Clinical Evaluation of Pediatric Posterior Zirconia and Stainless Steel Crowns: A Comparative Study.

Objective: To clinically evaluate and compare the performance of posterior pediatric zirconia crowns with stainless steel crowns. Materials and methods: Twenty nine children [3-9 years] were selected and given 70 preformed crowns [35: preformed zirconia crowns, Kinderkrown; 35: stainless steel crowns, KIDZ CROWN]. Crowns were evaluated for retention, marginal integrity, opposing tooth wear, plaque accumulation, gingival inflammation, and proximal contact at 3, 6, 9, and 12th month. Results: At the end of follow-up period overall success rate with zirconia crown was 93.5% and that of stainless steel crown was 96.7%. Statistical analysis showed no difference between the groups. Conclusion: Posterior preformed zirconia and stainless steel crowns showed good clinical performance. Preformed zirconia crowns can be an option for posterior full coronal restoration when esthetics is of prime concern for the parent and child. How to cite this article: Murali G, Mungara J, Vijayakumar P, et al. Clinical Evaluation of Pediatric Posterior Zirconia and Stainless Steel Crowns: A Comparative Study. Int J Clin Pediatr Dent 2022;15(1):9-14.

Assessment of Effectiveness Acceptability Complications and Parental Satisfaction of Pediatric Dental Patients Treated under Nitrous Oxide-oxygen Inhalational Sedation Using Porter Silhouette Mask.

Objectives: To estimate the concentration of nitrous oxide (N2O) required for effective sedation to render dental treatment for an anxious child and to assess the child's behavior, patient acceptance, parental satisfaction, postoperative complications, and ease of manipulation of Porter Silhouette mask by the dentist during N2O-O2 sedation. Study design: A total of 40 children, 6-10-year-old requiring dental treatment, were treated using N2O sedation. The level of N2O required for optimal sedation, patient behavior, level of acceptance of N2O by the patient, clinical recovery score, and postoperative complications were observed throughout the study. At the end of the treatment, a questionnaire was given to the parents to evaluate parental satisfaction. Results: The sedation was very effective, with 25-50% of N2O concentration. About 92.5% of children were fully cooperative, the dentist was able to place the mask with comfort in 92.5% of children, significant improvement was seen in the patient's behavior with minimal complications, and 100% of the parents were satisfied with the treatment under sedation. Conclusion: Inhalational sedation with N2O using Porter Silhouette mask results in effective sedation, with increased patient comfort, and parental acceptance in providing dental treatment. How to cite this article: AKR SP, Mungara J, Vijayakumar P, et al. Assessment of Effectiveness Acceptability Complications and Parental Satisfaction of Pediatric Dental Patients Treated under Nitrous Oxide-oxygen Inhalational Sedation Using Porter Silhouette Mask. Int J Clin Pediatr Dent 2022;15(5):493-498.

Oral manifestations of gastroesophageal reflux disease in children: A preliminary observational study.

AIMS: This study aimed to document the prevalence of oral manifestations seen among pediatric gastroesophageal reflux disease (GERD) patients in Chennai, Tamil Nadu, India. METHODOLOGY: This study was performed at various children's hospitals in Chennai. Fifty-one GERD patients who were assessed by endoscopy and 24 h pH-metry, 31 (60.78%) males and 20 (39.21%) females, aged 2-12 years (mean age, 7.43 years), comprised the study group. All patients answered a detailed frequency questionnaire related to regurgitation and acidic foods and participated in a clinical dental examination. STATISTICAL ANALYSIS USED: Data were analyzed using the SPSS statistical software package version 19. RESULTS: Among the GERD patients, 42 (82.35%) had dental erosion. A total of 668 (57.98%) deciduous teeth and 484 (42.02%) permanent teeth were examined, of which dental erosion was detected in 248 (21.52%) and 171 (14.84%) teeth, respectively. The most commonly affected primary tooth was the occlusal surface of the maxillary posteriors and commonly affected permanent tooth was occlusal surface of the mandibular molars. CONCLUSIONS: There may be a positive correlation between GERD and dental erosion. According to this study, presence of erosion, especially in posterior teeth, could be a key to diagnose GERD and refer the child to the gastroenterologist.

Comparative Evaluation of Endovac and Conventional Irrigating Syringe on Apical Extrusion in Primary Molars. An in vitro Study.

OBJECTIVES: The present study was undertaken to evaluate and compare the apical extrusion of irrigant and depth of irrigant penetration into dentine using the EndoVac irrigating system and manual irrigation system in primary molar teeth. STUDY DESIGN: Twenty five extracted primary molars satisfying the inclusion and exclusion criteria were divided into two groups with 29 roots in each group with an equal distribution of apical foramen area. The teeth were mounted in pre-weighed glass bottles and the canals were irrigated with 5.25% sodium hypochlorite solution mixed with acid fuchsin using either of irrigating systems according to the group ascertained. The amount of irrigant extruded was recorded. The roots were sectioned at two mm, four mm and six mm from the apex and examined under a stereomicroscope for depth of irrigant penetration. RESULTS: Apical extrusion of the irrigant solution was significantly less with the EndoVac system (1.18±1.04) when compared with the manual irrigation system (2.3±1.55) (P=0.002)*. Results showed that greater irrigant penetration was achieved using the EndoVac irrigation system compared to the manual irrigation system (P= 0.000)*. With both the irrigation systems, the depth of irrigant penetration was better in the six mm sections followed by the four mm sections and two mm sections (P=0.000)*. CONCLUSION: The EndoVac irrigation system demonstrated better efficacy compared to manual irrigation system with less apical extrusion and better depth of irrigant penetration into dentine.

Comparative Evaluation of the Efficacy of EndoVac and Conventional Irrigating Systems in Primary Molars - An in Vitro Study.

OBJECTIVE: The present study was undertaken to evaluate and compare the apical extrusion of irrigant and depth of irrigant penetration into the dentinal tubules using the EndoVac irrigating system and the manual irrigation system in primary molar teeth. STUDY DESIGN: Twenty five extracted primary molars satisfying the inclusion and exclusion criteria were divided into two groups of 29 roots in each group with an equal distribution of apical foramen area. The teeth were mounted in pre-weighed glass bottles and the canals were irrigated with both the irrigating systems using 5.25% sodium hypochlorite solution mixed with acid fuchsin which enables the irrigating solution to penetrate efficiently into the dentinal tubules. The amount of irrigant extruded was recorded. The roots were sectioned at 2mm, 4mm and 6mm from the apex and examine the depth of irrigant penetration into the dentinal tubules under a stereomicroscope. RESULTS: Apical extrusion of the irrigant was significantly less with the EndoVac system (1.18±1.04gms) when compared to manual irrigation system (2.3±1.55gms) (P<0.05). EndoVac irrigation system showed greater depth of irrigant penetration into the dentinal tubules (49.90±17.52mm, 32.17±12.20mm and 15.70±8.91mm) compared to the manual irrigation system (30.48±16.27mm, 14.74±9.67mm and 5.59±7.09mm) at 6mm, 4mm and 2mm respectively (P<0.05). Results showed that the depth of irrigant penetration into the dentinal tubules with both the irrigating systems was found to be significantly greater in the six mm sections compared to the four mm and two mm sections (P<0.05). CONCLUSION: The EndoVac irrigation system showed significantly greater efficacy compared to the manual irrigation system in primary molars with less amount of irrigant extrusion and better depth of irrigant penetration into the dentinal tubules.

In vivo Evaluation of 4% Articaine and 2% Lignocaine Intraligamentary Injection Administered with Single Tooth Anesthesia-Wand.

BACKGROUND: The available literature confirms the effectiveness of intraligamentary injections equal to nerve blocks and articaine equal to lignocaine with better depth of penetration for single tooth pulpectomy procedures with less postoperative soft tissue trauma. An advancement in the field of local anesthesia delivery is the Single Tooth Anesthesia-Wand (STA-Wand) which is relatively pain-free and offers comfort to the child. AIMS: This study aims to evaluate and compare the anesthetic effectiveness and postoperative complications of 4% articaine and 2% lignocaine intraligamentary injection administered as single tooth anesthesia using a computer-controlled local anesthetic delivery system, the STA-Wand. SETTINGS AND DESIGN: Using a randomized, split-mouth, cross-over study design, twenty children aged 4-10 years who required bilateral mandibular pulpectomies were administered intraligamentary injections with 4% articaine and 2% lidocaine in two appointments using STA-Wand. Pain, anxiety, and cooperation levels were scored by an operator and an observer at four phases of treatment using Wong-Baker Faces Pain Rating Scale and Two-6 point Co-operation Anxiety Rating Scale. Results were tabulated and analyzed. STATISTICAL ANALYSIS: Mann-Whitney U-test, paired t-test, and Student's t-test. RESULTS: Both the local anesthetic agents were equally effective with no significant difference (P > 0.05) throughout rest of the treatment procedure compared to injection phase in minimizing pain, anxiety, and gaining the cooperation levels of children whereas during injection phase, 4% articaine showed superior effectiveness in minimizing pain compared to 2% lignocaine (P = 0.054). CONCLUSION: Both the local anesthetic agents delivered using STA-Wand is clinically acceptable, effective, and safe for usage in children.

Comparative evaluation of shear bond strength and microleakage of tricalcium silicate-based restorative material and radioopaque posterior glass ionomer restorative cement in primary and permanent teeth: an in vitro study.

BACKGROUND: Restoration of carious primary molars is still a major concern while treating the young children that too in deep carious lesion which extends below the cemento-enamel junction (CEJ) where pulp protection and achieving adequate marginal seal are very important to prevent secondary caries. The needs were met with the development of new materials. One such of new bioactive material is tricalcium silicate-based restorative material (Biodentine), recommended for restoring deep lesions. AIM: To evaluate and compare shear bond strength and microleakage of tricalcium silicate-based restorative material (Biodentine) and glass ionomer cement (Fuji IX GP) in primary and permanent teeth. MATERIALS AND METHODS: Occlusal surface of crowns were ground flat. PVC molds were stabilized over flat dentin surface and filled with tricalcium silicate-based restorative material (Biodentine)/glass ionomer cement (Fuji IX GP) according to group ascertained. Shear bond strength was evaluated using universal testing machine (INSTRON). Standardized Class II cavities were prepared on both primary and permanent teeth, and then restored with tricalcium silicate-based restorative material (Biodentine)/glass ionomer cement (Fuji IX GP) according to group ascertained, over which composite resin material was restored using an open sandwich technique. Microleakage was assessed using dye penetration. Microleakage was examined using a stereomicroscope. RESULTS: RESULTS showed that glass ionomer cement (Fuji IX GP) exhibited better shear bond strength than tricalcium silicate-based restorative material (Biodentine). Mean microleakage score for glass ionomer cement (Fuji IX GP) in permanent teeth was 1.52 and for primary teeth was 1.56. The mean microleakage for tricalcium silicate-based restorative material (Biodentine) in permanent teeth was 0.76 and for primary teeth was 0.60. Glass ionomer cement (Fuji IX GP) exhibited more microleakage than tricalcium silicate-based restorative material (Biodentine), which was statistically significant both in permanent (P = 0.02) and primary (P = 0.006) teeth. CONCLUSION: Shear bond strength of glass ionomer cement (Fuji IX GP) is greater than tricalcium silicate-based restorative material (Biodentine) in both primary and permanent teeth. Tricalcium silicate-based restorative material (Biodentine) exhibited less microleakage compared to glass ionomer cement (Fuji IX GP) in both primary and permanent molars.

Child's dental fear: cause related factors and the influence of audiovisual modeling.

BACKGROUND: Delivery of effective dental treatment to a child patient requires thorough knowledge to recognize dental fear and its management by the application of behavioral management techniques. Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) helps in identification of specific stimuli which provoke fear in children with regard to dental situation. Audiovisual modeling can be successfully used in pediatric dental practice. AIM: To assess the degree of fear provoked by various stimuli in the dental office and to evaluate the effect of audiovisual modeling on dental fear of children using CFSS-DS. MATERIALS AND METHODS: Ninety children were divided equally into experimental (group I) and control (group II) groups and were assessed in two visits for their degree of fear and the effect of audiovisual modeling, with the help of CFSS-DS. RESULTS: The most fear-provoking stimulus for children was injection and the least was to open the mouth and having somebody look at them. There was no statistically significant difference in the overall mean CFSS-DS scores between the two groups during the initial session (P > 0.05). However, in the final session, a statistically significant difference was observed in the overall mean fear scores between the groups (P < 0.01). Significant improvement was seen in group I, while no significant change was noted in case of group II. CONCLUSION: Audiovisual modeling resulted in a significant reduction of overall fear as well as specific fear in relation to most of the items. A significant reduction of fear toward dentists, doctors in general, injections, being looked at, the sight, sounds, and act of the dentist drilling, and having the nurse clean their teeth was observed.

Comparative evaluation of fluoride release and recharge of pre-reacted glass ionomer composite and nano-ionomeric glass ionomer with daily fluoride exposure: an in vitro study.

AIM: This in vitro study was designed to investigate the effects of daily fluoride exposures on fluoride release and recharge by prereacted glass ionomer (PRG) composite and nano-ionomeric glass ionomer. MATERIALS AND METHODS: Seventy-two specimens (36 of each material) were prepared and by placing the restorative materials into Teflon mold. Each specimen was subjected to one of three daily treatments (n = 12): (1) No fluoride treatment (control); (2) application of a fluoride dentifrice (1,000 ppm) once daily; and (3) the same regimen as (2), plus immersion in a 0.05% sodium fluoride (NaF) mouth rinse (225 ppm) immediately following the dentifrice application. Specimens were suspended in a storage vial containing 10 ml demineralizing solution for 6 h and transferred to a new test tube containing 10 ml remineralizing solution for 18 h. Fluoride treatments of the specimens were completed every day prior to their immersion in the demineralizing solution. Media solutions were buffered with equal volumes of total ionic strength adjustment buffer (TISAB) II; fluoride levels were measured using a digital ion analyzer and fluoride electrode throughout the 21 day duration of the experiment. RESULTS: Nano-ionomeric glass ionomer showed a better amount of fluoride release than PRG composite irrespective of the fluoride treatment supplementation (P < 0.01). Additional fluoride supplementation improved fluoride release and recharge ability for both the materials when compared to their respective control groups. The fluoride recharge for both materials did not show any sustained pattern of release. CONCLUSION: Nano-ionomeric glass ionomer demonstrated a greater ability to release and recharge compared with that of PRG composite.

Prevalence of dentofacial abnormalities in children and adolescents with ß-thalassaemia major.

BACKGROUND: ß-thalassaemia major is a hereditary hemolytic anemia and the patients often experience growth retardation, protrusive maxilla, and depressed nasal bride leading to various degrees of malocclusion. AIM: The purpose of this investigation is to find the prevalence of dentofacial abnormalities in ß-thalassaemia major patients. SUBJECTS AND METHODS: Seventy-two patients between 6 and 18 years of age diagnosed with ß-thalassaemia major were examined for extraoral abnormalities, malocclusion, oral hygiene, and dental caries. Data obtained were tabulated and statistically analyzed using Chi-square and paired t-test. RESULTS: Thirty-nine (54.2%) were males and 33 (45.8%) were females. Prominent extraoral abnormalities were found in 41 (56.9%) of the individuals. Study population predominantly had class I occlusion (59.7%) followed by class II occlusion (23.6%) and no class III occlusion. Mean oral hygiene index-simplified score was 2.43 ± 1.24, mean decayed missing filled teeth (DMFT) score was 7.10 ± 3.92, and deft was 5.68 ± 3.12. CONCLUSION: Despite starting regular blood transfusion at an early age, ß-thalassaemia major patients showed marked facial abnormalities. When compared with individuals with no systemic disease, oral hygiene status was similar, but the caries experience was higher in ß-thalassaemia major patients. Therefore, emphasis to educate these patients in the prevention and control of dental caries and maintenance of good oral hygiene should be considered.

Evaluation of three different caries removal techniques in children: a comparative clinical study.

AIM: To evaluate and compare the efficacy of chemo mechanical (carie care) caries removal method with rotary and hand excavation by assessing the amount of time taken, the pain response experienced by the children and the amount of residual caries left out. STUDY DESIGN: Twenty patients between the age groups of 5-7 years were selected and caries removal was done by airotor hand instruments and cariecare gel. The efficacy, time taken and pain threshold was evaluated during caries removal. RESULTS: significant results were obtained when inter group comparison were made. CONCLUSION: it was concluded that cariecare was efficient in caries removal and can be used as an alternative for the airotor in management of dental caries especially in children.

Efficacy of mineral trioxide aggregate as an apical plug in non-vital young permanent teeth: preliminary results.

PURPOSE: The purpose of this study was to evaluate the efficacy of Mineral trioxide aggregate (MTA) clinically and radiographically as material used to induce root end closure in nonvital permanent teeth with immature apices (apexification) in children. METHODS: The study included 30 non vital young permanent, single rooted teeth of 22 children between 8 and 13 years of age. Treatment followed a standard non-surgical root canal treatment protocol and the root canal was filled with a apical plug of 4-5 mm of MTA (white MTA--Angelus, Brazil), followed by gutta-percha obturation. The children were reviewed for 1 year at 3 month interval and the teeth were assessed clinically and radiographically. RESULTS: MTA showed success rate of 100% both clinically and radiographically at the 12th months follow up and root end closure was seen in 86.6% of cases and root growth in 30% of cases. CONCLUSIONS: MTA showed clinical and radiographic success as an apexification material by inducing root end closure and root growth in non-vital young permanent teeth.