bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Infant Feeding Practices on Caries Experience of Preschool Children
Authors: Folayan Morenike , Sowole Christiana , Owotade Foluso , Sote Elizabeth
Published: April 2015

Aim: This study investigated the association between breastfeeding, bottle feeding, night feeding, age, and sex of the child on the caries experience. Method: Information was collected from the mothers of preschool children. Information included the age of the child, sex of the child, form of breastfeeding (whether exclusive,almost exclusive or mixed), duration of breastfeeding, night feeding habits of the child, and duration and content of bottle feeding. Intraoral examination was done to assess the dmft. The impact of the variables on the caries experience (rampant caries, no caries and the dmft) was then assessed. Results: The duration of breast feeding (p=0.002), and form of breast feeding (p=0.03) were significant predictors of the dmft. The dmft was highest in children who were breastfeed for longer than 18 months and highest for children who were exclusively breastfed. There is a strong association between rampant caries and duration of breast feeding only (p<0.001). The risk of having rampant caries increases by 10% (p = 0.012) with every month increase in the duration of breastfeeding. Conclusion: The duration of breastfeeding increased the risk for rampant caries in preschool children in Nigeria. The longer the duration, the higher the risk for caries.
Dental and Skeletal Changes in the Upper and Lower Jaws after Treatment with Schwarz Appliances Using Cone-Beam Computed Tomography
Authors: Tai Kiyoshi , Park Jae Hyun
Published: April 2015

Objective: The purpose of this research was to use cone-beam computed tomography (CBCT) images to evaluate dental and skeletal changes in upper and lower jaws after treatment with Schwarz appliances.Materials and Methods: 28 patients with Angle Class I molar relationships and crowding were randomly divided into two groups – 14 non-expanded and 14 expanded patients. 3D-Rugle CBCT software was used to measure various reference points before treatment (T0) and during the retention period of approximately 9 months after 6 to 12 month expansion (T1). Cephalometric and cast measurements were used to evaluate treatment in both groups. To test whether there were any significant differences between the control and treatment groups at T0 and T1, the Mann-Whitney U-test was used. Results: The dental arch (including tooth root apices) had expanded in the upper and lower jaws. Alveolar bone expansion of up to 2 mm apical to the cementoenamel junction (CEJ) was detected. The midpalatal sutures were separated in some cases and subsequent expansion was observed at the inner surface of the nasal cavity at the inferior turbinates. However,no significant (P > 0.05) difference was observed in the inter-width of the mandibular bodies, zygomatic bones, nasal cavity in the middle turbinate region, condylar heads, or antegonial notches. In mandibular and maxillary cast measurements, arch crowding and arch perimeter showed statistically significant changes in the expansion group. The mandibular width values demonstrated no significant changes as measured from a point 2 mm apical to the CEJ, whereas the maxillary width values demonstrated significant changes as measured from a point 2 mm apical to the CEJ. Conclusions: This study indicates that the Schwarz appliance primarily affects the dento-alveolar complex, while it has little effect on either the mandibular bodies, any associated structures including the maxillary midpalatal suture and the inter-width of the nasal cavity in the middle turbinate region. In addition, the center of rotation of the mandibular and maxillary first molar was observed apical to the root apex.
Midazolam-Fentanyl Analgo-Sedation in Pediatric Dental Patients – A Pilot Study
Authors: Pandey RK , Padmanabhan MY , Saksena AK , Chandra Girish
Published: April 2015

Objective: The objective of this study was to comparatively evaluate the effectiveness of submucosal fentanyl when administered in conjunction with oral midazolam during pediatric procedural sedations. Study design: Twenty three uncooperative ASA type I children who met the selection criteria were randomly assigned to receive either submucosal fentanyl (3µg/kg) or placebo, along with oral midazolam (0.5mg/kg). A triple blind, 2-stage cross-over design was adopted so that each child received both the regimens. Results:Transient oxygen desaturation was observed in 4 children who were sedated with the combination of oral midazolam and submucosal fentanyl. The overall success was 73.91% with oral midazolam and submucosal fentanyl regimen and 47.83% for oral midazolam and submucosal placebo regimen. The chances of ‘satisfactorily’completing a 45 minute dental procedure in an uncooperative pediatric patient was 2.8 times more,when submucosal fentanyl was used along with oral midazolam. Conclusion: Submucosal fentanyl appears to improve the short working time associated with oral midazolam. But the oxygen desaturation associated with this regimen necessitates further studies to evaluate the efficacy of this combination at relatively lower doses before being used routinely for pediatric procedural sedation and analgesia.
Resin Replica in Enamel Deproteinization and its Effect on Acid Etching
Authors: Espinosa R , Valencia R , Uribe M , Ceja I , Cruz J , Saadia M
Published: April 2015

Purpose: The goal of this in vitro study was to identify the topographical features of deproteinized (NaOCl)and etched with phosphoric acid (H3PO4) enamel surface, compared to phosphoric acid surface alone with a Resin Replica model. Materials: Ten extracted lower first and second permanent molars were polished with pumice and water, and then divided into 3 equal buccal sections having similar physical and chemical properties. The enamel surfaces of each group were subjected to the following treatments: Group A: Acid Etching with H3PO4 37% for 15 seconds. Group B: Sodium Hypochlorite (NaOCl) 5.25% for 60 seconds followed by Acid Etching with H3PO4 37% for 15 seconds. Group C; No treatment (control). All the samples were treated as follow: Adhesive and resin were applied to all groups after A, B and C treatment were performed; Then enamel/dentin decalcification and deproteinization and topographic SEM Resin Replica assessment were used to identify resin tags enamel surface quality penetration. Results showed that group B reached an area of 7.52mm2 of the total surface, with a 5.68 mm2 (73%)resin tag penetration equivalent type I and II etching pattern, 1.71 mm2 (26%) equivalent to type III etching pattern and 0.07 mm2 (1%)unaffected surface. Followed by group A with 7.48 mm2 of the total surface, with a 3.47 mm2 (46 %)resin tag penetration equivalent to type I and II etching pattern, 3.30 mm2 (45 %)equivalent to type III etching pattern and 0.71 mm2, and (9 %) unaffected surface. Group C did not show any resin tag penetration. A significant statistical difference (P <0,001) existed between groups A and B in resin quality penetration, leading to the conclusion that when the enamel is deproteinizated with 5.25% NaOCl for 1 minute prior H3PO4,the surface and topographical features of the replica resin penetration surface increases significantly with type I-II etching pattern.
Relationship of Dental Caries at Different Concentrations of Fluoride in Endemic Areas: An Epidemiological Study
Authors: Marya Charu Mohan , Dhingra Sonal , Marya Vandana , Ashokkumar BR
Published: April 2015

Objective: Fluoride has been an effective tool to prevent dental caries but efforts have been on to establish optimal level of fluoride in drinking water in different communities. The present study seeks to establish the safe and acceptable concentration of fluoride in drinking water which would lead to maximum caries protection with least amount of clinically observable dental fluorosis. Study Design: 30 villages from 2 districts of Haryana were classified according to differing levels of fluoride in the drinking water. 3007 school children(1558 males & 1449 female)] were examined and the DMFT score was related to the level of fluoride in drinking water. Results: The caries prevalence was maximum (48.02%) in the area having 0.50 ppm fluoride in drinking water. The children from area having the 1.13 ppm fluoride level had the least caries prevalence i.e. 28.07%. Conclusion: The results of the present study did not suggest any additional anticaries benefit beyond 1.13ppm fluoride level. The present investigation showed that the optimal fluoride levels for drinking water for our conditions were near 1.13ppm (1-1.2 ppm) as there was maximum caries protection with least amount of esthetically objectionable fluorosis at that level.
14 Year Follow-Up for a Severe Electrical Burn to Mouth and Lip: Case report.
Authors: Valencia Roberto , Garcìa Javier , Espinosa Roberto , Saadia Marc , Valencia Evaristo
Published: April 2015

Introduction: Electrical burns range from 4 to 7 % of the total burn accidents and many of them affect primarily children biting on a live wire. Great confusion exists in the literature about the proper management of electrical burns to the mouth in the acute and late phases. Case report: 14 year results are shown in a severe electrical burn sustained in a 1 year 2 months old girl, involving 90% of the lips and commissures,tongue, alveolar ridges and teeth (primary central incisors and permanent dental germs). Two weeks after she was out danger, an active splint expansion device was built and used for 8 months to prevent secondary microstomia. Later, a new active splint device was used for a year after lip plastic surgery. At age 13, orthopedics and orthodontics were accomplished with a lip tattoo completed at age 15. Conclusion: No matter how good the final esthetic and occlusal results are, prevention is always the best option.
Orthodontic Treatment of a Bilateral Cleft Lip and Palate Patient with Bilateral Tooth Transpositions and Congenitally Missing Teeth
Authors: Tai Kiyoshi , Park Jae Hyun , Tanino Masahiro , Sato Yasumori
Published: April 2015

Treatment of patients with a cleft lip and palate can be challenging. A boy, 15 years 11 months old, with a bilateral cleft lip and palate and a convex profile, transposed teeth and congenitally missing teeth was treated by orthodontic treatment. 3 year posttreatment records showed excellent results with good occlusion,facial balance and harmony, and long-term stability.
Gorlin-Goltz Syndrome and Neoplasms: A Case Study
Authors: Lopes Nilza , Caran Eliana , Lee Maria Lucia , Silva Nasjla Saba , Rocha André Caroli , Macedo Carla
Published: April 2015

Gorlin syndrome is a rare autosomal dominant disorder exhibiting high penetrance and variable expressivity. It is characterized by facial dysmorphism, skeletal anomalies, multiple basal cell carcinomas, odontogenic keratocysts (OKC), palmar and plantar pits, bifid ribs, vertebral anomalies and a variety of other malformations. Various neoplasms, such as medulloblastomas, meningiomas, ovarian and cardiac fibromas are also found in this syndrome. Objective: To describe a twelve-year-old patient with Gorlin-Goltz syndrome,with basal cell carcinomas and promyelocytic leukemia developed after receiving craniospinal radiation for a medulloblastoma. Bifid ribs as well as mandibular and maxillar OKC were also diagnosed. Conclusion:The patient with Gorlin-Goltz syndrome should receive close follow-up for early detection of malformations and malignant neoplasias.
Prevalence and Risk Indicators of Temporomandibular Disorder Signs and Symptoms in a Pediatric Population with Spastic Cerebral Palsy
Authors: Miamoto CB , Pereira LJ , Paiva SM , Pordeus IA , Ramos-Jorge ML , Marques LS
Published: April 2015

Objective: To determine risk indicators for signs and symptoms of temporomandibular disorders (TMD) in children with cerebral palsy (n=60) and control subjects (n=60). Study design: The subjects were assessed by means of questionnaire and clinical exam: 1) signs and symptoms of TMD; 2) malocclusions [Dental Aesthetic Index (DAI)]; 3) harmful habits; and 4) bio-psychosocial characteristics. Statistical analysis involved the chi-square, Fisher's exact tests (p≤0.05) and multivariate logistic regression (forward stepwise procedure). Variables that achieved a p-value ≤ 0.20 were used as potential predictors of signs and symptoms of TMD and applied as co-variables in the multivariate analysis. Results: The prevalence of at least one sign and/or symptom of TMD in the present sample was 1.7% (n=1) among the individuals in the control group and 13.3% (n=8) among the individuals with cerebral palsy. The presence of cerebral palsy (Odds Ratio:9.08; p=0.041), male gender (OR: 6.21; p=0.027), severity of the malocclusion (OR: 4.75; p=0.031), mouth breathing (OR: 5.40; p=0.022) and mixed dentition (OR: 4.73; p=0.035) were identified as risk indicators for signs and symptoms of TMD. Conclusions: It was concluded that children with cerebral palsy had a significantly greater chance of developing signs and symptoms of TMD.
Oral Health Status of Normal Children and those Affiliated with Cardiac Diseases
Authors: Suma G , Mohan Das Usha , Ambika G , Jairanganath
Published: April 2015

If a child's general health is compromised, care for his/her oral and dental health becomes an absolute necessity. Children with heart diseases require special dental care because of the risk of developing infective endocarditis. Aims and objectives was to evaluate the oral health status, parental oral health care knowledge of the pediatric cardiac patients and non cardiac group and infective endocarditis awareness among the parents of the cardiac group. Materials and methods include a total of 50 children with heart diseases and 50 non -cardiac children aged 2-12 years were examined for dental caries index and simplified debris index. A structured, administered questionnaire for parents/caregivers about knowledge of infective endocarditis and oral health were used for data collection. Results showed no statistically significant differences between the caries experience score for the two groups and oral health knowledge. Knowledge about Infective Endocarditis in parents of study group was very poor. Simplified Debris Index of age group 6-12 years was higher in study groups compared to the controls. Conclusion: Improvements should be made in educating parents and children on the importance of caries prevention and maintaining a good oral hygiene in prevention of infective endocarditis.
Oral Health Status and Practices of 5 and 12 Year Old Indian Tribal Children
Authors: Singh Abhinav , Bharathi MP , Sequeira Peter , Acharya Shashidhar , Bhat Meghashyam
Published: April 2015

Objectives: To assess oral health status and practices of 5- and 12-year-old Tribal school children.Methods: A total of 418, 5-year-old children and 327, 12-year-old children were enrolled. Information on demographic characteristics of participants along with oral health behavior was collected. Clinical data were collected on dental fluorosis, periodontal status, dental caries and treatment needs. Dean's index criterion was used to assess dental fluorosis. Community Periodontal Index (CPI) for periodontal conditions and Dentition status and treatment needs for dental caries were recorded. Results: Between meal sugar consumption was high (100%). None of the children in both the age groups had visited trained health personnel for dental treatment. Dental fluorosis prevalence in 5- and 12-year olds was 11.9% and 22.9% respectively. Bleeding on probing and calculus was common between both the age groups. A low mean number of healthy sextants were found and this decreased with age. Mean dmft/DMFT values for 5- and 12-year olds were 4.13 ± 3.90 and 1.15 ± 1.62. Significant caries index (SIC) scores for 5- and 12-year olds were 7.17 ±4.30 and 3.78 ± 3.21 respectively. Conclusion: The present study reveals high sugar consumption, dental fluorosis, poor oral hygiene, and untreated dental disease of tribal children. Under these circumstances, the implementation of preventive programs including restriction of sweets in school premises for the tribal children is the key to good oral health.
Soft Tissue Profiles of 3-5 Year Old Preschool Children
Authors: Dalci Kerem , Cetiner Serap
Published: April 2015

Objective: Identifying the characteristics of soft-tissue profiles in 3-5 year old children. Methods: Children that participated in the study were selected from the 6 major districts of Ankara. In the selected schools,3-5 year old 1513 children with primary dentition were examined and profile photographs were obtained. Facial convexity angle (FCA) and Total facial convexity angle (TFCA) were measured from profile photographs.Results: The mean values for the total facial convexity (145.9° ±4.2) and facial convexity(165.3° ±4.5) angles were determined. FCA and TFCA were significantly influenced by primary second molar terminal plane relationship. Conclusion: Finding of this study may be used as clinical references for pediatric dental patients and also, the significant relationship between soft tissue profile and primary occlusion is important for orthodontic diagnosis and treatment of pediatric dental patients.
Pulp Calcification in Traumatized Primary Teeth: Prevalence and Associated Factors
Authors: Mello-Moura ACV , Bonini GAVC , Zardetto CGDC , Rodrigues CRMD , Wanderley MT
Published: April 2015

Aim: To establish the prevalence of pulp calcifications in 946 patients at the Research and Clinical Center of Dental Trauma in Primary Teeth. Study Design: The clinical and radiographic records of 1,675 traumatized primary teeth were evaluated. Statistical analysis was performed using chi-square and univariate logistic regression. Results: 197 (20.8%) patients showed pulp calcification (PC). A total of 250 (14.9%)calcified teeth were observed. In most teeth, PC appeared within the first 12 months following trauma. PC prevalence was higher in cases of repeated trauma (29.6%) than in single trauma (16.4%), p <0.05, with a 2.14 chance of showing pulp calcification when a child suffered recurrent trauma. Most teeth showing calcified pulp, suffered trauma to the supportive tissue (67.4%), being statistically significant in relation to the trauma to dental tissue (p <0.05). Conclusion: PC is a sequelae in cases of trauma to the primary dentition;teeth that suffered recurrent traumatic injuries show higher risk of presenting.
Evaluation of Primary Tooth Enamel Surface Morphology and Microhardness after Nd: YAG Laser Irradiation and APF Gel Treatment—An in vitro study
Authors: Reddy Banda Naveen , Reddy G Vanaja , Shashikiran N
Published: April 2015

Objective: Laser irradiation and fluoride has been used as a preventive tool to combat dental caries in permanent teeth, but little has been done for primary teeth which are more prone to caries. The purpose of this study was to evaluate microhardness alterations in the primary tooth enamel after Nd-YAG laser irradiation alone and combined with topical fluoride treatment either before or after Nd-YAG laser irradiation.Method: Ten primary molars were sectioned and assigned randomly to: control group, Nd-YAG laser irradiation,Nd-YAG lasing before APF and APF followed by Nd-YAG lasing. The groups were evaluated for microhardness. Surface morphological changes were observed using SEM. Results: Statistical comparisons were performed. The control group's SEM showed a relatively smooth enamel surface and lasing group had fine cracks and porosities. In the lasing + fluoride group a homogenous confluent surface was seen. In the fluoride + lasing group an irregular contour with marked crack propagation was noted. There was a significant increase in the microhardness of the treatment groups. Conclusion: Nd-YAG laser irradiation and combined APF treatment of the primary tooth enamel gave morphologically hardened enamel surface which can be a protective barrier against a cariogenic attack
Oral Rehydration Salt-Liquid as an Alternative Storage Medium - A Preliminary Study
Authors: Subramaniam P , Eswara U , Girish Babu KL , Vardhan B
Published: April 2015

Objective: To assess the efficacy of Oral Rehydration Salt-Liquid (ORS-L) in the maintenance of the viability of Periodontal ligament cells (PDL). Materials and Method: Twenty freshly extracted teeth were used for this study. They were then randomly divided into 3 groups: Positive control group - 5 teeth which were immediately subjected to collagenase assay, without immersing in ORS-L; Negative control group - 5 teeth with an extra oral dry time of 24 hours, followed by subjecting to collagense assay without immersing in ORS-L and Test group (ORS-L) - 10 teeth with an extra oral dry period of 30 minutes, followed by immersion in ORS-L for a period of 45 minutes and then subjected to collagenase assay. The mean number of viable PDL cells were counted on a hemocytometer under 20X magnification. Results: The mean number of viable PDL cells was highest in the positive control group. In comparison to the negative control group, the test group showed a higher number of viable PDL cells. Conclusion: The study found that ORS-L was an effective solution in maintaining the viability of PDL cells.
Chondroid Choristoma: Report of a Rare Case
Authors: Saha Rooposhi , Tandon Shobha , Kumar Pramod
Published: April 2015

An 11-year-old girl reported with an intraoral swelling which was noticed by her mother at birth and increased to its present size during the last year. A thorough clinical examination did not shed a conclusive diagnosis. This case highlights and discusses the history, clinical features, histologic features, differential diagnosis and the clinical management of this lesion. Awareness of such an entity will enrich the knowledge of the pediatric dentists who may be the first ones to encounter such cases in their day-to-day practice.
Oral Health of Children with Congenital Heart Disease following Preventive Treatment
Authors: Suvarna Reshma , Rai Kavitha , Hegde Amitha
Published: April 2015

Congenital heart disease (CHD), abnormalities in the structural development of the heart, occurs in approximately 8:1000 live births. The causative microorganism for infective endocarditis in more than 60% of the patients with positive hemoculture of viridans streptococci (s.mutans, s.mitior) thus making it mandatory for these children to maintain their oral health. The present study assessed the oral health of children with congenital heart disease following preventive treatment. A total of 74 children with congenital heart disease were selected for the study with 30 healthy controls between the ages 5-16. The oral health was assessed by measuring the microbial counts, the OHI-S and the gingival indices. The data thus obtained were subjected to paired and unpaired t - test. Poor oral health was prevalent among these children of the study group as compared to the controls indicating a lack of sound knowledge of the maintenance of oral hygiene. Following preventive treatment the oral health improved considerably.
Enamel Deproteinization Before Acid Etching and its Effect on the Shear Bond Strength – An in vitro Study
Authors: Harleen N , Ramakrishna Y , Munshi AK
Published: April 2015

Objective: This study was undertaken to assess the effect of enamel deproteinization with 5.25% sodium hypochlorite (NaOCl) before phosphoric acid (H3PO4) etching on the shear bond strength of Adper™ Single Bond 2 adhesive and Filtek™ Z- 350 XT composite resin . Study design: Forty human sound permanent molars which were extracted for periodontal reasons were used in the experimental protocol as under:Group-A (20 teeth):– A 5X4 mm window of the enamel surface was etched with 37% H3PO4 gel for 15 seconds,washed with distilled water and air dried. A single coat of Adper™ Single Bond 2 adhesive was applied and photo polymerized for 20 seconds and Filtek™ Z- 350 XT composite resin block of length 5mm,width 4mm and height 5mm respectively was built and photo polymerized in increments for 20 seconds each. Group-B (20 teeth):- Similarly the enamel surface was treated with 5.25% NaOCl for 60 seconds, washed with distilled water and then etched with 37% H3PO4 gel for 15 seconds, washed with distilled water and air dried. A single coat of Adper™ Single Bond 2 adhesive was applied and photo polymerized for 20 seconds and Filtek™ Z- 350 XT composite resin block of length 5mm, width 4mm and height 5mm respectively was built and photo polymerized in increments for 20 seconds each. The shear bond strength of all the samples were measured (in MPa) on Instron Mechanical Testing Machine. Results: The mean shear bond strength value for Group-A was 13.51 ± 5.726 MPa and for Group-B being 15.06 ± 6.220 MPa. No statistically significant difference in the shear bond strengths was observed between the two groups. Conclusions:No significant effect of sodium hypochlorite enamel deproteinization on the shear bond strength of Adper™ Single Bond 2 adhesive and Filtek™ Z- 350 XT composite resin before acid etching was observed in this study.
Ingestion of Fluoride from Dentifrices by Young Children and Fluorosis of the Teeth - A Literature Review
Authors: Ekambaram Manikandan , Itthagarun Anut , King Nigel Martyn
Published: April 2015

The ADA recommends the use of fluoridated dentifrices as soon as the primary teeth erupt, so as to reduce the incidence of dental caries. However, young children can ingest a significant amount of dentifrice during normal toothbrushing; this is a potential problem because the permanent teeth are at risk from fluorosis for the first seven years of life. Aims: the objective of this paper was to review the literature on the role of fluoride dentifrices in causing dental fluorosis. Methods: Search strategy: a search for literature was performed using MEDLINE, OVID with the key words fluorosis, dentifrice, ingestion, and children. The search was limited to English language publications. Subsequently, 31 articles were retrieved, additional relevant articles were collected from the references cited in the initially identified papers. Ultimately, 96 articles were retrieved for review. Conclusions: Fluoride, should be used with caution so that the benefits out-way the adverse affects. Oral health care providers need to systematically assess individual tooth brushing habits and emphasize the advantages of early use of a fluoridated dentifrice whilst still meeting the need for the prudent use of small quantities of dentifrice. Dentifrices with a low concentration of fluoride may be appropriate for young children who are considered to be at low caries risk and the risk of fluorosis is minimal for children who ingest this dentifrice; nevertheless, it appears that more research is still required on the therapeutic effects of fluoride dentifrices which contain fluoride at a low concentration.
Impact of Pictorial Story on Pain Perception, Situational Anxiety and Behavior in Children: A Cognitive-Behavioral Schema
Authors: Aminabadi Naser Asl , Vafaei Ali , Erfanparast Leila , Oskouei Sina Ghertasi , Jamali Zahra
Published: April 2015

Aim: The present study evaluated the effect of listening to a pictorial story about going to the dentist on pain perception, situational anxiety and behavioral feedback during dental treatment in pediatric dental patients. Study design: Eighty, 6-7-year-old children were included. The childhood anxiety-related disorders using Screen for Child Anxiety Related Disorders (SCARED) Parent Version scale and intelligence quotient using Raven's Progressive Matrices were evaluated. The subjects were randomly assigned to two groups, listening to a pictorial story about going to a dentist (test), or listening to a pictorial story about going to a barbershop (control). A dental treatment was performed on each subject, during which, behavior was assessed using Sound, Eye, and Motor Scale. Pain perception and situational anxiety were then assessed using Wong-Baker Fasces Pain Rating Scale and Faces version of the Modified Child Dental Anxiety Scale, respectively. Results: There was a significant decrease in pain perception (P=0.02) and situational anxiety (P<0.001) in the test group. In addition, the test intervention significantly improved children's behavioral feedback during dental treatment (P<0.001). Conclusion: Preparation of children with pictorial story can be effective in decreasing pain perception and situational anxiety as well as improving behavior during dental treatment.
Comparison of Electrosurgical Pulpotomy with Zinc Oxide Eugenol or Zinc Polycarboxylate Cements Sub-Base
Authors: Nematollahi H , Sahebnasagh M , Parisay I
Published: April 2015

Purpose: The aim of this study was to compare the clinical and radiographic success rates of electrosurgical pulpotomy of human primary molars with zinc oxide eugenol (ZOE) and zinc polycarboxylate (ZPC) cements. Methods: In this randomized clinical trial study, 120 primary second molar teeth were treated by electrosurgical pulpotomy. Teeth were randomly assigned to two groups according to whether ZOE or ZPC cement was used as a sub-base. Teeth were restored with stainless steel crowns and were evaluated clinically and radiographically after 3, 6, and 12 months by two independent examiners. Clinical treatment outcomes and radiographic findings were statistically analyzed using Fishers' exact test with statistically significant differences defined for P < 0.05. Results: At 12 months, the clinical and radiographic success rates in the ZOE group were 98.2% and 84.2% and in the ZPC group were 96.2% and 75%, respectively (P ≯ 0.05 for all). Conclusions: The outcomes of this study suggested that either ZPC or ZOE sub-base have similar clinical and radiographic success in electrosurgical pulpotomy.
Evaluation of Pulpal Blood Flow Changes in Primary Molars with Physiological Root Resorption by Laser Doppler Flowmetry and Pulse Oximetry
Authors: Karayilmaz Hüseyin , Kirzioğlu Zuhal
Published: April 2015

Aim: The aim of this study was to undertake a comprehensive quantitative investigation of pulpal blood flow (PBF) changes in human non-carious primary molar teeth with variable degrees of root resorption by Laser Doppler Flowmetry (LDF) and Pulse Oximetry (PO) methods. Materials and Methods: Data was collected from clinically and radiographically healthy 86 mandibular primary molars which have different physiological root resorption levels (PRRLs). PRRLs for each of the teeth were assessed using periapical radiographs and teeth were subdivided into three groups. Results: The LDF values demonstrated a significant difference (p = 0.0001) between all groups although PO did not demonstrate any difference (p = 0.109). Statistical analysis of LDF values demonstrated significant differences between Groups A and C (p = 0.0001) and Groups B and C (p = 0.008). Furthermore, positive correlations were determined between LDF values and PRRL groups (p = 0.0001) and patients' ages (p = 0.0001). Conclusions: In our study, it was observed that the PBF values of human primary molars measured by LDF tended to increase with the progress of physiological root resorption and age. LDF was found to be a more effective method than PO to assess the pulpal vascularity changes of human primary molars.
Dental Caries and Salivary Alterations in Type I Diabetes
Authors: Rai Kavita , Hegde Amitha , Kamath Ananth , Shetty Suchetha
Published: April 2015

Insulin dependent diabetes mellitus is a severe disease that raises blood glucose levels because of hyperglycemia and insulinopenia. Fluctuations in water and electrolyte levels may result in xerostomia and other changes in the salivary composition. Since diabetes has an influence on oral health, it is important for the dentist to be aware of newer advances in the field of diabetes and to recognize specific oral problems related to diabetes. Thus, the dentist becomes an important part of the health care team for the patients with diabetes. Aim: The present study correlated salivary flow rate, salivary pH and total salivary antioxidant levels and dental caries in type I diabetic patients. Method: A total of 200 children that included 100 known diabetic children (study group) and 100 healthy children (controls) of both the sexes and from similar socioeconomic backgrounds formed the part of this study. Dental caries was assessed using DMFT index. The salivary total anti-oxidant level was estimated using phospho molybdic acid using spectrophotometric method. The salivary flow rate was recorded using the Zunt method and the salivary pH using the pH indicating paper. The results were statistically analyzed using t-test. Conclusions: The analyzed parameters showed increase in salivary anti-oxidant levels, reduced salivary flow rate, increase incidence of dental caries, salivary pH was decreased when compared to the control group.
Apexification of Anterior Teeth
Authors: Damle S , Bhattal H , Loomba A
Published: April 2015

Purpose: This study was undertaken to compare the clinical and radiographic effectiveness of Mineral Tri-oxide Aggregate (MTA) and Calcium Hydroxide in apexification of traumatized young permanent incisors. Methods: Thirty permanent incisors with necrotic pulps and open apices were evenly divided into two groups –Group I (MTA group) & Group II (Calcium Hydroxide group) and treated by apexification. The time taken for apical barrier formation was analyzed. In MTA group, obturation using gutta-percha points was done after 24 hours, whereas in Calcium Hydroxide group obturation was carried out after radiographic confirmation of an apical barrier. Follow up evaluation (clinical and radiographic) was carried out at- 3, 6, 9 and 12 months. Results: The mean time taken for barrier in Group I was 4.50 ± 1.56 months whereas for Group II was 7.93 ± 2.53 months (p value- 0.0002). Radiographic evidence of mean time taken for completion of lamina dura in Group I was 4.07 ± 1.49 months whereas the time period for Group II was 6.43 ± 2.59 months (p value- 0.0067). Conclusion: MTA demonstrated good success and an effective option for apexification with the advantage of reduced treatment time, good sealing ability, biocompatible and provides barrier for immediate obturation.
Periodontal Condition and Orofacial Changes in Patients with Thalassemia Major
Authors: FN Hattab
Published: April 2015

Objective: To assess the prevalence of periodontal disease, orofacial changes and craniofacial abnormalities in patients with thalassemia major (TM). Dental management is discussed. Study design: The sample consisted of 54 patients with TM, 31 males and 23 females aged 5.5 to 18.3 years, with the mean age (± SD) of 11.6 ± 3.2 years. The sample was divided into two subgroups according to age. A similar number of unaffected control group matched by age and sex served as a control. Clinical and radiographic examinations were carried out to assess the prevalence of changes caused by this disorder. Student’s t-test was used to compare the means between thalassemic group and the control group. The Chi-square test was employed to determine statistical differences in frequencies between the two groups. Results: Poor oral hygiene and gingivitis were observed in 61.1% and 43.0% of the thalassemic patients, respectively. The overall mean plaque score was 1.66 ± 0.51 and gingival score 1.43 ± 0.59. In all tested periodontal parameters, a higher frequency and severity were noted in the thalassemic patients compared with controls. More than half of the patients exhibited frontal bossing, saddle nose and to less extent maxillary protrusion; giving in severe cases (16.7%) a “chipmunk” like appearance. Dental discoloration and pallor oral mucosa were noted in 44.4% and 38.9%, respectively. Dental / jaw pain was reported by 40.0% and headache by 29.6% of the patients. Increased overjet was evident in 25.9% of the patients. The majority of the patients had thickened frontal bone (66.7%), and thinned inferior border of the mandible (64.6%). Widened dipolic spaces and spiky roots and were observed in one-third of the patients. The ramus length and width in the patients were significantly smaller than in controls (P > 0.001). Conclusion: TM may particularly diagnose through orofacial abnormalities. Dentists required understanding the complications and management of the disease.
Dental Adhesion
Authors: Manuja N , Nagpal R , Pandit IK
Published: April 2015

Contemporary dental adhesives show favorable immediate results in terms of bonding effectiveness. However, the durability of resin-dentin bonds is their major problem. It appears that simplification of adhesive techniques is rather detrimental to the long term stability of resin-tooth interface. The hydrostatic pulpal pressure, the dentinal fluid flow and the increased dentinal wetness in vital dentin can affect the intimate interaction of certain dentin adhesives with dentinal tissue. Bond degradation occurs via water sorption, hydrolysis of ester linkages of methacrylate resins, and activation of endogenous dentin matrix metalloproteinases. The three-step etch-and-rinse adhesives still remain the gold standard in terms of durability. This review discusses the fundamental process of adhesion to enamel and dentin with different adhesive techniques, factors affecting the long term bonding performance of modern adhesives and addresses the current perspectives for improving bond durability.
Analysis of Root Canal Treated Primary Incisor After Trauma
Authors: Tannure PN , Fidalgo TKS , Barcelos R , Primo LG , Maia LC
Published: April 2015

Background: The low number of clinical studies of traumatized teeth submitted to root canal treatment is completely out of proportion to the seriousness that dental trauma imposes on children in early years. Aim. This study evaluates the outcomes of root canal treatment (RCT) in traumatized primary incisors and identifies the predisposing factors associated with therapy success. Methods: This is a retrospective study conducted with all dental records of 704 patients who had one or more teeth with traumatic injuries. Patients with irreversible pulp changes in primary teeth leading to RCT with a 24 month follow-up met the inclusion criteria. Results: Twenty-five maxillary incisors of 17 children were evaluated. The children’s age at the time of therapy ranged from 24 to 72 months (mean 47.3). Pulp necrosis was the most common disorder (84.0%) and pre-operative periapical lesions were observed in 52.0%. Coronal discoloration was found in 48.0%. The roots were filled with ZOE paste (68.0%) or Guedes-Pinto paste (32.0%). Overall RCT success rate was 68.0%. The absence of pre-operative periapical lesions (p = 0.02) and pathological root resorption (p = 0.02) presented positive association with therapy success. Success was not associated to filling paste (p = 0.49), filling extent (p = 0.44), of discoloration (p = 0.39) nor the patients’ age (p = 0.59). Conclusions: RCT was considered successful in 68.0% of the cases at the 24 month follow-up. Failure of RCT in traumatized primary incisors was associated with pre-operatory periapical lesions and pathological root resorption. The filling paste, the filling extent and the patient’s age were unrelated with therapy success.
The Effects of Surface Pretreatment on the Microleakage of Resin-Modified Glass-Ionomer Cement Restorations
Authors: Bayrak S , Sen Tunc E , Tuloglu N
Published: April 2015

Objective: To evaluate the effect of different surface pretreatments on the marginal microleakage of Vitremer restorations. Study Design: Class V cavities were prepared on the labial and lingual surfaces of extracted human third molar teeth. Cavities were randomly distributed into six groups according to surface treatment, as follows: Group NC (negative control): no surface treatment; Group VP (positive control): Vitremer Primer; Group PA: 32% phosphoric acid; Group P 20% polyacrylic acid; Group PLP: self-etch adhesive (Prompt L Pop); Group PB: etch&rinse adhesive (Prime&Bond NT). All cavities were restored with Vitremer. Teeth were thermocycled, stained with 0.5% basic fuchsin dye and sectioned. Microleakage values were quantitatively assessed by linear measurement of dye penetration using image-analyzing software. Differences between occlusal and gingival microleakage values within groups were evaluated using paired ttests, and differences among groups were analysed using one-way analysis of variance (ANOVA) and Tukey tests. Results: There were statistically significant differences between the occlusal and gingival microleakage values for all groups (p<0.05). Microleakage differed significantly among surface pretreatment groups (p<0.001). The negative control and PLP groups showed similar microleakage values, but were significantly higher than other groups for both margins. Although there were no statistically significant differences between positive control and PA, PAA, PB groups, microleakage values of positive control group were smaller than all other experimental groups except for PB group. Conclusions: Vitremer restorations require surface pretreatment to prevent excessive microleakage. Pretreatment with etch&rinse adhesives and Vitremer Primer may reduce microleakage of Vitremer restorations.
Monostotic Langerhans' Cell Histiocytosis in a Child with Central Diabetes Insipidus
Authors: Costa Studart Soares E , Quidute ARP , Gurgel Costa FW , Costa Gurgel MH , Negreiros Nunes Alves AP , Sá Roriz Fonteles C
Published: April 2015

Langerhans' cell histiocytosis (LCH) comprises a rare group of reticuloendothelial system disorders that can produce focal or systemic manifestations. Diabetes insipidus is considered to be an important indicator of serious underlying diseases in children, including LCH. We report the case of a young patient with monostotic LCH confined to the mandibular ramus, who was diagnosed with the disease after presenting symptoms of central diabetes insipidus and was satisfactorily treated with multi-agent chemotherapy. Additionally, we discuss the clinical, radiographic, histological and immunohistochemical findings, as well as the multidisciplinary approach of this important disease, which should receive attention by dental practitioners, especially when it occurs in children.
Orofacial Findings and Dental Management of Williams-Beuren Syndrome
Authors: Campos-Lara P , Santos-Diaz MA , Ruiz-Rodríguez MS , Garrocho-Rangel JA , Pozos-Guillén AJ
Published: April 2015

Williams-Beuren syndrome is a rare congenital disorder involving the cardiovascular system, mental retardation, distinctive facial features, and tooth anomalies. The aim of the present report is to show a 10-year-old girl with Williams-Beuren syndrome, her general and orofacial clinical characteristics and the dental management.
Caries-Preventive Effect of Fissure Sealant Containing Surface Reaction-Type Pre-reacted Glass Ionomer Filler and Bonded by Self-etching Primer
Authors: Shimazu K , Ogata K , Karibe H
Published: April 2015

Objective: We aimed to evaluate the caries-preventive effect of a fissure sealant containing surface reactiontype pre-reacted glass ionomer (S-PRG) filler and bonded by self-etching primer versus those of 2 conventional resin-based sealants bonded by acid etching in terms of its impact on enamel demineralization and remineralization, enamel bond strength, and integrity of debonded enamel surfaces. Materials and method: Demineralization, remineralization, and bond strength on untreated enamel and enamel subsurface lesions of bovine incisors were assessed among the sealants by polarizing microscopy and microradiography; debonded enamel surfaces were examined by scanning electron microscopy. Results: The conventional resin-based sealants bonded by acid etching caused surface defects on the enamel subsurface lesions and significantly increased the lesion depth (p = 0.014), indicative of enamel demineralization. However, the SPRG filler-containing sealant bonded by self-etching primer maintained the enamel surface integrity and inhibited enamel demineralization. No difference in bond strength on both untreated enamel and enamel subsurface lesions was noted among the sealants. Conclusions: An S-PRG filler-containing fissure sealant bonded by self-etching primer can prevent enamel demineralization, microleakage, and gaps without the tags created by acid etching regardless of the enamel condition. Such sealants are suitable for protecting the pits and fissures of immature permanent teeth.
Nigella Sativa Oil as a Pulp Medicament for Pulpotomized Teeth: A Histopathological Evaluation
Authors: Omar OM , Khattab NM , Khater DS
Published: April 2015

Purpose: Concerns about the safety of formocresol (FC) as a pulpotomy agent in Pediatric Dentistry have lead to the search of new capping medicaments. Indigenous plant medicines such as Nigella Sativa (NS) have been the focus of many researches. Therefore the purpose of this study was to investigate histo-pathologically the pulp response to NS oil and FC in dogs. Method: Forty teeth in 4 male dogs of undefined breed aging 12-14 months were used in this study. Coronal access cavities were performed on the upper and lower premolars so that both medicaments were tested in the same animal in alternate sides of the mouth. Four weeks after treatment the animals were sacrificed, paraffin sections were prepared for histological, histochemical and immuno-histochemical staining. Results: specimens in the NS group showed mild to moderate vasodilatation. Few specimens showed scattered inflammatory cell infiltration and the odontoblastic layer was continuous. While the FC group showed moderate to severe vasodilatation with high inflammatory cell infiltrate and degenerative changes. Conclusions: NS possesses an anti-inflammatory effect and the pulp maintains its vitality after its application, which could qualify its use as a pulp medicament for pulpotomized teeth in clinical practice.
Incipient Enamel Lesions Remineralization using Casein Phosphopeptide Amorphous Calcium Phosphate Cream with and without Fluoride: A Laser Fluorescence Study
Authors: Bhat SS , Hegde KS , Habibullah MA , Bernhardt V
Published: April 2015

The aim of this in vitro investigation was to evaluate and compare the incipient enamel lesions remineralized by topical application of casein phospho peptide amorphous calcium phosphate (CPP-ACP) cream with and without fluoride. Method: Sixty caries free teeth were used in the study. They were divided into four groups as positive control, negative control and two experimental groups.The samples were demineralized and then remineralized using a CPP-ACP Cream with and without fluoride. The remineralization was evaluated at 7, 14 and 21 days using laser fluorescence. Results of this study showed that the laser fluorescence readings of test samples for remineralization were very highly significant at 14 and 21 days (p < 0.001). Conclusions: The degree of remineralization achieved between CPP-ACP and CPP-ACP with fluoride was statistically significant ( p = 0.040) at 21 days.
Cariogenic Potential of Pediatric Liquid Medicaments- An in vitro Study
Authors: Subramaniam P , Nandan N
Published: April 2015

Pediatric liquid medicaments (PLM) are popular and are easily accepted by both parents and children. They are widely prescribed and easily available. However the sugar content and properties of these preparations determines their cariogenic potential. Aims and Objectives: This study assessed the pH and viscosity of pediatric liquid medicaments, type and concentration of sugars present in them and their effect on the growth of Streptococcus mutans. Methodology: PLM included two each of the most commonly prescribed analgesics, antibiotics, nutritional supplements, antitussive and antiepileptic preparations. The endogenous pH was measured using a digital pH meter and the viscosity was measured using a digital Brookefield viscometer. Analysis of sugars (sucrose, glucose and sorbitol) was performed using High Performance Liquid Chromatography. The effect of PLM on Streptococcus mutans was done by ditch plate method. Results: The pH of PLM ranged from 3.70 to 7.04 and viscosity varied from 307.33cP to 2408.33cP. Fifty percent of the PLM contained sucrose, glucose and sorbitol, and sucrose was present in nine of the PLM. The antibiotic preparations showed zones of inhibition against growth of streptococcus mutans. Conclusions: The physical properties of Pediatric Liquid Medicaments as well as the type and concentration of sugars present in them can be indicative of their cariogenic potential.