Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study.

Context: Molar incisor hypomineralization (MIH) is an emerging clinical problem as the affected tooth is prone to dental caries with the lapse of time. Aims: To assess the prevalence, severity, and associated risk indicators of MIH amongst 8-13 years of children of Vadodara District, Gujarat, India. Materials and methods: A cross-sectional study with a sample size of 3,000 government schoolchildren. A total of 1,500 children each from urban and rural areas were randomly selected and examined. Only permanent incisors and first molars were examined. MIH was diagnosed clinically based on the diagnostic criteria established by the European Academy of Paediatric Dentistry (EAPD), 2003. To check the relation between the two variables-Pearson's chi-squared test was applied. Fisher's exact test was applied when less than five expected values were found. Results: A total of 286 children (9.6 %) had MIH, with 189 (rural) and 97 (urban) children. MIH was significantly higher in the rural population as compared to the urban. In the rural area, the cause was found to be a child suffering from an illness (>15 days) which was 35.98%, and in the urban area was due to prolonged use of antibiotics before 4 years of age, which was 28.87%. Conclusion: The overall prevalence rate of MIH among the screened children between the age-group 8 and 13 was found to be 9.6%. Males were more affected. The severity of MIH was more in molars compared to incisors and more in children of rural areas. Clinical significance: Protocol for early diagnosis and follow-up to access the squeal of breakdown should be undertaken along with parents and health workers. How to cite this article: Shah VU, Dave BH, Chari DN, et al. Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):280-286.

Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3-12 Years: A Randomized Clinical Trial.

Aim: A comparative evaluation of children's anxiety with the use of nitrous oxide-oxygen (N2O-O2) inhalation sedation during the administration of inferior alveolar nerve block (IANB). Materials and methodology: A total of 60 children between 3 and 12 years of age, with Frankl's behavior rating of 2-3 requiring IANB for any dental procedure were enrolled in this randomized clinical study. Group I (n = 30) received N2O and oxygen inhalation sedation at a concentration in the range of 25-50%, whereas group II (n = 30) received 100% O2 as a placebo. The physiological parameters like pulse rate, respiration, blood pressure, and O2 saturation were measured at the baseline, intraoperatively [during and after administration of local anesthesia (LA)] and postoperatively after the termination of the gases in both groups. The sedation level was measured intraoperatively (before administration of LA) using the Ramsay Sedation Score (RSS). The discomfort and anxiety were measured at the baseline, intraoperatively, and postoperatively using the Face, Legs, Activity, Cry, Consolability (FLACC) behavior scale. The data were evaluated using the statistical software International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) statistics 20.0. Results: There was a significant difference in the FLACC scores between the two groups, intraoperatively (p-value-0.002), and postoperatively (p-value-0.049). The mean of the RSS for group I was 2.80 + 1.03, and for group II was 1.80 + 0.81. All the physiological parameters recorded were within the normal range. Conclusion: The use of N2O-O2 inhalation improved the anxiety levels in children while receiving the IANB and showed significant anxiolytic and sedative effects as compared to O2 inhalation. Clinical significance: Nitrous oxide-oxygen (N2O-O2) inhalation can be used as a nonpharmacological behavior management adjunct for invasive treatments for children with utmost comfort for the child. How to cite this article: Thomas PS, Dave BH, Shah DJ, et al. Comparative Assessment of Anxiety during Inferior Alveolar Nerve Block under Nitrous Oxide + Oxygen and Oxygen Inhalation Sedation in Children Aged 3-12 Years: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(1):30-36.

Morphometric Assessment of Third and Fourth Cervical Vertebra Based on Hassel and Farman Method: A Radiographic Study.

AIM: To assess third and fourth cervical vertebra morphologic dimensions as per the cervical vertebral maturation stage proposed by Hassel and Farman from 7 to 18 years. MATERIALS AND METHODS: A cross-sectional radiographic study was conducted on 264 participants within an age-group of 7-18 years who were further categorized into six subgroups having an interval of 1 year and 11 months chronologic age. The maturation stage and morphometric evaluation of the cervical vertebra were assessed for the same patient. The maturation stage was assessed as per the morphologic classification given by Hassel and Farman. The morphometric evaluation was assessed by measuring the anterior (AH3 and AH4), vertebral body (H3 and H4), posterior heights, and anteroposterior width (APW3 and APW4) of third and fourth cervical vertebra in millimeters which was carried out with the help of "IC measure software." One-way analysis of variance (ANOVA), Tukey's multiple comparison, and Spearman's correlation coefficient were utilized to determine the significance and correlation between the vertebral maturation and millimetric measurement between age-groups. The multiple comparison levels were set at 0.05 level of significance. RESULTS: A high significant correlation was observed between PH3 and APW3 (r, 0.737**). Moderate significant correlation was observed with H3 and PH3 (r, 0.605**, 0.640*), and APW3, APW4 (r, 0.534**, 0.614*) in the initiation stage in both the vertebrae; AH3, H3 (r, 0.498**) and H3, APW3 (r, 0.576**) in deceleration stage. A negative moderate significant correlation between AH4, PH4 (r, -0.691**) was observed in the deceleration stage. The transition, maturation, and completion stages did not reveal any significant correlation. CONCLUSION: Significant morphologic difference was observed among all the stages of vertebral maturation. Higher dimensions were observed among males. Anteroposterior width had the highest dimension. Significant morphometric changes were observed in stages of maturation and transition stages. CLINICAL SIGNIFICANCE: The dimensions of anterior, vertebral, and posterior height of the third and fourth cervical vertebra can supplement in identifying the precise morphologic classification whenever there is an overlap in the opinion of staging cervical vertebral maturation based on Hassel and Farman.

Evaluation of knowledge regarding emergency management of avulsed traumatic dental injuries in children among general dental practitioners in India.

CONTEXT: Traumatic dental injuries (TDIs) leading to dental avulsion occur very frequently in society. Management of avulsion is critical for the dentist, as it requires appropriate knowledge. AIM: The study was conducted to evaluate the knowledge of the general dental practitioners (GDPs) regarding the emergency management of TDI leading to avulsion in children. SETTING AND DESIGN: Questionnaire-based cross-sectional survey design was utilized to assess the knowledge. SUBJECTS AND METHODS: Data for this cross-sectional survey were collected through questionnaires from July to September 2014. A total of 278 GDP were contacted and requested to fill a pretested questionnaire to assess the knowledge regarding tooth avulsion. The GDPs were grouped on the basis of their educational qualification and years of clinical experience. STATISTICAL ANALYSIS USED: Chi-square test was used for intra- and inter-group comparison. RESULTS: A total of 224 (80.57%) GDPs consented to participate in the survey. Markedly low knowledge levels were noted in the sample irrespective of educational qualification and years of experience with respect to replantation of the avulsed primary tooth, holding the root instead of the crown, choice of appropriate storage medium for transportation of avulsed teeth, use of medications, and splinting type and time. Clinical experience and higher educational qualification of GDPs revealed statistical significant difference in the methods of management for TDI leading to avulsion. CONCLUSION: Higher professional education and added clinical experience were associated with better knowledge in the management of TDI leading to avulsion. The finding warrants the need for informative educational programs to update and boost the knowledge of practicing dentists regarding emergency management of avulsed teeth.

Comparison of Antimicrobial Efficacy of (between) 0.2% Chlorhexidine and Herbal Mouthwash on Salivary Streptococcus mutans: A Randomized Controlled Pilot Study.

BACKGROUND: The chemomechanical plaque control measures are helpful in controlling dental plaque and thus caries, especially in pediatric age group. AIM: This study aims to compare effectiveness of herbal mouthrinse containing Terminalia chebula to that of 0.2% chlorhexidine against children's salivary mutans streptococci levels. SETTINGS AND DESIGN: A double-blind, randomized, controlled study design will be framed for conducting this study. METHODS: A total of 45 participants were randomly categorized in Group 1, Group 2, or Group 3 (control group, experimental group, or negative control). Baseline unstimulated saliva was collected. All the participants were instructed regarding the use of mouthrinse for 2 weeks. After 2 weeks, again unstimulated saliva was collected. After collection, saliva samples were sent for microbiological analysis. STATISTICAL ANALYSIS: The mean colony-forming units (CFU/ml) were determined. Paired t-test, ANOVA test, and post hoc test were applied for statistical analysis. RESULTS: Statistically significant difference in CFU count has been observed in 0.2% chlorhexidine and Oratreat groups at 15 days as compared to baseline (P < 0.001). At 15 days, reduction in CFU count has seen more in Oratreat group as compared to 0.2% chlorhexidine group, and the difference is statistically significant (P < 0.001). CONCLUSION: 0.2% chlorhexidine and Oratreat mouthwash reduce the salivary Streptococcus mutans count. Oratreat herbal mouthwash has proved to be better as compared to 0.2% chlorhexidine mouthwash.