Clinical performance of one shade universal composite resin and nanohybrid composite resin as full coronal esthetic restorations in primary maxillary incisors: A randomized controlled trial.

Background: Strip crowns are the first treatment of choice for restoring anterior teeth affected with early childhood caries. However, shade matching of resin composites is still an issue. The broad color matching ability of a recently introduced single shade composite, Omnichroma eliminates the need for shade-matching procedure, reduces composite inventory, and minimizes chair-side time. Aim: The aim is to evaluate the color match, color stability, and retention of one shade universal composite resin, Omnichroma and nanohybrid resin composite, Tetric-N-Ceram. Design: The study design involves split-mouth randomized controlled trial. Methods: The study was conducted on 25 children aged 3-5 years with multi-surface caries lesions in primary maxillary anterior teeth. Teeth were allocated to two groups randomly: Group 1 - One shade universal composite, Omnichroma (n = 25), Group 2 - Nanohybrid composite, Tetric-N-Ceram (n = 25). After caries excavation and tooth preparation, teeth were restored with corresponding materials using strip crowns. Color match at baseline, color stability, and retention after 6- and 12-month follow-up were evaluated using the Modified United States Public Health Services criteria. Analysis: The Mann-Whitney U test and Wilcoxon signed-rank test were used to analyze the data. Results: On comparison of Omnichroma and Tetric-N-Ceram groups, no statistically significant difference was observed in the color match at baseline (P = 0.716) as well as color stability (P = 0.575 at 6 months and 0.990 at 12 months) and retention (P = 0.153 at 6 months and 0.226 at 12 months) at both 6- and 12-month intervals. On intragroup comparison, the difference in the color stability at 6 and 12-month interval was statistically significant (P = 0.001) for both the groups, indicating that the color stability of restorations was better at 6-month interval compared to 12-month interval. In both Omnichroma and Tetric-N-Ceram groups, retention of restorations was better at 6-month interval compared to 12-month interval and this difference was statistically significant (P = 0.025 and 0.014, respectively). Conclusion: The clinical performance of Omnichroma in terms of color match, color stability, and retention was comparable to nanohybrid composite, Tetric-N-Ceram.

Evaluation of caries arresting potential of silver diamine fluoride and sodium fluoride varnish in primary molars: A randomized controlled trial.

Background: Caries management in the modern era has shifted away from the traditional surgical method toward a medical paradigm, which often includes fluoride therapy. Fluoride used in various forms has been proven to be effective in dental caries prevention. Silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish are effective in arresting caries in primary molars. Aim: This study aimed to evaluate the effectiveness of 38% SDF and 5% NaF varnish in arresting caries in primary molars. Settings and Design: This study was a split-mouth randomized controlled trial. Materials and Methods: The randomized controlled trial comprised 34 children aged 6-9 years with teeth having caries in both right and left primary molars without pulpal involvement. Teeth were randomly allocated into two groups. In Group 1 (n = 34), 38% SDF + potassium iodide was applied and in Group 2 (n = 34), 5% NaF varnish was applied. The second application was done after 6 months in both groups. Children were recalled at 6- and 12-month intervals and evaluated for caries arrest. Statistical Analysis: Chi-square test was used to analyze the data. Results: Caries arresting potential was found to be higher in the SDF group compared to the NaF varnish group at both 6-month (SDF - 82% and NaF varnish - 45%) and 12-month intervals (SDF - 77% and NaF varnish - 42%) and the difference was found to be statistically significant (P = 0.002 and 0.004, respectively). Conclusion: SDF was more effective in arresting dental caries in primary molars compared to 5% NaF varnish.

Effectiveness of Pre-cooling the Injection Site, Laser Biostimulation, and Topical Local Anesthetic Gel in Reduction of Local Anesthesia Injection Pain in Children.

AIM AND OBJECTIVE: Evaluation of the effectiveness of laser biostimulation (LBS), ice, and local anesthetic (LA) gel in reducing the injection pain during administration of local anesthesia in children. MATERIALS AND METHODS: A 3-arm, crossover randomized controlled trial included 30 children of age 9-12 years requiring extraction of primary maxillary posterior teeth. Children were randomly allocated to 3 groups of 10 each. After proper isolation and drying of the buccal mucosa, one of the three techniques, i.e., either LBS or ice or LA gel was applied for 1 minute followed by administration of the LA solution. The pain response was assessed using Wong-Baker Faces Pain Rating Scale and the Sound Eyes Motor scale (SEM). Kruskal-Wallis ANOVA and Mann-Whitney U tests were performed for intragroup and intergroup comparisons, respectively. RESULTS: Lower pain score of zero suggesting no hurt was given by more children in the ice group, followed by LA gel and LBS groups in both the scales. The differences in pain scores recorded were found to be statistically significant. CONCLUSION: Ice is found to be equally effective as LA gel, whereas low-level laser therapy is less effective compared to the other two techniques in reducing the injection pain during administration of maxillary posterior buccal infiltration in children. CLINICAL SIGNIFICANCE: Pain management during LA injection is a critical step in gaining initial trust and during the subsequent treatment visits. The present study suggests that simple methods like pre-cooling the injection site with ice can be used as an effective non-pharmacological technique to reduce injection pain. HOW TO CITE THIS ARTICLE: AmruthaVarshini I, Vinay C, Uloopi KS, et al. Effectiveness of Pre-cooling the Injection Site, Laser Biostimulation, and Topical Local Anesthetic Gel in Reduction of Local Anesthesia Injection Pain in Children. Int J Clin Pediatr Dent 2021;14(1):81-83.

To evaluate and compare the compressive strength of root dentin exposed to calcium hydroxide, mixed with various vehicles for a period of 30 days - An in vitro study.

Background: Long-term use of intracanal medicaments such as calcium hydroxide (CH) reduces the fracture resistance of dentin. Aim: This study aimed to evaluate and compare the compressive strength of root dentin exposed to CH, mixed with various vehicles after 30 days of placement. Settings and Design: Sixty single-rooted extracted human permanent premolars were collected, and complete instrumentation was done. Samples were divided into six groups. Materials and Methods: In Group I, no medicament was placed. In Group II, Group III, and Group IV, the root canals were filled with CH powder mixed with normal saline, distilled water, and local anesthetic solution. In Group V and Group VI, the root canals were filled with Metapaste and RC-Cal. Access cavities were sealed using IRM and were stored for 30 days. Teeth sectioned to obtain a 5 mm thick dentin cylinder subjected to compressive loading to evaluate the fracture resistance using a universal testing machine. Statistical Analysis: Results were analyzed using one-way ANOVA and multiple comparisons using Bonferroni test. Results: Highest mean compressive strength was recorded in Group I followed by Group II, Group IV, Group VI, Group III, and Group V. Conclusions: CH when used as a root canal dressing material will reduce the compressive strength of the teeth irrespective of the form of CH and vehicle.

Effect of preconditioning the fractured coronal fragments with remineralizing agents on fracture resistance of re-attached teeth.

BACKGROUND: Fragment re-attachment has been considered as one of the treatment modalities for the management of fractured anterior teeth. Hydration of fractured fragments aids in inhibiting the loss of ions and maintains vitality and esthetics. AIM: The study aimed to evaluate the effect of preconditioning the fractured fragments with remineralizing agents on fracture resistance of re-attached teeth. SETTINGS AND DESIGN: This was an in vitro study. MATERIALS AND METHODS: Sixty freshly extracted noncarious human permanent maxillary central and lateral incisors were randomly allocated into three Groups of 20 each: Group 1: 2% sodium fluoride (2%NaF), Group 2: casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and Group 3: self-assembling peptide P11-4 (SAP). These were further divided into two subgroups of 10 teeth each, based on contact time with remineralizing agents, i.e., 30 min and 2 h. Fractured fragments were treated with remineralizing agents for a specified contact time and then re-attached with flowable composite resin. Force required to fracture the re-attached tooth was recorded in Newtons using universal testing machine. STATISTICAL ANALYSIS: Unpaired t-test, one-way analysis of variance test, and post hoc Tukey test were used for the statistical analysis. RESULTS: A higher fracture resistance was noticed in fragments treated with 2% NaF (30 min- 215.6 N, 2 h- 188.5 N) compared to CPP-ACP (30 min- 141.3 N, 2 h- 111.1 N) and SAP (30 min- 134.8 N, 2 h- 149.5 N). At 30 min interval, it was found to be more in 2% NaF and CPP-ACP groups compared to 2 h. However, it increased with time in the SAP group. A statistically significant difference was found between the groups at both time intervals (P = 0.007 and 0.017). CONCLUSION: Preconditioning of fractured coronal fragments with 2% NaF showed higher fracture resistance compared to CPP-ACP and self-assembling peptide P11-4. Samples treated with SAP P11-4 exhibited good fracture resistance at 2 h contact time.

Zinsser-Cole-Engman Syndrome: A Rare Case Report.

Zinsser-Cole-Engmann syndrome also called Dyskeratosis Congenita (DKC) is a rare genodermatosis first described by Zinsser in 1906. Mutations in DKC1 gene is responsible for DKC. It is usually inherited as an X-linked recessive trait, resulting in a striking male predilection. It is characterized by a triad of reticular skin pigmentation, nail dystrophy and mucosal leukoplakia. Complications include predisposition to malignancy and bone marrow failure. Here, we report a case of DKC in a 9-year-old boy with classic triad of signs. Special investigations like endoscopy, barium swallow and bone-marrow aspiration study confirmed the diagnosis. There is no effective treatment for DKC. Some preventive measures can be adopted and the only long term cure for the haematological abnormalities is allogenic haemopoietic stem cell transplantation.