An in vitro comparison of casein phosphopeptide-amorphous calcium phosphate paste, casein phosphopeptide-amorphous calcium phosphate paste with fluoride and casein phosphopeptide-amorphous calcium phosphate varnish on the inhibition of demineralization and promotion of remineralization of enamel.

AIM: This study aims to determine and compare the extent of inhibition of demineralization and promotion of remineralization of permanent molar enamel with and without application of three remineralizing agents. MATERIALS AND METHODS: Forty extracted permanent molars were randomly divided into two groups 1 and 2, longitudinally sectioned into four and divided into subgroups A, B, C, and D. The sections were coated with nail varnish leaving a window of 3 mm × 3 mm. All sections of Group 1 were treated with their respective subgroup-specific agent: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste for subgroup A, CPP-amorphous calcium phosphate fluoride (ACPF) paste for subgroup B, CPP-ACPF varnish for subgroup C and subgroup D served as a control. The sections were then subjected to demineralization for 12 days following which lesional depth was measured under the stereomicroscope. All the sections of Group 2 were subjected to demineralization for 12 days, examined for lesional depth, then treated with their respective subgroup specific agents and immersed in artificial saliva for 7 days. The sections were then examined again under the stereomicroscope to measure the lesional depth. RESULTS: CPP-ACPF varnish caused significant inhibition of demineralization. All three agents showed significant remineralization of previously demineralized lesions. However, CPP-ACPF varnish showed the greatest remineralization, followed by CPP-ACPF paste and then CPP-ACP paste. CONCLUSION: This study shows that CPP-ACPF varnish is effective in preventing demineralization as well as promoting remineralization of enamel. Thus, it can be used as an effective preventive measure for pediatric patients where compliance with the use of tooth mousse may be questionable.

Comparative Assessment of Conventional Composites and Coloured Compomers in Permanent Molars of Children with Mixed Dentition: A Pilot Study.

INTRODUCTION: Early treatment of carious lesions in children is important for the maintenance of oral health. Multicoloured restorations could be the impetus for an extremely nervous or defiant child to take dental treatment. AIM: The aim of this study was to assess and compare the clinical success of conventional composites and coloured compomer material in first permanent molars of children with mixed dentition. MATERIALS AND METHODS: A total of sixty sites, divided into two groups, with thirty subjects in each group using split mouth design were chosen amongst patients reporting to Department of Pedodontics and Preventive Dentistry. In control group conventional composites were placed, similarly coloured compomers were placed in experimental group under standard operating protocol. Patients were recalled for assessment of clinical success amongst control as well as experimental group at regular intervals of one; three and six months follow up based on Modified Ryge's Criteria. Statistical analysis was done using Chi-square test using SPSS version 20.0 (Chicago, USA). RESULTS: Both conventional composites and coloured compomers had comparable retention rates in terms of anatomical form, marginal integrity, secondary caries and marginal discolouration. CONCLUSION: The coloured compomer material showed promising results in this six month follow up study in permanent molars and had properties comparable to that of conventional composites.

Combined laparoscopic and percutaneous management of calcified renal hydatid cyst--a novel nephroscope- and lithotripter-assisted technique.

OBJECTIVE: To describe the novel technique of percutaneous nephroscope-assisted renal hydatid cyst evacuation and lithotripter-assisted division of the cyst wall for combined laparoscopic and percutaneous management. METHODS: A calcified hydatid cyst of the kidney is a rare entity and needs special techniques for total laparoscopic management. A 45-year-old woman was treated successfully for a calcified renal hydatid cyst using the transperitoneal laparoscopic technique. A chlorhexidine gluconate and cetrimide mixture was used as the scolicidal solution to sterilize the cyst. The endocyst and daughter cysts were removed completely under vision, after placement of a single 26F nephroscope through a 10-mm port in the cyst, with grasper and lithotripter suction, using chlorhexidine-cetrimide mixture irrigation. Laparoscopic suction did not work well for the viscous contents. The calcified cyst wall did not yield to electrocautery or piecemeal fragmentation, until weakened by division and fragmentation using the pneumatic lithotripter. Partial cyst wall exicision/marsupialisation was complemented with omentoplasty. RESULTS: No intraoperative or early postoperative complications occurred. The patient recovered well with little pain and was discharged early. This technique, in which the principles of percutaneous nephrolithotomy were applied for a special problem, is the first of its type. CONCLUSION: Calcified renal hydatid cyst evacuation using the novel nephroscope-assisted retrieval of contents and lithotripter-assisted division of the calcified wall is a safe and feasible technique for total minimally invasive management.