International Journal of Clinical Pediatric Dentistry

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2018 | January-February | Volume 11 | Issue 1

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Priya Verma, Amitha M Hegde

Digit Ratio and Dental Caries: A Sexually Dimorphic Trait

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Dental caries, Digit ratio, Hormonal fingerprint

   DOI: 10.5005/jp-journals-10005-1474  |  Open Access |  How to cite  | 


Dental caries is the most common oral health disease affecting all age groups, races, and geographic locations. The need for the study was to determine the anatomical marker that could predict the taste perception and caries at an early stage. Aim of the study was to determine the correlation between digit ratio and caries experience in school-going children of south Canara region. An observational and cross-sectional pattern was adopted for the present study. The study was then evaluated to find out the correlation between the digit ratio that is thought to be predetermined with caries experience in children of age group 6 to 16 years. In the total sample of 2,037 children, the total population was divided into two categories, i.e., high digit ratio and low digit ratio. Of the total population, 1,112 had low digit ratio and 925 had high digit ratio. Caries experience was highest in low-risk group, followed by moderate, high risk, low risk, and very high risk groups. In all the categories, low digit ratio was affected more than high digit ratio. The study clearly states a positive correlation between digit ratio, taste, social behavior, and dental caries.



Meera Sandhu, Nitya Rai, Rina Sharma

Evaluation of Remineralization Potential of Beverages modified with Casein Phosphopeptide–Amorphous Calcium Phosphate on Primary and Permanent Enamel: A Laser Profiler Study

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:6] [Pages No:7 - 12]

Keywords: Carbonated beverages, Casein phosphopeptide– amorphous calcium phosphate, Erosion, Remineralization

   DOI: 10.5005/jp-journals-10005-1475  |  Open Access |  How to cite  | 


Purpose: To assess the erosive potential of carbonated beverages and the remineralization potential of beverages with added casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) paste on primary and permanent enamel. Materials and methods: A total of 32 primary and 32 permanent enamel specimens were immersed for 5, 10, and 30 minutes, respectively, in beverages, i.e., Coke, Sprite, Mirinda, and Mountain Dew, with and without added 0.2% CPP-ACP. Samples were profiled before immersion and after immersion under laser profiler. Results: Coke was found to be highly erosive at it caused significant enamel erosion at both 10 and 30 minutes of immersion (p < 0.05) for both primary and permanent enamel. The 30-minute immersion caused significant amount of remineralization over primary enamel in all groups, whereas permanent enamel remineralization was significant in Sprite and Mountain Dew at 30 minutes in all the groups (p < 0.05). Conclusion: This study demonstrated that enamel erosion occurred after immersion in carbonated beverages. Remineralization of enamel was observed after immersion in beverages modified with CPP-ACP paste. Primary enamel was susceptible to remineralization compared with permanent enamel. Within the limitations of this in vitro study, the application of CPP-ACP paste may enhance the remineralization after an erosive challenge and thus offer some protection for patients who are at risk for erosion.



Gurusamy Kayalvizhi, Dhayalan Nivedha, Renganathan Sajeev, Mohandoss Suganya, Venkatesan Ramesh

Evaluating the Efficacy of Xylitol Wipes on Cariogenic Bacteria in 19- to 35-month-old Children: A Double-blind Randomized Controlled Trial

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:5] [Pages No:13 - 17]

Keywords: Bacteria, Cariogenic, Child daycare center, Prevention, Streptococcus mutans, Xylitol

   DOI: 10.5005/jp-journals-10005-1476  |  Open Access |  How to cite  | 


Introduction: Dental caries is an infectious disease with Streptococcus mutans as the main cariogenic bacteria. Children with early S. mutans colonization have a higher risk of developing dental caries than those with later colonization. Therefore, prevention or delay of S. mutans colonization may be advantageous for the prevention of early childhood caries (ECC). Aim: To evaluate and compare the effectiveness of xylitol and placebo wipes on S. mutans count in 19- to 35-monthold children. Materials and methods: Forty-four children were randomly selected from a daycare center and divided into two groups. Allocation concealment was done and both (placebo and xylitol) wipes were distributed to their parents. Instructions were given regarding their use, to be used twice daily for 2 weeks and the S. mutans levels in the saliva were enumerated before and after wipes usage. The collected data were tabulated and statistically analyzed using paired and unpaired t-tests. Results: A clinically significant decrease in the S. mutans count was observed in the xylitol wipes group than the placebo wipes group. Intergroup comparison results were found to be statistically insignificant. Conclusion: Xylitol wipes usage could serve as a useful adjunct in reducing the cariogenic bacteria, especially S. mutans, and thus can be considered as an adjunct oral hygiene tool for caries prevention in young children



Marina G Roscoe, Sara V da Silva Bonifácio, Teddy B da Silva, João MS Pingueiro, Maurilo M Lemos, Murilo FN Feres

Association of Breastfeeding Duration, Nonnutritive Sucking Habits, and Malocclusion

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:5] [Pages No:18 - 22]

Keywords: Breastfeeding, Malocclusion, Nonnutritive sucking habits, Orthodontics

   DOI: 10.5005/jp-journals-10005-1477  |  Open Access |  How to cite  | 


Aim: This study aimed to investigate the associations between breastfeeding, nonnutritive sucking habits (NNSHs), and malocclusion in deciduous, mixed, and permanent dentition. Materials and methods: A sample of 50 children between 3 and 12 years, enrolled in a pediatric dentistry dental care program, underwent orthodontic examination for detection of occlusal patterns and malocclusion. In addition, data regarding breastfeeding duration and NNSH acquisition were obtained from standardized questionnaires responded by the children's parents or legal guardians. Results: Regardless of a long period of breastfeeding, a high incidence of NNSH in the evaluated sample was observed. Nevertheless, the presence of NNSHs was not significantly associated with malocclusion. Conclusion: The findings could not indicate a statistically significant association between breastfeeding duration, acquisition of NNSHs, and malocclusion. Longitudinal studies with larger samples are still needed to better support clinical decisions.



Roula Berbari, Alexandre Khairallah, Hussein F Kazan, Mohamad Ezzedine, Daniel Bandon

Measurement Reliability of the Remaining Dentin Thickness below Deep Carious Lesions in Primary Molars

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:6] [Pages No:23 - 28]

Keywords: Affected dentin, Deep carious lesions, Digital radiography, Remaining dentin

   DOI: 10.5005/jp-journals-10005-1478  |  Open Access |  How to cite  | 


Aim: This study was carried out to assess the reliability of measurements of the remaining dentin thickness under deep carious lesions as estimated from digital radiographs. The goal is to allow clinicians to correlate the radiographic measurement to the exact value of the remaining dentin thickness. The results obtained will be tested further in a study that will evaluate the histopathologic pulpal state according to the caries’ lesion depth. Materials and methods: The study was conducted in the Pediatric Dentistry Department at the Lebanese University, in collaboration with the research platform of the same university. Fifty deciduous molars with deep caries on proximal surfaces liable to extraction were collected. Before extraction, a digital in vivo periapical radiograph was taken, followed by manual excavation of the caries. After excavation, another radiograph was taken before the tooth was sectioned through the deepest site of the lesion. Another radiograph was then obtained for each tooth fragment. To evaluate the exact thickness of the remaining dentin, each fragment was measured on a histologic macrophotograph. The measurements were then compared statistically using a paired-samples t-test, and a correlation was sought. Results: No significant difference was observed in the radiographs between the measurement of the remaining dentin thickness before and after the excavation of caries. In contrast, the radiographic measurements of remaining dentin thickness were underestimated by an average of 20% compared with those made with macrophotographs. Limitations: Interpretation of radiographs varies from one practitioner to another and is a function of the operator's visual acuity. Conclusion: Measuring the residual dentin thickness on a radiograph underestimates the actual thickness by about 20%. Further studies are needed to confirm these results. Clinical significance: Our results indicate that remaining dentin thickness is greater in reality than is shown on a radiograph. This information can help clinicians to refine their diagnoses and treatment plans.



Mir FA Quadri, Fatimahi AM Jafari, Alanood TS Albeshri, Abdulaziz M Zailai

Factors influencing Patients’ Utilization of Dental Health Services in Jazan, Kingdom of Saudi Arabia

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:5] [Pages No:29 - 33]

Keywords: Health services, Jazan, Kingdom of Saudi Arabia, Oral health

   DOI: 10.5005/jp-journals-10005-1479  |  Open Access |  How to cite  | 


Introduction: One way of prevention and early detection of oral diseases is by utilizing the dental health care services on a regular basis. The current study aims to know the factors that play a role in influencing the dental service utilization in Jazan, Kingdom of Saudi Arabia. Materials and methods: A cross-sectional survey using a selfadministered questionnaire was designed and implemented. Study subjects comprised of patients visiting the dental clinics at Jazan University and the primary dental centers of five different suburbs in Jazan region of Kingdom of Saudi Arabia. Items in the questionnaire were grouped into three sections; “demographic details,” “self-reported dental visits,” and “potential factors” contributing to dental visits. Chi-square p-value of 0.05 or less was considered as significant and logistic regression with 95% confidence interval (CI) was performed to get more precise results. Results: The sample size was 395 (N) of which 44.8% were males and 53.4% were females. Less than half (45.8%) of the studied sample reported that their last visit to a dentist was within a span of one year and 33% of them think that a dentist should only be visited if they experience pain. Patients following instructions given by a dentist were 7 times [odds ratio (OR) = 0.13; CI = 0.04, 0.40] less likely to miss their regular dental appointments. Following this, patients receiving knowledge on their dental problems were seen to be twice (OR = 0.50; CI = 0.25, 0.98) less likely to be irregular with their dental visits. Finally, the patients who are better educated and literate were also 2 times (OR = 2.21; CI = 1.14, 4.28) more likely to be regular with their dental appointments in comparison with the patients who completed just their primary level education. Conclusion: Findings of this study will facilitate future oral health prevention programs to be more focused, thereby reducing the gap between high and low educated sectors of the population residing in Jazan.



Mohita Marwaha, Kalpana Bansal, Sonal Jain, Nidhi Sehrawat, Shanal Singla

Effect of Diet Modification on Salivary Parameters and Oratest in High-caries-risk Individuals

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:6] [Pages No:34 - 39]

Keywords: Dental caries, Diet counseling, Oratest, Saliva

   DOI: 10.5005/jp-journals-10005-1480  |  Open Access |  How to cite  | 


Aim: This study was aimed to assess the salivary parameters and caries activity test (Oratest) in high-caries-risk individuals and effect of diet modification and parental education on salivary parameters and Oratest. Materials and methods: Forty-five children aged between 5 and 8 years and decayed, extracted due to caries, filled teeth (deft)/decayed, missing, filled teeth (DMFT) scores >5 were selected and evaluated for salivary parameters, such as hydration status of oral mucosa, resting pH, unstimulated salivary flow rate (USFR) and stimulated salivary flow rate (SSFR), buffering capacity of stimulated saliva (BCSS) before and after diet counseling using GC India Saliva Check Kit. Oratest was performed to assess the caries activity. Children's parents were asked to record 5 to 7 days diet chart. Diet charts were collected and based on the evaluation of specific diet charts, diet counseling was provided. After 6 weeks, salivary parameters and Oratest were reevaluated. Baseline and postdiet counseling salivary parameters were subjected to statistical analysis using Student's t-test (paired) and Wilcoxon signed rank test. Results: From baseline to 6 weeks, USFR and SSFR were increased which were statistically significant. Buffering capacity and resting pH increased slightly but was not statistically significant. The reading of Oratest increased significantly, indicating a decreased caries activity in individuals. Conclusion: It can be concluded that diet counseling, parental education, and regular motivation can positively alter salivary parameters, such as USFR and SSFR.



Nahla Nassif, Balsam Noueiri, Abbas Ollek

Impact of General and Oral Complications of Diabetes Mellitus Type I on Lebanese Children's Quality of Life

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:6] [Pages No:40 - 45]

Keywords: Children, Chronic diseases, Diabetic, Oral complications, Oral health, Quality of life

   DOI: 10.5005/jp-journals-10005-1481  |  Open Access |  How to cite  | 


Introduction: Diabetes mellitus type I (DM1) has been increasing at an alarming rate worldwide. Children suffering from this chronic disease are subject to a high risk of systemic and oral complications, due to their young age and the lack of awareness of the relation between diabetes and oral health. Objective: The aim of this study is to evaluate the impact of oral and general complications of DM1 on the Lebanese children's quality of life. The goal was to assess the child's behavioral issues on the one hand and the oral issues on the other. Materials and methods: About 37 diabetic Lebanese children aged between 6 and 12 years, recruited from the Chronic Care Center (CCC), answered two questionnaires, one related to the disease and the second related to the oral complications. Results: A majority of the participants (81.1%) are aware of their disease, 73% know the importance of their treatment and 54.1% are able to control their glycemia; 45.9% are not annoyed with constantly carrying a monitor and 67.5% are bothered by their restricted diet. Only 5.4% of children isolate themselves. Concerning the oral complications: About 83.8% of the children do not suffer from oral ulcers, 56.8% are caries-free, and 64.9% have completed their dental treatment; 89.2% do not complain while eating and 94.6% are not able to brush their teeth properly. Conclusion: Diabetic patients are found to have good knowledge of the disease and its systemic complications but a little on their increased risk for oral diseases. In order to ensure a good quality of life for the diabetic children and their families, optimal control of diabetes, appropriate oral hygiene, and regular visits to the dentist must be respected.



Anju Bansal, Chitrita G Mukherjee, Uday Mukherjee, Madhushree Mukhopadhyay

Giant Cell Granuloma: Two Expressions in Pediatric Population

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:4] [Pages No:46 - 49]

Keywords: Central, Children, Giant cell granuloma, Peripheral

   DOI: 10.5005/jp-journals-10005-1482  |  Open Access |  How to cite  | 


A granuloma is a collection of epithelioid histiocytes that is often associated with multinucleated giant cells, and is considered widely to be a non-neoplastic lesion, although some lesions demonstrate aggressive behavior similar to that of a neoplasm. The diagnosis of giant cell granulomas (central and peripheral) is confirmed by histopathologic examination. Early detection and excision are important to minimize potential dentoalveolar complications. The following article consists of case reports of central and peripheral giant cell granuloma (PGCG), and discussion about the diagnosis and management of such lesions.



Vivek Chaturvedy, Nitul Jain, Gaurav Gaur

Dentigerous Cyst associated with Impacted Maxillary Premolar: A Rare Site Occurrence and a Rare Coincidence

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:3] [Pages No:50 - 52]

Keywords: Dentigerous cyst, Impacted premolars, Missing teeth, Nonsyndromic patient

   DOI: 10.5005/jp-journals-10005-1483  |  Open Access |  How to cite  | 


A dentigerous cyst is a developmental odontogenic cyst occurring most commonly in the third molar region of mandible and maxilla and maxillary canine region followed by mandibular premolar areas. However, dentigerous cyst occurring in association with impacted maxillary premolars is a very rare presentation accounting for less than 0.5% of total dentigerous cyst cases. In the following case report, a dentigerous cyst was reported in maxillary premolar region in a nonsyndromic patient having one missing premolar and another malformed one associated with the dentigerous cyst.



Srinivas Namineni, Ziauddin Mohammad, Apeksha Bagalkotkar, Sarada Penmetcha

A Novel Approach to extrude Subgingivally Fractured Tooth using Customized Removable Appliance

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:5] [Pages No:53 - 57]

Keywords: Begg bracket, Complicated crown root fracture, Fiber post, Orthodontic extrusion, Rolled cone technique

   DOI: 10.5005/jp-journals-10005-1484  |  Open Access |  How to cite  | 


Traumatic dental injuries (TDIs) are common in growing children. Among all the dental injuries, complicated crown root fractures (Andreasen Class VI) of maxillary permanent anterior teeth are relatively widespread. Such fractured teeth are often considered as hopeless and are extracted. However, if the tooth is to be retained, various treatment strategies have been proposed. The aim of the present case report is to suggest a new technique to treat a complicated crown root fracture. The management of this case included endodontic procedure and orthodontic extrusion to move the fracture line above the supragingival level. A customized removable Hawley's appliance with a modified single cantilever spring was fabricated and an anchoring Begg bracket was bonded on the residual crown of the tooth. This method is useful in the mixed dentition when there is insufficient anchorage of adjacent teeth because of preshedding mobility and trauma.



Alline J de Oliveira, Maria LG Silveira, Danilo A Duarte, Michele B Diniz

Eruption Cyst in the Neonate

[Year:2018] [Month:January-February] [Volume:11] [Number:1] [Pages:3] [Pages No:58 - 60]

Keywords: Congenital, Eruption cyst, Neonate

   DOI: 10.5005/jp-journals-10005-1485  |  Open Access |  How to cite  | 


The pediatric dental approach to the oral cavity of newborns requires special attention, as many aspects are unique and peculiar to this period of life. It is important that pediatricians and pediatric dentists be aware of the characteristics within normal newborn patterns and prepared to make a correct diagnosis of abnormalities at early stages. Congenital eruption cysts (ECs) are rarely observed in newborns, as at this stage of a child's life, tooth eruption is unusual. This study reports a case of EC treated successfully by monitoring of the lesion, without any surgical procedure. In the 4th month, the lesion had completely regressed, and the deciduous central incisors had erupted without problems. The clinical and radiographic monitoring of ECs in newborns seems to be a satisfactory management procedure, similar to what is recommended for older children.


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