Effect of 20-ppm ozone and 1% chlorhexidine gels on plaque index and Streptococcus mutans counts in the dental plaque in 6-12-year-old children: A randomized, double-blind clinical trial.

Background: One of the methods to control dental caries is to use ozone. Since it is difficult for children to use mouthwashes, the present study aimed to evaluate 20-ppm zone and 1% chlorhexidine (CHX) gels' effects on the plaque index and Streptococcus mutans counts in 6-12-year-old children. Methods: In the present double-blind clinical trial, 165 children, 6-12 years of age, referring to the Department of Pediatric Dentistry, Tabriz Faculty of Dentistry, were selected based on inclusion and exclusion criteria and randomly assigned to three groups: ozone gel, CHX gel, and control. The subjects were instructed to place an adequate amount of the gels on all the surfaces of their teeth with one clean finger. The patients and evaluators were blinded to the study groups. The plaque index and S. mutans counts in plaque samples were determined before intervention and three weeks after intervention on the buccal surface of the most posterior maxillary tooth (left or right). S. mutans counts were determined by culture. STATA software version 14 was used for statistical analyses using Wilcoxon, Kruskal-Wallis, and post hoc Dum tests. Statistical significance was defined at P<0.05. Results: The 20-ppm ozone and 1% CHX gels significantly decreased dental plaque compared to the control group (P<0.05), and their effects were similar (P>0.05). These gels significantly decreased the colonies and bacterial counts of S. mutans (P<0.05). Conclusion: The performance of 20-ppm ozone gel in decreasing the dental plaque and S. mutans counts was similar to 1% CHX gel.

The Impact of Child Dental Caries and the Associated Factors on Child and Family Quality of Life.

Introduction: Dental caries are considered as common health hazards and a serious lifelong threat to general health and quality of life. The present study aimed at identifying the impact of child dental caries and the associated factors on both child and family quality of life (QoL). Material and Methods. In this cross-sectional study, preschool children were selected randomly through clustered sampling from five educational districts in Tabriz, Iran, 2016. To assess the QoL related to oral health, the Early Childhood Oral Health Impact Scale (ECOHIS) was used. Clinical oral examination was performed to assess the presence of caries through the index of decayed, missing, and filled teeth (dmft). Descriptive and analytic statistical methods were used. To assess the underlying predictors of ECOHIS as a whole scale and the dimensions as a linear regression model were used as univariate and multivariate. Results: : Out of 756 children under 7 years old, 51.5% boys, mean (M) standard deviation (SD) of age 5.76 (0.78). About 85% of children had dental caries. The predictors of suboptimal ECOHIS related to both general and child dimensions were child age 6 year and above: r (756) = 2.43, and P ≤ 0.001, low-socioeconomic status: r (756) = 3.36 and P < 0.001 and high dmft: r (756) = 9.10 and P < 0.001. The predictors of suboptimal ECOHIS related to family domain were sex (girl): r (756) = 0.39 and P = 0.047; mother education (under12): r (756) = -0.92 and P < 0.001; mother job (employed) as univariate: r (756) = 0.71 and P = 0.002); and dmft: r (756) = -0.58 and P = 0.035. Conclusion: Adverse oral health of children imposes adverse effects on the QoL of children and families. Children's age, family socioeconomic level, presence of dental caries, child's gender, and mother's educational level were associated with the impact on QoL.

Comparison between the Radiographic and Clinical Rates of Success for TheraCal and MTA in Primary Tooth Pulpotomy within a 12-Month Follow-Up: A Split-Mouth Clinical Trial.

Background: The present study was conducted for contrasting the efficacy of TheraCal and MTA for primary molar pulpotomy. Methods: During the current split-mouth randomized clinical trial, 90 bilateral primary molars from 45 healthy 5- to 8-year-old children were pulpotomized using TheraCal in one bilateral tooth and MTA in the other, randomly. Glass ionomer (GI) was used to cover these materials. Then, the treated teeth were restored with stainless steel crowns (SSC) and followed up clinically and radiographically at months 6 and 12 after treatment for any pulpotomy failure indications. Finally, data were analyzed by chi-square test considering p value < 0.05 as statistically significant. Results: Among 82 teeth available at the final follow-up session, the total success rates were 98.1% and 99.3% for TheraCal and MTA, respectively, showing no significant difference between the two groups (p > 0.05). Conclusion: TheraCal can be used as an alternative material for pulpotomy of primary teeth instead of MTA.

Accuracy of Teledentistry for Diagnosis and Treatment Planning of Pediatric Patients during COVID-19 Pandemic.

Teledentistry is a new technology in the dentistry field, which has great benefits during pandemic such as the coronavirus disease 2019 (COVID-19). The overall purpose of the study was to assess the diagnostic sensitivity and specificity of virtual (mobile phone teledentistry) compared with clinical examinations during COVID-19. The basic design of the study was based on the comparison treatment plans by the students and the gold standard (clinical treatment plan of an expert pedodontist with 10 years of clinical experience). This double-blind clinical trial was conducted on 20 children (aged 6 to 12 years) with a chief complaint of dental caries with or without pain. An appropriate radiograph and five standard intraoral photographs (frontal view occlusion, maxillary occlusal view, mandibular occlusal view, right lateral view, and left lateral view) were prescribed for each patient according to the guidelines of the American Association of Pediatric Dentistry. Then, the treatment plan for the carious teeth was recorded for each patient. Each patient underwent a clinical examination at first and was followed randomly by a virtual examination by two dental students. Then, the clinical and virtual treatment plans were compared with each other, and also with the gold standard. The sensitivity and specificity values were calculated for each group. The accuracy of the diagnosis was measured by applying Cohen's kappa. Interexaminer reliability was measured using the intraclass correlation coefficient (ICC) and Cronbach's alpha. The mean kappa coefficient for the interexaminer agreement (for 24 teeth) was 0.62 in clinical and 0.69 in virtual examinations. The results showed no significant difference in the treatment plans of students and the gold standard (P > 0.05). The diagnostic sensitivity and specificity were 73.22% and 95.8% for clinical and 76.44% and 92.9% for virtual treatment plans showing no significant differences between virtual (mobile phone teledentistry) and clinical examinations (P > 0.05). The intraexaminer reliability of the examiners was found to be 0.92 by calculating the ICC. Then, teledentistry can be considered as a supplement to clinical examinations of pediatric dentistry, finally resulting in better patient management. However, more studies are necessary for teledentistry.

Non-Coding RNAs and Oral Cancer: Small Molecules With Big Functions.

Oral cancer remains a major public concern with considerable socioeconomic impact in the world. Despite substantial advancements have been made in treating oral cancer, the five-year survival rate for oral cancer remained undesirable, and the molecular mechanisms underlying OSCC carcinogenesis have not been fully understood. Noncoding RNAs (ncRNAs) include transfer RNAs (tRNAs), as well as small RNAs such as microRNAs, and the long ncRNAs such as HOTAIR are a large segment of the transcriptome that do not have apparent protein-coding roles, but they have been verified to play important roles in diverse biological processes, including cancer cell development. Cell death, such as apoptosis, necrosis, and autophagy, plays a vital role in the progression of cancer. A better understanding of the regulatory relationships between ncRNAs and these various types of cancer cell death is therefore urgently required. The occurrence and development of oral cancer can be controlled by increasing or decreasing the expression of ncRNAs, a method which confers broad prospects for oral cancer treatment. Therefore, it is urgent for us to understand the influence of ncRNAs on the development of different modes of oral tumor death, and to evaluate whether ncRNAs have the potential to be used as biological targets for inducing cell death and recurrence of chemotherapy. The purpose of this review is to describe the impact of ncRNAs on cell apoptosis and autophagy in oral cancer in order to explore potential targets for oral cancer therapy.

Vital pulp therapy following pulpotomy in immature first permanent molars with deep caries using novel fast-setting calcium silicate cement: A retrospective clinical study.

OBJECTIVES: To compare the success rate of vital pulp therapy following complete pulpotomy in immature first permanent molars, during caries treatment, using novel fast-setting calcium silicate cement (Novel CSC) versus MTA. METHODS: Six- to eight- years old children, who received pulpotomy of first immature permanent molar using one layer novel CSC (Protooth) or two layers slow-setting MTA (MTA Angelus) covered with glass ionomer were recalled for radiographic and clinical evaluation after two years. The effects of cement type, age, gender, jaw, anesthesia type, and restoration type were assessed on the clinical success of pulpotomy and continued root formation (apexogenesis) as the treatment outcome. RESULTS: Out of 366 included teeth in the study, 316 teeth were available for statistical analysis. The mean observation time was 28.2 ±â€¯2.7 months. Novel CSC showed significantly higher clinical success rate (93.1%) compared to MTA (84.5%). Restored teeth with stainless steel crowns after pulpotomy and treatments performed under general anesthesia had a statistically significant effect on treatment outcome in contrast to age, gender, and jaw type. CONCLUSION: The observations of this retrospective study suggested that the success rate of vital pulp therapy following complete pulpotomy using one layer fast-setting novel CSC was significantly higher than slow-setting MTA covered with glass ionomer. Treatment under general anesthesia and restoration using stainless steel crowns influenced the treatment outcome. CLINICAL SIGNIFICANCE: Novel fast-setting calcium silicate cement is a promising new biomaterial for vital pulp therapy in immature permanent molars that allows complete root formation overtime with apexogenesis. Clinicians must also be aware of the importance of immediate definitive restoration and proper sealing and isolation in vital pulp therapy.

A Randomized Split Mouth Clinical Trial Comparing Mineral Trioxide Aggregate with a New Fast-setting Calcium Silicate Cement in Direct Pulp Capping of Primary Molars: A Preliminary Report from a Long-term Follow-up.

AIMS AND OBJECTIVES: This study was done to compare the success rate of a novel fast-setting calcium silicate cement (protooth) with mineral trioxide aggregate (MTA) in direct pulp capping (DPC) of primary molars. MATERIALS AND METHODS: Forty-five patients with an age range of 5-7 years with 90 bilaterally symmetrical primary molars that had deep carious lesions were incorporated into a randomized split mouth clinical trial. Initially, the caries was removed. Afterward, the teeth randomly underwent DPC with either MTA or protooth. Restoration of the teeth was done by amalgam fillings. Clinical and radiographic examinations were performed after 6 months. To analyze the data, Chi-square statistical test was used. Values < 0.05 were considered statistically significant. RESULTS: After 6 months of follow-up, 88 teeth on 44 patients were available for evaluation. The MTA-treated teeth showed a success rate of 95.5%, while the same outcome for the protooth-treated teeth was 93.2%. The difference did not yield a statistically significant difference (p value > 0.05). CONCLUSION: The findings of this study showed favorable results for the novel calcium silicate cement "protooth" when compared to the outcomes of MTA in the DPC of primary molars. CLINICAL SIGNIFICANCE: The constant need for the development of more effective materials in the modern pediatric dentistry makes this novel cement of particular interest for pedodontists. The new cement is biocompatible, hydrophilic, and has fast-setting time and adequate tensile strength with favorable clinical results in the DPC of primary molars which can benefit pedodontists in their clinical practice. HOW TO CITE THIS ARTICLE: Shahamfar M, Azima N, Erfanparast L. A Randomized Split Mouth Clinical Trial Comparing Mineral Trioxide Aggregate with a New Fast-setting Calcium Silicate Cement in Direct Pulp Capping of Primary Molars: A Preliminary Report from a Long-term Follow-up. Int J Clin Pediatr Dent 2020;13(4):390-394.

Comparison of Effects Exerted by 4% Articaine Buccal Infiltration and 2% Lidocaine Inferior Alveolar Nerve Block on Pain Perception and Behavioral Feedback of Children during Pulp Treatment of Mandibular Second Primary Molars.

Background: One of the most impressive factors discouraging many people from seeking dental treatment is the fear of experiencing pain during dental procedures. Thus, the use of an effective method for pain control is vital in this regard. Articaine, which has an additional ester and thiophene groups that increase its biosolubility and permeability compared to older anesthetic agents, can be more effective on inducing anesthesia during dental treatment. Given the inconsistent currently available information on this concept, the present study was designed to compare the efficacy of articaine with that of lidocaine on pain control during pulp treatment of deciduous molar. Methods and materials: In this cross-sectional study, 38 patients who needed pulpotomy in both mandibular second molar of primary teeth were randomly divided into two groups, using the Randlist software. In the first meeting, infiltration with articaine 4% (epinephrine 1/100 000) was performed for all patients in group 1 on the left side of the mandible. At the next appointment, inferior alveolar nerve block was done with lidocaine 2% on the right side of the mandible (epinephrine 1/80 000). Notably, for all patients in the second group, the first injection was performed on the right second primary molar with articaine 4% (epinephrine 1/100 000), and inferior alveolar nerve block was also done with lidocaine 2% on the left side of the mandible (epinephrine 1/80 000). Results:Of the 38 patients included in the current study, 10 (26.3%) subjects in the lidocaine group and nine (23.6%) in the articaine group complained of pain during their dental treatment procedures, but this difference was not statistically significant. Conclusion: According to the findings of this study, buccal infiltration of 4% articaine had a comparable anesthetic outcome to that of 2% lidocaine for inferior alveolar nerve block in pulp treatment of the second primary mandibular molars.

Direct pulp capping of primary molars using a novel fast-setting calcium silicate cement: a randomized clinical trial with 12-month follow-up.

Objective: Novel fast-setting calcium silicate cement with fluoride (Protooth) has been developed for potential applications in tooth crowns. The aim of this study was to evaluate the success rate of direct pulp capping in primary molars using two-layer mineral trioxide aggregate (MTA) and overlying glass ionomer cement versus one-layer novel calcium silicate cement with 4 to 10 minutes setting time. Materials and methods: Ninety bilaterally symmetrical primary molars in the same jaw in 45 patients aged 5 to 7 years were included. Exposed pulps following caries removal were randomly capped with one-layer novel calcium silicate cement or two-layer MTA and glass ionomer cement. All cavities were filled with amalgam. Clinical and radiographic evaluations were performed after six and twelve months. 41 patients were available for the evaluations at the end of the 12-month follow-up. Results: The overall success rate of direct pulp capping, in a split-mouth design, using MTA covered with glass ionomer cement or one-layer novel calcium silicate cement after 12 months were 90% (37 out of 41 cases) and 85% (35 out of 41 cases), respectively, without statistically significant differences after 6 and 12 months. Conclusion: Within the limitations of this study, clinical and radiographic evaluations suggested one-layer novel calcium silicate cement would be successfully used in direct pulp capping of primary molars as a practical alternative to two-layer MTA and overlying glass ionomer cement.

Children's Pain Perception and Behavioral Feedback during Local Anesthetic Injection with Four Injection Site Preparation Methods.

Introduction:An effective pain control significantly contributes to an optimal dental treatment in pediatric dentistry. This study was conducted to compare children's pain perception and behavioral feedback during local anesthetic injection accompanied with counter-irritation, refrigerant, ice precooling or topical benzocaine. Methods:This study was conducted on 99 children who needed dental treatment in bilateral maxillary primary molars by local anesthesia. Subjects were randomly assigned to three groups, in which the injection site was prepared using counter-irritation in group I, ice precooling in group II, and refrigerant spray precooling in group III. In all three groups, 20% benzocaine gel was used in the injection site of opposite quadrant as a control. The perceived pain and behavioral feedback of children during injection were evaluated using the visual analogue scale (VAS) and sound, eye, and motor (SEM) indexes. Sign and Kruskal-Wallis tests were used to analyze data at a significance level of P < 0.05. Results:The perceived pain was significantly lower when using benzocaine compared to the other three methods (P < 0.05). Behavioral feedback of children when using benzocaine was not significantly different from the counter-irritation method (P=1.00). However, behavioral feedback with counter-irritation was significantly better than precooling (P < 0.05). Counter-irritation was significantly more effective than precooling methods in reduction of pain perception and improvement of behavioral feedback (P < 0.05). Conclusions:The perceived pain was significantly lower when the benzocaine method was used. Behavioral feedback was significantly better with benzocaine and counter-irritation methods compared to precooling procedures.

Comparison of the effect of pharmacotherapy and neuro-feedback therapy on oral health of children with attention deficit hyperactivity disorder.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic and progressive mental disorder related to the childhood period. This study aims to compare the oral health of two groups of ADHD children: those under pharmacotherapy and those under neuro-feedback therapy. MATERIAL AND METHODS: 72 ADHD children (aged 6-12) were divided into two 36 member groups: The pharmacotherapy group and the neuro-feedback therapy group. Unstimulated salivary flow (USF), DMFT, and plaque index were assessed in these children. Statistical analysis was carried out on the data with the independent t-test, which was performed using SPSS 16. The significance level of the study was p<0.05. RESULTS: In this study, the USF of ADHD children who used Ritalin was found to be significantly less than that of the neuro-feedback group (1.25 ± 1.21 vs. 1.91 ± 1.16 ml/min; p=0.002). Also, the plaque index (5.9 ± 3.1 vs. 3.94 ± 1.9; p=0.018) and DMFT scores (39% ± 9% vs. 31% ± 9%; p=0.018) were significantly higher for the pharmacotherapy group. CONCLUSIONS: Neuro-feedback therapy is preferable to Ritalin treatment for ADHD children in terms of their oral health status. Key words:Attention deficit hyperactivity disorder, drug therapy, neurofeedback, oral health.

The relationship between children's media habits and their anxiety and behaviour during dental treatment.

OBJECTIVE: The existing evidence suggests that media habits may have moderating role on children's psychological adjustment in the dental setting. The aim of this study was to investigate the relationship between children's media habits and their anxiety and behaviour management problems (BMP) during dental treatment. MATERIALS AND METHODS: A total of 289 children aged 3-6 years old were included. Dental anxiety (DA) and BMP were assessed using Clinical Anxiety Rating Scale and Frankl's Rating Scale during the dental treatment. The parents reported their own DA, educational level and economic status; and the children's and also their own daily hours of using media. The data were analysed with the Mann-Whitney U, Kruskal-Wallis, Chi-square or Fisher exact tests, Spearman's correlation coefficient and logistic regression. RESULTS: The children with DA had significantly higher amount of watching TV, playing e-games and surfing the Internet, and total amount of using electronic media than those without DA. The amount of watching TV and the total amount of using electronic media were significantly higher in the children with BMP than those without BMP. DA and BMP were significantly correlated with the children's hours of watching TV and total media time. CONCLUSIONS: There was a significant relationship between the amount of electronic media usage and DA and BMP in 3- to 6-year-old children.

Early occurrence of childhood dental caries among low literate families.

OBJECTIVE: The purpose of this cross-sectional study was to identify the oral health status and influencing factors in preschool children in Tabriz, Iran. A total of 756 children from 20% of the total district preschools were selected using a two-step random sampling procedure. Questionnaires were used to collect demographic and socio-economic data. Oral exams were conducted by a single pediatric dentist to assess the children's oral health, and to determine the number of decayed, missing, and filled teeth (dmft) according to the World Health Organization's (WHO) definition of caries. RESULTS: Out of 756 preschool children, 51.5% boys with mean age of years 5.76 (SD = 0.78) were enrolled. The median (25th-75th Pertcentile) of dmft index in boys and girls was 4 (2-9) and 5 (2-8), respectively. Only 15.1% children had decay-free teeth. The results of univariate analysis showed a significant relationship between dmft index and child age (P < 0.001), mother's years of education (P = 0.001), mother's employment status (P < 0.001), and family socio-economic status (P < 0.001). On multivariate analysis, statistical significance was found in sex (P = 0.007), age groups except for 5 years (P = 0.210), mother's education status (P < 0.001) as well as in families with intermediate (P = 0.024), and high (P = 0.072) socio-economic status.

Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children?

INTRODUCTION: Pain control is one of the most important aspects of behavior management in children. The most common way to achieve pain control is by using local anesthetics (LA). Many studies describe that the buccal nerve innervates the buccal gingiva and mucosa of the mandible for a variable extent from the vicinity of the lower third molar to the lower canine. Regarding the importance of appropriate and complete LA in child-behavior control, in this study, we examined the frequency of buccal gingiva anesthesia of primary mandibular molars and canine after inferior alveolar nerve block injection in 4- to 6-year-old children. STUDY DESIGN: In this descriptive cross-sectional study, 220 4- to 6-year-old children were randomly selected and entered into the study. Inferior alveolar nerve block was injected with the same method and standards for all children, and after ensuring the success of block injection, anesthesia of buccal mucosa of primary molars and canine was examined by stick test and reaction of child using sound, eye, motor (SEM) scale. The data from the study were analyzed using descriptive statistics and statistical software Statistical Package for the Social Sciences (SPSS) version 21. RESULTS: The area that was the highest nonanesthetized was recorded as in the distobuccal of the second primary molars. The area of the lowest nonanesthesia was also reported in the gingiva of primary canine tooth. CONCLUSION: According to this study, in 15 to 30% of cases, after inferior alveolar nerve block injection, the primary mandibular molars' buccal mucosa is not anesthetized.How to cite this article: Pourkazemi M, Erfanparast L, Sheykhgermchi S, Ghanizadeh M. Is Inferior Alveolar Nerve Block Sufficient for Routine Dental Treatment in 4- to 6-year-old Children? Int J Clin Pediatr Dent 2017;10(4):369-372.

Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts.

AIM: The aim of this study was to compare the survival of composite resin restorations retained by glass fiber posts or reversed-orientated (upside-down) metal posts in severely decayed primary anterior teeth after 6, 12, and 18 months. MATERIALS AND METHODS: A total of forty-four 3- to 5-year-old children with bilateral severely decayed primary maxillary canines were included. Patients were treated under general anesthesia. After pulpectomy, an intracanal post was seated in the primary maxillary canine on each side: either a glass fiber post or a metallic post in reversed orientation and teeth restored with light-cured composite. Survival rate of each technique was evaluated at predetermined follow-ups and data were analyzed with McNemar's test (α = 0.05). RESULTS: The difference in survival of restorations retained by two types of posts was not statistically significant in clinical and radiographical evaluations after 6, 12, and 18 months. The survival rate of reversed-orientated metal and glass fiber posts after 18 months was 81.1 and 67.6% respectively (p = 0.14). CONCLUSION: Reversed-orientated metal post did not show lower clinical survival compared with glass fiber posts in 18-month follow-up. Hence, reversed-orientated metal post can be considered as a potential method to obtain retention for composite restorations in severely decayed primary anterior teeth. How to cite this article: Vafaei A, Ranjkesh B, L0vschall H, Erfanparast L, Jafarabadi MA, Oskouei SG, Isidor F. Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts. Int J Clin Pediatr Dent 2016;9(2):109-113.

Oral health status, dental anxiety, and behavior-management problems in children with oppositional defiant disorder.

Mental disorders have been shown to affect children's oral health. This study was carried out to investigate the oral health status, dental anxiety (DA), and behavior-management problems (BMPs) during dental treatment in 6- to 9-yr-old children with oppositional defiant disorder (ODD)/attention-deficit hyperactivity disorder (ADHD). The study and control groups included 40 children with ODD/ADHD and 80 normal children, respectively. All participants received an amalgam restoration. During the procedure, the children's behavior was assessed using the Frankl Rating Scale and the Verbal Skill Scale. Parents rated their children's DA using the parental version of the Children's Fear Survey Schedule-Dental subscale (CFSS-DS). Comorbid anxiety disorders were assessed using the Kiddie-Sads-Present and Lifetime Version questionnaire. Oral health status was assessed using the gingival index and the decayed, missing, and filled teeth score for permanent (DMFT) and primary (dmft) teeth. The findings showed that DA and BMPs were significantly higher in children with ODD/ADHD than in the controls. Furthermore, the frequency of DA and BMPs was higher in children with both ODD/ADHD and a comorbid anxiety disorder than in those without comorbid anxiety disorder. Children with ODD/ADHD had significantly higher DMFT/dmft scores than those in the control group, whereas the difference in gingival index was not statistically significant. In conclusion, children with ODD/ADHD had higher levels of DA, BMP and poorer oral health status.

Impact of Self-concept on Preschoolers' Dental Anxiety and Behavior.

Background and aims . Different factors affect children's behavior during dental treatment, including psychological and behavioral characteristics. The aim of this study was to evaluate the correlation of self-concept on child's anxiety and behavior during dental treatment in 4 to 6-year-old children. Materials and methods. A total of 235 preschoolers aged 4 to 6 years were included in this descriptive analytic study. Total self-concept score for each child was assessed according to Primary Self-concept Scale before dental treatment. Child's anxiety and child's behavior were assessed, during the restoration of mandibular primary molar, using clinical anxiety rating scale and Frankl Scale, respectively. Spearman's correlation coefficient was used to evaluate the correlation between the total self-concept score with the results of clinical anxiety rating scale and Frankl Scale. Results. There was a moderate inverse correlation between the self-concept and clinical anxiety rating scale scores (r = -0.545, P < 0.001), and a moderate correlation between the self-concept and child's behavior scores (r = 0.491, P < 0.001). A strong inverse relation was also found between the anxiety and behavior scores (r = -0.91, P < 0.001). Conclusion. Children with higher self-concept had lower anxiety level and better behavioral feedback during dental treatment.

Does Timing of Eruption in First Primary Tooth Correlate with that of First Permanent Tooth? A 9-years Cohort Study.

Background and aims. Predicting the teeth eruption time is a valuable tool in pediatric dentistry since it can affects scheduling dental and orthodontic treatments. This study investigated the relationship between the eruption time of first primary and permanent teeth and the variation in the eruption time considering socioeconomic status (SES) in a 9-year population- based cohort study. Materials and methods . 307 subjects were examined at bimonthly intervals during the first and second years of life and then at six-month intervals until the eruption of first permanent tooth. Eruption times of primary and permanent tooth were recorded for each child. A modified form of Kuppuswamy's scale was used to assess the SES. Results. Among 267 subjects completed all follow-ups, the eruption time for first primary and permanent teeth indicated a direct strong correlation; in that one month delayed or early eruption of firstprimary tooth resulted in 4.21 months delayed or early eruption of first appearing permanent tooth (r = 0.91, n = 267, P <0.001). No significant correlation was observed between the eruption time of first primary and first permanent teeth and SES (P = 0.67, P = 0.75, respectively). Conclusion. The eruption timing for the first primary tooth had a correlation with the first permanent tooth eruption tim-ing, while SES did not have any influence on eruption times.

Laser-Casein phosphopeptide effect on remineralization of early enamel lesions in primary teeth.

BACKGROUND: The aim of this study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth. MATERIAL AND METHODS: Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crème, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win. RESULTS: The subjects of group D demonstrated a significant increase in the calcium and phosphate contents of enamel surface compared to those of groups A (P < 0.001, P < 0.001), B (P < 0.001, P < 0.001) and C (P = 0.024, P = 0.04), respectively. A statistically significant difference was seen for mean VHN between groups A and B (P = 0.002). SEM evaluations confirmed the results. CONCLUSIONS: The combination of Nd:YAG laser and CPP-ACP crème could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth. Key words:CPP-ACP, enamel remineralization, microhardness, Nd:YAG, primary teeth, SEM.

Class III Restoration of Anterior Primary Teeth: In Vitro Retention Comparison of Conventional, Modified and Air-abrasion Treated Preparations.

Background and aims. Anterior esthetic restoration is challenging in pediatric dentistry, due to limited durability and poor retention of the restoration.This study assessed the effect of air abrasion on tensile failure load of composite class III restorations using different preparation techniques. Materials and methods. 100 extracted human anterior primary teeth were divided, based on the preparation methods, into four groups each consisting of 25 subjects : conventional (A), labial surface bevel (B), conventional + air abrasion (C), and labial surface bevel + air abrasion (D). After restoring cavities, tensile failure load of samples was measured in Newton by Universal testing machine at a crosshead speed of 1 mm per minute. The data were analyzed by Kruskal-Wallis and Mann Whitney U tests using SPSS software. Results. There were statistically significant differences between groups A and C (P = 0.003), groups A and B (P & 0.001), groups A and D (P & 0.001), groups B and C (P = 0.028), groups B and D (P = 0.027), and also groups C and D (P& 0.001). Group D demonstrated the highest mean tensile failure load. Conclusion. Labial surface bevel treated by air abrasion showed significantly more retention of composite restoration.