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.

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.

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.

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.

Reconnoitering the Association of Gingival Melanin Pigmentation With Skin Color, Age, and Sex in Pre-School Children of Hazaribag: A Cross-Sectional Study.

Introduction The purpose of this study was to compare and evaluate the association of gingival melanin pigmentation with age, sex, and skin tone in pre-school children of Hazaribag, Jharkhand, India. Materials and methods The study included 310 children aged 3 to 6 years, who were divided according to skin color into the following: group I: Fair, group II: wheatish, group III: brown; and group IV: dark. The children were selected using a census method where all participants fulfilling inclusion criteria were selected from the outpatient department of the Department of Pediatric and Preventive Dentistry, Hazaribag College of Dental Sciences and Hospital, Hazaribag. The subjects were further grouped into different age groups of 3-4 years, 4-5 years, 5-6 years, and 6 years. Subjects were examined in natural daylight, and gingival melanin pigmentation was assessed using the Dummett-Gupta Pigmentation Index. The scoring was done for each arch segment. These categorical data were analyzed using the chi-square test. Results Gingival pigmentation was found to increase with increasing age, whereas female subjects showed less pigmentation than males. Majority of the children had wheatish complexion, and a significant positive correlation was found between skin tone and gingival pigmentation; the darker the skin tone, the darker was the gingival pigmentation. Anatomically, greater pigmentation was found in the anterior than posterior region of arches. Greater pigmentation was found in the labial than lingual region; greater pigmentation was also reported in the mandible than maxilla. Conclusion There was a positive correlation of gingival melanin pigmentation with age, sex, and skin tone in pre-school children. Clinical significance The association of gingival pigmentation with skin color had been documented, but very few studies have been published on adults and children on this subject. However, there is no study that evaluates the association of gingival melanin pigmentation with age, sex, and skin tone of children of pre-school age.

Evaluation of Regenerative Potential of Locally Delivered Vitamin C along with Microneedling in the Treatment of Deficient Interdental Papilla: A Clinical Study.

AIM: To evaluate the efficacy of intrapapillary injections of vitamin C along with microneedling (MN) in enhancing deficient interdental papilla (IDP) in esthetic zones clinically. MATERIALS AND METHODS: Fifteen patients diagnosed with black triangles according to Norland classification system for loss of papillary height were selected. After oral prophylaxis and baseline measurements of insufficient interdental papilla, the vitamin C injection was loaded in disposable syringe 30G × 1/2" needle. The needle was inserted at 45° angle, 2-3-mm apical to the involved papilla and all surrounding areas. Each involved papilla was injected with an amount till blanching was visible. After that, MN was done in the required area. This method was repeated for 5 times at 7 days intervals consecutively. The final clinical photographs and measurements were recorded after 7 days of last dose administered. RESULTS: There was a statistically significant difference in the mean IDP height observed over the time period (p = 0.002). CONCLUSION: An overall healthy appearance of gingiva with a remarkable increase in papilla growth was observed. CLINICAL SIGNIFICANCE: Vitamin C injection along with MN can be considered as an alternative to invasive surgical procedures in reconstruction or regeneration of the missing IDP.

Effectiveness of Gelatin Sponge Along with i-PRF in Endodontically Involved Tooth with Grade II Furcation Defects: A Clinical and Radiographic Study.

AIM: To evaluate the effectiveness of gelatin sponge [Abgel] with injectable platelet-rich fibrin (i-PRF) in the surgical treatment of mandibular Grade II furcation defects in endodontically involved teeth. MATERIALS AND METHODS: The present study was a single-center clinical trial wherein 20 mandibular grade II furcation defects were treated with gelatin sponge combined with i-PRF results were compared both clinically and radiographically at baseline, 3, and 6 months postoperatively. Statistical analysis was done using Statistical package for social sciences (SPSS) we software. For pre and post comparison, paired t-test, analysis of variance (ANOVA) and Wilcoxon test were used. RESULTS: There was a statistically highly significant improvement seen in all the clinical parameters vertical clinical attachment level (V-CAL), horizontal clinical attachment level (H-CAL) and probing pocket depth (PPD) and radiographic parameters at baseline and 6 months postoperatively p < 0.01. CONCLUSION: Open flap debridement along with Abgel combined with i-PRF is an effective treatment modality in reducing the horizontal and vertical component of grade II furcation defects. CLINICAL SIGNIFICANCE: Gelatin sponge with i-PRF is a cost-effective treatment modality in achieving periodontal regeneration.

Effect of Lingual Arch Space Maintainer on the Position of Mandibular Molars and Incisors in the Vertical Direction during the Resolution of Mandibular Incisors Crowding: A Systematic Review of Clinical Trials in Humans.

INTRODUCTION: This systematic review was designed to define and measure the changes in the position of mandibular molars and incisors in the vertical direction while using a lingual arch appliance as a space maintainer. MATERIALS AND METHODS: The source of data collection used was PubMed, Medline, Cochrane Central, and Cochrane Database of Systematic Reviews for articles published until March 2021. INCLUSION CRITERIA: Studies on human subjects in the English language using either prospective or retrospective methods considering the effect of the lingual arch used as a space maintainer in the mandibular arch. RESULTS: Four out of 465 studies acknowledged in the literature search met the final inclusion criteria. CONCLUSION: A lingual arch is an effective appliance for controlling the position of mandibular molars and incisors in the vertical direction. HOW TO CITE THIS ARTICLE: Ahuja V, Thosar NR, Shrivastav S, et al. Effect of Lingual Arch Space Maintainer on the Position of Mandibular Molars and Incisors in the Vertical Direction during the Resolution of Mandibular Incisors Crowding: A Systematic Review of Clinical Trials in Humans. Int J Clin Pediatr Dent 2021;14(S-1):S76-S81.

Impacted Mandibular Premolar Concomitant with Compound-Complex Odontome in a 13-year-old Girl: A Case Report.

Odontomas, the benign odontogenic tumors of epithelial and mesenchymal origin, are very common in occurrence and are now widely accepted as hamartomas. Odontomes are invariably composed of enamel and dentin, and may also have variable amounts of cementum and pulp. Largely, odontomas have been categorized into the compound and complex varieties. Compound odontoma epitomizes itself as aberrations with the presence of all types of dental tissues and showing an orderly distribution in the form of tooth-like structures; whereas complex odontoma describes itself as aberrations in which the presence of some or all dental tissues and in a disorganized distribution. Herein, a case of compound-complex odontome associated with the impaction of a mandibular second premolar is being presented in a 13-year-old girl. HOW TO CITE THIS ARTICLE: Ahuja VR, Jayanna R, Ahuja A, et al. Impacted Mandibular Premolar Concomitant with Compound-Complex Odontome in a 13-year-old Girl: A Case Report. Int J Clin Pediatr Dent 2020;13(6):729-733.

Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans.

BACKGROUND: It is well-recognized fact that periodontal diseases are caused by multifactorial etiologies, in which microorganisms play an important role. An essential component of therapy is to eliminate or manage these pathogens. This has been traditionally accomplished through mechanical means by scaling and root planning which is ineffective in some of the aggressive periodontal diseases. These aggressive diseases involve particular groups of microorganisms which are not eliminated by mechanical means; and they require anti-infective therapy, which includes local and systemic antimicrobials. This approach of therapy is of interest to periodontist due to the aforementioned shortcomings of conventional methods. MATERIALS AND METHODS: A manual and electronic search was made for human studies up to March 2011 that presented clinical and microbiological data for the efficacy of a systemic antibiotics in generalized aggressive periodontitis along with scaling and root planning. A systematic approach was followed by two independent reviewers and included eligibility criteria for study inclusion, quality assessment, and determination of outcome measures, data extraction, data synthesis, and drawing of conclusion. RESULTS: Only three randomized controlled human trials qualified, and they concluded that both scaling and root planing (SRP) mono-therapy and SRP with antibiotics proves beneficial in improving clinical and microbiological parameters in aggressive periodontitis. Better results were seen in SRP with antibiotic groups as compared with SRP alone. CONCLUSION: Because of the insufficient quantity and heterogenecity of studies, no adequate evidence could be gathered to use the beneficial effects of these antibiotics along with SRP in aggressive periodontitis compared with SRP alone.