Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements.

The most common pathological condition, dental caries when remain untreated which shows pulpal involvement and may lead to invasive treatment, such as crown placement followed by pulp therapy. Larger carious lesions on primary molars stainless steel crowns (SSCs) placement by means of conventional tooth preparation. The modern approach to managing carious lesions concentrates on using less invasive treatment techniques, with the focus being on biofilm change. One among such alternative method of managing the primary molars is the Hall's technique. Another most important factor for the survival of a crown is its sealing ability, in which luting cements, such as adhesive cements, have a crucial role as they help in providing a suitable marginal seal and thereby cause a reduction in the microleakage. Silver diamine fluoride (SDF) has proven anticariogenic activity in arresting carious lesions. Hence the aim was to evaluate and compare the microleakage of SSCs placed by Hall's technique, Hall's technique with SDF, and the conventional crown technique using different luting cements. A total of 60 primary first and second molars with occlusoproximal caries, which were initial and moderate in nature. The blocks were randomly divided into three groups, in which precontoured SSCs were applied by using either the Hall's technique or the conventional technique. After subjecting tothermocycling, the samples were examined under stereomicroscopic for microleakage evaluation. A few samples were randomly selected from each subgroup, and a scanning electron microscopic (SEM) examination was done. Highest values of microleakage were noted with Hall's technique resin-modified glass ionomer cements (RMGIC) luting cement group. It can be concluded from the present study that the conventional technique was found to be superior over the Hall's technique with SDF and then by the Hall's group alone. SDF application beneath the Hall's crown appears to be promising approach for the reduction of microleakage. How to cite this article: Thakur NS, Tyagi P, Tiwari S, et al. Comparative Evaluation of Microleakage in Hall's with SDF, Hall's, and Conventional Technique Using Different Luting Cements. Int J Clin Pediatr Dent 2023;16(1):16-21.

Clinical Outcome of Direct Pulp Therapy in Primary Teeth: A Systematic Review and Meta-analysis.

Background: Direct pulp treatment is carried out when a healthy pulp gets mechanically/accidentally exposed during the operative procedures or trauma. Aim: To determine the effects of various direct pulp capping materials as measured by the clinical and radiographic analysis. Design: Two reviewers performed a database search of the studies published between January 2005 and November 2020. The inclusion criteria were papers published in the English language; children aged 3-12 years having deep carious lesions in primary teeth. All potential studies were acknowledged by their title and abstract. The full-text analysis of potentially relevant studies, the selected studies were included in the systematic review. A meta-analysis calculation was performed for the overall data and the subgroup data. Results: The database searching led to 57 articles, which were of direct pulp treatment in primary teeth, after the removal of duplicates, 55 records remained but did not meet all inclusion criteria. A high variability was observed among the papers. Further filtering with criteria led to nine articles, which met all inclusion criteria. Meta-analysis demonstrated the success rates of DPT in primary teeth (95% confidence interval -0.799-0.898); P < 0.001. Clinical assessments of various direct pulp capping materials suggested 84.9% of success irrespective of the material used. The nine studies were heterogeneous according to the random effect model (P < 0.001, I2 = 84.08%). Conclusions: Direct pulp treatment has the advantage of being a conservative vital pulp therapy reducing the need for a more invasive treatment.

Knowledge, Attitude, and Practice of Pediatric Dentists Regarding Oral Health Management of Visually Impaired Children.

Aim: The aim of this study is to investigate the knowledge, attitude, and practices of pediatric dentists regarding oral health management of visually impaired children. Material and methods: A combination of convenience sampling and snowball sampling was used to send an online Google form survey questionnaire to pediatric dentists all around the world. Four sections made up the questionnaire-the first asked for personal information, while the second, third, and fourth examined the knowledge, attitudes, and practices of pediatric dentists, respectively. The IBM Statistical Package for the Social Sciences (SPSS) for Windows, version 21.0, was used to analyze the data. Result: The total responses (511) were broken up according to the different continents. The Asian continent produced the most pediatric dentists (206, 40.3%). Most of the participants in the study were females (365, 71.4%), and the maximum was postgraduate students (203, 39.7%). Moreover, the participants were practicing in the private sector (445, 87.1%) and had an experience of 2-5 years (118, 23.1%). Good knowledge scores were significantly associated with work profile (p = 0.014*) years of practice, and associated countries had shown significant differences (p ≤ 0.001). Conclusion: According to this study, the majority of the pediatric dentists included have just rudimentary knowledge of children who are visually impaired. Pediatric dentists are prevented from treating and properly managing visually impaired children as a result of deficient practices in the field of visually impaired children. How to cite this article: Tiwari S, Bhargava S, Tyagi P, et al. Knowledge, Attitude, and Practice of Pediatric Dentists Regarding Oral Health Management of Visually Impaired Children. Int J Clin Pediatr Dent 2022;15(6):764-769.

An analysis of the palatal surface anatomy of maxillary central incisors: complexity behind the simplicity.

BACKGROUND: The palatal surface of the maxillary anterior teeth in conjunction with the incisal edge represents the mechanical area, which is of great importance for lateral and anterior guidance. Therefore, in terms of restorative dentistry, it is crucial for the clinician to have a detailed knowledge of the palatal surface anatomy (PSA) of the different maxillary anterior teeth in order to reestablish a definitive correlation between form, function, and esthetics. The aim of the present study was to analyze the variations in the PSA of the maxillary central incisors (CIs) and their correlation with tooth form and gender. MATERIALS AND METHODS: Impressions of the maxillary arch of 500 study participants were taken and then classified according to PSA and tooth form. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software. The chi-square test was utilized for comparisons among PSA, tooth form, and gender of the participants. RESULTS: The results showed Type 5 to be the most common PSA in maxillary CIs and the square tooth form to be the most common tooth form among both genders; Type 5 was also found to be the most common PSA within the square tooth form.

Dental Anxiety Scales Used in Pediatric Dentistry: A Systematic Review and Meta-analysis.

AIM: To assess various dental anxiety scales used in children and to know the effectiveness of different projective dental anxiety scales used in pediatric dentistry. BACKGROUND: Dental anxiety poses a significant problem in child patient management and is considered to be the main barrier for successful completion of the dental treatment. REVIEW RESULTS: This systematic review and meta-analysis has been registered at the International prospective register of systematic reviews-PROSPERO-CRD42021247586. The systematic review was conducted in accordance with the Preferred Reporting Items in Systematic Review and Meta-Analysis (PRISMA) guidelines. Electronic databases [PubMed (MEDLINE), COCHRANE Library, EMBASE, EBSCO host, and Google Scholar database] were searched for corresponding references up to 2021. Observational cross-sectional studies comparing two different dental anxiety scales were selected for this systematic review. Search strategy generated 500 articles out of which 13 studies included in qualitative synthesis and only 7 studies were taken for quantitative synthesis. Among these seven studies, five studies compared FIS and VPT scales, two studies compared RMS, FIS, and VPT scales. Results of meta-analysis showed that an overall mean difference of dental anxiety between VPT and FIS scales was 0.11 (95% CI: 0.26-0.48), RMS and FIS scales was 0.05 (95% CI: 0.40-0.50), RMS and VPT was 0.27 (95% CI: 0.80-0.27) in the investigated population. CONCLUSION: No statistically significant difference was noted in all comparisons suggesting that all these scales are at par in assessing anxiety levels in pediatric population. CLINICAL SIGNIFICANCE: The projective scales Raghavendra, madhuriu, sujata pictorial scale (RMS), Facial image scale (FIS), and Venham's picture test (VPT) can be a pragmatic tool in assessing children's dental anxiety.

Biological posts and crown: An esthetic recovery of smile.

Anterior teeth fracture is a common form of dental trauma that mainly affects children and adolescents. Maxillary incisors are the most commonly affected teeth. Loss of coronal tooth structure might affect esthetics and function. In recent decades, dentistry has shown many scientific and technological advances in restorative materials. However, no synthetic restorative material can replicate the natural tooth structure. Hence, the use of natural tooth as a restorative material has been suggested in literature and is termed as a biological restoration. The present case report represents the successful use of biological post and crown and was adequate with respect to adhesion, function, and esthetics with the follow-up period of 1 year. Hence, it may be concluded that the biological restoration, if feasible, is a cost-effective way to restore a damaged tooth with acceptable esthetics and tooth functions in the stomatognathic system.

A comparative evaluation of antimicrobial efficacy and flow characteristics of two epoxy resin-based sealers-AH plus and Perma Evolution: An in vitro study.

AIM OF THE STUDY: Bacteria that persist at the time of obturation increase the possibility of persistent apical periodontitis. An ideal sealer should be able to kill these remaining bacteria that are present on the dentinal walls as well as inside the dentinal tubules. This could be possible if a sealer has antimicrobial properties with optimum flow characteristics. Hence, the aim of this in vitro study was to assess the antimicrobial efficacy of epoxy resin-based sealer: AH Plus and Perma Evolution against Enterococcus faecalis on the 1st, 3rd, 5th, and 7th day and also to compare the flow characteristics of both epoxy resin-based sealers. MATERIALS AND METHODS: E. faecalis ATCC 35550 strain was used to assess the antibacterial efficacy of sealers by agar-diffusion test (ADT) and direct-contact test (DCT). Flow characteristics of sealers were measured according to the ADA specification no. 57. RESULTS: In ADT, Perma Evolution sealer showed larger zone of inhibition than AH plus on the 1st, 3rd, 5th, and 7th day, and in DCT, both sealers were equally effective in inhibiting E. faecalis growth on the 1st, 3rd, 5th, and 7th day. Flow test showed no significant difference between Perma Evolution and AH Plus sealer. CONCLUSION: Both the tested sealers were equally effective against E. faecalis up to 7 days of incubation period. Considering flow properties, both the tested sealers showed optimum flow as per the ADA specification no. 57.

Degradation of Resin Restorative Materials by Streptococcus Mutans: A Pilot Study.

OBJECTIVE: To evaluate the degradation of three resin based restorative materials by S Mutans. STUDY DESIGN: Class I cavity was prepared in extracted premolars and were randomly divided into 3 groups (Group I - Conventional composite (CC), Group II - Resin Modified GIC and Group III-Giomer). Teeth were then restored by respective restorative material and equally divided in two subgroups (Control and Experimental). Experiment subgroup samples were then incubated in 2 ml of BHI with 1:10 dilution of SM (MTCC-497) grown overnight in BHI whereas control subgroup samples were incubated in BHI without SM. The incubation solution was collected at 2,14 and 30 days interval, and the analysis for identification and quantification of Bis-HPPP was done by High performance Liquid Chromatography. RESULTS: Statistical analysis of the collected data revealed a statistically increased Bis HPPP production in the presence of SM in all the tested materials, with minimum in Resin Modified GIC and a maximum in Conventional Composite (CC). CONCLUSION: SM degrades the resin based restorative materials & among the tested materials Resin Modified GIC appears to be most Biostable.

Invitro Evaluation of Fluoride Release from Hydroxyapatite Reinforced Glass Ionomer with or without Protective Coating.

INTRODUCTION: Glass Ionomer Cement (GIC) is well known for its fluoride releasing property but has its own drawbacks of poor mechanical properties, sensitivity to initial desiccation and moisture contamination. To overcome these, search led to the reinforcement of hydroxyapatite and application of surface coating agent but their effect on fluoride release is still not clear. AIM: To evaluate and compare the release of fluoride from Hydroxyapatite Reinforced Glass Ionomer (HA-GIC) with and without protective coating. MATERIALS AND METHODS: Specimens were prepared as follows- Eight percent by weight conventional glass ionomer was replaced by hydroxyapatite powder (HA) and an indigenous product was prepared (HA-GIC). This powder was mixed with liquid of conventional GIC and allowed to set, then G coat plus coating agent was applied in surface coated group and light cured. Fluoride release of the sample was measured every 24 hrs for seven days and weekly from 7(th) to 21(st) day using combination ion selective electrode. RESULTS: Mean values clearly reveal a significant decrease in the fluoride release from day 1 to day 21 for both the groups. Results of repeated measure ANOVA revealed statistically significant difference between two groups (p <0.001). CONCLUSION: Coating the hydroxyapatite reinforced glass ionomer will allow for slow and steady release of fluoride for a long period of time into oral environment.

Evaluation and comparison of the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism.

BACKGROUND: Autism is a neurobiological disorder characterized by impaired social interaction, communication difficulties, and lacking manual dexterity. These limitations make the oral hygiene maintenance very difficult. AIM: The aim of this present study is to evaluate and compare the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism. SETTING AND DESIGN: Sample comprised 22 children with autism who daily visited a day care and education center named ARUSHI - a center for children with special health care needs in Bhopal. METHODS: Children were divided into two groups (Group A and B) according to toothbrush used and further divided into subgroups (A1 and B1 [low fluoridated - Pediflor toothpaste] and A2 and B2 [calcium sucrose phosphate - Enafix toothpaste]). Oral hygiene instructions and brushing technique demonstration were given every day for a period of 1-month. Oral health status was evaluated before and after the study using simplified oral hygiene index (OHI-S) and its Miglani's modification for primary dentition, plaque index (PI), gingival index (GI), and decayed, missing, and filled teeth (DMFT)/deft index. The perception of parents regarding oral hygiene practices for their kids was also evaluated by an awareness and attitude questionnaire. STATISTICAL ANALYSIS: OHI-S, GI, PI, and DMFT/deft were statistically evaluated using Mann-Whitney U- test. RESULTS AND CONCLUSION: Mean value of OHI-S decreased significantly with powered toothbrush (0.035 [P < 0.05]) in both groups. However, PI decreased significantly for Enafix when used with powered toothbrush (0.042 [P < 0.05]). Perception of parents was seen to improve significantly after 1-month study (0.000 [P < 0.05]).

Evaluation of treatment related fear using a newly developed fear scale for children: "Fear assessment picture scale" and its association with physiological response.

INTRODUCTION: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. AIMS: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. SETTINGS AND DESIGN: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. STATISTICAL ANALYSIS USED: Shapiro-Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. RESULTS: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure. CONCLUSIONS: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.

Pre-surgical Alveolar Molding in A Newborn Patient with Complete Unilateral Cleft Lip and Palate-A Report.

Clefts of the lip, alveolus and palate (CLAP) are the most common congenital malformations seen in the head and neck region. Children with CLAP face a vast variety of problems like feeding difficulties, hearing loss (ear infections), missing or malformed teeth and speech defects, along with psychosocial stigma which influences the social development and rehabilitation of such patients. Management of CLAP has been recognized as a unique challenge for parents as well as medical team. Pre-surgical alveolar molding has shown promising results in solving the problems which are associated with CLAP, to a great extent. We are reporting a case of a newborn patient with complete unilateral cleft lip and palate, who had inability in suckling and nasal regurgitation of oral fluids since birth, which were aided by providing a Pre-surgical alveolar molding to facilitate feeding and also to improve future facial appearance. This article highlights the effectiveness of alveolar molding appliance which was used to direct growth of the alveolar ridges and lips in the pre surgical treatment of cleft lip and palate. As a result of this appliance, the primary surgical repair of the nose and lip which was done, healed under minimal tension, thereby reducing scar formation and improving the aesthetic results.

Plastinated fetus: 3D CT scan (VRT) evaluation.

OBJECTIVE: The intent of this study was to evaluate the effect of plastination on the morphology and structure of stored organs, to find out how much accuracy a plastinated specimen has, and to look into the changes that occurred because of plastination. MATERIALS AND METHODS: A human fetus of gestational age 24 weeks was plastinated, and 3D CT scan evaluation of the fetus was done. RESULTS: The results showed normal, well-defined, clearly identifiable organs, with no alteration in morphology and structure of organs. CONCLUSION: In our opinion, plastinated specimens are better way of visualization of morphology and structure of stored organs, which is a useful tool for teaching as well as for research purposes.