International Journal of Clinical Pediatric Dentistry

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2019 | November-December | Volume 12 | Issue 6

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Original Article

Saudamini G More, Roopali Sankeshwari, Anil V Ankola

Exploring Parental Knowledge and Indigenous Practices for Infant Teething in Indian Population: A Cross-sectional Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:479 - 483]

   DOI: 10.5005/jp-journals-10005-1688  |  Open Access |  How to cite  | 


To assess the parental knowledge and practices regarding infant teething and attitude towards infant oral health among parents of infants aged 6 months to 3-years. Materials and methods: A cross-sectional study was conducted among 400 parents who met the inclusion criteria. A self-designed, validated questionnaire comprising 13 questions was used. Questionnaire comprised of sociodemographic details, knowledge and experience of teething symptoms, practices used to relieve it and overall attitude towards infant oral health. Descriptive statistics and Chi-square test was applied. Results: Parents attributed fever (87%), diarrhea (65%), gum irritation (71%) and desire to bite (78%) as common teething symptoms. Ninety-eight percent of the participants did not know that delayed tooth eruption could be an indicator for systemic disease. In case of first born child, parental knowledge was poor as compared to 2nd or 3rd born child (p = 0.023). Parents had a positive attitude regarding consulting a physician for teething problems and visiting a dentist for issues related to infant oral health. Tlismi necklaces (67%) and homeopathic tablets (25.8%) were two unique remedies identified in this population. Parents also reported over-the-counter use of systemic analgesics (58.2%). Emergence of upper teeth before lower teeth was considered as a bad omen by few parents. Conclusion: Parents wrongly attributed several systemic illnesses as teething symptoms. Though parents had a positive attitude towards infant oral care, it was not inculcated into practice. Clinical significance: Parents should be advised against self-medication and to report systemic illness in children to pediatricians and pediatric dentists for correct diagnosis and appropriate treatment. This study also highlights the need for educating parents about infant teething and oral care practices related to primary dentition for eruption of healthy permanent dentition.


Original Article

Venugopal R Nagireddy, Daneswari Reddy, Niharika Puppala, Ajayreddy Mareddy, Annie Chris

Nanosilver Fluoride—A Paradigm Shift for Arrest in Dental Caries in Primary Teeth of Schoolchildren: A Randomized Controlled Clinical Trial

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:7] [Pages No:484 - 490]

   DOI: 10.5005/jp-journals-10005-1703  |  Open Access |  How to cite  | 


Background: Due to limited financial resources, poor access to basic oral care, and the high cost of restorative treatment, children of low-income nations have their general health, social well-being, and education opportunities affected by untreated dental caries. Arresting caries treatment (ACT) has been proposed to manage untreated dental caries in children of disadvantaged communities. Aims and objectives: The purpose of the present controlled clinical trial is to investigate the effectiveness of a new anticaries agent, nanosilver fluoride (NSF), preventing and arresting caries in children. Materials and methods: A total of 100 deciduous molars both maxillary and mandibular are randomly selected from 60 children of 4–9 years of age group, which were randomly divided into NSF experimental group and saline control group. Teeth were clinically diagnosed and treated by one masked examiner and followed up at 7 days, 5 months and 12 months by another calibrated examiner who was blinded to the type of treatment. The criteria of the ICDAS II were followed to determine the activity of lesion and the diagnosis of caries. The Pearson's Chi-square test was used to compare the groups during different follow-up examinations. Results: Seventy-eight percent of decayed teeth showed hard arrested dentine at 7 days; after 5-month analysis in the NSF group, 72.91% of the teeth showed arrested caries; and in the control group, only 34% of teeth showed arrest of caries. At 12-month analysis in the NSF group, 65.21% of teeth showed arrested cavities, and in the control group, 28.88% of teeth showed arrest of caries. Conclusion: The present study proves that NSF is an anticaries agent and presents a noninvasive option for caries arrest and treatment when applied directly to dentin caries lesions.


Original Article

Beatriz X Ávila-Curiel, Carlos J Solórzano-Mata, José A Avendaño-Martínez, Briceida Luna-Vásquez, Rafael Torres-Rosas

Playful Educational Intervention for Improvement of Oral Health in Children with Hearing Impairment

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:3] [Pages No:491 - 493]

   DOI: 10.5005/jp-journals-10005-1701  |  Open Access |  How to cite  | 


Dental care to vulnerable population is a pending issue in health policies due to the lack of appropriate and specialized strategies. Children with sensory deficits represent a challenge to professionals in prevention of oral diseases fundamentally due to communication problems. Aims and Objectives: This study was conducted to compare the simplified oral hygiene index (OHI-S) before and after a playful learning intervention in children with hearing impairment between 6 years and 11 years. Study design: Educational strategies were adopted for children with hearing impairment in Mexican Sign Language. The intervention consisted of three meetings explaining topics and activities of preventive content on health and oral hygiene for the children and their tutors. Simplified oral hygiene index was determinate before and after intervention. Results: The mean of OHI-S score was 12% good status before the intervention and 64% after the application of the educational strategy. Conclusion: Teachers and dentists can enhance oral health promotion actions to children with hearing impairment in elementary institution using playful learning interventions.


Original Article

Sindura Allani, Jyotsna V Setty, Ila Srinivasan, Apoorva Jawa, Dandamudi Lalitya

Determination of Relationship between Lip Prints and Skeletal Malocclusion in Children of Age 9–14 Years

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:6] [Pages No:494 - 499]

   DOI: 10.5005/jp-journals-10005-1684  |  Open Access |  How to cite  | 


Aim: To determine the relationship between lip prints and sagittal skeletal jaw relation in children of age 9–14 years. Materials and methods: The lateral cephalograms of a total of 90 children were analyzed cephalometrically to categorize as skeletal class I, II, or III jaw relation groups. Each group had 30 patients. Lip prints of each sample were recorded and analyzed. Statistical analysis: The data obtained were statistically analyzed (Z test) to compare lip print patterns among patients of different sagittal skeletal jaw relations. Results: (1) Type IV lip print pattern was significantly higher (p < 0.05) in occurrence on lower lip of class III group males when compared to males of class I group; (2) The proportion of type I lip print pattern on lower lip was significantly higher (p < 0.05) in overall subjects having class II jaw relation; (3) Type II lip print pattern on upper lip and type I lip print pattern on lower lip were significantly higher (p < 0.05) in females of class II group as compared to class III group; (4) Type III upper lip print pattern was significantly higher (p < 0.05) in females of class III group as compared to class II group. Conclusion: In the present study, type I lip print pattern on lower lip was significantly higher (p < 0.05) in overall subjects having class II jaw relation; some interrelations between lip print patterns and malocclusions were found especially in skeletal class II and III jaw relation groups. No definite lip print pattern could be associated with any particular sagittal skeletal jaw relation. Clinical significance: Lips prints and craniofacial skeleton develop at the same embryonic period. Developmental factors that cause malocclusions might also reflect in the lip print patterns.


Original Article

Pratibha Taneja, Ruchi Nagpal, Charu M Marya, Sakshi Kataria, Vibhav Sahay, Deepak Goyal

Temporomandibular Disorders among Adolescents of Haryana, India: A Cross-sectional Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:7] [Pages No:500 - 506]

   DOI: 10.5005/jp-journals-10005-1689  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to determine the prevalence and determinants of temporomandibular disorders (TMD) among 12- to 15-year-old adolescents of Faridabad. Materials and methods: The study included a sample of 300 adolescents (132 males and 168 females) with age ranging from 12 to 15 years. Data were collected through clinical examination and Fonseca anamnestic questionnaire. The prevalence of TMD signs was assessed through Fonseca anamnestic questionnaire while TMD symptoms were measured by clinical examination. Various determinants of TMDs such as Angle's classification, crossbite, overjet, overbite were also recorded. Data were then analyzed using SPSS version 21. Inferential statistics were performed using Chi-square test. Results: The overall prevalence of both TMD signs and symptoms was 51%. Females had higher prevalence (57.1%) of TMD symptoms when compared to males (43.2%). TMD signs has shown a statistical significant relationship with overbite (p = 0.007) and bruxism (p < 0.0001) only. No significant association was found between age, gender, Angle's molar relation, crossbite, and TMD signs. Statistical significant association was found between gender (p = 0.016), Angle's molar relation (p = 0.005), overbite (p = 0.001), crossbite (p = 0.030), bruxism (p < 0.0001), and TMD symptoms. Conclusion: No Significant relationship was reported between malocclusions and TMD sign except for overbite and bruxism, but significant relationship were found between TMD symptoms and malocclusion.


Original Article

Nirmala Krishna

Eye Movement Distraction: A New Distraction Technique for Management of Dental Anxiety during Intraoral Local Anesthesia Administration in Children

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:3] [Pages No:507 - 509]

   DOI: 10.5005/jp-journals-10005-1690  |  Open Access |  How to cite  | 


Background: To evaluate the efficacy of eye movement distraction (EMD) in reducing anxiety during intraoral local anesthetic administration in needle-phobic children. Materials and methods: A total of 228 children aged 8–13 years were divided into two groups: group I (EMD) and group II (control), and subjective feelings of each child were recorded with a faces pain scale-revised (FPS-R) score. Both the groups (I and II) were compared using the Chi-square test. Results: Children in the EMD group showed low FPS-R scores, which is statistically significant when compared to the control group (p < 0.0001). Conclusion: Eye movement distraction can be used as an effective distraction modality to reduce anxiety during local anesthesia administration in needle-phobic children.


Original Article

Dhanu G Rao, Raghavendra Havale, Manasa Nagaraj, Namira M Karobari, Athira M Latha, Namratha Tharay, Santhebachalli P Shrutha

Assessment of Efficacy of Virtual Reality Distraction in Reducing Pain Perception and Anxiety in Children Aged 6–10 Years: A Behavioral Interventional Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:4] [Pages No:510 - 513]

   DOI: 10.5005/jp-journals-10005-1694  |  Open Access |  How to cite  | 


Aim: The aim of the present study was to assess the effectiveness of virtual reality distraction on pain perception and state anxiety levels undergoing restorative treatment in children. Materials and methods: This was an interventional study with 30 children of age 6–10 years came to the Department of Pedodontics and Preventive Dentistry. The intervention was distraction with virtual reality eyeglasses and the parameters considered includes pain perception analyzed subjectively by Wong Baker FACES pain rating scale and objectively by FLACC scale; anxiety was analyzed physiologically by measuring pulse rate and oxygen saturation levels using pulse oximeter. The parameters were recorded before the treatment, i.e., baseline, during and as well as after the restorative treatment procedure. The values noted were tabulated and subjected to appropriate statistical analysis with p value set at 0.05. Results: The study displayed a very high statistical significance in reduction of pain perception and anxiety levels in all the comparisons made at three time periods, i.e., baseline, during and after treatment procedure (p < 0.0001). Conclusion: Virtual reality distraction can be considered as a budding distraction tool in the arena of behavior management that helps adapt the child to dental environment and able to deliver qualitative dental care. Clinical significance: Managing an anxious child is one of the challenging tasks for a pediatric dentist in the day-to-day life. As the world progresses with newer interventions, virtual reality distraction is one among them that has the ability to reduce pain perception and anxiety in children with a positive approach.


Original Article

Jijo Mon, Sharath Asokan, Pollachi RG Priya, Thoppe DY Kumar, Mythili G Balasubramaniam

Effect of Herbal Water, Ozonated Water, Water, and Chlorhexidine Mouthrinses on Oral Health Status of Children: A Randomized Controlled Trial

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:6] [Pages No:514 - 519]

   DOI: 10.5005/jp-journals-10005-1693  |  Open Access |  How to cite  | 


Aim: To evaluate the antibacterial effect of herbal water, ozonated water, and chlorhexidine mouthrinses on salivary Streptococcus mutans level and to assess their effectiveness of these mouthrinses on the oral health status of children. Materials and methods: A parallel multiarm randomized controlled trial was conducted in 100 children aged 10–12 years. Debris index-simplified (DI-S), calculus index-simplified (CI-S), oral hygiene index-simplified (OHI-S) scores, and Streptococcus mutans counts were recorded at baseline (T1). They were randomly divided into four equal groups (n = 25): HW, herbal water; OW, ozonated water; W, water; and CHX, chlorhexidine. Intervention period was 15 days and data collection was repeated after 15 days (T2) and 30 days (T3). Saliva samples were used to evaluate S. mutans count. Results were tabulated and analyzed statistically. Results: OW had minimum DI-S score at T2 and T3 periods. HW had the minimum CI-S score at T2 and T3 periods. CHX had the minimum S. mutans count at T2 and T3 periods. OW showed maximum reduction in OHI-S score at T2 period. HW showed maximum reduction in OHI-S score at T3 period. Conclusion: Herbal water and ozone water can be used as an alternative to chlorhexidine in maintaining the oral health status. Clinical significance: Herbal water and ozonated water can be used in children instead of chemical mouthrinses to avoid any adverse effects.


Original Article

RajaSagi Aswani, Vinay Chandrappa

Resin Infiltration of Artificial Enamel Lesions: Evaluation of Penetration Depth, Surface Roughness and Color Stability

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:4] [Pages No:520 - 523]

   DOI: 10.5005/jp-journals-10005-1692  |  Open Access |  How to cite  | 


Aim: To evaluate the penetration depth, surface roughness, and color stability of resin infiltration restoration of artificial enamel lesions induced in primary and permanent teeth. Materials and methods: Primary (group I, n = 30) and permanent (group II, n = 30) extracted non-carious human anterior teeth were subjected to demineralization for four days after creating a window of 5 mm × 5 mm on the labial surfaces. Demineralized area was infiltrated with the low viscosity resin. Ten samples from each group were evaluated for penetration depth, surface roughness, and color stability, respectively. Penetration depth was determined using a stereomicroscope at 80× magnification. Surface roughness of sound and infiltrated enamel was recorded using a profilometer. The color stability was assessed at 2, 4, and 8 weeks along with baseline values using vita easy shade spectrophotometer. Results: Data were analyzed using the student “t” test and Friedman test. The degree of resin penetration was observed to be higher in primary teeth (32.6 ± 15.72 μm) compared to permanent teeth (24.23 ± 6.85 μm), but no significant difference was found (p = 0.138). Surface roughness values of resin infiltrated enamel is similar to that of sound enamel in both primary (p = 0.617) and permanent teeth (p = 0.234). The mean color stability scores immediately after resin infiltration at 2, 4, and 8 weeks intervals showed no statistically significant difference in primary (p = 0.998) and permanent teeth (p = 0.213). Conclusion: Resin penetration into enamel lesions was more in primary teeth enamel compared to permanent. The early enamel lesions, when treated with resin infiltration, showed surface characteristics similar to sound enamel and also exhibited acceptable color up to 8 weeks duration. Clinical significance: Resin infiltration can be considered as an effective and predictable treatment option for the restoration of early enamel lesions owing to its deeper penetration, provision of better surface characteristics, and reliable masking of white spot lesions in both primary and permanent dentitions.


Original Article

Rohan Chaudhary

Comparative Microbiological Evaluation after Caries Removal by Various Burs

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:4] [Pages No:524 - 527]

   DOI: 10.5005/jp-journals-10005-1678  |  Open Access |  How to cite  | 


Aim: The aim of the study was to compare the caries removal efficacy in terms of bacteriology and efficiency in terms of time taken by conventional and smart burs. Materials and methods: A total of 40 extracted permanent molars with occlusal caries were selected for this study. These teeth were split at the center of carious lesion buccolingually, in order to obtain two similar halves. Thus, 80 samples were obtained in this way and were randomly divided into 2 groups of 40 samples each. Caries was removed using conventional burs in group I and polymer bur Smartprep (SS white) in group II. The time involved in caries removal was measured for both the groups. After excavation of all carious lesions, the samples were decalcified, dehydrated, and embedded in paraffin wax from which thin sections of 5 μm were obtained, which were histologically evaluated for bacterial presence under a light microscope. Results: An intergroup comparison between conventional bur (group I) and smart bur (group II) showed a statistically nonsignificant difference in terms of the presence of microorganisms after caries removal with a p value of 0.073638 (p > 0.05). However, the time taken for caries removal was significantly more for smart burs than diamond burs with a p value of 0.001 (p < 0.05). Conclusion: The polymer burs were found to be as effective as the conventional burs in terms of microbial presence after caries removal, but are more time-consuming than conventional burs.



Dichen P Bhutia, Geeta Singh, Shadab Mohammed, Hari Ram, Jagdish Gamit, Debraj Howlader

Prevalence and Etiology of Pediatric Maxillofacial Injuries: A Unicenter-based Retrospective Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:4] [Pages No:528 - 531]

   DOI: 10.5005/jp-journals-10005-1687  |  Open Access |  How to cite  | 


Background: Children are uniquely susceptible to craniofacial trauma because of their greater cranial mass-to-body ratio. The craniofacial injuries comprise approximately 11.3% of an overall pediatric emergency, and its etiology affects the incidence, clinical presentation, and treatment modalities, which are influenced by sociodemographic, economic, and cultural factor of the population being studied. Materials and methods: A retrospective review to analyze the epidemiology of facial injuries in pediatric population (age range-0–16 years), divided into three age groups, i.e., group I (0–5 years), group II (6–11 years) and group III (12–16 years), was carried out over a 3-year span, in order to determine the facial injury pattern, mechanism and concomitant injury by age. Results: A total of 1,221 patients with facial injuries, reporting to our trauma center and outpatient department were identified. Majority of these injuries were encountered among boys (64%). Motor vehicle collision (46.5%) was the most common cause of facial fracture and dentoalveolar injuries in group II and group III, while fall was the most common cause among the group I (30.2%). Mandible was the most commonly fractured bone (34.7%) followed by nasal (33.3%), maxilla (17.5%), and zygoma (14.3%). More than 50% sustained concomitant injuries. Conclusion: The importance of epidemiological analysis lies in the identification of trauma burden, which could help motivate and develop more efficient ways to plan resources allocation and deliver adequate care and preventive steps. Improvisation upon National Prevention Programs could lower incidences of such injuries.



Ramya Rai, Kukkalli K Shashibhushan, Prashant Babaji, Pradeep M Chandrappa, Vundela R Reddy, Zeenath Ambareen

Clinical and Radiographic Evaluation of 3Mix and Vitapex as Pulpectomy Medicament in Primary Molars: An In Vivo Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:6] [Pages No:532 - 537]

   DOI: 10.5005/jp-journals-10005-1686  |  Open Access |  How to cite  | 


Objective: To evaluate the clinical and radiographic success rates of 3Mix and Vitapex in the treatment of necrosed primary teeth. Materials and methods: Seventy teeth of healthy children aged 4–9 years with necrotic primary molar (nonvital) were treated with 3Mix (lesion sterilization tissue repair therapy) and Vitapex before restoration with stainless steel crowns. The participants were followed up clinically and radiographically for 3 months and 6 months, respectively. The outcome was compared using Fisher exact test with a significance level of p < 0.05. Results: Clinical success rate of 3Mix group at 3 months and 6 month follow-up was 100% and 97.14% and that of Vitapex group was 100% and 100%, respectively. The radiographic success rate of 3Mix group at 3 months and 6 months was 74.29% and 77.14% and of Vitapex group was 97.14% and 97.14%, respectively. Considering the clinical success, no statistical difference was found between the two groups at the end of 6 month (p = 1.000). But radiographically statistical significant difference was found between the two groups (p = 0.028). Conclusion: Non-instrumentation endodontic treatment using 3Mix has shown a good clinical success of 97.14% but the radiographic success rate at 6 months was lower (77.14%). So it can be suggested that the use of 3Mix antibiotic treatment cannot replace conventional root canal treatment over the long term.



Jagruti H Thakur, HN Subhadra

Evaluation of CRAFT as a Tool for Caries Risk Assessment in 3- to 6-year-old Children and its Validation against Alban's Test: A Pilot Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:538 - 542]

   DOI: 10.5005/jp-journals-10005-1698  |  Open Access |  How to cite  | 


Introduction: Dental caries is a multifactorial disease and a dynamic process that can be prevented and reversed during the early stage. Risk assessment is an important step in decision-making and treatment planning. There are no valid tools available for the Indian population. Caries risk assessment for treatment (CRAFT) is a chairside tool for caries risk assessment and management. Valid, reliable, economical, and chairside caries risk assessment tool is the need of the hour for general and pediatric dentists. Aim: To evaluate CRAFT as a tool for caries risk prediction among 3-years to 6-years-old children and to validate it against Alban test. Materials and methods: A pilot study was conducted, including forty 3-years to 6-years-old children. Salivary samples were collected and inoculated on B.C.G.-Dextrose Agar. Caries activity was assessed using Alban test. Their parents/guardians completed the CRAFT assessment in entirety. Results: The data were tabulated and subjected to suitable statistical analysis. High positive correlation between CRAFT scores and Alban's test (Spearman's Rho = 0.874) was found. Conclusion: CRAFT scores were highly correlated with Alban scores in 3- to 6-year-old children. CRAFT could be successfully employed as a reliable, economical, chairside, and clinically feasible risk assessment tool with further research on a larger sample size. Clinical significance: CRAFT can provide a framework for the clinician for preventive care and enhance patient–participation for CRA.



Gilmar J Begnini, João A Brancher, Ana TB Guimarães, Melissa R de Araujo, Eduardo Pizzatto

Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:543 - 547]

   DOI: 10.5005/jp-journals-10005-1691  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate the oral health conditions of children and adolescents with attention deficit hyperactivity disorder (ADHD). Materials and methods: Two groups were selected: a test group comprising 51 individuals with ADHD and a control group with 50 individuals without ADHD, with ages ranging from 7 to 14 years. Through an intraoral clinical examination, the numbers of decayed, missing, and filled teeth (DMFT index), the visible plaque index (VPI), the gingival bleeding index (GBI), bruxism, and dental traumatism were verified. A questionnaire confirmed oral hygiene supervision. Results: In the test group, the average DMFT index was 3.41 while it was 2.52 in the control group (p = 0.405). The VPI in the test and control groups was 36.84% and 24.54%, respectively (p = 0.004). The GBI was 8.37% for the test group and 4.94% for the control group (p = 0.012). The DMFT index when supervised the oral hygiene by those responsible in comparison with the nonsupervision was 1.89 and 4.31, respectively, in the test group, and 1.71 and 2.94, respectively, in the control group. Conclusion: These data suggest that children and adolescents with ADHD present with worse oral health conditions and need greater attention from dental professionals and those responsible for their diet and oral hygiene. Clinical significance: Attention deficit hyperactivity disorder needs a special attention. This research brings this important issue focus on oral health.



Puneet M Khari

Evaluation of Clinical Effectiveness and Patient Acceptance of Hall Technique for Managing Carious Primary Molars: An In Vivo Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:548 - 552]

   DOI: 10.5005/jp-journals-10005-1699  |  Open Access |  How to cite  | 


Introduction: Hall technique (HT) is a biological approach where decay is sealed under preformed metal crowns without any caries removal, tooth preparation or local anesthesia. Dental caries is one of the most common prevailing chronic condition that affect both adults and children. Since children are anxious and apprehensive to dental treatment, their uncooperative behavior might cause hindrance in the treatment, which often leads to manage them in general anesthesia. To better address the dental care needs in pediatric patients, dental surgeons require some alternatives for management of caries and restorative treatment in children. The Hall technique is one such conservative treatment approach developed by Dr Norna Hall in 1980s. Aim: The purpose of this study was to assess the clinical effectiveness and patient acceptance of Hall technique for managing carious primary molars. Materials and methods: 84 children in the age group 6–10 years with class I and class II carious lesions limited to dentin were selected for the study. Occlusal vertical dimension (OVD) was measured preoperatively, postoperatively and after 6 months. Discomfort level was assessed by facial pain rating scale and by questionnaires filled on the day of placement of SS crown, 1 week after placement and 6 months after placement. Results: The Hall technique was found to be successful, as there was no failure clinically as well as radiographically within 6 months of placement of SS crown. The increased OVD postoperatively returned to its normal values within 6 months, the mean change in the OVD was found to be statistically significant (p = 0.02). Conclusion: The Hall technique proved to be clinically effective and acceptable by maximum number of children.



Sheeja R Mathew, Retna K Narayanan, Kannan Vadekkepurayil, Jeeva Puthiyapurayil

One-year Clinical Evaluation of Retention Ability and Anticaries Effect of a Glass Ionomer-based and a Resin-based Fissure Sealant on Permanent First Molars: An In Vivo Study

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:7] [Pages No:553 - 559]

   DOI: 10.5005/jp-journals-10005-1702  |  Open Access |  How to cite  | 


Aim: To evaluate and compare the retention ability, anticaries effect and marginal discoloration when sealed with a glass ionomer-based sealant (Fusion i-seal) and a resin-based fissure sealant (Helioseal-F) on permanent first molars. Materials and methods: Caries free, fully erupted permanent first molars of 50 children between 6 years and 8 years were sealed with pit and fissure sealants under rubber dam isolation. Glass ionomer-based sealant was applied on a permanent first molar and the contralateral molar with resin-based sealant. The sealants were evaluated at regular intervals for a period of 1 year. Statistical analysis was done by Chi-square test. Results: Higher retention rates were noted for resin-based sealant (88%) compared to glass ionomer-based sealant (78%). None of the teeth sealed with resin sealant developed caries whereas 2% of teeth sealed with glass ionomer sealant developed caries. Marginal discoloration was not noted in teeth sealed with glass ionomer sealant whereas slight marginal discoloration was noted for 6% of teeth sealed with resin sealant. Conclusion: Clinically a difference was noted in the retention rate, anticaries effect and marginal discoloration whereas statistically no significant difference was noted for the two sealants after 1 year. Clinical significance: Pit and fissure sealants are highly effective and economical in preventing occlusal caries in young permanent tooth with low failure rate.



Rama S Choudhary

Animal Bite in a 6-month-old Child and Facial Injury with Associated Unusual Nasal Injury: Management of Injuries along with 1-year Follow-up

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:6] [Pages No:560 - 565]

   DOI: 10.5005/jp-journals-10005-1683  |  Open Access |  How to cite  | 


In children, accidental injuries (AI) are the most common cause of major trauma. Although rare, nonaccidental injuries (NAI) can also cause major trauma. Among NAI, animal bites form a significant fraction. Animal bites form a significant fraction of NAI in children. Amongst animal bites, dog and cat bites are the most common. In adults, the likelihood of bites is on leg/thigh but in children due to their low stature, bites are more common on scalp, head, neck, or chest region. As children have lower tissue mass/size, what appears a small wound in adults comparatively appears as a larger wound in children, causing severe disfigurement. The present paper discusses cat bite injury to maxillofacial region, distinguishing from other differential diagnoses. Potential complications, initial management, and total rehabilitation of facial injuries especially nasal injury caused by a cat in a 6-month-old child are also discussed.



Green Pigmentation of Teeth Caused by Neonatal Cholestatic Jaundice and Sepsis: A Case Report

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:3] [Pages No:566 - 568]

   DOI: 10.5005/jp-journals-10005-1696  |  Open Access |  How to cite  | 


Aim: The aim of this article is to report a case of green discoloration of primary teeth associated with neonatal cholestatic jaundice and sepsis in a 2-year-old girl. Background: Systemic changes can lead to dental alterations of the teeth. One of the disorders is elevated serum bilirubin levels that can cause pigmentation of teeth. Green pigmentation of teeth is uncommon, but when it occurs, is a cause of concern for parents and the child, as he may also loose self-confidence. Case description: The parents reported to the clinic with the child whose chief complaint was green pigmented teeth. Her medical records revealed she was preterm and was diagnosed with neonatal cholestatic jaundice which lead to hyperbilirubinemia and sepsis. On review at 36 months of age, all her deciduous teeth were completely erupted and a striking demarcation was visible between the green incisal edges and the normally colored cervical one-thirds of all primary teeth. Treatment alternatives were suggested and the child was kept on regular follow-ups. Conclusion: So, one should be aware of such condition and seek medical practitioner or reports to confirm the diagnosis. If such a condition exists, esthetic treatment can be achieved with the newer techniques in cosmetic dentistry. Clinical significance: Green pigmentation has very limited causes. The time of illness coincides with the stage of tooth formation. Proper medical history is important to evaluate the extent of pigmentation and probable involvement of the permanent teeth.



Anshad M Abdulla, Abdulrahman Y Almaliki, Nasim V Shakeela, Zuhair Alkahtani, Majed AS Alqahtani, Shan Sainudeen, Shaheen V Shamsuddin

Prosthodontic Management of a Pediatric Patient with Christ-Siemens-Touraine Syndrome: A Case Report

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:4] [Pages No:569 - 572]

   DOI: 10.5005/jp-journals-10005-1697  |  Open Access |  How to cite  | 


Ectodermal dysplasias (ED) are a group of rare genetic disorders characterized by congenital defects involving two or more ectodermal structures. Christ-Siemens-Touraine syndrome or hypohidrotic ectodermal dysplasia is the commonest form of ED. Hypohidrotic ectodermal dysplasia (HED) is an X-linked disorder characterized by excessively dry skin due to the absence of sweat glands (anhidrosis), sparse body hair especially on the scalp and eyebrows (hypotrichosis), brittle nails, absence of sebaceous glands (asteatosis) and malformed or absent teeth. Oral manifestations include oligodontia or complete anodontia, conical teeth, underdeveloped alveolar ridges, generalized spacing and delayed eruption of permanent teeth. This case report discusses a classical case of HED and the options for rehabilitation in a growing patient. A thorough knowledge about the clinical manifestations of ED will lead to proper diagnosis and appropriate treatment plan thereby leading to significant improvements in esthetics, phonetics and masticatory function in ED patients, which in turn leads to improved quality of life in these individuals.



Sarah A Mubaraki

Hypoplasia Resulting from Nutritional Deficiency: A Case Report

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:4] [Pages No:573 - 576]

   DOI: 10.5005/jp-journals-10005-1700  |  Open Access |  How to cite  | 


Aim: The aim of the study was provide information to dentists about the causes of enamel hypoplasia and treatment alternatives available to dentists working with immature permanent teeth. Background: Hypoplasia resulting from nutritional deficiency is a developmental anomaly resulting from defects in amelogenesis. The treatment strategy should be based on the degree of involvement as well as the functional and esthetic needs in each case. Case description: This article reports the case of a 14-year-old boy presenting with enamel hypoplasia affecting multiple anterior and posterior teeth that were treated conservatively. Conclusion: Enamel hypoplasia resulting from severe calcium deficiency affects esthetics, child self-esteem, and quality of life. This report highlights the history of severe calcium deficiency during childhood, and conservative treatment to improve the esthetic and reduce tooth sensitivity. Clinical significance: Conservative approach was done for all the affected permanent teeth and was used to improve the esthetic and to have an effective transitional treatment to tell the child to reach a stage of stable occlusion.



Fabienne Wotjiuk, Isabelle Hyon, Sylvie Dajean-Trutaud, Zahi Badran, Tony Prud homme

Dental Management of Neurofibromatosis Type 1: A Case Report and Literature Review

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:577 - 581]

   DOI: 10.5005/jp-journals-10005-1668  |  Open Access |  How to cite  | 


Neurofibromatosis type 1 (NF1) is a clinically heterogeneous neurocutaneous genetic disorder that manifests in the form of coffee-milk spots on the skin, Lish nodules, lentigines on the underarms and on the inguinal region, and neurofibromas. Orofacial manifestations of NF1 are common. Through a review of the literature, bone lesions, orthodontic and dental abnormalities, periodontal manifestations, and caries related to NF1 will be explored. In this study, we present a clinical case of a patient with neurofibroma in the oral cavity and infraocclusion of primary molars, as well as his dental management.



Raed R Gholman, Emtenan H Felemban

Dental Rehabilitation of a Child with Acute Lymphocytic Leukemia: A Case Report

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:582 - 586]

   DOI: 10.5005/jp-journals-10005-1664  |  Open Access |  How to cite  | 


Leukemia is the cancer of blood cells and bone marrow and it is the most common cancer in children. The cause of acute lymphocytic leukemia is unknown, but many predisposing risk factors could be associated, such as an exposure to radiation, chemical or viral infections. A six-year-old boy was presented with multiple carious teeth and severe pain related to his lower left teeth. Regarding medical history, the child was diagnosed with acute lymphocytic leukemia and after consultation with patient's physician; dental treatment was planned to be accomplished under general anesthesia. The aim of treatment was to eliminate sources of infections, restore carious teeth, relief pain, and improve oral hygiene and patient's parents\' education regarding general and oral health. Full-mouth rehabilitation was accomplished after preparing the patient with pediatric hematology/oncology team under general anesthesia. During recall visits, good oral hygiene and caries-free teeth were obtained. It is important to have solid knowledge regarding the medical conditions, the necessary consultations with medical subspecialties and the appropriate timings for treatment.



Avantika Tuli, Shivangi Chandra, Ayush Pokhriyal, Shalini Tomar

A New Home for a Streetless Occupant: A Case Report

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:3] [Pages No:587 - 589]

   DOI: 10.5005/jp-journals-10005-1639  |  Open Access |  How to cite  | 


This is a case report of a 14-year-old female patient in whom a premolar from a donor was used as an allotransplant to replace her missing lower premolar. The treatment results over 6 months showed successful periodontal healing and functioning of the allotransplanted tooth. The aim of this paper is to report a procedure, allotransplantation of tooth, which is followed from ages but less preferred and documented and is surrounded by variable prognosis and also highlight the use of a intentionally extracted tooth for orthodontic purpose, which otherwise goes as a waste and moreover the use of this technique can supplement the need of an implant for the time being in the young patient without compromising her alveolar bone height, functioning, and esthetics.


Survey Article

Aroonika S Bedre, Deepa Gurunathan

Knowledge and Awareness among General Dental Practitioners in Chennai Regarding Rehabilitation with Full Coverage Restoration in Children

[Year:2019] [Month:November-December] [Volume:12] [Number:6] [Pages:5] [Pages No:590 - 594]

   DOI: 10.5005/jp-journals-10005-1674  |  Open Access |  How to cite  | 


Introduction: The endodontic treatment of primary teeth does provide symptomatic relief and masticatory rehabilitation to the child, but mere completion of endodontic procedure does not guarantee long-term success. Teeth that have not been restored coronally after endodontic treatment have high chances of failure. Aim: The aim of this study was to evaluate the knowledge and awareness among general dental practitioners in Chennai regarding rehabilitation with full coverage restoration in children following pulp therapy. Materials and methods: A multiple choice questionnaire comprising 15 questions was given to 150 general dental practitioners in Chennai. The questionnaire assessed their knowledge and clinical practice of pulp therapy, tooth preparation, and restorative crowns for pediatric patients. The data were collected and statistically analyzed. Results: The findings of this study reveal wide variations in the knowledge and practice of general dental practitioners in Chennai regarding rehabilitation with full coverage restoration in children. Conclusion: The conclusion drawn from this study is that we need to update their knowledge regarding rehabilitation with full coverage restorations in children.


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