Introduction: Invasion of microorganisms and their multiplication in root canals (RCs) results in endodontic infections of primary teeth. Acute and chronic inflammation may be present in the periapical area and are based on the amount and virulence of microorganisms, especially anaerobic bacteria present in the RC. To identify microorganisms very precisely in endodontic infections, polymerase chain reaction (PCR) is used. Aim: The aim of the present study is to identify the specific anaerobic bacteria like Porphyromonas gingivalis, Prevotella intermedia, and Actinomyces naeslundii in the RCs of primary teeth using real-time PCR. Methodology: Fifteen subjects aged 3-8 years who had endodontic infections in primary molars were selected. The cases who had been selected did not receive any endodontic treatment and antibiotics within 3 months, and children with systemic diseases were not included. Sample collection: Samples were taken by placing absorbent paper points into the largest canals of maxillary and mandibular molars for 60 seconds and are then transferred to a sterile Eppendorf tube with tris-hydochloride EDTA (TE) buffer. The samples were stored at ?80°C. All samples were subjected to PCR analysis. Result: The specific anaerobes detected in the samples were A. naeslundii (93.3%), Prevotella intermedia (53.3%), and Porphyromonas gingivalis (13.3%). Conclusion: The results suggested a high bacterial diversity in the RCs of infected primary teeth.

Purpose: This study evaluates the fracture strength of pulpotomized primary molars restored with amalgam, miracle mix, cermet, resin-modified glass ionomer cement, and nanocomposites. Materials and methods: Fifty primary first and second molars were collected for this study. All the teeth were randomly divided into five groups (n = 10). Standard pulpotomy cavities were prepared. Teeth were air dried and the canal orifices were capped with a layer of zinc oxide eugenol. A lining of calcium hydroxide was placed over it. Amalgam, miracle mix, cermet, resin-modified glass ionomer cement, and nanocomposite were placed in groups I, II, III, IV, and V, respectively. All the samples were then subjected to the fracture strength test using the universal testing machine and the results were statistically analyzed. Results: All the groups were compared by the ANOVA one-way test which indicated that there were statistically significant differences among the five groups. Conclusion: Nanocomposites can be considered to be the best restorative material in terms of fracture strength among amalgam, miracle mix, cermet, and resin-modified glass ionomer cement.

Aim: This study aimed to assess the iron stain removal efficacy of three toothpastes in extracted primary teeth. Materials and methods: In this in vitro study, 60 extracted sound primary teeth were selected, decoronated at the cementoenamel junction, and their pulp chambers were filled with a composite. The teeth were then immersed in ferrous sulfate solution and brushed 3,000 times in an automatic tooth-brushing machine using Colgate, whitening Crest, and conventional Crest dentifrices. Stain removal was done in four groups using a prophylaxis paste. Digital images were obtained from the teeth before and after brushing with dentifrices and the changes in color parameters were measured using Photoshop and iColor software programs. Changes in color parameters were statistically analyzed using one-way ANOVA while multiple comparisons were done by Tukey's test. Results: The greatest change in chroma was observed in the prophylaxis group and then in the whitening Crest, Colgate, and conventional Crest (mean values of −65.2, −31.07, −21.27, and −0.73, respectively). Prophylaxis completely removed the stains. The greatest reduction in value occurred in conventional Crest, Colgate, and whitening Crest (−18.07, −12.23, and −0.4, respectively). In the L *a *b * system, the least reductions were noted in the whitening Crest, Colgate, and conventional Crest (mean values of −1.96, −3.92, and −3.37, respectively). Prophylaxis significantly improved tooth brightness (a mean increase of 4.26). Conclusion: None of the toothpastes in this study were capable of effectively removing iron stains. Crest whitening toothpaste was slightly effective in this regard. Clinical significance: Iron drops are routinely prescribed for children younger than 2 years of age to prevent iron deficiency and iron deficiency anemia. However, iron stains on teeth are a common concern for many parents. Finding toothpastes with greater efficacy for iron stain removal can help in this respect.

“In vitro” studies seek to simulate actual biological conditions in the laboratory providing principles to be studied later. To facilitate the development of new techniques of root instrumentation in primary teeth and to ensure the integrity and function of the element, this study aimed to demonstrate the technological advances in endodontics through endodontic treatment performed on artificial primary teeth using a rotary instrumentation system and reciprocation. Instrumentation of the root canal was performed via a manual, rotary, and Reciproc system. Results showed that current systems can facilitate endodontic treatment in one session. These procedures become increasingly easy with the help of technological advances in dentistry.

Aim: Children having dental anxiety usually hesitate to seek dental care which can result in poor oral health and may lead to expensive and complex dental treatment in the future. The aim of the present study is to compare and evaluate the effectiveness of various distraction techniques in managing pediatric dental patients. Materials and methods: Eighty healthy children selected for the study were randomly divided into 4 groups with 20 children in each group. Group I was termed as the control group; in group II, the audio distraction technique was used. Group III received audio-video distraction (AVD) by means of a chair-mounted audio-video device and group IV received AVD by means of a ceiling-mounted television. Each child had four dental visits. Child's anxiety in each visit was assessed using four parameters: RMS pictorial scale (RMS-PS), Venham picture test (VPT), pulse rate, and oxygen saturation. Results: Ceiling-mounted AVD was found to be the most effective in reducing the anxiety followed by chair-mounted AVD. Audio distraction was found to be the least effective but was better than the control group. Conclusion: The AVD technique is simple, passive, and noninvasive means of behavior management and can be used alternatively in managing anxious pediatric dental patients.

Aims: The aim of this study is to determine the prevalence of traumatic dental injuries (TDIs) to anterior teeth in 8-12-year-old schoolchildren of Patiala city in North India and to study the risk factors related to dental trauma. Materials and methods: An epidemiological cross-sectional survey was conducted. The study consisted of 3,000 schoolchildren from various schools of Patiala city in North India. The body mass index was calculated. Lip competency, anterioposterior molar relationship, overjet, and overbite were examined. Dental injuries to anterior teeth were recorded according to the Ellis classification. Data were collected on a proforma. Results: The prevalence was found to be 11.4%. Maximum injuries occurred in the 11-year age group and the boys: girls ratio was 1.7:1. The home was the most common place with fall being the most common reason. The relationship between obesity and dental trauma was found to be statistically insignificant, whereas a statistically significant relationship was found between TDIs and incompetent lips, incisal overjet ≥5 mm, and Angle's class II div I molar relation. The Ellis class I fracture was the most predominant type. Conclusion: The high prevalence of dental trauma stresses the need for the development of preventive strategies. There is a need for increased awareness among parents and children regarding dental trauma.

Aims and objectives: The aim of this study is to evaluate and compare the dental caries stratus and treatment needs of hemophilic children with that of healthy and normal children. Materials and methods: A descriptive cross-sectional study was conducted on 60 subjects with age ranging from 7-16 years attending and registering their names, residential address, parental occupation, and other criteria in Hemophilic Society at the Telangana state. The oral hygiene status was recorded by using oral hygiene index-simplified (OHI-S). Teeth affected by dental caries and teeth restored/extracted as sequale of dental caries were assessed using decayed, missed, filled tooth (DEFT) and DMFT for primary and permanent dentition, respectively. Statistical analysis: Data were analyzed by means of SPSS, version 21.0, and the Chi-square test and the Kruskal-Wallis test. Results: The mean oral hygiene index simplified scores were 1.28 in 7-9 years and 1.87 in 13-16 years, respectively. The mean DMFT + DEFT of 7-9 years was 4.76 and for 13-16 years was 3.11 highest mean DMFT + DEFT 4.76 was recorded in the 7-9 years age group. Conclusion: The present study showed that oral hygiene status of hemophilic children was poor and treatment requirement was high among hemophilic children. The overall prevalence of dental caries was 73.3% and the treatment needs were 93.90%.

Aim: The aim of this study was to evaluate the bond strength and thereafter analyze the mode of failure of the three sealers applied to smear free radicular dentine with final drying using 70% isopropyl alcohol and paper points. Materials and methods: A total of sixty root canals were prepared and then segregated into two groups (n = 30) as per the drying protocol, namely paper points or 70% isopropyl alcohol. Then, these roots were divided into three sub-groups (n = 10) with respective sealers and obturation materials, namely AH Plus and gutta-percha (AH/GP), EndoSequence BC and gutta-percha (EBC/GP), and MTA Fillapex and gutta-percha (MFP/GP). The roots were then sectioned from each third, and the push-out test was performed. Failure modes were examined under a stereomicroscope. Data were statistically analyzed by 2-way analysis of variance post hoc Tukey tests with a significant level of 5%. Results: Overall canals dried with isopropyl alcohol showed higher bond strength values than paper point (p < 0.05). The AH/GP group showed lower bond strength than EBC/GP (p < 0.05) but higher than MFP/GP (p < 0.05). The most frequent type of failure was cohesive in the AH/GP group and adhesive in the EBC/GP group whereas MFP/GP had almost similar adhesive and cohesive failures. Conclusion: Seventy percent isopropyl alcohol drying improved the bond strength of the root canal sealers with the dentinal tubules better than the ideal paper point drying.

Objective: The aim of this study was to assess the effectiveness and reliability of magnification, DIAGNOdent in detection of smooth surface white spot lesions. Study design: Three hundred children aged 5-10 years were examined by two examiners for presence of smooth surface white spot lesions using naked eye and magnifying loupes in wet and dry conditions followed by DIAGNOdent analysis. Data was analysed using Cohen's kappa coefficient, Friedman test and Paired t test. Accuracy was assessed by sensitivity and positive predicted values. Results: Significant difference was found between naked eyes and magnifying loupes with and without air drying. While insignificant difference was found between DIAGNOdent and loupes. Conclusion: Magnifying loupes with air drying is an effective method in detection of smooth surface white spot lesion. Clinical significance: With the increased knowledge about the pathogenesis of dental caries and its ability to be remineralisable if detected early, makes it all the more important for the clinician to be vigilant in detection of early lesion to prevent the avoidable restorative approach for the same. Incorporation of magnification to routine dental examination by general dentist can help in early diagnosis and treatment of dental decay. This could prevent further progression of dental caries and reduces the incidence of tooth decay

Aims: The aim of this study is to evaluate the effect of cavity disinfection with 2% chlorhexidine (CHX) and Ag-Au nanoparticles on microleakage and resin tag penetrability of composite restoration under in vitro conditions. Materials and methods: Twenty-five human permanent molars extracted for therapeutic reasons were used in the study. Class V cavity of standard dimension was prepared on the buccal and lingual surfaces of the teeth. The teeth were randomly allocated into two groups based on the cavity disinfectant used: group I being 2% CHX gluconate (chlorhexidina Friedrich and Bianca Mittelstadt (FGM)) and group II being cavity disinfectant containing Ag-Au nanoparticles (nanocare gold). In both the groups, the dentin was etched with 37% phosphoric acid and cavity disinfectants were applied following which dentine bonding agent and composite resin were applied and cured. The specimens were then viewed under a stereomicroscope and a scanning electron microscope for microleakage and resin tag formation, respectively. Results: The results were statistically analyzed using an independent “t” test. No significant difference was seen between the two groups with respect to both microleakage and resin tag penetration values (p > 0.05). Conclusion: The cavity disinfectant containing Ag-Au nanoparticles did not affect the sealing ability and resin tag penetrability of composite resin in permanent molars when compared with 2% CHX.

Objectives: The purpose of this study is to compare the mechanical properties (compressive strength (CS) and diametral tensile strength (DTS)) of four different restorative materials: conventional glass ionomer (Fuji IX), ClearFil AP-X, Filtex Z350-XT, and Cention N. Materials and methods: Specimens (n = 80) were prepared from Fuji IX, ClearFil AP-X, Filtex Z350-XT, and Cention N for testing compressive strength and DTS. Statistical analysis: Results obtained were subjected to one-way ANOVA and Tukey's post hoc test at significance (p < 0.001). Results: There were significant differences among restorative materials tested. ClearFil AP-X exhibits the highest mechanical properties (CS and DTS) and least values were obtained by the Fuji IX. Conclusion: Strength is one of the most important criteria for the selection of a restorative material. Stronger materials better resist deformation and fracture, presenting more equitable stress distribution, greater probability, and greater stability of clinical success.

Aim: The aim of this study is to determine the effect of ultraviolet irradiation on the bond strength of composite veneer adhered to the SSCs. Materials and methods: Seventy anterior typhodont teeth (API, New Delhi, India) were randomly divided into two groups (N = 35/group) to be crowned with 70 maxillary left central incisor SSCs, size no. 3 (3MESPE, St. Paul, USA). The crowns were adjusted and cemented with the glass ionomer cement (type I, Ivoclar Vivadent, New York, USA). The labial surfaces of the experimental group were exposed to UV irradiation for 80 minutes using the UV chamber (Easy UV Chamber, India) with 2 UV lamps that produced 30 W of power to induce photoactivation. Standardized composite blocks (Ivoclar Vivadent, Gurgaon, India) of 4 × 4 × 1 mm were fabricated using Teflon molds and light cured for 60 seconds. The samples were fixed in the acrylic resin (NicTone62), with a label bearing the number of each sample. The samples were stored in a dry medium for 24 hours and tested using a universal testing machine. Results: The mean shear bond strength in the non-UV group was 26.03 ± 9.42 MPa, while in the UV group, it was 35.10 ± 14.80 MPa. Thus, there was a statistically significant difference in the mean value of the shear bond strength between the non-UV and UV groups. The shear bond strength in the UV group is much higher as compared with the non-UV group. Conclusion: Based on this study's results, the following conclusion can be made: ultraviolet irradiation of pediatric stainless steel crowns was found to significantly increase the shear bond strength of composite resin. Clinical significance: UV irradiation could provide suitable adhesion of composite resins to stainless SSCs, leading to in-office veneering of SSCs.

Aim: The treatment of white lesions should aim at arresting the lesion progression of carious lesions and improving the esthetics by diminishing the opacity of the developmental disturbances of a tooth. The objective of this review was to present the scientific basis, the principles of resin infiltration and to discuss its inherent clinical applications. Data sources: Data were identified by PubMed searches. Papers published in English between 2010 and 2015 were selected and most up-to-date or relevant references were chosen. Conclusion: The resin infiltration technique, while promising, needed more clinical evidence for conclusive findings. However, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should aim at arresting the progression of white spot lesions. Combining this microinvasive approach with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long term restorative needs and costs, thus complementing the concept of minimum intervention dentistry.

The treatment of complicated crown root fracture in children possesses a great challenge to pedodontists. A 10-year-old boy presented with trauma to the permanent maxillary left central incisor. Upon clinical and radiographic examination, revealed mobility of coronal fragment, open apex, and vertical fracture involving enamel dentin and pulp. Instead of the standard root canal treatment protocol, revascularization was performed after stabilizing the coronal fragment. The detachment of the coronal fragment occurred following a fall for the second time after 1 month of placement of mineral trioxide aggregate (MTA) over the blood clot. The coronal seal was intact; hence, the coronal fragment was reattached and the crown was placed. At 12-month follow-up, clinical and radiographic evaluation showed that the tooth was asymptomatic and functional. With increasing scope of clinical facts, patient, and practitioner favorable reception, regenerative techniques may be used as a standard technique in treating complicated crown root fracture in young permanent teeth.

Introduction: Odontomas generally appear as small, solitary, or multiple radio-opaque lesions found on routine radiographic examinations. Traditionally, odontomas have been classified as benign odontogenic tumors and are subdivided into complex or compound odontomas morphologically. Frequently, they interfere with the eruption of the teeth. Case report: This paper describes the case of a compound odontoma in a 10-year-old boy diagnosed after extraction of the retained right primary mandibular first molar in the radiograph. A surgical excision was performed and the histopathological examination revealed a compound odontome. Conclusion: Early diagnosis of odontomas and complete removal ensures better prognosis.

Aim: To check the efficacy of decompression technique in children with dentigerous cysts. Background: Most commonly occurring odontogenic cysts in the oral cavity are radicular cysts and dentigerous cysts.¹ According to Kramer, a cyst is defined as a pathological cavity having fluid, semi-fluid, or gaseous contents, which is not created by the accumulation of pus. A cyst which is lined by epithelium is known as a true cyst and that which is not lined by epithelium known as a pseudocyst.² The dictionary meaning of dentigerous is “structures resembling teeth”.³ A dentigerous cyst is found enveloping the crown of an unerupted, embedded, or submerged tooth by the expansion of its follicle till the neck of the tooth.1 It is not unusual for a dentigerous cyst to mimic a radicular cyst, especially when the cyst is associated with a pulpectomized or carious primary tooth and its unerupted permanent successor. This article presents two cases of infected dentigerous cysts. The first case was of a female patient associated with tooth 45; and another case was of a male patient associated with tooth 35. The infected dentigerous cyst in both the cases was treated with the most conservative option available, i.e., decompression technique. Case description: In this article, two cases of infected dentigerous cysts are discussed, in which one case deals with the female patient associated with tooth 45 and the other case deals with the male patient associated with tooth 35. The infected dentigerous cysts in both the cases were treated conservatively, i.e., with the decompression technique. Conclusion: The present case report states that the decompression technique may be the most conservative method available for managing dentigerous cysts in children.

Vitamin D-dependent rickets (VDDR) is a disorder of bone development characterized by softened weak bones. It is of two types-vitamin D-dependent rickets-I (VDDR-I) and vitamin D-dependent rickets type II (VDDR-II). Vitamin D-dependent rickets type II is a rare autosomal recessive disorder. The patients exhibit characteristic clinical features as well as numerous dental manifestations such as hypoplastic teeth, missing teeth, enlarged pulp chambers, and recurrent spontaneous abscesses. The case presented in this article is of vitamin D-dependent rickets type II in a pediatric dental patient who reported with multiple missing teeth and required treatment consisting of restorations and extractions. The aim of the present article is to raise awareness on the characteristics of this disorder, as well as its treatment and dental considerations.

Aim: Crowns are applicable on primary teeth with extensive caries, cervical decalcification, developmental defects, interproximal caries extending beyond line angles, and following pulpotomy or pulpectomy. Background: Until now, prefabricated crowns, i.e., stainless-steel crowns (SSCs), pre-veneered SSC, and all ceramic/porcelain/zirconia crowns have been available in a range of sizes to match the first and the second primary molar teeth. Case description: This case report illustrates a clinical use of computer-aided design and manufacturing technology (CAD/CAM) for the fabrication of a crown for a decayed primary molar using a study model as a reference. The material used was a hybrid ceramic CAD/CAM block. Conclusion: This approach has the advantage of the customization of the abutment tooth in contrast to the previously mentioned prefabricated options.

Introduction: Epidermoid cysts are commonly found in various part of the body, but its occurrence in the oral cavity is relatively rare. Case presentation: Present case highlights the importance of involvement of epidermoid cyst within the tongue in 10-year-old child. Discussion: The occurrence of epidermoid cyst within the tongue is an extremely rare phenomenon and only few cases have been reported in the literature. Clinically they are painless, slowly growing mass causing difficulty in breathing, eating and swallowing Imaging modalities most importantly; ultrasonography helps in the evaluation of the lesion. However, histopathology remains the mainstay for definitive diagnosis in such conditions. Conclusion: From the present case, it is concluded that such type of cases needs to be reported as it highlights the importance of keeping the rarities in mind along with common lesions while making a diagnosis.