bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of maxillary midline diastema with emphasis on etiology
Authors: Gkantidis Nikolaos , Kolokitha Olga-Elpis , Topouzelis Nikolaos
Published: April 2015

The importance of the presence of a maxillary midline diastema resides in its position and the concern it causes to patients. This specific diastema has been attributed to genetic and environmental factors, even though it is often a normal feature of growth, especially in primary and mixed dentition.

The need for treatment is mainly attributed to esthetic and psychological reasons, rather than functional ones. Although it is often the case, treatment plans should not be selected empirically but rather should be based on adequate scientific documentation. Possible therapeutic approaches include orthodontics, restorative dentistry, surgery and various combinations of the above. The ideal treatment should seek to manage not only the diastema in question but also the cause behind it. Irrespective of the treatment alternative selected, permanent retention of stable results should be considered as a treatment objective.

The aim of this paper is to underscore the main etiological factors for the presence of a maxillary midline diastema and to illustrate the clinical and laboratory examinations required to recognize these factors. Furthermore, alternative treatment options are discussed depending on the etiology of the problem.
pH of Medicated Syrups–Does It Really Matter? – An in-vitro Study: Part-II
Authors: Babu KL Girish , Rai Kavita , Hegde Amitha
Published: April 2015

The aim of the present in vitro study was to quantify the endogenous erosive potential of the various pediatric liquid medicaments by measuring the calcium dissolution of primary enamel after immersing it for different time intervals (1min, 10 min and 8 hours) using atomic absorption spectrometer (AAS). The eight commonly used pediatric liquid medicaments which were selected had definitive endogenous calcium dissolution potential. All the medicaments showed calcium dissolution of primary enamel at alkaline pH and near neutral pH. The calcium dissolution potential of pediatric liquid medicaments when compared with their respective pH showed no statistically significant correlation. In conclusion, there was evidence of calcium dissolution from all the pediatric liquid medicaments.
Hyalinosis Cutis et Mucosae: Diagnosis Based on Oral Manifestations – Report of a Case
Authors: Xanthinaki AA , Donta C , Gatou V , Tsichlakis C
Published: April 2015

Hyalinosis cutis et mucosae is a rare, autosomal recessive disorder characterized by diffuse deposition of a hyaline-like material in the skin and mucous membrane of the oral cavity, upper respiratory tract, and internal organs. In the first weeks of life it begins with typical hoarseness due to hyaline deposits in the larynx. Rough, yellowish-white papular deposits in the skin and the oral mucosa usually develop during childhood. The etiology and pathogenesis are unknown and the treatment is only symptomatic.

A 14-year old boy developed several typical clinical features of the disease since birth and remained undiagnosed until he was referred by his dentist to our department for oral evaluation. The clinical, histopathological and immunological aspects of the patient are discussed in detail. Oral and systemic manifestations of the disease are also reviewed.

The oral mucosa appeared nodular, diffusely enlarged and thickened because of infiltration with waxy-yellowish-white plaques and nodules. The patient also exhibited a thickened, furrowed appearance of the skin with several skin scars, eyelid nodules, loss of eyelashes and voice hoarseness. The clinical diagnosis of hyalinosis cutis et mucosa was confirmed histologically.
Cleft Lip and Palate: Association with Other Congenital Malformations
Authors: Beriaghi Soraya , Myers Sandra , Jensen Scott , Kaimal Shanti , Chan Cynthia , Schaefer G Bradley
Published: April 2015

Orofacial clefts are frequently associated with other congenital malformations. Studies vary in incidence and types of anomalies. Objective: To evaluate associated malformations in orofacial cleft patients at a major research hospital. Study Design: Medical records of 1127 patients, in the Cleft Palate / Craniofacial Clinic, Boys Town National Research Hospital, from January 1980 through February 2000 were reviewed. Patients were divided into two categories: 1) cleft palate only (CP), and 2) cleft lip, with or without cleft palate (CL±P). Further categorization included location and type, if any, of other congenital malformations.Results: 47.2% of patients had CP and 52.8% had CL±P. 32.2% of all cleft patients had associated congenital malformations. The orofacial region was the most common site, followed by cardiovascular, central nervous, and skeletal systems. Congenital malformations were more common in CP (38.7%), than CL±P(26.4%). Of malformations diagnosed, 63.1% were chromosomal/syndromic anomalies while 36.9% were non-chromosomal/syndromic. Conclusions: Recognition of the spectrum of congenital malformations,associated with orofacial clefting, is essential for further diagnostic testing and in some cases genetic counseling.
Total Antioxidant Capacity of Saliva and its Relation with Early Childhood Caries and Rampant Caries
Authors: Hegde Amitha , Rai Kavita , Padmanabhan Vivek
Published: April 2015

Dental caries is an infectious and communicable disease and multiple factors influence the initiation and progression of the disease. Recently it has been claimed that oxidative stress may play an important role in the onset and the development of several inflammatory oral pathologies and dental caries may also be included. Saliva could constitute a first line of defense against free radical- mediated oxidative stress. This is the reason why antioxidant capacity of saliva has led to increasing interest and hence the need for this study.

The antioxidant capacity of saliva was investigated in 100 children who were divided into four groups. Two of which comprised the study and control groups of children with ECC (below 71months of age) and the other two groups comprised of the study and control groups of the children with rampant caries [(RC) (6-12yrs)]. Unstimulated saliva samples were collected from all the groups. Total antioxidant capacity of saliva was evaluated by spectrophotometric assay.

The results indicated that the total antioxidant capacity (TAC) of saliva increased in children with caries. TAC also increased with the age of the children.
In vitro toxicity of MTA Compared with other Primary Teeth Pulpotomy Agents
Authors: Borges de Menezes José Vitor Nogara , Takamori Esther Rieko , Borro Bijella Maria Francisca Thereza , Granjeiro José Mauro
Published: April 2015

Objective: The main goal of this work is to compare the In vitro toxicity of MTA with other primary teeth pulpotomy agents. Study Design: The In vitro toxicity of MTA, calcium hydroxide, ferric sulphate solution,diluted formocresol and Buckley's formocresol were tested using MTT and Neutral Red Uptake cell viability assays. The results for MTA were compared to those obtained for the other substances using ANOVA and Tukey statistical tests (p<0,05). Results: MTA had the lower in vitro toxicity and Buckley's formocresol, the higher, with statiscally significant difference. Conclusion: Among the primary teeth pulpotomy agents tested, MTA showed the lower In vitro toxicity, standing as the most promising substitute to formocresol.
Systemic Lupus Erythematosus Presenting with Oral Mucosal Lesions – A Case Report
Authors: Ramakrishna Y , Reddy J Sharada
Published: April 2015

Systemic Lupus Erythematosus (SLE) is an autoimmune rheumatic disease, principally affecting women during child bearing years and is characterized by the presence of auto antibodies against a variety of auto antigens such as double-stranded DNA, intracellular ribonuclear proteins and membrane phospholipids. The presentation of lupus erythematosus ranges from a skin rash unaccompanied by extracutaneous stigmata to a rapidly progressive lethal multiorgan disease. A wide spectrum of oral mucosal lesions is found in the cutaneous and systemic forms of lupus erythematosus. We report a 11-year-old female child with classical features of Systemic Lupus Erythematosus associated with oral mucosal lesions.
Relationship between Severe Early Childhood Caries, Mother's Oral Health and Mutans Streptococci in a Low-Income Group: Changes from 1996 to 2007
Authors: Irigoyen Camacho Ma. Esther , Pérez Leonor Sánchez , Pérez Álvaro García , Zepeda Zepeda Marco Antonio
Published: April 2015

The relationship between dental caries and mutans streptococci (ms) in children and their mothers is a key factor in the prevention of early childhood caries. Changes in early childhood caries over time in Mexican children have not been well documented. Objective: to compare the dental caries indices and presence of ms in 3- to 5-year-old children and their mothers in two surveys, the first one carried out in 1996 and the second one in 2007. Study design: cross-sectional study. Results: The first survey included 102 mother-child dyads and the second 103. Dental caries index dmfs was 7.17 (± 10.9) and 4.58 (± 7.1) in the first and second survey, respectively (p<0.05). Ms levels were higher in 1996 than in 2007 (p<0.001). The prevalence of Severe Early Childhood Caries (SECC) was 42.2% and 34.95% in first and second surveys, respectively,(p>0.05). Children with SECC showed higher counts of ms than children without this condition. A high caries index in mothers was associated with higher caries experience in their children. Conclusion: the compassions of the surveys indicated a decline in dental caries indices over an 11-year period. High caries experience in the mother had a negative impact on the oral condition of the child.
Clinical Performance of Art Restorations in Primary Teeth: A Survival Analysis
Authors: Faccin Elise Sasso , Ferreira Simone Helena , Kramer Paulo Floriani , Ardenghi Thiago Machado , Feldens Carlos Alberto
Published: April 2015

Objective: To assess the survival of Atraumatic Restorative Treatment (ART) restorations in primary teeth performed in a dental clinical setting. Study Design: One hundred and five single-surface ART restorations placed in 56 preschool children (mean age 31 months) were included. Final-year dental students performed the restorations using standard ART procedures with hand instruments. A resin-modified glass ionomer cement (Vitremer 3M/ESPE) was used as a restorative material. Performances of the restorations were assessed directly by the ART evaluation criteria. Follow-up period ranged from 6 to 48 months. Survival estimates for restoration longevity were evaluated using the Kaplan-Meier method. Log-rank test (P≤.05) was used to compare the success rates according to demographic and clinical characteristics of the restorations at baseline (age, sex, arch and segment). Results: Mean and median estimate times of survival were 37(95%CI: 32-42) months and 38 (95% CI: 29-47) months respectively. Success rates for ART restorations were 89%, 85% and 72% in 6 to 11, 12 to 24 and 25 to 48 months of evaluation respectively. Differences in success rates among demographic and clinical characteristics were not statistically significant. Conclusion:High survivals rates of the ART restorations found in this study seem to indicate the reliability of this approach as an appropriate treatment option for primary teeth in a clinical setting.
Craniofacial Growth in Children Affected by Juvenile Idiopathic Arthritis Involving the Temporomandibular Joint: Functional Therapy Management
Authors: Farronato Giampietro , Carletti Vera , Maspero Cinzia , Farronato Davide , Giannini Lucia , Bellintani Claudio
Published: April 2015

The aim of this study was twofold: 1) to asses the effects of a functional appliance on condyles damaged by juvenile idiopathic arthritis (JIA). and 2) to evaluate its ability to reduce alterations in craniofacial development.Study design: Seventy-two JIA patients with temporomandibular involvement, ages ranging between 4 and 16 years, were treated. All of them presented temporomandibular joint involvement. They were treated with an activator and followed for 4 years. Results: At the second examination, it was possible to observe a reduction in mandibular retrusion and in the sagittal discrepancy between mandible and maxilla, a reduction in the angle of divergence, a counterclockwise rotation of the mandible, a reduction of the gonial angle, a longer mandibular ramus, a reduction in the discrepancy between anterior and posterior height caused by an increase in posterior height and a forward positioning of the chin. Conclusion: The functional appliance reduces the severity of facial alterations improving mandibular and condylar growth.
Effect of Tooth Preparation on Sealant Success—An in vitro Study
Authors: Subramaniam Priya , KL Girish Babu , HK Naveen
Published: April 2015

This study compared the depth of penetration and marginal leakage of filled and unfilled sealants, with and without tooth preparation. One hundred and twenty extracted human third molar teeth that were free of restorations, fluorosis, caries, and sealants were used. After adequate storage and surface debridement, the teeth were randomly divided into four groups of 30 teeth each. In two groups, the occlusal surfaces were left intact, while in the other two groups, the occlusal surfaces were prepared using a diamond bur. Teeth in two groups were sealed with a filled sealant, and an unfilled sealant was used to seal teeth in the other two groups. The sealed teeth were then prepared for marginal leakage, immersed in 5% methylene blue (at 37°C)for 24 hours. Subsequently, buccolingual sections were made and each section was examined for sealant penetration and marginal leakage, using a stereomicroscope. The depth of dye penetration and marginal leakage was evaluated according to a method described by Ovrebo and Raadal. The unfilled sealant placed after tooth preparation showed better enamel fissure penetration and less marginal leakage than the filled sealant.
The Efficacy of a Modified Omega Wire Extension for the Treatment of Severely Damaged Primary Anterior Teeth
Authors: Aminabadi Naser Asl , Zadeh Farahani Ramin Mostofi
Published: April 2015

Objectives: The restoration of the severely damaged anterior teeth is considered a serious challenge in contemporary dental practice. The aim of the present study was the clinical and radiographic evaluation of a modified omega loop technique for the restoration of the severely damaged primary anterior teeth. Study design: A total of 144 anterior teeth in 60 healthy children (male: 32, female: 28) aged 3-4 years, severely damaged by dental caries, were included in the present study. The root canal therapy was performed for the selected teeth. After the construction of the modified omega loop, coronal 4 mm of intracanal ZOE was removed. A thin layer of polycarboxylate cement was placed over ZOE followed by the insertion of the modified omega loop and subsequent restoration of the crown with an internal compomer core and an external composite restoration. The patients were followed at the intervals of 6, 12, and 24 months postoperatively.Results: The partial loss of the restorative material after 6 months occurred in 5.9% of the teeth. The failure rates after 12 and 24 months were 10.8% and 18.5%, respectively. The primary canines exhibited minimum loss of the restorative material. Two teeth exhibited pathological mobility after two years. There were not any signs of root fracture or recurrent caries in any of the restored teeth. Conclusion: It may be concluded that the modified omega loop is an efficient technique for the restoration of the severely damaged anterior teeth. The ease of manipulation and short chair-side time are further advantages of the technique.
Netherton Syndrome: Dental Considerations
Authors: Ahn Hannah , Yoon Richard
Published: April 2015

Triads of congenital erythroderma and ichthyosis, hair shaft abnormalities, and immune dysregulation have been recognized as Netherton's syndrome (NS). A pediatric patient with NS is presented. Clinical manifestations are described along with a pertinent review of the literature.
Panoramic Radiographic Representation of Progressive Periodontal Destruction in a Family with Six Affected Papillon-Lefèvre Siblings
Authors: Abdel Ghaffar Khaled , Rose-Nelson Camille , Glascoe Alison , Brown Ronald
Published: April 2015

The panoramic radiographs of six Papillon-Lefèvre affected siblings from one family are evaluated and compared. These six affected siblings range in age from seven to twenty-four years of age. Tooth loss and periodontal disease progression are radiographically documented as these affected siblings age and eventually become endentulous with evident ridge resorption
A Comparative Evaluation of Agents Producing Analgo-sedation in Pediatric Dental Patients.
Authors: Padmanabhan MY , Pandey RK , Saksena AK , Chandra Girish
Published: April 2015

Objective: Procedural sedation and analgesia (PSA) has reduced the need for general anesthesia (GA) for many surgical procedures in pediatric patients. The objective of this study was to evaluate the efficacy of four analgo-sedative combinations- midazolam plus ketamine (MK), midazolam plus tramadol (MT),promethazine plus tramadol (PT) and promethazine plus ketamine (PK) in facilitating dental treatment of uncooperative children. Study design: Thirty six uncooperative ASA type I children who required extensive dental treatment were randomly assigned to receive one of the four analgo-sedative combinations during each visit. A 4-stage cross-over design was adopted so that each child received all the four combinations. Safety was monitored through vital signs and side effects. Results: The overall success was 81% with MK,69% for PK, 67% for MT and 42% for PT and the difference between the success rates of these agents was statistically significant (p < 0.001). The required dental treatment could be successfully completed at least during 3 sessions in 23 children (62.2%). Conclusions: Segmental dental treatment under analgo-sedation can be considered as a viable alternative before considering patients for dental management under GA. MK and MT were found to be safe and effective for sedating pediatric dental patients.
Clinical Evaluation of Papacarie in Primary Teeth
Authors: Kotb Rehab Mohamed Salah , Abdella Ahmed AbdelHamid , El Kateb Mona Abdullah , Ahmed Amel Mahmoud
Published: April 2015

The change in the concepts of cavity preparation and the development of reliable adhesive materials lead to the development of alternative methods of caries removal. Chemo-mechanical caries removal (CMCR)involves the chemical softening of carious dentin, followed by its removal with gentle excavation. Objective:The present study was conducted to evaluate clinically the efficiency of caries removal using a new chemo-mechanical agent (Papacarie) compared to the conventional drilling method including the need for local anesthesia, the need for drill, duration of the treatment and the pain reaction. Study design: This study was split mouth design. The study was performed on thirty seven bilateral open carious lesions. They were divided into two equal groups according to method of caries removal. In Group I, caries was removed using the Papacarie system and in Group II, caries was removed with the conventional drill. Results: The results showed that the Papacarie was as efficient as the drill in caries removal from open carious lesions with no significant difference in the operating time. The new CMCR agent also reduced significantly the need for local anesthesia and the use of drill. In addition, Papacarie was also more comfortable than the traditional rotatory instruments. Conclusions: It was concluded that Papacarie could be an effective caries removal method to treat children, particularly those who present with early childhood caries or management problems.
Efficacy of 10% Povidone Iodine in Children Affected with Early Childhood Caries: An In Vivo Study
Authors: Simratvir Mauli , Singh Namita , Chopra Saroj , Thomas Abi
Published: April 2015

For prevention of dental caries, S. mutans numbers must be reduced and prevented from returning to the original level. An antibacterial agent that is effective and also acceptable to young children can help to establish a favorable oral environment and halt the caries process. Purpose: This study was conducted to evaluate the efficacy of topical antimicrobial (10% Povidone- Iodine) on S.mutans counts in children with Early Childhood Caries after full mouth rehabilitation. Also its effects on the clinical outcomes in terms of incidence of new caries and secondary caries were evaluated.

Method: Full mouth rehabilitation was done in 30 children (mean age 4.2 years) suffering from Severe Early Childhood Caries (SECC). Stimulated saliva samples were collected to determine the post operative baseline S.mutans counts. Thereafter the subjects were randomly divided into two groups. The experimental group received 10% Povidone Iodine at 3 months interval for a period of 12 months while the control group received placebo (deionized water) at similar intervals.

Change in the S.mutans count at 6 and 12 month intervals were compared to the baseline post-operative mutans score. Results revealed that application of 10% Povidone Iodine caused a significant reduction in the rise of Streptococcus mutans levels from the baseline postoperative score after 12 months of treatment thus decreasing the oral load of the organisms. Reduction in counts; in turn decreased the relapse of caries in these children. Conclusion: Thus oral rehabilitation coupled with regular application of 10% Povidone Iodine application can be a good alternative to control dental caries in children affected with Early Childhood Caries (ECC).
Increased Dental Trauma in Children with Attention Deficit Hyperactivity Disorder Treated with Methylphenidate – A Pilot Study
Authors: Katz-Sagi H , Redlich M , Brinsky-Rapoport T , Matot I , Ram D
Published: April 2015

The purpose of this pilot study was to investigate the prevalence of trauma to incisor teeth in children with normal overjet and lip competence, treated with methylphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD). The study group consisted of 24 children (19 boys, 5 girls) aged 5-12 years (mean 8.45±2.25), diagnosed with ADHD and treated with methylphenidate at a minimal dosage of 10 mg per day. The control group consisted of 22 healthy children (13 boys, 9 girls) aged 5-12 years (mean 9.15±2.28). The dental examination included incisor relation measurements in the anterior segment (overjet), which was recorded using an orthodontic ruler. Lip competence was clinically determined, and anterior teeth were examined for dental trauma. The prevalence of dental trauma was significantly higher in the study group than in the control group (29.1% vs. 4.5% P = 0.02, t-test one tail). In conclusion, children with ADHD treated with methylphenidate have a high-risk for dental trauma. We believe that preventing dental trauma in this high risk group is possible. Consequently, the pediatrician and all medical staff attending to these children should encourage parents to consult frequently with a pediatric dentist to diagnose dental trauma and provide early treatment when needed.
Formocresol versus Calcium Hydroxide Direct Pulp Capping of Human Primary Molars: Two Year Follow-Up
Authors: Aminabadi Naser Asl , Zadeh Farahani Ramin Mostofi , Oskouei Sina Ghertasi
Published: April 2015

Objectives: Clinical and radiographic evaluation of the premedicated direct pulp capping using formocresol(PDC) versus conventional direct pulp capping using calcium hydroxide (CDC) in human carious primary molars. Study design: A total of 120 vital primary molars with pinpoint exposure during caries removal in 84 patients aged 4-5 years were selected. In the PDC group (n = 60), 20% Buckley's formocresol solution, and in the CDC group (n = 60), calcium hydroxide powder were applied to the exposure sites followed by placement of zinc oxide-eugenol base. Teeth were restored with preformed stainless steel crowns. Clinical and radiographic evaluations of the treatment outcomes were performed at regular intervals of 6 and 12 months, respectively, for two years post-operatively. Results: The prevalence of spontaneous pain,sensitivity on percussion, and fistula were significantly higher in the CDC group compared to the PDC group (P < 0.05). The number of teeth exhibiting periapical/furcal radiolucency or external/internal root resorption was also higher in the CDC group (P < 0.05). The clinical success rate of the PDC was 90% compared to the 61.7% of the CDC (P < 0.05). The radiographic success rates of the PDC and CDC groups were 85% and 53.3%, respectively (P < 0.05). Conclusion: It seems formocresol premedicated direct pulp capping could safely be used as a substitute for conventional direct pulp capping.
Removal of Organic Debris from Occlusal Fissures: Advantage of Carisolv System over Sodium Hypochlorite
Authors: Yamada Yoshishige , Hossain Mozammal , Kimura Yuichi , Masuda Yoshiko , Jayawardena Jayanetti Asiri , Nasu Yuya
Published: April 2015

Objective: The purpose of this in vitro study was to evaluate and compare the removal of artificial debris from pits and fissures using the Carisolv system and sodium hypochlorite. Study design: Forty artificial fissures prepared on extracted human teeth were filled with artificial organic debris. Debris was removed using either Carisolv or 10% sodium hypochlorite gel. After stereoscopic observation, samples were filled with a sealant and subjected to microleakage test. Results: Both Carisolv and sodium hypochlorite demonstrated adequate cleaning ability and prevention of microleakage. Although both Carisolv and 10% sodium hypochlorite are effective at removing debris from fissures, Carisolv presents greater advantages in terms of safety and antibacterial properties. Conclusion: Fissure cleaning using Carisolv might be an effective approach to improve the retention of fissure sealants.
Teething: Myths and Facts
Authors: Sood Sankalp , Sood Mangla
Published: April 2015

From grandmothers to medical professionals, everyone seems to have a list of symptoms they believe are linked to teething. During this time period of an infant's life, passive immunity due to maternal antibodies wanes and exposure to a wide variety of childhood illnesses occurs. Parental false beliefs associated with teething may interfere with the prompt diagnosis and management of a range of serious illnesses. Strong parental beliefs which are not borne out by evidence will unlikely change until professionals (most of whom are also parents) change theirs. Therefore, there is a need to know the facts and the false beliefs attributed to teething. Medical professionals need to be educated about teething to provide reasonable explanations to concerned caregivers. This article examines the signs and symptoms frequently attributed to teething and their possible alternative causes. The contemporary principles of the management of teething are discussed,including supportive care.
Genotoxic Effects of Dental Panoramic Radiograph in Children
Authors: El-Ashiry Eman , Abo-Hager Eman , Gawish Abeer
Published: April 2015

This study was completed to evaluate chromosomal damage (micronucleus) and cellular death in exfoliated buccal mucosa cells taken from healthy children following exposure to panoramic radiation during dental radiography. Method: Twenty children who underwent panoramic dental radiography for diagnostic purposes were included. Cytological preparations were stained with Feulgen stain, identified under light microscopy. Micronuclei, apoptotic nuclear alterations (condensed chromatin, karyorrhexis, pyknosis) and necrosis (karyolysis) were scored. Results showed no statistically significant differences in children's micronucleated oral mucosa cells before and after panoramic dental X-Ray exposure. On the other hand,there was a statistically significant increase in nuclear alterations closely related to genotoxicity such as condensed chromatin, karyorrhexis and pyknosis, while karyolysis of oral mucosal cells did not show significant increase after panoramic X-Ray exposure. Conclusion: Dental panoramic radiography may not be a factor that induces chromosomal damage, but is able to promote genotoxicity in children.
Green Teeth Associated with Neonatal Hyperbilirubinemia Caused by Biliary Atresia: Review and Case Report
Authors: Sommer Suzana , Magagnin Karine , Kramer Paulo , Tovo Maximiano , Bervian Juliane
Published: April 2015

Green pigmentation in teeth is an uncommon condition associated with bilirubin deposits in dental hard tissues. Its occurrence causes anxiety to both child and family. The purpose of this paper is to present a case involving an eleven-year-old girl with green pigmentation of permanent teeth who underwent a liver transplant due to biliary atresia when she was one year old. The reported case confirms the relevance of past medical history in establishing the diagnosis and treatment plan of green teeth.
Effect of Ozone Pretreatment on the Microleakage of Pit and Fissure Sealants
Authors: Cehreli S Burcak , Yalcinkaya Zeynep , Guven-Polat Gunseli , Çehreli Zafer Cavit
Published: April 2015

Objective: This study investigated the effect of ozone pretreatment on the microleakage and marginal integrity of pit and fissure sealants placed with or without a self-etch 6th generation adhesive. Study Design: Freshly-extracted, human third molars were randomly assigned into two main groups (n=48):Group A: Fissures were pretreated with ozone; Group B: Fissures were left untreated. The teeth were further randomly divided into two subgroups (n=24/each) so that half of teeth were sealed with a conventional fissure sealant (Fissurit F, Voco, Germany), while the remaining half received the same sealant bonded with a self-etch adhesive (Clearfil Protect Bond, Kuraray, Japan). Following thermal cycling (1000X), the specimens were subjected to dye penetration within 0.5% basic fuchsin for 24h. The extent of dye penetration was measured by image analysis. Kruskal Wallis and Mann-Whitney U tests were used for statistical analysis of the data (p=0.05). Two randomly-selected sections from each group were observed under SEM.Results: In all groups, ozone pretreatment significantly reduced the extent of microleakage (p<0.001). SEM investigation demonstrated better adaptation of the sealants in ozone-pretreated groups. Clearfil Protect Bond did not improve the marginal seal of Fissurit F (p>0.05). Conclusion: Ozone pretreatment favorably affected the marginal sealing ability of the tested fissure sealants.
Rare Association of Klippel Feil Syndrome with Cleft Palate and Congenital Cardiac Deformities: A Case Report
Authors: Subramaniam Priya , Babu KL Girish , Sugnani Sony
Published: April 2015

Klippel Feil Syndrome comprises of three characteristic deformities of short neck, a low dorsal hair line and restricted neck mobility. This is a case report of Klippel Feil Syndrome and its rare association with cleft of hard and soft palate, coarctation of aorta, dextrocardia and situs inversus. An interdisciplinary approach towards the management included cardiac surgery, cleft repair and complete oral rehabilitation of the patient. Presently the patient is undergoing speech therapy and is under regular follow up.
Microleakage Evaluation using Acetate Peel Technique
Authors: Mohapatra Abinash , Sivakumar N
Published: April 2015

Objectives: To evaluate and measure the interfacial space or the restoration cavity integrity for probable microleakage using acetate film; acetate peel technique under different magnifications. Study design: Premolar tooth was obtained and standardized class V restoration with Z-350 done both buccally and lingually. The tooth was hemisectioned buccolingually and embedded in epoxy resin, polished, acid etched, washed and dried. The sectioned sample was flooded with acetone and a pre-cut acetate film placed over it. As the acetone evaporated, the film took the shape of the micro relief produced by etching and dried in 10-15mins. It was pulled off the tooth surface and mounted between two glass slides for examination under research microscope with different magnifications. Results: This enabled us to measure the interfacial space that might lead to leakage of restoration and also could detect the intricate details of tooth. Conclusion: The acetate peel technique is an efficient way to study the interfacial space/ restoration-cavity marginal integrity at a higher magnification and was a fast and reliable tool for assessing the microleakage of a restorative material.
Microleakage and SEM Analysis of Flowable Resin Used as a Sealant Following Three Fissure Preparation Techniques – An in vitro Study
Authors: Chaitra TR , Subba Reddy VV , Devarasa GM , Ravishankar TL
Published: April 2015

Objective: Preventive procedures using pit and fissure sealants are one of the important aspects of pediatric dental practice. The objectives of this in vitro study were to comparatively evaluate microleakage and resin tag penetration of a flowable resin used as a sealant on molars after preparation with Conventional, Enameloplasty and Fissurotomy techniques. Method: A total of 48 teeth were divided into 3 groups (n-16). Group A(CST),Group B (EST),and Group C (FT). Following the fissure preparation sealant was applied as per manufacturer's instructions. 8 samples in each group were used for Microleakage and Resin tag analysis. Microleakage analysis was done under Stereomicroscope after Methylene blue dye immersion by using scoring system. The resin tag analysis was done by measuring the length of resin tags on scanning electron microscope (SEM) images consisting of 10μm scale taken under optical zoom of 2000 X. Results: Significantly lesser microleakage score (P<0.01) and longer resin tag penetration (P<0.001) observed in EST(mean score 0.5±0.53) & (12.19±1.93μm) when compared to CST(mean score 1.75±0.89) & (5.96±1.84μm)and FT (mean score 1.5±0.53) & (6.76±1.82μm) which showed more microleakage and short resin tags. No statistical significance between CST and FT was found. Conclusion: EST has proven to be an excellent method for preparation of pits and fissures when Flowable composite is used as a sealant because of its lesser microleakage and longer resin tag penetration.
Reduction in Bacterial Loading Using 2% Chlorhexidine Gluconate as an Irrigant in Pulpectomized Primary Teeth: A Preliminary Report
Authors: Ruiz-Esparza CL , Garrocho-Rangel A , Gonzalez-Amaro AM , Flores-Reyes H , Pozos-Guillen AJ
Published: April 2015

Objective: The aim of this study was to evaluate the reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigating solution in pulpectomized primary teeth. Study design: A randomized, controlled clinical trial was performed that included primary teeth with pulp necrosis. Forty necrotic teeth were included, 20 irrigated with 2% chlorhexidine gluconate (experimental group) and 20 with sterile saline solution (control group); in all cases, 2 microbiological samples from within the canals were taken with sterile paper points, the first after the canal opening and before the first irrigation, and the second after instrumentation and final irrigation, before filling. All samples were evaluated by McFarland's scale. Results: The results were statistically analyzed by the Mann-Whitney U test. After analyzing samples before and after irrigation in the control group (saline), we found a significant decrease of bacterial load (P <0.0002). The same occurred in the chlorhexidine group samples (P <0.0001). When both groups were compared postirrigation,a statistically significant difference was observed in favor of 2% chlorhexidine gluconate.Conclusion: Two percent chlorhexidine gluconate showed a greater reduction of intracanal bacterial loading compared with that observed with sterile saline solution. This irrigating solution is suggested as an alternative for pulpectomy of necrotic primary teeth.
Effect of Orthodontic Appliances on Oral Microbiota—6 Month Follow-up
Authors: Topaloglu-Ak Asli , Ertugrul Fahinur , Eden Ece , Ates Mustafa , Bulut Hakan
Published: April 2015

Objective: This study investigates the effect of fixed and removable orthodontic appliances among children on salivary Streptococcus mutans, Lactobacillus sp. and Candida albicans. Study Design: The study was conducted on 69 patients aged between 6-17 years who used fixed or removable orthodontic appliances. Five ml samples of unstimulated saliva from each patient were collected at baseline and at the 1, 3 and 6 month periodic controls. Samples were diluted and plated on Mitis Salivarus Agar (MSA), Man Rogosa Sharp Agar (MRS) and Saboroud Dextrose Agar (SDA). The growths on the plates were examined under a stereomicroscope. Numbers of colony forming units (CFU) per plate were counted. For statistical analysis,the paired t test and Chi-Square were used. Results: S mutans and Lactobacillus sp counts increased significantly 6 months after the insertion of fixed/removable orthodontic appliances in the oral cavity. A significant increase for C albicans presence was noted after 3 months compared with baseline for fixed appliances.Conclusion: Long-term utilization of orthodontic appliances may have a negative effect on microbial flora and increase the risk of new carious lesions and periodontal problems. Patients should be recalled within short time intervals to be motivated for oral hygiene during their orthodontic therapy.
Talon Cusps: Conservative Management
Authors: Bansal AV , Choudhary P , Kulkarni VK , Bansal A , Shashikiran ND
Published: April 2015

Talons cusp is an uncommon developmental dental anomaly characterized by presence of an accessory cusp like structure projecting from tooth neck towards incisal edge. This anomaly commonly affects permanent dentition than primary dentition. This article describes early diagnosis and management of two patients with talons cusp. Conservative treatment by selective grinding , followed by fluoride varnish application was done. The patients were followed up for one year without any complications. This indicates conservative means of management to be the most desirable way of managing such anomalies.
Dentistry for Mexicans with Special Needs: A Commentary
Authors: Waldman HB , Saadia M , Valencia R , Perlman SP
Published: April 2015

There are more than 2 million residents with disabilities in Mexico. Despite national legislation to assure individuals with disabilities needed services, including education and employment, social inclusion of these individuals is difficult since societal views exclude them from functioning as members of a community. While there are no national studies of the dental needs of individuals with disabilities in Mexico, reports of the general population indicate limited use of dental services and the need for increased restorative services. Examples of dental education accreditation standards in other countries are used as models for the improvement in the preparation of dental students to provide services for individual with special needs.
A Digital Method to Predict the Mesiodistal Widths of Canines and Premolars in an Egyptian Sample
Authors: Ibrahim Iman , Elkateb Mona Abdullah , Aziz Wahba Nadia , El Harouny Nadia
Published: April 2015

Objective: Treatment planning in the mixed dentition is important for proper tooth alignment. A mixed dentition analysis, should accurately predict the mesiodistal widths of unerupted permanent teeth. The aim of the present study was to determine which sum of mesiodistal widths (MDW) of permanent teeth will be the best predictor for MDW of unerupted permanent canines and premolars. Study Design: The study was conducted on 102 Egyptians, 51 males and 51 females, mean age 16.7±0.5 years with fully erupted permanent teeth, and intact proximal surfaces. Dental casts were obtained and scanned to produce digital images that were used on a specially designed software program to measure the MDW of permanent teeth. Casts were divided into training and validation sets, where 9 models of tooth combinations were used to develop a regression equation that describes the relation between them and sum of MDW of erupted maxillary or mandibular canines, first and second premolars. The validation set was used to test the accuracy of the proposed equation. Results: R2 of regression models ranged from 0.3 (for models #2,4,5 and 8) to 0.36 for model #1. The highest regression in model #1 (sum of MDW of lower first permanent molars and upper central incisors) indicated a high linear association between the sum of MDW of tooth combination model #1 and the MDW of maxillary and mandibular permanent canines and premolars. There was no significant difference between the actual and the predicted MDW, when the proposed equation was checked for its accuracy in the entire validation set (p>0.05). Conclusion: The combination of the sums of lower permanent first molars and upper permanent central incisors was the best predictor for the MDW of both maxillary and mandibular permanent canines and premolars.The newly proposed prediction equation may be considered clinically useful for mixed dentition analysis in Egyptian subjects.
A Comparative Evaluation of Drops versus Atomized Administration of Intranasal Ketamine for the Procedural Sedation of Young Uncooperative Pediatric Dental Patients: A Prospective Crossover Trial
Authors: Pandey RK , Bahetwar SK , Saksena AK , Chandra Girish
Published: April 2015

Objective: The objective of this study was to compare and evaluate the efficacy and safety of drops and atomized administration of intranasal ketamine (INK) in terms of behavioral response for agent acceptance during administration and for agent efficacy and safety for the sedation of young uncooperative pediatric dental patients. Study design: Thirty Four uncooperative ASA grade-1 children, requiring dental treatment were randomly assigned to receive INK as drops and atomized spray in one of the subsequent visit. This was a two stage cross-over trial and each child received INK by both modes of administration. The vital signs were monitored continuously during each visit. Results: A statistically significant difference in patients acceptance (P<0.0001) was observed in the atomized administration when compared to drops administration for the procedural event of drug administration. Moreover, there were also significant differences(P<0.05) between onset of sedation and recovery time between two groups. All the vital signs were within normal physiological limits and there were no significant adverse effects in either group. Conclusions: INK is safe and effective by either mode of intranasal (IN) drug administration for moderate sedation in facilitating dental care for anxious and uncooperative pediatric dental patients. Moreover, INK when administered with the mucosal atomization device, the acceptance of the drug was associated with less aversive reaction, rapid onset and recovery of sedation, as compared to the drop administration of the same agent.
Congenitally Missing Maxillary Lateral Incisor Treated with Atypical Extraction Pattern
Authors: Tai Kiyoshi , Park Jae Hyun , Takayama Aiko
Published: April 2015

The congenital absence of one or more maxillary lateral incisors poses a challenge to effective treatment planning for general dentists and dental specialists. An evaluation of anterior smile esthetics must include both static and dynamic evaluations of frontal and profile views to optimize both dental and facial appearance. This article presents a case with canine substitution treatment to replace a missing maxillary lateral incisor combined with the extraction of two mandibular lateral incisors and a small maxillary lateral incisor. Both the patient's occlusion and facial appearance were significantly improved after orthodontic treatment.
An Evaluation of Different Caries Removal Techniques in Primary Teeth: A Comparitive Clinical Study
Authors: Kochhar Gulsheen Kaur , Srivastava Nikhil , Pandit IK , Gugnani Neeraj , Gupta Monika
Published: April 2015

Objective: To compare the efficacy of caries removal, time taken and to evaluate the pain threshold experienced by the patient during various caries removal methods. Study Design: Eighty patients between the age groups of 5-9 years were selected and caries removal was done by Hand instruments, Airotor, Carisolv and Papacarie. The efficacy, time taken and the pain threshold was evaluated during the caries removal by Ericson D et al scale, visual analogue scale respectively. Results: Highly significant relation (<0.05) was observed when intergroup comparison was made using one way analysis of variance (ANOVA). Conclusion:It was concluded that chemomechanical removal of caries with Papacarie and Carisolv were found to be effective measures of caries removal and could be considered as viable alternatives to painful procedures like Airotor in management of dental caries especially in children.
Comparison of Oral Midazolam and Triclofos in Conscious Sedation of Uncooperative Children
Authors: Shabbir Afreen , Bhat Sham , Sundeep Hegde , Salman Sheikh Mohammed
Published: April 2015

Objective: To compare the safety and efficacy of two orally administered conscious sedation agents, Triclofos 70mg/kg and Midazolam 0.5mg/kg in pediatric dental patients. Study Design: In this cross over study twenty four sedation sessions were carried out with twelve children between the age group of 3 to 9 years. Children exhibiting negative behavior according to Frankl behavior rating scale (Rating No.2) were selected. Patients were randomly assigned to receive oral midazolam 0.5mg/kg or triclofos 70mg/kg. The alternate drug was administered at the next appointment. Patients' behavioral responses were recorded using a scoring system established by Houpt et al and modified by Badalaty et al considering the degree of sleep, body movement, crying and overall behavior. Scoring was done for both midazolam and triclofos session as well as for the session which was tried without medication. Ratings were made during all the procedures like injection of LA, extraction, cavity preparation, restoration and pulp therapy. Statistical analysis was done using Friedman test and Wilcoxon sign rank test. Results: Both the drugs showed significantly higher scores when compared to the session which was tried without medication although the scores for midazolam were significantly higher than triclofos. Conclusion: Oral midazolam in a dose of 0.5mg/kg is more effective in regulating patient behavior when compared to triclofos.
Dental Pulp Stem Cells from Primary Teeth Quality Analysis: Laboratory Procedures
Authors: Saha Rooposhi , Tandon Shobha , Rajendran Ramesh , Nayak Rashmi
Published: April 2015

Objectives: To present details of isolation, processing and differentiation of stem cells from inflamed dental pulp of primary teeth. Materials and methods: Tissue sample was collected from teeth indicated for a single visit pulp therapy. Samples were transported and processed in the laboratory which included culturing of cells, isolation and in vitro differentiation into multiple lineages. The results for the analysis of various cell surface markers used for dental pulp were compared with bone marrow. Results: There was no statistically significant difference found in the expression of various surface markers between dental pulp and bone marrow. The stem cells from dental pulp were differentiated into multiple lineages. Conclusion: Isolation of cells from oral tissues is technique sensitive.
Atypical Orofacial Conditions in Noonan Syndrome: A Case Report
Authors: Toureno Leo , Park Jae Hyun
Published: April 2015

Noonan syndrome (NS) is a relatively common condition characterized by chest deformation, congenital heart disease, short stature and distinctive facial features. Due to its genetic heterogeneity NS patients exhibit a range of clinical signs. Severe gingivitis and supernumerary teeth are rarely seen in connection with NS. In addition, there has not been a report on NS patients with atypical bilateral enlargement of the mental foramens and inferior-alveolar canals. This case report describes a NS patient who has undergone growth hormone (GH) therapy and is presenting with classical and rare NS phenotypes.