A comparison of various minimally invasive techniques for the removal of dental fluorosis stains in children.

CONTEXT: Dental fluorosis is caused by successive exposure to high concentrations of fluoride during tooth development leading to enamel with lower mineral content and increased porosity. AIMS: The aim of the study was to evaluate and compare the effectiveness of minimally invasive techniques for the removal of dental fluorosis stains in children in vivo. DESIGN: Ninety children in the age group of 10-17 years were selected. MATERIALS AND METHODS: The study sample was equally and randomly divided into three groups; Group 1: In-office bleaching with 35% hydrogen peroxide (HP) activated by light-emitting diode (LED) bleaching unit (35% HP), Group 2: Enamel microabrasion (EM) followed by in-office bleaching with 44% carbamide peroxide gel (EM), Group 3: In-office bleaching with 5% sodium hypochlorite (5% NaOCl). Statistical analysis was done using one-way ANOVA test. RESULTS: Bleaching with 35% HP activated by LED bleaching unit and EM followed by bleaching with 44% carbamide peroxide were equally effective for the removal of dental fluorosis stains in children in vivo. However, bleaching with 5% NaOCl could not completely remove moderate to severe stains. It was effective in removing only mild stains. Bleaching and microabrasion procedures caused slight decrease in tooth sensitivity readings by electric pulp vitality tester which continued to increase over time. However, none of the patients reported sensitivity in their teeth at any point of time. Patients were highly satisfied with the treatment outcome postoperatively but reported slight relapse of color in the three groups. CONCLUSIONS: Bleaching and microabrasion techniques can consider as an interesting alternatives to conventional operative treatment options.

Buccal midazolam spray as an alternative to intranasal route for conscious sedation in pediatric dentistry.

OBJECTIVES: To evaluate the acceptance of midazolam spray through buccal route as compared to intranasal route and compare the efficacy of the drug through both the routes. STUDY DESIGN: 30 patients aged 2-8 years with Grade I or II Frankl's Behaviour Rating Scale were selected who required similar treatment under local anesthesia on two teeth. Midazolam spray was administered randomly through buccal or intranasal routes for the two appointments. Scoring was done for the acceptance of drug and Houpt's score was recorded for the behaviour of patients during the treatment. RESULTS: Acceptance of drug through buccal route was significantly better than the intranasal route (p < 0.05) but no statistically significant difference was found in the behaviour scores for the two routes of administration (p > 0.05). CONCLUSION: Midazolam spray can be effectively used through the buccal mucosa in children who give poor compliance with the intranasal administration.

Multiple pulp stones in primary and developing permanent dentition: a report of 4 cases.

Pulp stones are foci of calcification or discrete calcifications in the dental pulp. They are frequently found on bitewing and periapical radiographs, but their occurrence in entire dentition is unusual. We are reporting four cases in which the occurrence of pulp stones ranged from their presence in just primary teeth (Cases 1 and 2) to involvement of young permanent teeth also (Case 3) and even unerupted permanent teeth (Case 4). In all the cases, dental, medical, and family histories as well as the findings from the clinical examination of the patient were not contributory. Histopathological report revealed true denticle. Metabolic evaluation of patients through liver function test, kidney function test, and blood investigation did not show any metabolic disorders. Patients were also evaluated for any systemic, syndromic, or genetic involvement, but this was also noncontributing. Therefore, it is suggested that these unusual cases may be of idiopathic origin.

Hypodontia and delayed dentition as the primary manifestation of cleidocranial dysplasia presenting with a diagnostic dilemma.

Cleidocranial dysplasia is a rare autosomal disorder which manifests as partial or complete absence of clavicles, multiple supernumerary teeth, and delayed closure of fontanelle. Classical cases of cleidocranial dysplasia are easily diagnosed very early in the life. However, cases with partial manifestation of the syndrome and noncontributory family history are difficult to diagnose. Here, we report a case of 8.5-year-old girl child who presented with delayed tooth development (without any supernumerary teeth), anterior open fontanelle, and normal clavicles, thus resulting in a diagnostic dilemma.