, and respiratory rate were reduced. Clinical significance The study highlights the imperative role of rubber dam isolation in improving dental and medical effectiveness. In addendum to this, our research promotes the clinical use of rubber dams in pediatric dentistry.

Conservative Management of Maxillary and Mandibular Fractures in a Pediatric Patient With a Modified Open Cap Splint: A Case Report.

Pediatric maxillofacial fractures, which are not very prevalent, account for around 5% of all face injuries. Children under the age of 13 are more susceptible to craniofacial injuries because they have a larger cerebral mass-to-body ratio than adults. The fracture pattern in children does not resemble that of adults, due to which the treatment of pediatric fractures differs from that of adults and can pose substantial difficulties to the pediatric dentist due to many factors, including the complex anatomy of the developing jaw. In this case report, a 5-year-old male patient presented with an injury to the upper and lower jaw. A case was managed with a conservative approach by using a modified open cap splint. A radiographic investigation, including CT brain and face, was done, which revealed the mandibular symphyseal fracture, bilateral condyle, and right Lefort II fracture. A modified open cap splint was fabricated and fixed with circummandibular and circumzygomatic wiring under general anesthesia. After two months, the fractured site showed good healing on orthopantomography (OPG), and satisfactory occlusion was achieved. The patient was kept on monthly follow-ups for up to five months. Treatment guidelines for pediatric maxillary and mandibular fractures are different from those for adults in that most pediatric cases are managed by a conservative approach. Cap splints are a versatile treatment option for juvenile mandibular fractures because they can be used to restore function and aesthetics with minimal morbidity, do not impede jaw growth or the development of dentition, and can be applied to patients of a wider range of ages.

Understanding the Distinction Between Traumatic Fibroma and Mucocele in Pediatric Patients: A Report of Two Cases.

Traumatic fibroma is a reactive oral cavity lesion that manifests as a localized, non-neoplastic, inflammatory hyperplastic papule of fibrous connective tissue. Alternatively, mucocele is another frequent oral lesion, caused by mucus pooling in the tissues as a result of trauma to minor salivary glands. This article aims to shed light on traumatic fibroma and mucocele of the lower lip in pediatric patients. Two pediatric patients complained of soft tissue growth on the left side of the lower lip. Appropriate diagnosis, treatment planning, and light amplification by stimulated emission of radiation excision were done for both patients. The excised samples were sent for histopathological analysis. Both patients showed clinical resolution in a short period without any discomfort. A comprehensive understanding of these variances is essential for precise diagnosis and tailored treatment strategies.

Evaluation and Comparison of Facial Appearance Using the Golden Ratio: An Anthropometric Study in Preschool and School-Going Children of Santhal Tribe in West Bengal.

Introduction Golden ratio and beauty are two inseparable sides of the same coin and have been studied for centuries by the Greeks. This divine ratio is defined as an invincible parameter in aesthetic dentistry to measure looks, symmetry, and balance. Being beautiful and handsome also boosts confidence in today's children and therefore is a top priority for young growing kids. However, there is no study done to define facial measurements based on the golden ratio in preschool and school-going children that can succor aesthetics in formative years. The purpose of this research was to evaluate facial proportions in the vertical dimension, quantify them in reference to the golden ratio, and analyze the association with gender among preschool and school-going children of the Santhal tribe in the Bankura district. Materials and methods A total of 399 subjects, 198 children of 3-5 years with primary teeth and 201 children of 6-12 years with mixed dentition, were selected from schools in villages of Bankura district, West Bengal, India. The subjects were made to relax in a sitting position and a digital vernier caliper was used to record the following vertical facial parameters: total facial height (TFH), trichion-gnathion distance (Tr-Gn), and subnasale-gnathion distance (Sn-Gn). The total facial height was correlated with sexual dimorphism and dentition. The ratio of Tr-Sn/Sn-Gn was calculated and compared with the golden ratio. The ratio was classified as normal (if it was between 1.6 and 1.699, i.e., normal to the golden ratio value), long (if it was more than 1.699, i.e., more than the golden ratio value), or short (if it was below 1.6, i.e., less than the golden ratio value). This facial analysis based on the golden ratio was correlated to sexual dimorphism and dentition. The data were recorded, compared with gender, and statistically analyzed using the unpaired t-test and Chi-square test. Results The total facial height was larger in males than females in both primary and mixed dentition; however, the value was highly significant in primary dentition. Tr-Sn/Sn-Gn ratios were lower in the long facial category in both males and females in both preschool and school-going children. The values were statistically significant in these ratios for both dentitions. Conclusion The majority of children in the Santhal tribe of Bankura in West Bengal did not conform to the golden ratio and showed long faces. There was a significant association of facial features with sexual dimorphism. Clinical significance The early prediction of facial features in children and its confirmation with the established golden ratio can be considered an imperative parameter to comprehend facial aesthetics and symmetry.

Dental Management of an Uncooperative Child with Hearing Impairment and Mutism Under General Anesthesia.

Oral health is a vital part of overall health, particularly for children with special healthcare requirements. The terms "dumb" and "mute" are frequently linked with the term "deaf" due to the connection between hearing loss and speech impairment. A hearing and speech-impaired child may be unable to express completely because of the communication barriers. It is important to treat special children with utmost care and safety. This case report describes the dental management of an 8-year-old special child reported with multiple carious lesions under general anesthesia as she was not well acquainted with sign language. In a hospital setting under general anesthesia (GA), all necessary treatments are carried out in a single appointment. Since it is monitored by a multi-disciplinary team it can safely provide effective care to a child with hearing impairment and mutism.

Diode Laser-Assisted Pulp Polyp Excision and Canal Disinfection in a Primary Molar: A Case Report.

This case report presents the successful application of diode laser technology in the management of a pulp polyp in a primary molar, showcasing its efficacy in both excision of the proliferative tissue and subsequent canal disinfection. An eight-year-old patient with a symptomatic primary molar exhibiting a pulp polyp was selected for this intervention. The diode laser, with its specific wavelength and precise tissue interaction, allowed for a minimally invasive and efficient removal of the pulp polyp. Additionally, the laser was utilized for thorough disinfection of the root canals, targeting bacterial pathogens while preserving surrounding healthy tissue. The case was monitored over a three-month follow-up period, demonstrating favorable clinical and radiographic outcomes. This report emphasizes the potential of diode laser technology as a feasible adjunct in the treatment of pulp polyps in primary molars, showcasing its benefits in terms of reduced invasiveness, enhanced precision, and effective canal disinfection in pediatric endodontics.

Dental Management of a Child With Sickle Cell Anemia: A Case Report.

Sickle cell disease (SCD) has been identified as one of the most prevalent genetic conditions. It alters the shape and function of red blood cells. This brief case report presents a case of a five-year-old male with sickle cell disease who complained of pain in the left mandibular region due to deep proximal caries. Before dental management, a complete fitness evaluation was performed with the help of a pediatrician, followed by informed consent. Dental management includes pulpectomy followed by stainless steel crown placement and Glass ionomer cement (GIC) restoration for superficial caries. Other oral manifestations were observed, including a smooth tongue and mucosal pallor. It was concluded that dentists and health professionals should be knowledgeable of the general and oral anomalies that can be present in individuals with sickle cell anemia in order to take preventive action and implement effective management.

Comparative Evaluation of Horizontal Lip Position With Ricketts Esthetic Plane in Preschool and School-Going Children of Bankura, West Bengal: A Craniofacial Anthropometric Study.

Introduction The horizontal lip position and esthetic plane are two important parameters to define facial beauty, and these factors are always given importance in children undergoing fixed orthodontic therapy. The purpose of this study was to evaluate horizontal lip position in primary and mixed dentition children with class I occlusion and to analyze its association with gender among preschool and schoolchildren of villages in the Bankura district in West Bengal. Materials and methods Researchers screened 437 children for the study and selected those who met the inclusion criteria. A total of 407 children were segregated: 201 children aged three to five years with the flush terminal plane and mesial step in primary teeth and 206 children aged seven to eleven years with class I occlusion in mixed dentition were selected from schools in villages in Bankura district, West Bengal, India. The subjects were instructed to hold the head in the natural head position by looking straight, and points were marked on the nose and chin tip, respectively. A metallic ruler was placed from nose to chin, representing Rickett's esthetic line. The horizontal lip distance to the esthetic plane of both upper and lower lips was measured as a linear distance from the most anterior part of the lip to the metallic ruler. The data were recorded, compared with gender, and statistically analyzed using the Chi-square test using the Statistical Package of Social Sciences software (SPSS version 19.0, 2015, IBM Corp., Armonk, NY). Results The most prevalent horizontal lip distance for both upper and lower lips to the esthetic line for primary and mixed dentition in the Bankura region of West Bengal was category I, where the lip is seen beyond the E plane, followed by category II, where lips are at a horizontal distance in the range of 0-1.5 mm from the esthetic line. A significant correlation of lip position with Rickets aesthetic plane was also illustrious with gender in primary dentition, but a non-significant association with gender was noted in mixed dentition. Conclusion Children with class I occlusion from the Bankura district of West Bengal showed a higher percentage of lip position beyond the esthetic plane in both primary and mixed dentition, which is not in line with the inference of Ricketts's studies on the Caucasian population. There is a definite association between gender and horizontal lip distance in Ricketts esthetic plane. Protrusive upper lips were seen more in males, and retrusive lips were seen more in females. Clinical significance  The horizontal lip position with reference to Ricketts esthetic plane has been documented in the literature for adults and teens undergoing fixed orthodontic treatment. However, there is no study done to define these measurements in preschool and school-going children, which can assist in determining future esthetic profiles and in preparing a protocol for early age interceptive orthodontics along with aesthetic rehabilitation of the anterior area of the mouth.

Minor physical anomalies including palatal rugae pattern and palatal dimensions in children with sickle cell disease: A cross-sectional analytical study.

Background: Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods: A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10-18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm-5 mm), and fragmentary rugae (<3 mm). The shape of each primary palatal rugae was identified and categorized as curved, wavy, straight, circular and non-specific. Linear and angular measurements of the palatal rugae patterns and palatal dimensions (width, height, area) were measured and recorded. Results: The total number of palatal rugae and fragmentary rugae was lesser in Group SCD than in Group C (p < 0.05). The depth of the palate was significantly increased, whereas the area of the palate significantly decreased in Group SCD. Conclusions: The children with SCD showed distinctive palatal rugae patterns and dimensions when compared with normal healthy children that can be attributed as potential MPAs for sickle cell disease. Children with SCD had an under-developed palatal rugae pattern with a deep, narrow and small palate when compared to healthy children.The dimensions of the palatal rugae pattern in SCD showed reduced distance between the incisive papilla and the first and last rugae, indicating a further decrease in the anteroposterior dimensions of the palate. These findings may aid in the early diagnosis and prevention of malocclusion in children with SCD by appropriate interceptive orthodontic treatment.

Evaluation of Antibacterial Activity of Madhuca longifolia (Mahua) Stem Extract Against Streptococcus mutans: An In Vitro Study.

Introduction Madhuca longifolia is one of the important folklore medicinal plants with a plethora of established pharmaceutical properties. Its twigs are used as chewing sticks (toothbrushes), and it is believed that if a person uses it daily, it will make their gum healthy and strong. No study has ever been conducted to evaluate the antibacterial effect of M. longifolia extracts against oral microorganisms. Materials and methods Fresh stem twigs (Madkam Kaarkad) of M. longifolia were collected and dried. The dried stem was cut into small pieces, 5 g of which was mixed with 50 ml distilled water (in the ratio 1:10) and kept for two days for maceration. After two days, the liquid was filtered and the final filtrate was obtained, from which dry pellets were made and stored in the refrigerator at 4°C. Brain heart infusion agar was used as a medium to grow the lyophilized bacteria. Pure strains of Streptococcus mutans 890 were obtained from the Microbial Type Culture Collection (MTCC) and MTCC-suggested protocol was followed for the revival of lyophilized bacteria. The agar well diffusion method was used to determine the zone of inhibition. The extract of stems with different concentrations (10%, 7.5%, 5.0%, and 2.5%) and at different volumes (100 µl, 150 µl, 200 µl, and 250 µl) was transferred to the agar plates. Chlorhexidine 0.2% was used as a control and it was also transferred to agar plates, which were incubated aerobically at 37°C for 24 hours. Antibacterial activity was interpreted from the size of the diameter of zones of inhibition measured in millimeters using a measuring scale in all the agar plates. Results The minimum zone of inhibition of 11 mm at 2.5% concentration and 100 µl volume of M. longifolia extract and the maximum zone of inhibition of 20 mm at 10% concentration and 250 µl volume was notified. While for chlorhexidine at 0.2% concentration, the zone of inhibition obtained was 9.5 mm at 40 µl volume. The minimum inhibitory concentration (MIC) value of M. longifolia was found to be 35 mg/ml. Conclusion M. longifolia showed marked antibacterial activity against S. mutans and has a high MIC value. Therefore, this plant can be considered an effective agent against oral diseases like dental caries.

Management of Turner's Hypoplasia Using Resin Infiltration: A Case Report.

The causes of enamel discoloration can vary, leading to aesthetic concerns for patients. Injuries to primary teeth can lead to developmental issues in permanent successors, with enamel hypoplasia, commonly referred to as Turner's tooth. Diverse methods are available for addressing tooth discoloration. A case of an 11-year-old pediatric patient with a brown patch on the upper left central incisor was reported to the Pediatric Dentistry Department. A well-demarcated, yellowish-brown lesion was present on the labial surface of 21 and was diagnosed as Turner's hypoplasia. Resin infiltration was done using the Icon Smooth Surface (DMG America Company, Englewood, NJ) resin infiltration kit. The resin infiltration technique provides an approach to meet aesthetic requirements. In this case, the resin infiltration technique was successfully utilized to address the discoloration of the left maxillary central incisor, which was affected by Turner's hypoplasia.

Comparative evaluation of three different regression-equation-based mixed dentition analysis of children for prediction of the mesiodistal width of permanent canine and premolars.

BACKGROUND: Dental malocclusion is common all over the world, and it is caused by a difference in arch length and tooth size. This necessitates mixed dentition analysis for early intervention treatment planning such as eruption guiding, serial extraction, space maintainer, space regainer, and jaw extension. The aim of the study is to comparatively evaluate three different regression equation based mixed dentition analysis of children for prediction of the mesiodistal width of permanent canine and premolars in population of Vidarbha region. METHODS: This study comprised of 300 patients aged 13 to 16 years old. The impressions of patients were poured, and the mesiodistal width of their teeth was measured and documented. Three independent analyses were performed using the Ling and Wong method (L&W), the Bernabe and Flores-Mir method (B&F), and the Tanaka and Johnston method (T&J), and the results were compared to the sum of permanent canine and premolar teeth (SPCP). ANOVA with post hoc analysis was used to compare the predicted mesiodistal diameter (MDD) by analysis to the SPCP observed on cast. RESULTS: The mesiodistal width of SPCP of maxilla and mandibular teeth had statistically significant difference (P<0.001) with the predicted width by Ling and Wong method, Bernabe and Flores method and Tanaka and Johnston method for patients of Vidarbha region. CONCLUSIONS: The study concluded that all the three analysis overestimated the mesiodistal width of the sum of permanent canine and premolar in the patients. Tananka and Johnston analysis method was better in predicting the SPCP of the children of Vidarbha region.

Comparative Evaluation of Electronic Acupuncture Pen and 2% Lignocaine Gel as an Intraoral Topical Anesthetic Agent in Children.

Background The most exasperating aspect for pediatric patients in a dental setup is the fear and anxiety caused by injections, called "blenophobia". There are numerous local anesthetic agents available to reduce the needle prick pain. Taking into consideration the paradigm shift, there is always a possibility for alternate treatment options. This study aimed to evaluate and compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) application through an electronic acupuncture pen (Meridian Energy Acupuncture Pen W-912 GENERIC) and 2% lignocaine gel as an intraoral topical anesthetic agent in children. Method Patients aged 6 to 12 years were eligible for inclusion. The topical anesthetic agents were administered to the patients in a bilateral split-mouth technique. In Group A, 2% topical anesthetic gel was administered on the first visit on one side of the mandible and topical anesthesia through the electronic acupuncture pen was administered on the next visit, on the opposite side of the mandible. The electronic acupuncture pen was applied on one side of the mandible on the first visit, and on the next appointment, 2% topical anesthetic gel on the other side was administered in Group B. Sound, eye, motor scale (SEM) and faces pain scale-Revised (FPS) were used as tools of evaluation after local anesthesia was administered.  Results  The comparison between electronic acupuncture pen and 2% lignocaine gel using the SEM scale shows a statistically insignificant difference (p-value = 0.082). Similarly, a comparison of FPS values between both groups indicates no significant difference (p-value = 0.582). However, results show a reduced pain perception in both groups. Conclusion Topical anesthetic agents are commonly used to reduce needle prick pain in children. TENS through the electronic acupuncture pen, a revisited aid in scientific research, has proved its efficacy as a topical pain reduction measure during dental treatment. This device overcomes the shortcomings of the anesthetic gels and also nullifies the chances of overdosage, hypersensitivity, and disagreeable taste. Thus, this tool can be used in dental practice for the management of pain in children.

Exploring the Synergistic Effect of Simvastatin in Oral Health Applications: A Literature Review.

Statins are the first line of treatment for hyperlipidaemia. Along with lowering lipids, it also lowers mortality and cardiovascular risk. Statins play a major role in maintaining the homeostasis of the oral cavity via a number of different mechanisms. It includes regeneration of dentin and pulp by differentiation and increased development of mineralized tissue via the bone morphogenetic proteins (BMP)-2 Pathway. It shows effective bone health by leading to osteogenic differentiation mesenchymal stem cells, by facilitating epithelization process in wound healing, anti-inflammatory, antioxidant, antimicrobial, antiviral, and fungicidal properties. To the finest of the information we have, there have been very few comprehensive studies that have investigated the effects of statin drugs on various aspects of dental and oral health. As a result, the main objective of this review was to examine the effect of statins on oral health applications. According to the findings of our extensive review, statins have noteworthy and promising effects on several aspects of oral health, including dental pulp cells, chronic periodontitis, alveolar bone loss, orthodontic tooth movement, and so on. Nevertheless, it is concluded that local or even systemic administration of simvastatin should be regarded as an innovative, easily accessible, and safe therapeutic agent that has a significant impact on enhancing the oral health.