bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Evaluation of Bactericidal Potential of Four Root Canal Filling Materials against Microflora of Infected Non -Vital Primary Teeth
Authors: Harini Priya , Bhat Sham , Sundeep Hegde K
Published: April 2015

Background and objectives: Since complete debridement of the root canals of the primary teeth is not practically possible due to the highly variable root canal anatomy, success of the endodontic therapy depends partly on the use of antibacterial irrigating agents and root canal filling materials. Recent literature indicates that anaerobes comprise a majority of the bacteria in necrotic root canals of primary teeth. The study determined the antibacterial effectiveness of four root canal filling materials namely Calcium hydroxide,Zinc oxide eugenol, Vitapex and Metapex against microbial specimens obtained directly from necrotic root canals of primary teeth. Method: Microbial specimens were collected using sterile paper points, from 15 primary maxillary and mandibular posterior teeth of randomly selected children in the age group of 4-10 years with infected non vital primary teeth, requiring pulpectomy procedure. The microbial specimens collected were subjected to microbiological analysis and the antimicrobial potential of root canal filling materials were tested using Agar diffusion technique. Results: were statistically analyzed using one-way ANOVA. Facultative/Aerobic organisms were isolated in all the cases, anaerobic organisms were isolated in 80% of the cases, and Candida albicans was isolated in 1 case. ZOE showed superior inhibitory activity against most of the organisms isolated followed by Vitapex, Calcium hydroxide and Metapex in descending order.Conclusion: Our data may be useful as a guide for relative antimicrobial effectiveness or non-effectiveness of the materials employed. In vivo studies are required to state the specific antimicrobial activity and merits and demerits of any of the test filling material.
The Pattern of Maxillary Canine Impaction in Relation to Anomalous Lateral Incisors
Authors: Jena Ashok Kumar , Duggal Ritu
Published: April 2015

Objective: To investigate the probability and pattern of maxillary canine impaction in relation to anomalous adjacent lateral incisors. Subjects and Method: A total 66 patients (M=24, F=42) in the age range of 12 to 18 years who had at least one impacted maxillary canine were included for the study. The maxillary lateral incisor anomalies and nature of canine impactions were diagnosed from the radiographs and study models. Maxillary lateral incisors were classified as normal, peg shaped, impacted and congenitally missing. The maxillary canine impactions were classified as buccal and palatal impaction. Each affected maxillary side was considered separately. This resulted total 88 cases for which the probabilities of different canine positions adjacent to the different categories of lateral incisor anomalies were evaluated statistically. Results:The occurrence of palatal canine impaction was almost1.6 times more than the buccal canine impaction. Total 11.76% of the bucally impacted canines and 38.89% of the palatally impacted canines were associated with anomalous lateral incisors. There was no positive association between anomalous lateral incisors and maxillary canines. In relation to anomalous lateral incisor, the probability of palatal canine impaction was more than the buccal canine impaction. Conclusions: There was no positive association between lateral incisor anomalies and maxillary canine impaction. However, there was a high probability of palatal canine impaction when adjacent lateral incisors were anomalous.
Efficacy of Mineral Trioxide Aggregate as an Apical Plug in Non-Vital Young Permanent Teeth: Preliminary Results
Authors: Annamalai Sankar , Mungara Jayanthi
Published: April 2015

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.
Timing of Myofunctional Appliance Therapy
Authors: Singh Shishir , Singh Meghna , Saini Ashish , Misra Vaibhav , Sharma V , Singh G
Published: April 2015

Objective: To identify the stage of skeletal maturity, as depicted by the Cervical Vertebrae Maturity Index at which the maximal response to myofunctional therapy could be expected. Design: The soft copies of pre and post treatment lateral cephalometric radiographs of the sample comprising of 48 subjects, on myofunctional therapy, were traced on 'Nemotec Dental Studio NX' software. Three groups were formed based on the stages of skeletal maturity and comparison was done. Results: The treated samples were compared with control samples consisting of subjects with untreated Class II malocclusions, also selected on the basis of stages in cervical vertebrae maturation. Inter-group comparison of the treated samples revealed statistically significant changes in Group II (Stages 3 to 4 of Cervical Vertebrae Maturity Index). Conclusion: Maximum response to myofunctional therapy can be expected in patients during the stages 3 to 4 of cervical vertebrae maturation index, i.e., during or slightly after the pubertal peak.
Toxic Epidermal Necrolysis. A case report
Authors: Villalta Patricia , Velez Ines , Mejia Lina , Ospina Ana Maria
Published: April 2015

We present an extreme case of Toxic Epidermal Necrolysis, which corresponds to a severe form of Stevens Johnson Syndrome. This is a potentially fatal immune reaction that affects skin and mucosa, producing blisters and sloughing of the epithelium. Severe sequelae, including blindness, hearing loss, tooth malformation and esophageal destruction are seen in this case.
Clinical and Radiographic Study of Chemical-Mechanical Removal of Caries Using Papacárie: 24-Month Follow Up
Authors: Bussadori SK , Guedes CC , Bachiega JC , Santis TO , Motta LJ
Published: April 2015

Background: The chemical-mechanical removal of caries involves the chemical softening of the infected dentin, following by the mechanical removal of the softened tissue using non-cutting manual instruments. Papacárie® (Fórmula&Ação, Sao Paulo, Brazil) is a product in gel form used for the chemical-mechanical softening of the affected tissue. Objective: The purpose of the present study was to evaluate the effectiveness of Papacárie®. Methods: Clinical and radiographic evaluations were performed on 14 young permanent molars treated with Papacárie® and restored with glass ionomer cement (VitroMolar, DFL Ind. Com LTDA,Rio de Janeiro, Brazil) 24 months following intervention. Results: Success was achieved in 13 of the 14 cases. Conclusion: Papacárie® was effective in the treatment of carious lesions and constitutes a conservative alternative that offers benefits to patients.
Microstructure of Mineralized Tissues in Human Primary Teeth
Authors: Ruschel HC , Ligocki GD , Flaminghi DL , Fossati ACM
Published: April 2015

The aim of this study was to analyze the structural characteristics of the mineralized dental tissues - enamel,dentin and cementum - in primary teeth and to correlate the histological aspects observed in function of the dental type – single-rooted or multi-rooted. Method: Eighteen human primary noncarious teeth were sectioned in facial-lingual (single-rooted) and mesio-distal direction (multi-rooted). One to three samples from each tooth were obtained. The samples were prepared by the ground technique and analyzed under light microscopy at different magnifications. A quantitative and descriptive analysis of the morphology of the mineralized tissues was performed. Results: Spindles, tufts and lamellae were consistently observed mainly in the occlusal surface of the primary molars. The scalloped pattern of the dentinoenamel junction was not always present. The same was seen for zones of interglobular dentin. Dead tracts in dentin and tertiary dentin were observed mainly in single-rooted teeth below areas of dental attrition. Areas of cellular and acellular cementum were observed in the two dental types. Conclusions: Primary teeth have some structural peculiarities and these should be investigated concerning the clinical repercussion.
Evaluation of Oral Hygiene Status, Salivary Characteristics and Dental Caries Experience in Acute Lymphoblastic Leukemic (ALL) Children
Authors: Hegde AM , Joshi S , Rai K , Shetty S
Published: April 2015

Leukemia constitutes approximately 30% of all childhood cancers and Acute Lymphoblastic Leukemia(ALL) is the most common type of malignancy. Oral dryness, ulceration, increased dental decay seen is due to altered salivary flow rate and buffering capacity in these children. Oxidative stress may play an important role in the malignancies resulting in onset of inflammatory oral pathologies. Saliva constitutes first line of defense against free radical-mediated oxidative stress. The present study attempted to relate the oral health status, salivary flow rate, salivary pH, gingival health status, dental caries experience and total salivary antioxidant levels in ALL children. A total of 120 children aged 4-10 years (90 leukemic children, study group and 30 normal healthy siblings, control group) were divided into 4 groups of 30 each. Oral health status, gingival status and dental caries experience was recorded followed by un-stimulated saliva collection. Total antioxidant capacity of un-stimulated saliva was evaluated. The results depicted deterioration in oral health status, gingival status and increased dental caries experience in leukemic children. Salivary flow rate, salivary pH and total salivary antioxidant levels were lowered in leukemic children when compared with control group.
ZOE Paste Pulpectomies Outcome in Primary Teeth: A Systematic Review
Authors: Barcelos R , Santos MPA , Primo LG , Luiz RR , Maia LC
Published: April 2015

Objective: To perform a systematic review in which the clinical research question for primary teeth with irreversible pulpal pathosis was "how pulpectomies with zinc oxide eugenol (ZOE) paste performed compared to other materials in their clinical and radiographic outcomes after twelve months or more follow-up period.Study design: A literature survey of the electronic database (1950-2010) used the Medical Subject Headings and free text terms. Forty three references were retrieved and inclusion criteria were applied; 15 articles remained for full-text evaluation. From these, two were selected for data extraction regarding quality characteristics and results. Results: Selected studies showed moderate or high risk of bias. The overall success of pulpectomy was 80.0% (Calcicur), 60.0% (Sealapex) and varied from 85.0% to 100.0% (ZOE) and 89.0% to 100.0% (Vitapex). Solely Calcicur presented success rate significantly lower when compared to ZOE and Vitapex. These pastes lead to overfilled canals and particles of extruded ZOE were still evident even after the evaluation period. Resorption of Vitapex, Calcicur and Sealapex within the root canal was also reported. Conclusions: In primary teeth with irreversible pulpal changes ZOE pulpectomies yielded similar outcome than Vitapex and Sealapex, although there was no agreement with regard to filling materials' resorption.
A Comparative Evaluation of Intranasal Midazolam, Ketamine and their Combination for Sedation of Young Uncooperative Pediatric Dental Patients: A Triple Blind Randomized Crossover Trial
Authors: Bahetwar SK , Pandey RK , Saksena AK , Girish Chandra
Published: April 2015

Objective: The purpose of this study was to evaluate and compare the efficacy and safety of intranasal (IN)administration of midazolam (M), ketamine (K) and their combination (MK) to produce moderate sedation in young, uncooperative pediatric dental patients. Study design: In this three stage crossover trial forty five uncooperative ASA type-1 children, who required dental treatment, were randomly assigned to receive one of the three drugs/combination by IN route during three subsequent visits. The efficacy and safety of the agents were assessed by overall success rate and by monitoring of vital signs, respectively. Results: The onset of sedation was rapid with K as compared to M and MK. The difference was statistically significant(P<0.01) between K and M. The overall success rate was 89% with K, MK was 84% and 69% with M. The difference between the overall success rates of K and M was statistically significant (P<0.01). Vital signs were within physiological limits and there were no significant adverse effects with any medication.Conclusions: M, K and MK are safe and effective by IN route to produce moderate sedation for providing dental care to pediatric dental patients who have been otherwise indicated for treatment under general anesthesia.
Comparison of Some Dietary Habits on Corrosion Behavior of Stainless Steel Brackets: An in vitro Study
Authors: Shahabi M , Jahanbin A , Esmaily H , Sharifi H , Salari S
Published: April 2015

Background and Objective: Resistance to corrosion is an advantageous property of orthodontic brackets;however, due to low levels of pH found in the mouth of a patient, localized corrosion may occur. This can affect tooth movement by increasing friction between the arch wire and bracket slot and initiate enamel discoloration. Additionally, corrosion causes the release of elements that may lead to cytotoxic and biological side effects. The aim of this study was to compare the amount of corrosion caused by lemon juice, vinegar and Coca-Cola® on orthodontic brackets in vitro and then to recommend the most suitable diet during orthodontic treatment. Method: Sixty orthodontic brackets in three groups of twenty were immersed in a test solution (Fusamaya-Meyer artificial saliva plus lemon juice, vinegar or Coca-Cola) at a temperature of 37°C±1. Moreover, a negative control consisting of twenty brackets were put in pure artificial saliva. After 6 weeks the amount of corrosion was determined by measuring δW of mean weights of brackets and the results were analyzed by general linear models (repeated measurement).

Results: Significant differences were seen during different weeks of the study (P<0.001) and different solutions(P<0.001). This study showed the amount of corrosion in orthodontic brackets was the most for cola followed by vinegar and then lemon juice. In addition, mean differences for cola versus lemon juice was -0.010(sig. <0.001), vinegar versus lemon juice was -0.006 (sig. =0.001) and cola versus vinegar was -0.004(sig. =0.013). Conclusion: Acidic effervescent soft drinks such as cola have to be eliminated or minimized in the nutritional diet of orthodontic patients because of their harmful effects on their brackets.
Caries Protective Agents in Human Milk and Bovine Milk: An in vitro Study
Authors: Shetty Vabitha , Hegde Amitha , S Nandan , Shetty Suchetha
Published: April 2015

Objectives: To estimate Calcium and Phosphorus withdrawal from hydroxyapatite in the presence of bovine milk and human milk from which the following protective fractions namely Casein, Whey protein, Lactose and Milk fat have been individually removed and to compare the above protective fractions in human and bovine milk. Method: Human milk obtained from lactating mothers in the labor ward of Kshema hospital was subjected to immediate analysis. Bovine milk was obtained from a local dairy. Equal quantities of human milk and bovine milk (1ml) were separately subjected to the systematic removal of the four milk fractions. As each fraction was removed, the remaining milk samples were subjected to testing. Powdered hydroxyapatite from human dental enamel was subjected to demineralization with the addition of the milk sample under test for 20 minutes. This mixture was then centrifuged. Aliquots of the supernatant were taken for calcium and Phosphorus analysis using photospectrometry. Ten demineralization tests were similarly carried out for every milk fraction for both human and bovine milk separately. Equal samples of whole bovine milk and whole human milk were also subjected to similar testing. Results: The calcium and phosphorus dissolution values were higher when the individual fractions were eliminated from both human milk/enamel samples and bovine milk/enamel samples as compared to the values obtained from whole human milk/whole bovine milk /enamel samples. Further, higher calcium and phosphorus dissolution values were observed when the fractions were individually and separately removed from the whole human milk/enamel samples as compared to the corresponding values obtained when these fractions were removed from bovine milk/enamel samples. Conclusion: The evaluated milk fraction in bovine milk namely casein,whey protein, lactose and milk fat were individually more caries protective when compared to the corresponding fractions in human milk.
Pattern of Tooth Extraction in Children Attending Tertiary Health Care Centers In Nigeria: A Prospective Study
Authors: Ashiwaju Modupe , Folayan Morenike , Sote Elizabeth , Isikwe Micheal
Published: April 2015

Background: To identify the causes of tooth extraction in a tertiary pediatric center in an urban centre in Nigeria. Method: Data was collected prospectively from 400 children attending one of the four tertiary dental clinics. The demographic profile, the indications for tooth extraction, and the tooth extracted were noted. Data was compared with result of study conducted 21 years back in the same center, and data from two other tertiary health centers in the region. Results: The prevalence of tooth extraction was 58.8% in the study population. This occurred in significantly more male patients. Tooth loss was commonest amongst the 7-10 age group. Dental caries was the main cause of tooth loss for all age groups. Most patients (66.0%) lost a single tooth. The lower molars were the most frequently lost teeth (47%). Indications for tooth extraction were similar in the region. Conclusion: Dental caries remains the most common cause of tooth extraction. The indications for tooth extraction remain the same but the prevalence of tooth loss per cause of tooth loss had not changed over the last 21 years, and across institutions in Southwestern Nigeria.
Association between Caries, Obesity and Insulin Resistance in Mexican Adolescents
Authors: Loyola-Rodriguez Juan Pablo , Villa-Chavez Carlos , Patiño-Marin Nuria , Aradillas-Garcia Celia , Gonzalez Cesar , de la Cruz-Mendoza Esperanza
Published: April 2015

Aim: To determine the association among dental caries, obesity and insulin resistance in Mexican adolescents.Methods: Body Mass Index, obesity (OB) blood pressure, insulin level, insulin resistance (IR), triglycerides level, serum HDL-cholesterol (cHDL), DMFT index and salivary flow were measured. Results:Anthropometric measures showed a significant statistical difference (p < 0.05). Insulin level was 8.98 for healthy subjects, whereas for OB-IR group was 25.35, there was a statistical significant difference (p <0.05). Triglycerides level was 88.50 for healthy subjects and 169.40 mg/dL for OB-IR; cHDL was 52.88 for healthy and 41.82 mg/dL for OB-IR group, both showed a statistically significant difference (p < 0.05). Salivary flow was 4.30 for healthy and for OB-IR group was 5.48 ml/min showed a significant statistical difference(p < 0.05). DMFT index was 3.02 for healthy and for OB-IR adolescents was 4.78, showed a significant statistical difference (p < 0.05). The caries component of DMFT index was 1.84 for healthy and was 3.52 for OB-IR adolescents, showed a significant statistical difference (p < 0.05). According to the multivariate analysis, DMFT (OR=3.10; IC95%=0.20-1.02, p=0.042) and decay (OR=3.30; IC95%=0.19-1.0,p=0.011) were associated with subjects with OB-IR. Conlusion: OB-IR Mexican adolescents showed a positive association with DMFT.
Nutritional Considerations and Dental Management of Children and Adolescents with HIV/AIDS
Authors: Mittal Meenu
Published: April 2015

The HIV infected child has increased caloric needs, yet multiple factors interfere with adequate nutritional intake. Nutritional support is needed to maintain optimum nourishment during the symptomatic period, in order to prevent further deterioration of the nutritional status during acute episodes of infection, and to improve the nutritional status during the stable symptom free period.

With the advent of better methods of detection and better therapies, we are beginning to see HIV infected children surviving longer, and thus coming under the care of a host of affiliated medical personnel, including dentists. Oral health care workers need to provide dental care for HIV-infected patients and recognize as well as understand the significance of oral manifestations associated with HIV infection.

The present article reviews, on the basis of literature, nutritional status, nutrition assessment and counseling in HIV/ AIDS children and adolescents. Dental treatment considerations in these, as well as modifications in treatment if required, are also discussed.
Esthetic Restorative Options for Pulpotomized Primary Molars: A Review of Literature
Authors: Guelmann Marcio , Shapira Joseph , Silva Daniela , Fuks Anna
Published: April 2015

Objective: The goal of this manuscript was to review the existing literature in regards to esthetic options to restore pulpotomized primary molars. Study design: A pubmed literature search has been performed and all relevant studies were assessed. Results: Two laboratory, 3 restrospective and 4 prospective clinical studies were found, reviewed and analyzed. Conclusions: Based on the limited information available, we concluded that tooth colored and bonded restorations showed promising results as alternative materials to replace stainless steel crowns after pulpotomies in primary molars. Hybrid composites tend to perform better than compomers. Resin modified glass ionomer cements demonstrated excellent marginal seal and retention. More long-term follow up studies are necessary until more definitive recommendations can be made.
Eating Disorders and their Implications on Oral Health — Role of Dentists
Authors: Kavitha PR , Vivek P , Hegde Amitha
Published: April 2015

Eating disorders (EDs) are primary psychological conditions, often associated with severing medical complications. EDs are characterized by perturbed eating behavior patterns. Their increasing incidence and prevalence is causing concerns to healthcare professionals. Because eating disorders are a complex issue, a multidisciplinary approach to treatment is required and this team includes Psychiatrists, Psychologists and Nutritionists.The purpose of this paper is to review the role of the dentists especially the pediatric dentist and orthodontist in identifying oral manifestations of EDs, which may be utilized for oral diagnosis, referral and management of underlying psychiatric condition and also secondary oral conditions.
Effect of Polyol Gums on Salivary S Mutans Levels
Authors: Subramaniam Priya , Suresh Babu P
Published: April 2015

The predominant sugar substitutes used in chewing gum are polyols which are low-caloric substances. The polyols most frequently used in chewing gums are sorbitol and xylitol. Aim:The present study assessed the effectiveness of xylitol and sorbitol chewing-gums on levels of S mutans in saliva. Method: The study group consisted of 30 normal and healthy males aged between 13-17 years. A pellet of gum (sorbitol or xylitol) was given to each participant after breakfast (8am), lunch (2pm) and dinner (8pm) for the study period of 3 months. On the first day of the study, baseline salivary samples were collected after breakfast from all participants and assessed for S mutans levels. At the end of 3 months, salivary samples were collected and processed in a similar manner. Conclusion: Salivary S mutans levels showed a significant reduction after the use of xylitol based chewing gum than with sorbitol based chewing gum.
A Delayed Hypersensitivity Reaction to a Stainless Steel Crown
Authors: Yilmaz A , Ozdemir CE , Yilmaz Y
Published: April 2015

Stainless steel crowns are commonly used to restore primary or permanent teeth in pediatric restorative dentistry. Here, we describe a case of a delayed hypersensitivity reaction, which manifested itself as perioral skin eruptions, after restoring the decayed first permanent molar tooth of a 13-year-old Caucasian girl with a preformed stainless steel crown. The eruptions completely healed within one week after removal of the stainless steel crown. The decayed tooth was then restored with a bis-acryl crown and bridge. Since no perioral skin eruptions occurred during the six-month follow-up, we presume that the cause of the perioral skin eruptions was a delayed hypersensitivity reaction, which was triggered by the nickel in the stainless steel crown.
Correlation of Dental Maturity with Skeletal Maturity from Radiographic Assessment
Authors: Morris John M. , Park Jae Hyun
Published: April 2015

There have been many attempts to correlate dental development with skeletal growth. The relationship is generally considered to be moderate at best. However, there is evidence that hand-wrist radiographic interpretation of remaining growth can be augmented by taking into account the developing dentition. In addition, the practicality of evaluating routine dental radiographs and avoiding additional radiation is advantageous. To this point, no system has been described to match apical development by Demirjian’s stages and compare it to skeletal development and remaining growth. This study reviewed articles pertinent to the relationship between developing teeth and skeletal maturity and remaining growth, and a system is proposed to give practitioners an additional assessment for growth and development.
Salivary Sialic Acid Levels and Dental Health In Children with Congenital Heart Disease
Authors: Hegde AM , Kavita Rai , Sushma KS , Shetty Suchetha
Published: April 2015

Congenital cardiac disease is one of the most common developmental anomalies in children. Higher caries prevalence and gingivitis compared to healthy children have been shown in children with congenital heart disease which has a significant implication in the medical care of these patients associated with bacteraemia and endocarditis. Sialic acids being terminal sugar components and marker of chronic inflammatory response are found to be present at higher levels in children with poor oral health status. So the present study aimed to evaluate the oral health status and salivary sialic acid levels among the children with congenital heart disease and normal healthy siblings. A total of 71 children with heart diseases aged 6-10 years attending various heart institutes were examined for oral hygiene status, gingival status and dental caries status by using modified WHO oral assessment form. A case-matched control group of 50 children were also examined. Salivary flow rate, pH and sialic acid levels were measured after saliva collection. The results were subjected to Unpaired t test and Pearson’s Correlation Coefficient Test.

The salivary pH, salivary flow rate, dental caries status, oral hygiene and the gingival status were significantly compromised with a positive correlation with the sialic acid levels in saliva, leading to increased treatment needs in the study group. Therefore the amount of sialic acid in the saliva can be a useful index of the severity of oral disease.
Anxiety in Children during Occlusal ART Restorations in Primary Molars Placed in School Environment and Hospital Dental Setup
Authors: Roshan NM , Sakeenabi B
Published: April 2015

Objective: To evaluate the anxiety in children during occlusal atraumatic restorative treatment (ART) in the primary molars of children; and compare the anxiety for ART procedure performed in school environment and in hospital dental setup. Study design: A randomized controlled trial where One dentist placed 120 ART restorations in 60 five- to seven year-olds who had bilateral matched pairs of occlusal carious primary molars. A split-mouth design was used to place restorations in school and in hospital dental setup, which were assigned randomly to contralateral sides. Anxiety was evaluated by Modified Venhem score and the heart rate of the children at five fixed moments during dental treatment. Results: At the entrance of the children into the treatment room, statistically significant difference between treatment in school environment and treatment in hospital dental setup for venham score and heart rate could be found (P=0.023 and P=0.037 respectively). At the start of the treatment procedure higher venham score and heart rate was observed in children treated in hospital dental setup in comparison with the children treated in school environment , finding was statistically significant (P=0.011 and P=0.029 respectively). During all other three points of treatment, the Venham scores of the children treated in school were lower than those of the children treated in hospital dental setup but statistically not significant (P>0.05). Positive co-relation between Venham scores and Heart rate was established. No statistically significant relation could be established between boys and girls. Conclusions: Overall anxiety in children for ART treatment was found to be less and the procedure was well accepted irrespective of environment where treatment was performed. Hospital dental setup by itself made children anxious during entrance and starting of the treatment when compared to children treated in school environment.
Effect of Various Concentrations of Sodium Hypochlorite on Primary Dentin: An in vitro Scanning Electron Microscopic Study
Authors: Gowda L , Mohan Das U
Published: April 2015

Background: Sodium hypochlorite solutions have been evaluated for their effects in bonding procedures as they are found to deplete or remove the organic portion of the dentin, particularly the collagen fibrils. The aim of this in vitro study was to assess and compare the efficacies of 1%, 2.5%, 5% and 10% NaOCl at 30, 60 and 120s on etched primary dentin. Methods: 84 primary anterior teeth were ground to expose a flat dentin area on the buccal surface. The specimens were divided into fourteen groups of six each based on the dentin surface treatment (35% phosphoric acid etching for 7 seconds-AE and/or NaOCl application), NaOCl solution concentrations (1%, 2.5%, 5% and 10%) and time of application (0, 30, 60 and 120s). Specimens were prepared for SEM and photomicrographs were taken of the surface and were scored against a five point scale, based on the smear layer and amount of collagen removed. The scores were submitted to Kruskal-Wallis and Mann Whitney tests. Results: This study showed the presence of smear layer in the control group. The group treated with Acid Etchant showed a demineralized pattern of dentin with exposure of dentin tubules and collagen fibrils network on the intertubular and peritubular dentin which was not significantly different from the groups treated with 1% and 2.5% NaOCl. Groups treated with 5% NaOCl were not statistically different from each other, the surface was corroded but collagen fibrils were not completely depleted. Groups treated with 10% NaOCl were not statistically different from each other and showed complete removal of collagen fibrils with wider tubular apertures and several secondary tubules on peritubular and intertubular dentin. Conclusion: Higher concentrations of NaOCl solutions (5% and 10%) produced significant changes in the etched primary dentin. The higher the concentration of the NaOCl solution, the lower can be the time for the application of the solution for the complete removal of collagen fibrils.
Esthetic Smile Rehabilitation through Autogenous Bonding of Dental Fragment: A Case Report
Authors: Gonçalves-Sena L , Guimarães Rosa Dutra AC , Corrêa-Faria P , Botelho AM , Ramos-Jorge ML , Aguiar Tavano KT
Published: April 2015

Autogenous tooth fragment bonding offers advantages over restorations with composite resins and porcelain, including better esthetics, greater durability, reestablishment of the natural function of the dental element and short execution time. A case is presented of a 14-year-old male patient who suffered an oblique crown fracture of the permanent right maxillary central incisor (11) due to a traumatic fall. The clinical examination revealed pulp exposure with no invasion of the biological space. Due to the extension of the fracture, endodontic treatment and the placement of an intra-root esthetic pin was needed. The tooth was restored using the autogenous fragment bonding method. Excellent esthetic and functional results were observed after two years of follow up.
Salivary Ferritin as a Predictive Marker of Iron Deficiency Anemia in Children
Authors: Jagannathan N , Thiruvengadam C , Ramani P , Premkumar P , Natesan A , Sherlin HJ
Published: April 2015

Objectives: The objective of the study was to determine the salivary Ferritin levels in children with iron deficiency anemia and its reliability as a predictive marker of the disease and whether these levels could give a new hypothetical insight on the oral epithelial changes seen in patients with iron deficiency anemia. Study Design: The study comprised of 60 children of which the study group comprised of 30 individuals; aged 8-14 years with iron deficiency anemia. Venous blood was collected and hematological examination was performed to determine the hemoglobin and serum ferritin levels to confirm the diagnosis. Saliva was then collected from 30 children with iron deficiency anemia and an equal number of controls. The ferritin levels in saliva were then analyzed using solid phase ELISA. Result: The mean value of salivary ferritin in iron deficient cases was 153.24±46.58 µg/dl and the mean ferritin levels in control subject were 93.87±30.15 µg/dl. Thus the salivary ferritin was found to be significantly higher in iron deficient subjects compared to the controls. Conclusion: The result of our research affirms the fact that the expression of ferritin in saliva of iron deficiency anemia may be due to the enzymatic functions in the saliva and the endocytosis of ferritin which can possibly elevate the salivary ferritin. The diminished level of cytochrome oxidase, together with its relatively high Ferritin content, depicts the association of oral epithelial changes and ferritin occurring in iron deficiency anemia.
Evaluating the Effect of Probiotic Containing Milk on Salivary mutans streptococci Levels
Authors: Juneja A , Kakade A
Published: April 2015

Purpose: To evaluate the changes in mutans streptococci counts in saliva after short term probiotic intervention and its delayed effects on salivary mutans streptococci count. Methods: 40 children in the age group of 12-15 years with medium to high caries activity were randomly divided into Group I Control (plain milk group) and Group II Experimental (probiotic supplemented milk group). Duration of the study was 9 weeks; which was evenly divided into three phases: baseline, intervention and post-treatment period; each phase consisting of three weeks. After baseline period of 3 weeks, children in group I were given plain milk and in group II milk containing probiotic Lactobacillus rhamnosus hct 70 for 3 weeks; followed by a 3 weeks follow up period. After every phase saliva samples were collected to estimate salivary mutans streptococci counts. Results: The difference in the post follow up mutans streptococci count of group I and group II, was highly significant with p value < 0.001. In the control group, the difference in the mean salivary baseline, post treatment and post follow up mutans streptococci counts was not statistically significant (p = 0.001). In the experimental probiotic group, the difference in mean salivary baseline, post treatment and post follow up mutans streptococci counts was statistically highly significant ( p = 0.000, p ≤ 0.001). Conclusions: Statistically significant reduction in salivary mutans streptococci counts immediately after consumption of probiotic Lactobacillus rhamnosus hct 70 containing milk suggest a beneficial effect of probiotic Lactobacillus rhamnosus hct 70 in the prevention of dental caries.
An in vitro Evaluation of Antimicrobial Efficacy of Primary Root Canal Filling Materials
Authors: Sapna Hegde , Priti Kamlesh Lala , Dinesh Rao B , Shubha AB
Published: April 2015

Objective: The present study aimed to evaluate and compare six different materials commonly used for filling the root canals of primary teeth for antimicrobial efficacy against some of the microorganisms commonly found in infected root canals. Study design: In this experimental in vitro study six root canal filling materials were tested for antimicrobial efficacy against eight microbial strains using the agar diffusion method. Results: Zinc oxide eugenol paste exhibited the strongest antimicrobial potential followed by Endoflas™, zinc oxide-calcium hydroxide-sodium fluoride mixture, zinc oxide-calcium hydroxide mixture and calcium hydroxide paste (Apexcal™). The addition of sodium fluoride to the zinc oxide-calcium hydroxide mixture enhanced the antimicrobial efficacy. Metapex™ demonstrated minimal inhibition and Vaseline™ was non-inhibitory. Conclusions: All the test filling materials demonstrated varying antimicrobial activity against the microorganisms tested. Zinc oxide eugenol paste and materials containing zinc oxide were found to be more effective against the microorganisms compared to materials without zinc oxide.
In Vivo Evaluation of Lesion Sterilization and Tissue Repair in Primary Teeth Pulp Therapy Using Two Antibiotic Drug Combinations
Authors: Jaya AR , Praveen P , Anantharaj A , Venkataraghavan K , Prathibha Rani S
Published: April 2015

Aim : The purpose of this study is to evaluate and compare the clinical and radiographic effectiveness of Ciprofloxacin, Minocycline, Metronidazole combination with Ciprofloxacin, Minocycline and Tinidazole combination when used for Lesion Sterilization and Tissue Repair in primary teeth. Method: 25 healthy children, visiting Dept. of Pediatric & Preventive Dentistry, D.A.P.M.R.V.Dental College, Bangalore, India, aged between 6 - 9 years who were having 30 infected primary teeth are selected and divided into 2 groups. In Group A, a mixture of 3mix-MP Ciprofloxacin, Metronidazole and Minocycline was placed on the floor of the pulp chamber covering the root canal orifices. In Group B a mixture of Ciprofloxacin, Tinidazole and Minocycline was placed as a layer on the floor of the pulp chamber. The procedure was completed in a single visit. Post operative clinical evaluation was done after 1,6,12 and 24 months. Postoperative radiographic evaluation was done at 6,12 and 24 months. Results: No statistically significant difference is observed between both the groups and a combination of Ciprofloxacin, Minocycline and Tinidazole antibacterial drugs can be used on teeth pulpally involved with physiologic root resorption. Conclusion: After a 24 Month follow up, we can conclude that primary teeth with the periradicular lesions, can be conserved by using combination of Ciprofloxacin, Minocycline and Tinidazole antibacterial drugs.
Comparative Evaluation of Formocresol and Mineral Trioxide Aggregate in Pulpotomized Primary Molars - 2 Year Follow Up
Authors: Airen P , Shigli A , Airen B
Published: April 2015

Aim: The aim of the present study was to clinically and radiographically evaluate Mineral Trioxide Aggre-gate (MTA) as an agent for pulpotomy in primary teeth and to compare it with that of Formocresol (FC) pulpotomy. Method: Seventy first and second primary mandibular molars of children were chosen on patients who required minimum two pulpotomies in either arch or same arch. After the standardized technique of Pulpotomy with MTA and Formocresol, all molars were treated with a thick mix of Zinc oxide Eugenol cement into the coronal pulp chamber followed by preformed stainless steel crown. The children were followed up for clinical and radio graphical examination after 6,12 and 24 month for Pain, Swelling, Sinus/ fistula, Periapical changes, Furcation radiolucency and internal resorption. Results: MTA represents 97% clinical success rate in comparison to Formocresol with 85% success. Radiographically also MTA showed more promising results with 88.6% success in comparison to Formocresol with 54.3%. Conclusions: Thus, MTA pulpotomy has emerged as an easier line of treatment to save the premature loss of primary teeth due to caries or trauma.
Systematic Reviews in Dental Research. A Guideline
Authors: Maia LC , Antonio AG
Published: April 2015

Background: A systematic review aims to combine outcome data from published studies in a population. It is based on a number of steps and although there are numerous advantages in systematic review studies, dentists have been finding difficulties in performing them. Objective: Taking into account the misconceptions and difficulties in conducting this kind of study, this article aims to guide readers for understanding, performing, and interpreting comprehensive systematic reviews in dental research.
Maxillary Protraction at Early Ages. The Revolution of New Bone Anchorage Appliances
Authors: Solano-Mendoza B , Iglesias-Linares A , Yañez-Vico RM , Mendoza-Mendoza A , Alió-Sanz JJ , Solano-Reina E
Published: April 2015

Purpose: An update is provided on the different types of early treatment for class III malocclusions of maxillary origin. There is an increasing tendency to prescribe maxillary orthopedic treatment with skeletal an-chorage, with the purpose of enhancing the skeletal and reducing the dentoalveolar effects - offering a management option for children with important deformations that otherwise would have to wait until adult age to receive surgical treatment. Method: A literature review has been made of maxillary bone orthopedic traction appliances in growing children with class III malocclusions. A Medline (PubMed) search was made using the following MeSH terms: Cephalometric, Child, Malocclusion class III / therapy, Extraoral traction appliances, Palatal expansion, Bone plates, Skeletal anchorage, Orthodontic anchorage. Results: Many articles show that the greatest maxillary advances are obtained at very early ages, though with a greater tendency towards relapse. However, skeletal anchorage has been seen to afford a lesser relapse rate and greater dentofacial orthopedic efficiency due to its low dentoalveolar impact. In any case, further randomized clinical studies are needed to firmly establish the quantifiable differences in terms of maxillary advance, optimum traction age, optimum traction appliance and potential side effects. At present, the incorporation of surgically inserted bone anchorage appliances (miniplates and miniscrews) offers a purely orthopedic approach to treatment, with minimization of the undesirable side effects of traditional dentofacial orthopedic compensation based on dentoalveolar anchorage. Nevertheless, further studies are needed to consolidate the supporting scientific evidence in this field.
Adhesiveness of Various Glass Ionomer Cements in Cavities Treated with Carisolv
Authors: Yamada Y , Masuda Y , Kimura Y , Hossain M , Manabe A , Hisamitsu H
Published: April 2015

Objective: The purpose of this study was to investigate the adhesion of glass ionomer cements to dentin and the effect of pretreatment using Carisolv. Study design: Forty extracted permanent teeth with caries were used for this study. All lesions were removed using the Carisolv system and teeth were divided into eight groups. Groups 1 to 4 were filled with three types of conventional glass ionomer cements and a resin modified glass ionomer cement. Group 8 was restored with composite resin. In the remaining three groups (Groups 5 to 7), several pretreatment procedures, including EDTA and dentin primer application and a combination of these, were performed before restoring with resin modified glass ionomer cement. All restorations were thermocycled, and microleakage tests were performed on all teeth. Results: There were no statistical differences among Groups 1, 2 and 3 or between Groups 4 and 8. However, Groups 1 to 3 had higher microleakage levels than Groups 4 and 8. Groups 5 to 7 showed similar leakage levels as Group 4. Conclusion: Pretreatment with EDTA or dentin primer did not improve bonding ability. Combination of caries removal using Carisolv and a resin modified glass ionomer cement restoration without pretreatment seems to be an acceptable method for caries treatment.
Differences in Pain Perception in Children Reporting Joint and Orofacial Muscle Pain
Authors: Chaves TC , Martins Nagamine H , Mêlo de Sousa L , Siriani de Oliveira A , Hallak Regalo SC , Bevilaqua Grossi D
Published: April 2015

Purpose: To determine changes in orofacial pain perception in community-based children by assessing the pressure pain threshold (PPT) with an algometer and pain intensity by manual palpation (MP). Methods: A total of 100 children from the community aged 7 to 12 years were assessed. Thirty-eight children reported pain in the orofacial region. Of these children,10 reported joint pain (GJ), 12 reported joint and muscle pain(GJMM), 5 reported muscle pain (GMM), 11 reported pain during mastication(GMAST), and 62 reported no pain. An ANOVA (p<0.05) was used to determine the differences in pain intensity and PPT among groups. Results: Significantly higher pain intensity upon MP was observed for the temporalis muscle in the GJMM, GMAST and GJ groups compared to the remaining groups. The PPT values were significantly lower in the masseter, temporalis muscles, TMJ and thenar region in the GJMM group compared to the other groups. Conclusion: MP more accurately differentiated symptomatic subjects from symptom-free TMD subjects, and PPT values were more sensitive to the discrimination of pain in the orofacial sites assessed. In addition, the changes in perception at a larger number of sites among children reporting mixed pain may suggest the presence of a possible mechanism of central sensitization.
Propolis and Commonly Used Intracanal Irrigants.: Comparative Evaluation of Antimicrobial Potential
Authors: Jolly M , Singh N , Rathore M , Tandon S , Banerjee M
Published: April 2015

The objective of endodontic therapy is not just simple cleaning and filling of root canals, but successful treatment requires the establishment of a sufficient level of disinfection. Aim: To evaluate, in vivo, the antimicrobial and inflammatory/irritant potential of Propolis against mixed endodontic aerobic and anaerobic bacteria. Method: An in vivo randomized controlled trial was conducted in a group of 60 children aged 6-12 years presenting with an acute apical abscess of the maxillary primary molars. Fifteen children each were divided randomly into four groups where irrigation during pulpectomy was performed using either 2% chlorhexidine, 4% calcium hydroxide or 4% Dimethyl Sulfoxide (DMSO) extract of propolis with normal saline as the control irrigant. Microbiological samples were taken from the disto-buccal root canal before initiating the pulpectomy as well as after 3 days later and for mixed aerobic and anaerobic bacterial cultures. Results: In all the four groups, a significant decrease in mean aerobic colony forming units (cfu) count was seen. Maximum change in anaerobic cfu count was seen with 2% chlorhexidine. Conclusions: Chlorhexidine proved to be superior antimicrobial agent against both endodontic aerobes and anaerobes. Calcium hydroxide was found to be least effective.