International Journal of Clinical Pediatric Dentistry

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2018 | March-April | Volume 11 | Issue 2

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Nahla Nassif, Balsam Noueiri

Impact of Diabetes Mellitus Type 1 on Lebanese Families’ Quality of Life

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:61 - 65]

Keywords: Diabetes mellitus type 1, Diabetic child, Family burden, Guilt feeling

   DOI: 10.5005/jp-journals-10005-1486  |  Open Access |  How to cite  | 


Introduction: Diabetes mellitus type 1 (DM1) markedly alters the lives of individuals and their families. Family members can be affected by diabetes and its treatment, causing burden, distress, and reduced quality of life (QOL). Objective: The aim of this research is to study the relationship between the diabetic child and the family members, to evaluate the stress and emotional issues between siblings, and to weigh in on the psychological, affective, and financial burden that parents have to deal with in their daily life. Materials and methods: A total of 37 diabetic Lebanese families recruited from the Chronic Care Center (CCC) answered two questionnaires, one about general information and the other related to psychological and financial impact of DM1 and its oral complications on the families. Results: About 56.8% have monthly income below $1,000; 16.2% of parents have an educational upper limit of college degree; 83.8% of the mothers are housewives; 75.7% of parents feel guilty about their child's condition; 89.2% feel that their diabetic child is frustrated with their diet. For 78.4%, the siblings are jealous of the diabetic child; 13.5% of parents are well aware of the oral complications of diabetes and 86.5% think that treating the diabetic child's teeth is more important than the siblings’ ones; 91.9% assist their diabetic child's toothbrushing, but 81.1% of family members do not visit the dentist regularly. A total of 100% allocate special budget for the diabetic child's diet and 59.4% have an additional budget dedicated to the diabetic child's treatment; 81.1% declared that their career is affected by their child's illness. Conclusion: The diabetic child expressed frustration with their diet. The child's siblings are jealous as they feel left behind. The parents experienced guilt feeling and psychological stress. They have social restriction and financial problems. The QOL of families living with a diabetic child is altered negatively.



Saravana K Kandaswamy, Asokan Sharath, PR Geetha Priya

Comparison of the Effectiveness of Probiotic, Chlorhexidine-based Mouthwashes, and Oil Pulling Therapy on Plaque Accumulation and Gingival Inflammation in 10- to 12-year-old Schoolchildren: A Randomized Controlled Trial

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:66 - 70]

Keywords: Chlorhexidine, Gingival index, Plaque index, Probiotic, Sesame oil

   DOI: 10.5005/jp-journals-10005-1487  |  Open Access |  How to cite  | 


Introduction: The use of a mouthwash augments mechanical removal of plaque by brushing and flossing and helps maintain oral health through its antiplaque and antibacterial chemical properties. Aim: To evaluate the effectiveness of a probiotic mouthwash, sesame oil pulling therapy, and chlorhexidine-based mouthwash on plaque accumulation and gingival inflammation in schoolchildren aged 10 to 12 years. Materials and methods: The randomized controlled trial included 45 healthy schoolchildren aged 10 to 12 years and studying in Government High School, Tiruchengode, Tamil Nadu, India. The participants were randomly divided into three groups, I, II, and III, with 15 children in each group as follows: group I: probiotic mouthwash; group II: chlorhexidine mouthwash; and group III: sesame oil. Baseline scores of plaque index (PI) and modified gingival index (GI) were recorded followed by a full mouth oral prophylaxis. The designated mouth rinses were distributed to the respective groups and they were instructed to rinse once daily. Their parents supervised the children during the use of mouthwash. On the 15th and 30th day, the children were subjected to the same clinical measurements. Children's acceptance of their plaque control method was assessed using a modified facial image scale. Results: Intragroup comparisons for both the GI and PI scores were statistically significant (p ≤ 0.001) in all the three groups. Difference in the GI scores between the 15th and 30th day was statistically significant for chlorhexidine group alone (p = 0.024). Intergroup comparisons between the three groups were not statistically significant. Conclusion: Probiotic mouthwash, chlorhexidine mouthwash, and sesame oil were equally effective in reducing plaque and in improving the gingival status of children. The difference between the gingival scores on the 15th and 30th day was statistically significant in the chlorhexidine group.



Kalyani Uppu, Ghanashyam P Madu, Sowjanya Nalluri

Estimation of Salivary Glucose, Calcium, Phosphorus, Alkaline Phosphatase, and Immunoglobulin A among Diabetic and Nondiabetic Children: A Case–Control Study

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:8] [Pages No:71 - 78]

Keywords: Alkaline phosphatase, Calcium, Nondiabetic healthy children, Phosphorus, Salivary glucose, s-IgA, Type I diabetic children

   DOI: 10.5005/jp-journals-10005-1488  |  Open Access |  How to cite  | 


Introduction: Saliva is vital for oral health and helps to maintain oral homeostasis. It may show qualitative and quantitative variations owing to any changes in the systemic health. Diabetes mellitus (DM) is a metabolic disease and the individuals may be at higher risk for oral health problems. Objective: The study was aimed to estimate the levels of various salivary components among diabetic and nondiabetic children with similar caries status and also to analyze possible association between caries status and possible caries determinants in the saliva of diabetic children. Materials and methods: A total of 70 children in the age group of 6 to 13 years with minimal dental caries (Decayed, Missing and Filled Teeth index (DMFT/dmft >1 and <5)) were selected. Group I comprised of type I diabetic children and on medication for diabetes and group II included healthy nondiabetic children. Salivary samples were collected from the participants by passive drool method and estimation of all salivary parameters was done using autoanalyzer. Results: Statistical analyses were done using Student's t-test and results are presented as mean ± standard deviation (SD). There was a highly significant difference in mean glucose value between diabetic and nondiabetic children. Levels of salivary calcium, phosphorus, and salivary immunoglobulin A (s-IgA) did not show any significant difference between the two groups. There was also a statistically significant difference in the alkaline phosphatase (AP) levels, which was found to be higher in diabetics. Conclusion: An elevation in the levels of salivary glucose and AP was evident in diabetic children, which can be a risk marker for dental caries. There was no correlation in the levels of salivary calcium, phosphorus, and s-IgA levels among diabetic and healthy children. Clinical significance: The salivary factors evaluated in the study may prove to be useful measures of caries experience in diabetic children.



Manoj Chandak, Nilima Thosar, Silpi Basak

Evaluation of Antimicrobial Activity of Two Endodontic Sealers: Zinc Oxide with Thyme Oil and Zinc Oxide Eugenol against Root Canal Microorganisms—An in vitro Study

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:4] [Pages No:79 - 82]

Keywords: Antimicrobial efficacy, Zinc oxide eugenol paste, Zinc oxide mixed with thyme oil paste

   DOI: 10.5005/jp-journals-10005-1489  |  Open Access |  How to cite  | 


Aim: The present study was aimed to find out and compare the antimicrobial effect of the paste containing zinc oxide cement mixed with thyme oil (ZO + Th oil) with that of the paste containing zinc oxide and eugenol (ZO + E) against Staphylococcus aureus, Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa, common root canal pathogens of deciduous teeth. Materials and methods: An in vitro antimicrobial effect was carried out by the agar diffusion method. The ZO + Th oil paste was filled in the punched holes of Mueller Hinton agar at two equidistant points. The same was followed for ZO + E paste. For 24 hours, all the plates were incubated at a temperature of 37°C. The inhibition zones in millimeters around the wells were calculated. There were 6 times repetitions of the test for each microorganism. Data were tabulated and analyzed statistically using one-way analysis of variance (ANOVA) and Tukey's post hoc comparison test. Level of significance for the tests was 5%. Results: Zones of bacterial inhibition were highest for ZO + Th oil paste against the pathogenic microorganisms S. aureus, followed by E. coli, E. faecalis, P. aeruginosa while for ZO + E paste, the decreasing order against pathogenic microorganisms was E. coli, S. aureus, E. faecalis, and P. aeruginosa. Statistically significant difference was found in both the pastes, ZO + Th oil paste and ZO + E paste. Conclusion: ZO + Th oil paste showed higher levels of antimicrobial effect against the root canal pathogens.



Influence of Storage Media and Duration of Fragment in the Media on the Bond Strength of the Reattached Tooth Fragment

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:6] [Pages No:83 - 88]

Keywords: Bond strength, Fracture, Reattachment, Storage media, Tooth Mousse

   DOI: 10.5005/jp-journals-10005-1490  |  Open Access |  How to cite  | 


Introduction: Fracture of anterior teeth is the most frequent type of injury in the permanent dentition. Composite materials have made possible the use of adhesive materials and techniques, but storage of fragment in the media can enhance the bond strength. The purpose was to evaluate the influence of storage media and duration of the fragment in the media on the bond strength of the reattached fragment of teeth. Materials and methods: A total of 104 permanent maxillary central incisors were included. Samples were divided into four groups of 26 teeth each, further divided into eight groups of 13 teeth each and sectioned 3 mm apical to the incisal edge and stored in four storage media—tap water, artificial saliva, sodium fluoride, and Tooth Mousse at 12 and 24 hours. The bond strength was measured by universal strength testing machine. Results: Tooth Mousse showed statistically significant difference (p-value 0.001) compared with sodium fluoride, artificial saliva, and tap water when stored in both 12 and 24 hours’ duration. Conclusion: Tooth Mousse was a better storage media when compared with sodium fluoride, artificial saliva, and tap water. Clinical significance: Tooth Mousse can be considered as a best storage media for fragment reattachment.



Madhagudanahalli S Lakshmi, Kudlapur T Srilatha, Bhojraj Nandlal, Seema Deshmukh

Clinical Evaluation of Preventive Effect of Fissure Sealants on Initial Carious Lesion of Permanent Mandibular Molars Pretreated with and without Fluoride Varnish by Fluorescence Camera

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:89 - 93]

Keywords: Fluorescence, Fluoride varnish, Pit and fissure sealant

   DOI: 10.5005/jp-journals-10005-1491  |  Open Access |  How to cite  | 


The important armamentarium in the present day scenario against caries prevention is considered to be a combination of preventive methods. The present study was conducted to evaluate the preventive effect of pit and fissure sealant pretreated with fluoride varnish on initial carious lesion by fluorescence camera (FC).



Inder K Pandit

A Comparative Evaluation of Efficacy of Streptococcus mutans Counts in Saliva: An in vivo Study

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:6] [Pages No:94 - 99]

Keywords: Chlorhexidine mouthwash, Dental caries, Fluor protector varnish, Probiotic (Yakult) and dentifrice, Streptococcus mutans

   DOI: 10.5005/jp-journals-10005-1492  |  Open Access |  How to cite  | 


Dental caries is a disease of multifactorial origin and Streptococcus mutans is considered as the chief pathogen responsible for its development. However, reduction in the number of pathogenic bacteria, particularly S. mutans, with the use of various preventive measures, can reduce dental caries to a significant level. Therefore, the present clinical study was undertaken to evaluate and compare the efficacy of toothbrushing, fluoride varnish, chlorhexidine mouthwash, and a probiotic (Yakult) in reducing the S. mutans counts in the saliva using Dentocult SM Strip Mutans kit in children. A total of 40 school students between the age group of 4 and 8 years were selected for the study and S. mutans count was taken on the first dental visit using Dentocult SM Strip Mutans test kit. After the initial scores of S. mutans were obtained, the children were divided into four groups and provided with different caries preventive regimen for 2 weeks. After 2 weeks, the scores of S. mutans were reevaluated for reduction in their counts, if any. The data thus collected were tabulated and statistically analyzed. All the groups showed a significant reduction in S. mutans counts with the highest reduction from the Fluor Protector varnish followed by chlorhexidine mouthwash, probiotic (Yakult), and toothbrushing.



Priyam R Velani

Determination of ABO Blood Groups and Rh Typing from Dry Salivary Samples

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:100 - 104]

Keywords: ABO blood group, Absorption–inhibition method, Dried salivary samples, Rh typing

   DOI: 10.5005/jp-journals-10005-1493  |  Open Access |  How to cite  | 


Introduction: A unique blood group is a characteristic every individual possesses. Blood group antigens like A, B, D, H, etc., are found to be present on the cell surfaces of red blood cells (RBCs). Besides blood, these are also secreted in various body secretions like semen, sweat, amniotic fluid, and saliva. Blood grouping has several applications in forensic sciences and is also a major part of routine medical investigations. Presence of these antigens in saliva is dependent on the secretor status of an individual. Saliva samples at the crime scene are very crucial, as they help in deoxyribonucleic acid typing, sex determination, bite mark analysis, and blood grouping. Dried salivary samples are often obtained in more number of cases as compared with the wet form, due to the variable time lapse between the occurrence of the crime and the start of the investigation. Blood grouping from these samples proves to be very efficient. Thus, the present study aims at evaluating the accuracy of ABO blood group determination and Rh typing from dried salivary samples. Also, the study would establish the use of saliva as a noninvasive technique in routine blood examinations, especially in children who have needle phobia. Materials and methods: Blood grouping and Rh typing were performed on the dry salivary samples obtained from the 47 subjects using the absorption–inhibition technique. This was then compared with the results obtained using extraction socket blood and evaluated. Results: The present study showed a 100% positive correlation for ABO blood grouping, but a mere 14.81% positive correlation for Rh typing between the dried salivary samples and the extraction socket blood. Conclusion: Dried salivary samples can thus be put to immense use in several areas of forensic investigations. It could also help in developing alternate methods for routine blood investigations in children and adults.



Javaregowda P Beena, Punyatoya Sahoo, N Sunil Raj, Narayana C Kumar

Manuka Honey: A Potent Cariostatic Agent–An in vitro Study

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:105 - 109]

Keywords: Antibacterial, Dabur honey, Lactobacillus, Manuka honey, Streptococcus mutans

   DOI: 10.5005/jp-journals-10005-1494  |  Open Access |  How to cite  | 


Aim: The aim of the study was to test the antibacterial activity of manuka honey and compare its efficacy with another commercially available honey (Dabur honey) on the cariogenic bacteria on Streptococcus mutans and Lactobacillus. Materials and methods: An in vitro study was carried out on 40 agar specimens; the samples were divided into two groups of 20 samples consisting of S. mutans and Lactobacillus respectively. The 20 samples in each group were further subdivided into four groups of five each, which were tested with 25% manuka honey, 100% manuka honey, 25% Dabur honey, and 100% Dabur honey for both Lactobacillus and S. mutans groups. The antibacterial activity was tested using the agar well diffusion method against S. mutans and Lactobacillus. Antibacterial activity was assessed by measuring the diameter of inhibition of zones surrounding the wells. The results obtained were statistically analyzed (one-way analysis of variance test, p-value). Results: The results showed that 25% of manuka honey has statistically significant (p ≤ 0.001) antibacterial effect than 25% of Dabur honey on both Streptococcus and Lactobacillus species, and manuka honey with 100% concentration showed a statistically significant (p ≤ 0.001) antibacterial effect than 100% Dabur honey on the same species of bacteria. 100% of both the honeys showed statistically significant (p ≤ 0.001) antibacterial effect than 25% concentrations of the same on S. mutans and Lactobacillus. Conclusion: Manuka honey had more antibacterial activity than Dabur honey on S. mutans and Lactobacillus bacteria in the in vitro study. This effect was dependent on the concentration of honey used.



Manish Madan, Pallav Singhal, Anu Garg, Akash Dupper

Validating the Usage of Cariogram in 5- and 12-year-old School-going Children in Paonta Sahib, Himachal Pradesh, India: A 12-month Prospective Study

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:6] [Pages No:110 - 115]

Keywords: Cariogram, High-risk patients, Low-risk patients, Medium-risk patients

   DOI: 10.5005/jp-journals-10005-1495  |  Open Access |  How to cite  | 


Aim: To validate the caries risk profiles in 5- and 12-year-old school-going children and to single out main contributing factor, if any, using cariogram over a period of 1 year. Materials and methods: A cariogram model was used to create caries risk profiles on 499 children aged 5 and 12 years ±6 months. They were divided into 2 groups. The group I and group II consisted of 250 and 249 children respectively. Reexamination was done after 1 year and caries increment was recorded. The caries risk profiles generated by the cariogram software were compared with caries increment. Results: Percentage of subject having caries increment in groups I and II in high-, medium-, and low-risk group after 1 year was 66.2, 39.5, and 13%, and 48.5, 27.3, and 13.9% respectively. The mean caries increment after 1 year in groups I and II in high-, medium-, and low-risk patients was 0.96, 0.49, and 0.13, and 0.7, 0.36, and 0.11 respectively. Linear regression analysis showed dental caries, diet content, diet frequency, plaque index, Streptococcus mutans count, fluoride, salivary flow rate, and buffer capacity are significantly associated with actual chance to avoid caries. Conclusion: The risk of developing new carious lesions consistently reduced from high-risk category to low-risk category, reflecting the cariogram ability in accurately estimating future caries. Hence, cariogram can be said to be a useful tool for caries prediction. Initial dental caries came out to be the strongest predictor of future caries.



Sumita Upadhyay

Perception of Indian Dental Surgeons regarding Molar Incisor Hypomineralization

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:6] [Pages No:116 - 121]

Keywords: Dental surgeons, Molar incisor hypomineralization, Perception

   DOI: 10.5005/jp-journals-10005-1496  |  Open Access |  How to cite  | 


Aim: To determine the perception of Indian dental professionals about prevalence, severity, and etiological factors of molar incisor hypomineralization (MIH). Materials and methods: An online survey was mailed to dental professionals encompassing various questions regarding etiology, diagnosis, prevalence, and management of MIH. Results: More than 90% of the respondents encounter teeth with hypomineralization in their practice, with less than half of them encountering such teeth on a monthly basis. Among these more than one-third find it difficult to manage one or the other aspect of MIH. The etiology was found to be varying as per the respondents. Conclusion: Molar incisor hypomineralization is a common condition encountered by dental professionals with no apparent consensus regarding the anticipated prevalence, severity, and etiology of this condition. Knowledge of clinicians’ level of perception could be an incentive for pediatric dentists to become more acquainted with MIH by conducting research into its different aspects.



Paras Angrish, Subrata Saha, Ashok V Sengupta, Shantanu Mukherjee

A Survey on the Use of Antibiotics among the Dentists of Kolkata, West Bengal, India

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:6] [Pages No:122 - 127]

Keywords: Analgesics, Antibiotics, Overuse, Resistance

   DOI: 10.5005/jp-journals-10005-1497  |  Open Access |  How to cite  | 


Introduction: Dental infections are multimicrobial in origin with their etiological factors involving a combination of Grampositive, Gram-negative, facultative anaerobes, and obligate anaerobic bacteria. Thus, antibiotics and analgesics account for a great majority of medicines prescribed by the dental surgeons. Inappropriate prescription of antibiotics by health care professionals has become a worldwide issue nowadays. Aim: The purpose of the present study was to: • Determine the pattern of antibiotic prescription among dentists of Kolkata. • Assess the attitude of dentists toward antibiotic resistance. Materials and methods: An electronic version of the questionnaire of cross-sectional survey regarding antibiotic use and attitude toward growing antibiotic resistance was constructed using Qualtrics (Qualtrics Pvt. Limited Provo, Utah), an internet online survey tool that was e-mailed to dental surgeons of Kolkata registered with Indian Dental Association (IDA), West Bengal. A reminder e-mail was given after 1 month to recollect the responses from them. Results: The survey was e-mailed to 300 dental surgeons, out of which 115 dental surgeons completed the survey, thereby achieving a response rate of 38.33%. Majority of the respondents (60%) chose amoxicillin in nonallergic patients. Average minimum duration of antibiotic therapy was 5 days. The drug of first choice for patients with an allergy to penicillin was erythromycin. The prime determinant of antibiotic use was facial swelling (68%). The prime determinant to select a particular brand of antibiotics was affordability of that brand (61%). Almost all (99%) dental surgeons were aware of antibiotic resistance being a growing concern. As per their views, there was overprescription of antibiotics.



Davi de Sá Cavalcante, Cristiane SR Fonteles, Thyciana R Ribeiro, Lúcio M Kurita, Alynne Vde M Pimenta

Mandibular Regional Odontodysplasia in an 8-year-old Boy showing Teeth Disorders, Gubernaculum Tracts, and Altered Bone Fractal Pattern

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:7] [Pages No:128 - 134]

Keywords: Cone beam computed tomography, Fractal analysis, Gubernaculum tracts, Mandible, Regional odontodysplasia

   DOI: 10.5005/jp-journals-10005-1498  |  Open Access |  How to cite  | 


Regional odontodysplasia (RO) is a rare nonhereditary developmental condition usually affecting maxilla and female patients. A few number of articles have used the cone beam computed tomography (CBCT) to describe imaging findings in RO. Thus, this article aims to report unusual imaging findings in a Brazilian child who presented with mandibular RO. A healthy 8-year-old boy was referred for evaluation of an anterior mandibular gingival enlargement. Radiographically, all right mandibular teeth showed wide pulp chambers and shortened roots with thin dentinal walls and open apices, featuring a “ghost teeth” appearance, which indicated a diagnosis of RO. Missing teeth and altered radiopacity were observed. Cone beam computed tomography provided great insight into RO, allowing to identify gubernaculum tracts (GTs) associated with RO teeth. Fractal analysis of the bone surrounding RO teeth revealed an altered trabecular pattern. Clinical significance: This case describes a rare developmental teeth-related pathology in a boy who showed unusual features on imaging exams. The CBCT provided the observation of RO tooth-related GTs, probably a new finding added to the international literature regarding RO, as well as the pulp chamber volume characterization of an affected tooth not published yet. In addition, it was observed an altered fractal pattern of the mandibular bone adjacent to RO teeth, which has not been described to date.



Ipshita A Suyash

A Case of Painless Excision

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:6] [Pages No:135 - 140]

Keywords: Laser, Painless dentistry, Peripheral giant cell granuloma, Soft tissue lesions

   DOI: 10.5005/jp-journals-10005-1499  |  Open Access |  How to cite  | 


Soft tissue lesions of the oral cavity are seen in children at the dental office. This case report aims to showcase the ability of laser to treat recurrent soft tissue lesions in the oral cavity in a painless manner. This painless procedure provides relief to the child and parent who suffer from anxiety toward dental treatment.



Ziauddin Mohammad, Apeksha Bagalkotkar, Ashank Mishra, Gopi Veerala

Customized Hybrid Bluegrass Appliance: An Innovative Technique

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:141 - 145]

Keywords: Bluegrass, Esthetics, Functional space maintainer, Natural tooth pontic, Oral habits

   DOI: 10.5005/jp-journals-10005-1500  |  Open Access |  How to cite  | 


Oral habits in the form of thumb sucking and tongue thrusting are commonly learned patterns of behavior seen in preschool children and they are associated with anxiety, fear, hunger, oral pressure, and sleep. Chronic practice can cause dentoalveolar, perioral problems, and atypical root resorption (ARR) of anterior primary teeth. The ARR is provoked by the thumb sucking habit, and leads to early loss of anterior primary teeth. The early loss of anterior tooth may result in speech and masticatory problems, and psychological disturbance to the child. Hence, pediatric dentists play a crucial role in giving necessary information to parents and guardians. Starting from counseling to appliance therapy, various treatment modalities have been reported in the literature. One of them is bluegrass appliance; it is a nonpunitive habit reminder therapy. The present case report describes a customized hybrid bluegrass appliance designed to eliminate thumb sucking and tongue thrusting habit, and to perform as an esthetic functional space maintainer.



Snigdha Pattanaik, Navya Puvvula, Noorjahan Mohammad

Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:5] [Pages No:146 - 150]

Keywords: Fixed orthodontics appliance, Fixed twin block appliance, Functional appliance, Growth modulation, Skeletal class II malocclusion

   DOI: 10.5005/jp-journals-10005-1501  |  Open Access |  How to cite  | 


Background: Patients with class II malocclusion generally seek orthodontic treatment for esthetic concern. Various myofunctionl appliances can be used for the treatment of skeletal as well as the dental malocclusion in a growing patient. Among various functional appliances, twin block appliance is most commonly used due to better patient compliances. It redirects the mandibular growth to correct the maxillomandibular relationship, enhancing facial esthetics. This article presents a modified design of the twin block appliance which is less bulky, more esthetic, can be used concurrently with fixed orthodontic appliance, and is easily accepted by uncooperative patients. Case summary: An 11-year-old-boy, who presented himself with a skeletal class II malocclusion, was treated with simultaneous use of fixed twin block along with fixed orthodontic appliance to correct both the skeletal and dental malocclusion. The twin block design was modified to have a better compatibility with the fixed orthodontic appliance.



Mariana C Ilha, Paulo F Kramer, Simone H Ferreira, Henrique C Ruschel

Pre-eruptive Intracoronal Radiolucency in First Permanent Molar

[Year:2018] [Month:March-April] [Volume:11] [Number:2] [Pages:4] [Pages No:151 - 154]

Keywords: Dentin, Dentition permanent, Tooth crown, Tooth resorption

   DOI: 10.5005/jp-journals-10005-1502  |  Open Access |  How to cite  | 


Pre-eruptive intracoronal radiolucency (PECR) is characterized by the existence of a radiographic radiolucent area inside the coronal dentin prior to dental eruption. It is a rare clinical entity of unknown etiology, usually asymptomatic and diagnosed through routine radiographs. The aim of this article is to report the treatment of a PECR in an 8-year-old girl. Surgical procedure to expose the crown was conducted; upon tooth eruption, the radiolucent lesion was accessed and the tooth was restored. The case has an 18-month follow-up and emphasis on aspects linked to diagnosis and clinical approach was discussed.


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