Aim: The purpose of this present study is to compare the ability of MTA and Portland cement to seal furcal perforations in extracted primary molars using the dye extraction leakage model. Materials and methods: Sixty primary molars were selected and randomly divided into four groups after access openings and furcal perforations were created in the pulp chamber floor. Group I (n = 20) in which perforations were repaired with MTA (ProRoot MTA, MTA-Angelus), group II (n = 20) in which perforations were repaired with the Portland cement, group III (n = 10) in which perforations were left unsealed (positive control), and group IV (n = 10) without perforations (negative control). All samples were subjected to 1% of basic fuchsin dye challenge followed by dye extraction with 65 wt% of nitric acid. Samples were analyzed using the automatic microplate spectrophotometer 545 nm and the readings were statistically analyzed. Results: There was no statistically significant difference in the microleakage between MTA and Portland cement repair groups. Conclusion: Portland cement provides an effective seal for primary teeth furcal perforations and can be considered a more economic substitute for MTA as a repair material enhancing the prognosis of perforated primary teeth that would otherwise be extracted.

Background: There are a lot of questions in the mind of parents related to primary teeth. Various myths are also prevalent in the society about deciduous dentition. As a pediatric dentist, we come across various questions that are repeatedly asked, other than the chief complaint of the patient. No study has been conducted till date to address such queries. The current study highlights the major queries of parents related to their child's oral health. Objectives: The purpose of the study is to evaluate the most frequently asked questions by aediatric patient's parents in day-to-day practice apart from the chief complaint and to compare the queries of urban and rural population. Method: A sample size of 200 was taken for the study. Parents/attendants of the patients were given a questionnaire which consisted of queries of parents other than chief complain. The data were analyzed to find out what most of the parents want to know from a pediatric dentist about their child's dentition. Results: Based on the survey, we were able to evaluate the most common questions about child's oral health and it was observed that there is a difference in the queries of parents among the rural and the urban population. Conclusion: The role of a pediatric dentist is of the utmost importance in creating awareness among patients and their parents about oral health and the importance of primary teeth.

Objectives: This study aimed to assess the level of knowledge, attitudes, and practices fissure sealants among undergraduate Saudi dental students. Methods: A modified questionnaire consisted of 24-items was distributed among 226 undergraduate dental students, males and females of different years at Al-Farabi Colleges, Riyadh, Saudi Arabia. Chi-square/Fisher's exact tests were used for descriptive statistical analyses. Results: The response rate was 100%. Most of the respondents were male (60.2) and (39.8%) were female. With regard to the level of study, 20.8% were in the fourth year, 43.8% in the fifth year, and 16.8% were in the sixth year. The respondents showed a sensible level of learning about sealants, with the majority (88%) believed that there is strong scientific evidence about fissure sealants effectiveness and around 90% showed a good understanding of sealant placement instructions. Furthermore, respondents demonstrated inadequate learning about sealants clinical practice. Conclusion: Despite a high proportion of undergraduate dental students' showed sufficient knowledge about dental sealant, following guidelines and standardized procedures in clinical practice is lacking. The findings suggest an urgent need of dental colleges to additionally and/or update their curriculum regarding fissure sealants to reflect advance dental education that concentrates on evidence-based practice (EBP) in Pediatric Dentistry and Dental Public Health need for regular continuing education courses for the dental professional.

Aim: The aim of this study is to determine the retention rate and pattern of different pit and fissure sealants placed on the occlusal surface of newly erupted first permanent molars after 3, 6, 9, and 12 months. Materials and methods: Seventy children were enrolled in this study. They divided into seven groups (m = 10) according to the type of the sealant. The four permanent first molars of each child were sealed. The sealant was applied according to the instructions from the manufacturer. A clinical evaluation was carried out at 3, 6, 9, and 12 months. The clinical observations were divided into three categories: total retention (TR), partial retention (PR), and total loss (TL). Results: The resin-based sealant performed better than the glass ionomer-based sealant except for the Ketac Molar Easymix. At 3 months, there was no significant difference among all the tested groups (p > 0.05), while at 6, 9, and 12 months, there was a highly significant difference (p < 0.001). The glass carbomer sealant showed the least retention rate at all intervals. Conclusion: With an exception of the Ketac Molar Easymix, resin-based sealers performed better than glass ionomer-based sealers. Clinical significance: A proper application of pit and fissure sealant will decrease the chance for caries development in newly erupted teeth.

Introduction: The pharyngeal airway, tongue, and hyoid bone are correlated. The hyoid bone is connected to the pharynx, mandible, and cranium through muscles and ligaments and its position with respect to them determines the tongue posture and function. It also plays an important role in maintaining the airway and upright natural head position. Different skeletal patterns have different morphologies and shapes of the mandible, which might be affected by the position of the hyoid bone and the pharyngeal airway depth. This cephalometric study was conducted to relate the pharyngeal airway depth and the hyoid bone position of different skeletal patterns in sagittal dimension, and it determines and compares the linear parameters of the pharyngeal airway depth in Class I, II, and III malocclusion groups and anteroposterior, vertical, and angular positions of the hyoid bone positions in Class I, II, and III malocclusion groups. Materials and methods: Lateral cephalometric radiographs selected for study were divided into three groups of 30 samples each based on ANB angle and ? angle into skeletal Class I, Class II, and Class III, respectively. Five linear measurements for the pharyngeal airway depth, four linear measurements for anteroposterior position, two linear measurements for vertical position, and one angular measurement for angular hyoid bone position were made. Results: The pharyngeal airway depth was found to show no statistically significant difference between Class I and Class III malocclusions. The pharyngeal airway depth in Class II malocclusion was found to be statistically smaller at D1 as compared to that in Class I and Class III malocclusions, whereas it remained the same at the rest of the locations measured, i.e., D2, D3, D4, and D5. The Class III malocclusion group showed a significant statistical difference in the anteroposterior hyoid bone position at all levels (i.e., H1, H2, H3, and H4) as compared to the Class II malocclusion group, whereas it showed a statistically significant difference as compared to the Class I malocclusion group at H1 and H3. The angular inclination of the hyoid bone in the Class II malocclusion group showed a statistically significant difference with the Class I and Class III malocclusion group but the Class III malocclusion group showed no significant difference statistically when compared to the Class I malocclusion group. Conclusion: The pharyngeal airway depth in the Class II malocclusion group was also found to be narrower at the superiormost level measured at the posterior nasal spine from the posterior pharyngeal wall. The hyoid bone position was variable in angular and anteroposterior dimensions among different malocclusion groups.

Objective: In children, manual dexterity poses a problem with the use of manual tooth brushes (MB), resulting in inefficient plaque removal. Recently, novel chewable brushes (CB) have been introduced which could overcome this problem but are less researched in children. The objective of this study is to assess and compare the plaque removal effectiveness of CB with that of MB. Materials and methods: A total of 60 patients aged 8 to 10 years were enrolled in a single-blinded randomized clinical trial. At baseline, disclosing solution was applied and the Turesky modification of the Quigley-Hein index (TQHI) plaque index and Loe and Silness gingival index were recorded. The subjects were randomly divided into two groups as group I (MB) and group II (CB) and they were instructed to use their respective brushes for a period of 1 week. For statistical comparison, the difference (prebrushing minus postbrushing) in average scores was calculated. Data were evaluated by the independent t test and paired t test, with p < 0.05. Results: The overall plaque scores reduced from 1.71 ± 0.4 to 0.79 ± 0.24 when using CB and from 1.64 ± 0.64 to 1.13 ± 0.47 when using MBs. On lingual tooth surfaces, CB showed a plaque reduction of 38.70 ± 11.04 to 12.60 ± 4.79 compared to less reduction from 37.43 ± 14.26 to 28.73 ± 11.37 for MB. The overall gingival scores were also reduced from 0.33 ± 0.51 to 0.09 ± 0.07 when using CB and from 0.30 ± 0.33 to 0.19 ± 0.23 when using MB. Differences in scores between the two brushes were statistically significant (p = 0.0001). Conclusion: It was concluded that the experimental CB was able to remove a significant amount of plaque, particularly on the lingual surfaces, and reduced gingival index scores, thereby improving oral hygiene and gingival health status.

Aim: The purpose of the study is to establish baseline normative data regarding facial soft tissue profile measurements in preschool children of Thiruvananthapuram. Materials and methods: The present study was a cross-sectional study conducted at the Department of Pedodontics, Government Dental College, Thiruvanthapuram. Two hundred fifty children of 3 to 5 years of age reporting at the outpatient department with complete primary dentition and flush terminal plane molar relation were the sampling unit. Children with mixed dentition, with the a presence of proximal caries and any oral habit and maxillofacial trauma/pathology/developmental defects, were not included in the study. The level of significance for the study was set as p < 0.05. Results: Mean values of the study variable with standard deviation obtained with a narrow range of 95% the confidence interval indicated higher accuracy of the study. Conclusion: The values obtained in the study can be used as a reference for an initial orthodontic evaluation of a child during the early mixed dentition period. The study will help in predicting the direction of growth of the dentofacial region, its effect on facial parameters, and, hence, the treatment plan can be modified accordingly. The study will serve as the reference study for further studies with molar plane relation other than FTP.

Aim: This study assessed the gingival health of permanent first molars before and 6 months after restoration with stainless steel crowns (SSCs). Materials and methods: This study was conducted on 23 children aged 6 to 12 years who required SSCs for their permanent first molars in one quadrant and had a contralateral first molar without SSC. Gingival color, inflammation, bleeding on probing (BOP), and probing pocket depth (PPD) were measured around both teeth. SSC was placed and, 6 months later, the same parameters were measured at both sides. Results: Gingival color significantly improved and PPD, BOP, and inflammation in mesiobuccal and mesiolingual areas around the first molars restored with SSC significantly decreased after 6 months (p < 0.05). However, in distobuccal and distolingual areas, no significant change occurred in these indices 6 months after placement of SSC (p > 0.05). Conclusion: The results showed that SSCs with proper fit have no adverse effect on gingiva of permanent first molars given that the patient maintains a good oral hygiene.

Aims: The aim of this study is to evaluate and compare the demineralization inhibitory effect, fluoride release at varying time intervals, and antibacterial property of MI varnish and fluor protector varnish. Materials and methods: Twenty-four extracted human premolars were sectioned mesiodistally. The buccal and the lingual halves of the teeth were utilized to evaluate the demineralization inhibitory effect and fluoride release of MI varnish and fluor protector varnish, respectively. To evaluate the demineralization inhibitory effect, 150-μm axial longitudinal section was obtained that was photographed and evaluated under a polarized light microscope. To evaluate the fluoride release, a fluoride-specific ion electrode was used. To evaluate the antibacterial susceptibility, the disk diffusion test (Kirby-Bauer method) was done. Results: Statistical analysis was done using the Students unpaired t test for intergroup comparison and the p value <0.01 was obtained for all the three parameters, i.e., demineralization inhibitory effect, antimicrobial property, and fluoride releasing property at different time intervals. Conclusion: A combination of casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) in fluoride varnish seems to enhance the caries preventive potential of fluoride varnish and antibacterial activity against Streptococcus mutans. Clinical significance: MI varnish, a combination of CPP-ACP and fluoride varnish could be the future of minimally invasive dentistry as it is minimally invasive yet an effective modality for caries prevention.

Aim: The aim of this study is to investigate the penetration abilities of a commercially available low-viscosity resin infiltrant into developmentally hypomineralized teeth in vitro. Materials and methods: Four extracted third molars of a 17-year-old patient with signs of developmental enamel hypomineralization (discoloration, increased opacity, and surface roughness) were infiltrated with a low-viscosity resin mixed with a fluorescent dye, according to the manufacturer's standard protocol. Four extracted molars with sound enamel or showing only initial fissure caries were used as a control group. Specimens were embedded in polymethylmethacrylate, and grindings were prepared. High-resolution projectional radiography of the grindings was performed, and, for one specimen, quantitative micro-computed tomography was used to measure hydroxyapatite density in enamel and dentin lesions. After decalcification, the grindings were examined by reflected bright-field microscopy, wide-field fluorescence microscopy, and confocal laser scanning microscopy. Fluorescence micrographs were superimposed on the radiographs and analyzed correlatively. Results: The pattern of hypo-/demineralization in enamel and dentin in developmentally hypomineralized teeth showed a good congruence with the pattern of resin infiltration. Cavitations and dentin tubules up to a depth of 2 mm beyond cavitations were filled by the infiltrant. In control teeth, the penetration of the infiltrant was limited to decalcified enamel areas (initial fissure caries). Conclusions: In vitro infiltration of developmentally hypomineralized enamel was successful. Clinical significance: Resin infiltration might be considered as a routine procedure in the treatment of developmentally hypomineralized teeth. Further investigations with higher sample sizes, different degrees of severity, different stages of lesion extension, and modified treatment protocols are necessary.

Aim: This study was conducted to evaluate the effectiveness of green tea mouthwash on the salivary level of Streptococcus mutans in the preschool children. Materials and methods: In this randomized controlled clinical trial, 40 cooperative children (4-5 years old) were divided into two groups. The study group included 20 children who did the routine tooth brushing 3 times/day, and then green tea extract mouthwash (8 mL/day) 2 times/day for 4 weeks. The control group included other 20 children who did the routine tooth brushing as the study group but did not use any green tea extract mouthwash. The quantitative microbiological laboratory cultivation method of S. mutans was carried out for each child at the baseline, after 2 weeks, and after 4 weeks of the study period. Results: Statistically, the results showed that there was a statistically significant difference in the mean log S. mutans counts between the study and control groups in both follow-up periods after 2 weeks and after 4 weeks. Also, there were statistically significant mean percentage decreases in log S. mutans counts for the two groups. Conclusion: The use of green tea mouthwash showed promising results in reducing the cariogenic salivary S. mutans counts. Clinical significance: Green tea extract mouthwash is a nontoxic and safe, particularly for children. Catechins, the main bioactive ingredient of green tea, show an antibacterial action; thus, it has a promising effect in decreasing the count of salivary S. mutans and in the prevention of dental caries.

The dental caries is not simply a continuous and unidirectional process of the demineralization of the mineral phase, but a cyclic event with periods of demineralizations and remineralisation. The remineralization process is a natural repair mechanism to restore the minerals again, in ionic forms, to the hydroxyapatite (HAP) crystal lattice. It occurs under near-neutral physiological pH conditions whereby calcium and phosphate mineral ions are redeposited within the caries lesion from saliva and plaque fluid resulting in the formation of newer HAP crystals, which are larger and more resistant to acid dissolution. Numerous types of remineralizing agents and remineralizing techniques have been researched and many of them are being used clinically, with significantly predictable positive results. The recent researches on remineralization are based on biomimetic remineralization materials, having the capability to create apatite crystals within the completely demineralized collagen fibers.

Introduction: Self-insertion of foreign objects in teeth is a common occurrence in children facing dental problems in an attempt to alleviate irritation, drainage, or other symptoms from teeth. However, this could lead to the development of infection and may worsen the condition if not intervened at an early stage. The removal of such objects and the preservation of involved teeth pose a challenge and, in some cases, the tooth must be extracted to resolve the infection. Aims and objectives: The aim of this article is to report cases of foreign object insertion and discuss the related consequences, thereby, stressing the importance of regular dental visits and maintenance of oral hygiene so as to minimize dental neglect. Case Studies: The article discusses four case reports of children in the age group 2-14 year old who reported with self- inserted foreign objects in their teeth. Discussion: Regular dental visits and timely dental management can help reduce the complications associated with such incidents. Ultrasonic instruments, the Masserann kit, periapical surgery and various other techniques have been recommended by the authors for successful removal of foreign objects from the pulp chamber and the canal.

Aim: To evaluate the clinical and radiological results of a revascularization treatment done in a nonvital, immature permanent tooth using the amniotic membrane. Case description: A 12-year-old boy reported with a complaint of pain in the lower left back tooth since 1 month due to dental caries. On clinical examination, the mandibular left second premolar was tender on percussion and discolored due to dental caries. Radiographic examination of the same tooth revealed open apex, thin root dentinal walls, and periodontal ligament widening. An access opening was prepared, necrotic pulp extirpated completely followed by thorough irrigation. After drying the canal, closed dressing with the 3-mix antibacterial paste was given for 15 days. After 15 days, the paste was removed and the amniotic membrane was placed inside the canal extending 1 mm beyond the apex and mineral tri-oxide aggregate was placed over this followed by sealing of the cavity. The patient was followed up at 1, 3, and 6 months for clinical and radiographic evaluation. Conclusion: After 6 months, clinically the tooth found asymptomatic. Radiographic examination showed continued root elongation, closure in the periapical opening, thick root dentinal walls with narrowing of the canal space, and normal periradicular architecture. Clinical significance: Amniotic membrane can be used as a scaffold for revascularization in nonvital immature teeth.

Background: Ectopic eruption of the permanent first molar is a common eruption disorder occurring during mixed dentition. The prevalence of this condition ranges from 3% to 4% in children. It is described as an abnormal mesioangular eruption path of the first permanent molar with a possibility of initiating the premature resorption of the distal root of the adjacent primary second molar. Non-treatment can result in the early loss of the second primary molar, space loss, and impaction of second premolars. Various treatment modalities have been mentioned in the literature for the management of ectopic eruption. Aim: This article presents the case of an eight-year-old boy with irreversible bilateral ectopic eruption of the permanent maxillary first molars. Case description: A modifed Croll's appliance was the treatment of choice to correct the path of eruption of the latter molars. An activation of the appliance was performed at intervals of two weeks. Conclusion: The result was obtained six weeks later and a regular follow-up was scheduled.

Premature loss or severely destruction of upper primary anterior teeth by early childhood caries (ECC) is a challenge for the pediatric dentist. In the anterior region, esthetics is an important concern along with function and space management. Tooth rehabilitation in this region becomes fundamental. The purpose of this report was to present a case of a 4-year-old child with the early loss of both central upper incisors and caries lesions on both upper lateral incisors. Both 51 and 61 were extracted due to ECC. The patient was rehabilitated with a fixed esthetic space maintainer and the vital lateral upper incisors, destroyed by ECC, restored with direct composite resin veneers. The final result reestablished local, systemic, psychological, aesthetic, and social problems of the child.

Aim: Among traumatic dental injuries, intrusive dislocation is considered to be one of the most serious injuries. Despite the high success rate in complacent patients, the traditional technique of calcium hydroxide inoculation has drawbacks. The good antimicrobial and sealing properties combined with excellent biocompatibility and high success rates of the mineral trioxide aggregate (MTA) encourage its use. Background: The objective of this study was to report a successful case of intrusive dislocation in a short time with a follow-up of eight years. Case description: A patient, seven years of age, presented intrusive dental dislocation, confirmed by radiographic examination, which revealed besides axial displacement of the central incisor towards the bone, incomplete root development. The passive repositioning was chosen as the treatment modality. After cleansing of the root canal, therapy with hydroxide paste was performed for 30 days, and then the apex was closed using an artificial barrier made with apical MTA buffer to facilitate root canal obturation. Conclusion: Clinical and radiographic signs at 6 months and 8 years of preservation evidence the success of the therapy. Clinical relevance: Teeth with incomplete root formation when traumatized may have their development process interrupted; consequently their root canals remained ample with thin and fragile walls and the open apex which represents a great challenge to the accomplishment of endodontic therapy. The process of apexification with MTA as in this case is an alternative to traditional therapy based on calcium hydroxide, conferring a faster treatment and a decrease in the odds of fracture of the tooth since from the confection of the apical barrier there is a possibility of being the same restored at an early stage.