Prevalence of dens invaginatus and palatogingival groove in North India: A cone-beam computed tomography-based study.

Aim: The aim of this study was to study the prevalence of dens invaginatus (DI) and palatogingival groove (PGG) in maxillary lateral incisors, and the occurrence of apical periodontitis in association with these anomalies in North Indian population. Methodology: Maxillary lateral incisors in 163 cone-beam computed tomography scans were assessed to determine the presence of DI and PGG. Anomalies identified were then classified as per Oehler's and Gu's classification, respectively. Their side and gender predilection and association with apical and lateral radiolucency was also studied. Statistical Analysis: Descriptive data were reported as percentages. Chi-square analysis was used to determine the association with gender and side predilection. Results: DI was present in 13.5% of the scans, while PGG was present in 7.3% of the scans. No significant gender and side predilection was observed. 6.67% of lateral incisors with DI and 25% of lateral incisors with PGG had an associated apical radiolucency. 33.33% of lateral incisors with PGG had an associated lateral radiolucency. Conclusions: There is a high prevalence of DI and PGG in maxillary lateral incisors.

Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students.

AIM AND OBJECTIVE: To investigate the effect of dental environment stressors and coping mechanisms on perceived stress in postgraduate dental students. MATERIALS AND METHODS: This cross-sectional study enrolled 250 postgraduate students from four dental colleges. Modified dental environment stress (DES) questionnaire was used to study the dental environment-related stressors, perceived stress score (PSS) to measure the extent of stress perception, and brief COPE (BC) scale to measure the use of various coping strategies deployed to combat stress. An independent T-test was used to determine the associations of these measures with gender and marital status and one-way ANOVA for associations with year of study. Hierarchical regression was used to determine the effect of demographic factors, career-related psychological background, health-related habits, DES, and BC score on PSS. RESULTS: "Synopsis, thesis, library dissertation" and "lack of adequate infrastructure" were reported as the highest stressors by the postgraduate students. Only 4.8% of respondents perceived low stress, while 65.2% perceived high stress. A high correlation between the DES score and PSS was observed. Active coping, acceptance, and positive reframing were the most commonly utilized coping strategies. Planning and use of emotional support were the only coping strategies that were significant negative predictors of PSS. Problem-focused coping strategies had a positive, but non-significant correlation with PSS, while emotion-focused coping strategies had a significant negative correlation with PSS. CONCLUSION: Postgraduate dental environment causes a high-stress perception in students and reactive coping strategies have only a limited role in reducing stress perception. HOW TO CITE THIS ARTICLE: Sikka N, Juneja R, Kumar V, et al. Effect of Dental Environment Stressors and Coping Mechanisms on Perceived Stress in Postgraduate Dental Students. Int J Clin Pediatr Dent 2021;14(5):681-688.

Factors causing stress in postgraduate dental students during COVID-19 pandemic: A cross-sectional survey.

BACKGROUND: COVID-19 pandemic has impacted the academic and clinical training of postgraduate dental students. This study aimed to assess various factors causing psychological stress in them, and the extent of stress perception during pandemic. MATERIALS AND METHODS: In this cross-sectional study, 250 postgraduate students from nine dental colleges of Haryana and National Capital Region, India, responded to an online questionnaire sent electronically to them in September 2020, which included modified dental environment stress (DES) score, Perceived Stress Scale (PSS), and questions regarding COVID-associated stress (CAS). Students already diagnosed with any psychiatric disorder or having a history of any major adverse event during the last 6 months likely to affect their psychological health were excluded from this study. The data obtained were analyzed using Chi-square test, Independent t-test, univariate ANOVA with post hoc tests, Pearson moment correlation, and multiple hierarchical regression tests. P < 0.05 was considered statistically significant. RESULTS: DES score was moderate for 48.8% and high for 34.4% of the participants. PSS was moderate for 69.2% and high for 18.8% of the participants. The most stressful factor in dental environment was the pattern of university examination, while the most stressful factor specific to COVID-19 was the fear of family members contracting the infection. PSS score was significantly higher in female participants. DES and CAS scores were significantly higher in students staying in hostels. Multiple hierarchical regression model depicted gender, mean health, and DES score as significant predictors of PSS. CONCLUSION: Postgraduate dental students reported the adverse impact of COVID-19 pandemic upon their training and prospects as a reason for the increase in stress.

Prevalence of myths regarding oral health among pregnant women in North India.

OBJECTIVES: To study the prevalence of myths regarding oral health care in pregnant women in North Indian population. METHODS: This cross-sectional study used a self-administered closed-ended questionnaire to assess oral healthcare related beliefs and practices in 400 pregnant women who reported for prenatal checkup in a tertiary healthcare centre in North India. The questionnaire included questions to elicit information on socio-demographic factors, beliefs and practices of oral hygiene during pregnancy, attitude towards dental problems occurring during pregnancy and the reasons associated with a specific belief. Prevalence of various myths was observed, and its associations with various socio-demographic factors, adverse pregnancy outcomes and dental symptoms were analysed. RESULTS: 84.2% of the respondents harboured at least one oral healthcare related myth. 63.4% of respondents deferred brushing for many days after delivery. 36.6% of respondents avoided consumption of hot/cold food and drinks during pregnancy due to fear of tooth loss. 24.5% of respondents believed local anaesthesia could affect baby's developing organs, and 21.8% of the studied population believed tooth extraction might cause miscarriage. Females possessing more myths were more likely to experience severe oral health problems during pregnancy. Education was depicted as a significant negative predictor of the prevalence of myths. No significant correlation between myths prevalence and history of adverse pregnancy outcomes was found. CONCLUSION: Neglect of oral health due to myths about oral hygiene practices and dental treatment during pregnancy is a serious concern. A very high prevalence of these myths is an obstacle to goal of optimal maternal and child health.

Retrieval of Extruded Mineral Trioxide Aggregate Using a Novel Suction Device.

Treatment of necrotic immature permanent teeth is an exigently demanding situation for an endodontist. Regenerative endodontic procedures are being employed for such teeth in a hope to restore a functional pulp tissue and continue root development. However, currently advocated techniques may not be effective in retaining mineral trioxide aggregate (MTA) in its coronal position. The present paper describes two immature teeth with pulpal necrosis and apical periodontitis that were treated through revascularization. In both the cases, apical extrusion of the coronal MTA plug occurred. A suction tip was customized to completely retrieve the extruded material. Both cases proved out to be a clinical and radiographic success over extended follow-up periods.

Comparative evaluation of platelet-rich fibrin, mineral trioxide aggregate, and calcium hydroxide as pulpotomy agents in permanent molars with irreversible pulpitis: A randomized controlled trial.

BACKGROUND: Pulpotomy has been proposed as an alternative for the management of irreversible pulpitis in permanent molars with closed apices. AIM: To compare the performances of calcium hydroxide (CH), mineral trioxide aggregate (MTA), and platelet-rich fibrin (PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis. MATERIALS AND METHODS: Fifty-four permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups, and full pulpotomy was performed using CH, MTA, or PRF as pulpotomy agents. Pain intensity was recorded using numeric rating scale score at baseline, 24 h, 7 days, 6 months, and 1 year. Clinical and radiographic assessments were done at 6 months and 1 year. STATISTICAL ANALYSIS: Kruskal-Wallis test and Friedman test were used for intergroup and intragroup comparison of pain scores, respectively. The radiographic outcomes between the three study arms were compared using Chi-square test. RESULTS: Clinical success rate was 94.4% at 7 days, which dropped to 85.4% at 12 months. All three agents were equally effective in providing pain relief at all the intervals tested, with no significant difference between them (P > 0.05 at all intervals). However, at 6 months and 12 months, 26.2% and 52.4% teeth depicted slight widening of periodontal ligament space. No significant difference was observed between the radiographic success rates observed with the three groups (P = 0.135 at 6 months, 0.717 at 12 months). CONCLUSION: Pulpotomy exhibited a high clinical success rate in mature molars with irreversible pulpitis and selection of biomaterial did not affect its outcome.

Endodontic Management of a Mandibular Incisor Exhibiting Concurrence of Fusion, Talon Cusp and Dens Invaginatus using CBCT as a Diagnostic Aid.

Teeth with aberrant anatomy present a challenge to the endodontist. Advanced tools like cone beam computed tomography aid in exploring the details of endodontic architecture in such cases. The aim of this case report is to highlight the advantage of CBCT in endodontic management of teeth with multiple dental anomalies. A mandibular lateral incisor associated with an extraoral sinus tract revealed unusual clinical anatomy. A provisional diagnosis of type III dens in dente was made based on radiographic findings. Considering the complex anatomy, CBCT was advised to get a confirmatory diagnosis. The anatomic details revealed by CBCT differed significantly from the provisional diagnosis. A final diagnosis of concurrence of fusion with a supernumerary tooth, talon cusp and type II dens invaginatus was established and endodontic treatment of the concerned tooth was carried out. Non-surgical endodontic treatment resulted in successful resolution of the sinus tract and healing of the periapical lesion. CBCT, thus proves to be an excellent diagnostic tool for management of teeth with unusual anatomy, paving way for a conservative treatment free of endodontic mishaps.

Effect of blood contamination and decontamination protocols on acetone-based and ethanol-based total etch adhesive systems.

STATEMENT OF THE PROBLEM: The efficacy of various decontamination protocols to reverse the effect of blood contamination after acid-etching may depend on the type of adhesive. OBJECTIVES: To compare the effect of blood contamination and various decontamination protocols on acetone-based and ethanol-based total-etch adhesive systems. METHODS: Occlusal dentin of 64 human molars was etched and contaminated with fresh human blood. The samples were assigned to two groups as per adhesive used: Prime & Bond NT (acetone-based) and Adper Single Bond 2 (ethanol-based) and then subdivided into eight groups: (1) control, (2) no decontamination, (3) water rinsing, (4) re-etching, (5) sodium hypochlorite, (6) sodium hypochlorite/sodium ascorbate, (7) hydrogen peroxide, and (8) ethanol. Adhesives were applied and specimens were prepared for µTBS after composite buildup. The data were subjected to analysis of variance followed by post hoc Tukey test. RESULTS: Blood contamination significantly reduced µTBS of both the adhesives. Re-etching and NaOCl/Asc were effective in restoring µTBS to the level of control for both the adhesives whereas NaOCl was effective only for Prime & Bond NT. CONCLUSION: Both re-etching and NaOCl can be used for regaining µTBS of blood-contaminated acid-etched dentin. NaOCl/Asc yields better results than NaOCl alone, specifically for ethanol-based adhesive. CLINICAL SIGNIFICANCE: Knowing the adverse effects of prolonged acid-etching, other alternatives for decontamination of etched dentin after blood contamination should be considered. NaOCl alone or NaOCl followed by sodium ascorbate may prove to be good alternatives. These choices also may determine the type of adhesive system.