Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study.

Introduction: With the paradigm shift in the management of dental caries, the focus is now laid on remineralization therapies that can arrest the progression of the disease and remineralize the subsurface lesions. Objectives: The purpose of this study was to determine and compare the remineralizing potential of silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish (FV) on enamel surfaces in primary and permanent teeth. Materials and methods: A total of 120 primary anterior teeth and 120 premolars were used to prepare enamel blocks in acrylic resin. The mean baseline surface microhardness (SMH) for each sample was determined using a microvickers hardness testing machine. Thereafter, the samples were randomly and equally distributed into groups and subgroups based on the materials used, that is, SDF, CPP-ACP, FV, and distilled water (control). After subjecting the samples to a pH cycling regime, SMH was determined again and the percentage change in SMH was calculated. Results: The data were tabulated and subjected to statistical analysis using an independent t-test and one-way analysis of variance (ANOVA). In primary teeth, the least mean percentage reduction in SMH was observed after the application of FV followed by SDF, CPP-ACP, and control. In permanent teeth, both SDF and FV showed the least percentage reduction of enamel SMH followed by CPP-ACP and control. Conclusion: Silver diamine fluoride (SDF), FV, and CPP-ACP showed remineralizing potential in both primary and permanent teeth. How to cite this article: Kaur S, Bhola M, Bajaj N, et al. Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S91-S96.

Comparative Evaluation of Smear Layer Removal Efficacy of Neem Leaf Extract, Propolis, and Orange Oil when used as Endodontic Irrigants: An in vitro Scanning Electron Microscopic Study.

Introduction: In root canal treatment, chemical debridement of the root canal with the help of irrigants is important due to the complex internal anatomy of the teeth. Biomechanical root canal preparation produces a smear layer. It covers the dentinal tubules, which may interfere with the penetration of various irrigants and intracanal medicaments, so the smear layer has to be removed. The potential side effects and certain limitations of chemical irrigants for smear layer removal have led to a shift toward herbal alternatives. Objective: The aim of the present study was to evaluate and compare the smear layer removal efficacy of Neem leaf extract, Propolis, and Orange oil as endodontic irrigants using the scanning electron microscope. Materials and Methods: Ninety samples were taken and then randomly (simple random sampling method) divided into three experimental groups (n = 30) depending upon different endodontic irrigants used: Group 1-Neem leaf extract, Group 2-Orange oil and Group 3-Propolis and smear layer removal evaluation was done under the scanning electron microscope Scanning Electron Microscope (SEM) at all the levels, i.e., coronal, middle, and apical. Results: The collected data were analyzed using the Chi-square test. Group 1 (Neem leaf extract) showed the highest smear layer removal efficacy, which was followed by Group 2 (Orange oil) and the least efficacy of smear layer removal was shown by Group 3 (Propolis) at coronal, middle, and apical levels. Conclusion: Group 1 (Neem leaf extract) performed significantly better in removing the smear layer at coronal, middle, and apical levels as compared to the other two groups.

Comparative Evaluation of Changes in Salivary pH and Streptococcus mutans Count in Saliva by Natural Sugar Substitutes: An In Vivo Study.

Aim: The purpose of this study was to compare the effect of natural sugar substitutes-stevia, jaggery, and honey on salivary pH and Streptococcus mutans (S. mutans) count in saliva. Materials and methods: Children aged between 7 and 12 years with no active carious lesion were selected. A total of 80 subjects were randomly selected and divided into three experimental groups and one control group, with 20 subjects in each group. Prior to rinsing with the respective solutions, the baseline pH and S. mutans count were evaluated for each individual. All solutions were freshly prepared whenever required. After rinsing with the respective solutions, saliva samples were collected to evaluate pH and S. mutans count. The pH was analyzed at different time intervals, that is, 0 (immediately after rinsing), 15, and 30 minutes. The S. mutans count was analyzed after 30 minutes of rinsing with the respective solutions. Results: The results were tabulated and statistically analyzed using one-way analysis of variance (ANOVA) and post hoc tests. The results depicted that group I (stevia) showed a maximum increase in salivary pH, followed by group III (honey) and group III (jaggery) at different time intervals (0, 15, and 30 minutes). The maximum number of subjects who had shown a decrease in S. mutans count were from group III (honey), followed by group I (stevia), and group II (jaggery) after 30 minutes of rinsing with the respective solutions when compared to baseline S. mutans count. Clinical significance: It is a universally known fact that dental caries is a multifactorial disease process, one of the key factors of which is the consumption of sugar. Of all the fermentable carbohydrates, sucrose is considered the archcriminal in the carious process. Hence, this advocates the need for developing suitable sugar substitutes that help in controlling dental caries. An ideal sugar substitute should not only minimize the risk of dental caries but also should have nutritional benefits. Conclusion: Natural sugar substitutes (stevia, jaggery, and honey) have the ability to reduce caries risk in children. How to cite this article: Sharma W, Bhola M, Bajaj N, et al. Comparative Evaluation of Changes in Salivary pH and Streptococcus mutans Count in Saliva by Natural Sugar Substitutes: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(5):728-733.

Clinical Evaluation of Root Resorption and its Correlation with Obturation Quality in Pulpectomized Deciduous Teeth with Different Obturating Materials: An In vivo Study.

AIMS AND OBJECTIVES: The aim was to evaluate the root resorption in pulpectomized deciduous teeth and its correlation with obturation quality using zinc oxide and eugenol (ZOE), Metapex and Endoflas at the interval of 6 and 12 months. MATERIALS AND METHODS: A total of 150 infected primary mandibular molars were randomly and equally divided into three subgroups (n = 50 each): Group 1 (ZoE), Group 2 (Metapex), and Group 3 (Endoflas) based on the obturation material preferred. The teeth were clinically and radiographically evaluated at 6 and 12 months' postoperatively by another investigator who was blinded to the type of filling material that was used in each tooth. Kruskal-Wallis test, Mann-Whitney Test, and Wilcoxon Signed-Rank Test was used for statistical analysis. RESULTS: When the obturation quality was assessed, the optimal filling was found in 78% of the cases while the rest have underfilling (9%) and overfilling (13%). The incidence of overfilling was higher in the cases with some root resorption. After 12 months, Group 2 showed maximum variation with the highest incidence (70%) of extensive resorption both interradicular and intraradicular (Grade 3 score) followed by Group 1 (26%) and Group 3 (16%), respectively. CONCLUSION: Among all the materials, Endoflas showed the highest success rate with least incidence of resorption both outside and within the root canal (hollow tube effect) whereas least success rate was observed with Metapex having the hollow tube effect in majority of the cases (70%) after the follow-up of 12 months.

Mineral trioxide aggregate-induced apical closure in nonvital immature permanent maxillary incisor.

Treatment of nonvital immature permanent teeth with calcium hydroxide is associated with few difficulties such as weakened tooth root, root canal reinfection, and long treatment time. Mineral trioxide aggregate (MTA) apical plug method is an alternative treatment method for open apices and has gained popularity in the recent times. This case report describes the management of a late-referral case of periapically involved, traumatized immature permanent incisor by endodontic treatment and the use of MTA apical plug. After preparing the access cavity, the working length was determined. The root canals were irrigated with 3% sodium hypochlorite and disinfected with metapex for 2 weeks. MTA was then placed in the apical 3 mm of the root canal. The remaining part of the root canal was filled with thermoplastic gutta-percha, and the coronal restoration was finished with composite resin. After 1-year follow-up, radiograph showed successful healing of periradicular radiolucency.