International Journal of Clinical Pediatric Dentistry

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2020 | January-February | Volume 13 | Issue 1

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Original Article

Y Hasita Manaswini

Impact of Calcium Glycerophosphate-supplemented Carbonated Beverages in Reducing Mineral Loss from the Enamel Surface

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:1 - 5]

Keywords: Calcium glycerophosphate, Carbonated beverage, Erosion, Hardness, Tooth demineralization

   DOI: 10.5005/jp-journals-10005-1705  |  Open Access |  How to cite  | 


Aim: The aim of this study was to evaluate the surface microhardness and mineral loss from enamel exposed to carbonated beverages supplemented with and without calcium glycerophosphate (CaGP). Materials and methods: Forty enamel blocks were prepared from 20 extracted premolars, and their initial surface microhardness was measured using the Knoop microhardness testing machine. The samples were divided into four groups based on the concentration of CaGP added to the beverage: group I: beverage without CaGP (control group), group II: beverage with 2 mM CaGP, group III: beverage with 5 mM CaGP, and group IV: beverage with 10 mM CaGP. The samples were subjected to four cycles of exposure to plain and CaGP-supplemented carbonated beverage with an intermittent buffering in artificial saliva, after which the final surface microhardness was measured. The mineral loss from enamel blocks was estimated spectrophotometrically. Results: The obtained data were analyzed using paired t test and analysis of variance. A highly significant (p < 0.01) reduction in surface microhardness was observed in group I (beverage without CaGP). The reduction in surface microhardness in group III (beverage + 5 mM CaGP) and group IV (beverage + 10 mM CaGP) was not significantly different from that of sound enamel. A highly significant difference in calcium loss was observed between the groups (p = 0.00). Calcium loss reduced as the CaGP concentration increased in the groups. A similar trend was observed when phosphate loss was analyzed. Conclusion: Addition of CaGP to the carbonated beverages significantly prevented the reduction in surface microhardness of enamel and mineral loss. As the concentration of CaGP in carbonated beverages increased from 2 mM to 10 mM, the mineral loss is decreased. Clinical significance: Consumption of carbonated beverages has been increasing among the children and adolescents, leading to a higher incidence of dental erosion and caries. Hence, supplementation of these acidic beverages with buffering agents such as CaGP may help in preventing such dental problems among vulnerable populations.


Original Article

Kempaiah S Madhusudhan, Nitin Khargekar

Nutritional Status and its Relationship with Dental Caries among 3–6-year-old Anganwadi Children

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:6 - 10]

Keywords: Anganwadi, BMI-for-age, Dental caries, Malnutrition

   DOI: 10.5005/jp-journals-10005-1706  |  Open Access |  How to cite  | 


Aim: The purpose of this study is to determine dental caries status in 3–6-year-old malnourished children. Materials and methods: A total of 500 children aged 3–6 years enrolled in anganwadi were selected for this study. The nutritional status was evaluated by anthropometric measurements such as body weight and height [body mass index (BMI)-for-age]. Dental caries status was recorded according to WHO criteria. The obtained data were subjected to statistical analysis. Results: The prevalence of underweight was 41% and prevalence of dental caries was 61%. Conclusion: Low BMI-for-age is a risk factor for dental caries. Clinical significance: Inclusion of BMI-for-age calculation in routine case history pro forma helps in timely diagnosis, prevention, and treatment of children suffering from malnutrition.


Original Article

Richa Singhal, Pratibha Patil, Mahantesh Siddibhavi, Anil V Ankola, Roopali Sankeshwari, Vaibhav Kumar

Antimicrobial and Antibiofilm Effect of Cranberry Extract on Streptococcus mutans and Lactobacillus acidophilus: An In Vitro Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:11 - 15]

Keywords: Cranberry, Minimum bactericidal concentration, Minimum inhibitory concentration

   DOI: 10.5005/jp-journals-10005-1707  |  Open Access |  How to cite  | 


Background: Nature has been a source of medicinal treatments since millennia and plant-based systems continue to play an essential role. Aim: To study the antimicrobial and antibiofilm effect of cranberry on Streptococcus mutans and Lactobacillus acidophilus. Materials and methods: The ethanolic extract of cranberry was tested against standard MTCC strains of S. mutans (MTCC 25175) and L. acidophilus (MTCC 8129) for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The time kill assay was performed to check the time-dependent bactericidal effect of the cranberry extract on microorganisms. Percentage of cell adhesion and biofilm inhibition of the dental microorganism at various doses of cranberry extract was measured by a spectrophotometer and biofilm morphology characteristics were observed under scanning electron microscopy. All the tests were carried out in triplicates. Data were computed in the SPSS software and mean/SD was determined. The results are presented in a descriptive manner; Kruskal–Wallis analysis of variance (ANOVA) and the Friedman's test were applied for comparative evaluation of the groups. p value <0.05 was considered statistically significant. Results: The results showed that MICs of cranberry extract against S. mutans and L. acidophilus are 12.5 mg/dL and 6.125 mg/dL, respectively, and MBCs are 25 mg/dL and 12.5 mg/dL, respectively. A significant decrease in the biofilm formation and cell adhesion of microorganisms at MIC (50%) and MBC (70%) was observed as compared to control as observed under a spectrophotometer and a scanning electron microscope. Conclusion: This study has identified bactericidal, bacteriostatic, and antibiofilm effects of cranberry extract against S. mutans and L. acidophilus in a time-dependent and dose-dependent manner.


Original Article

Kirti Chaudhry, Manjit Talwar, Narasimha RV Vanga, Gurvanit K Lehl

A Comparative Evaluation of Three Different Dental Age Estimation Methods in India: A Test of Ethnic Variability

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:16 - 20]

Keywords: Demirjian method, Dental age estimation, Forensic odontology, Forensic sciences, Haavikko method, Willems method

   DOI: 10.5005/jp-journals-10005-1708  |  Open Access |  How to cite  | 


Aim: The present study aimed to evaluate and compare the applicability of Demirjian, Willems, and Haavikko methods of dental age estimation in southeastern (Dravidian ethnicity) and northwestern regions (Aryan ethnicity) of the Indian population. Materials and methods: The study includes the orthopantomographs (OPGs) of 303 individuals (173 males and 130 females) of age ranging from 5 to 14 years. The participants in the present research were evaluated under two study groups: group I: participants of the southeastern region and group II: participants of the northwestern region. Dental age was calculated using Demirjian, Willems, and Haavikko methods and compared with the chronologic age of each participant. The accuracy of dental age estimation methods was evaluated by mean absolute error. One-way analysis of variance (ANOVA) and Student's t tests were used to test the significant difference between the chronologic age and estimated dental ages. Results: The Demirjian method showed overestimation, while Willems and Haavikko methods showed underestimation for boys and girls in both the ethnic groups of Indian population. The Willems method of dental age estimation showed comparatively more accurate and reliable results in both the ethnic groups of the Indian population. Conclusion: The dental age estimation by Demirjian, Willems, and Haavikko methods showed no significant variation between the different ethnicities of the Indian population. Clinical significance: The present research will be helpful in pedodontic, orthodontic, and forensic investigations for accurate and reliable dental age estimation in different parts of Indian population.


Original Article

Vignesh Ravindran, Aravind S Kumar

Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:6] [Pages No:21 - 26]

Keywords: Pediatric rotary files, Postoperative pain, Reciprocating files

   DOI: 10.5005/jp-journals-10005-1709  |  Open Access |  How to cite  | 


Aim: The purpose of this randomized clinical trial was to evaluate the intensity and duration of postoperative pain after pulpectomy of primary teeth using three preparation techniques. Materials and methods: A total of 60 patients were randomly allocated to three groups of 20 patients each, according to the root canal instrumentation techniques used. In group I, the teeth were prepared using manual NiTi K flex files till size 35. In group II, the teeth were prepared using NiTi K flex files till size 35 in reciprocating motion. In group III, the teeth were prepared using Kedo-S pediatric rotary files. After root canal preparation, the canals were obturated with endoflas paste and were restored permanently with composite filling material. The intensity and duration of postoperative pain were evaluated after 6, 12, 24, 48, and 72 hours, using a four-point pain-intensity scale. Results: There was a statistically significant difference among the groups, wherein the postoperative pain was more in NiTi K flex files used in reciprocating motion followed by manual NiTi K flex files and Kedo-S pediatric rotary files. Conclusion: Postoperative pain was more with NiTi K flex files in reciprocating motion and was less with Kedo-S rotary files after root canal preparation in primary maxillary molars.


Original Article

Thejavinuo Suohu, Swati Sharma, Pooja Mishra

A Comparative Evaluation of Pain Perception and Comfort of a Patient Using Conventional Syringe and Buzzy System

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:4] [Pages No:27 - 30]

Keywords: Buzzy system, Conventional syringe, Pain perception

   DOI: 10.5005/jp-journals-10005-1731  |  Open Access |  How to cite  | 


Aim and objective: To evaluate the pain perception and comfort of patient during local anesthesia (LA) delivery using Buzzy system and conventional syringe. Materials and methods: Fifty children aged 5 to 10 years were randomly divided into two groups, the main inclusion criteria being administration of LA for dental treatment. Parameters include Wong Baker face pain reading scale (WBFPRS) for subjective evaluation and pulse oximeter and face leg activity crying consolability (FLACC) scale for objective evaluation. The values obtained were statistically analyzed. Results: FLACC score was higher in conventional group as compared to the Buzzy group, which was statistically significant. Conclusion: External cold and vibration via Buzzy can reduce pain and anxiety during LA delivery.


Original Article

Vinola Duraisamy, Ananda X Pragasam, Suresh K Vasavaih, John B John

Maternal Knowledge Regarding Feeding Practices and its Effect on Occlusion of Primary Dentition in Children: A Cross-sectional Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:4] [Pages No:31 - 34]

Keywords: Dentition, Feeding practices, Maternal knowledge, Occlusion

   DOI: 10.5005/jp-journals-10005-1737  |  Open Access |  How to cite  | 


Background: Infant feeding practices are an important factor influencing malocclusion in deciduous dentition, which can have long-lasting negative outcomes on oral health-related quality of life. Hence, knowledge, attitudes and cultural practices of mothers are vital in prevention of this. Objective: The present study was carried out to assess the mother's knowledge about feeding practices and its influence on primary dentition. Materials and methods: The current study was a cross-sectional study of 187 mothers of 3- to 5-year-old children identified with malocclusion, conducted in the pedodontics department of tertiary care teaching dental hospital in South India. Results: Majority of the mothers were graduates (31.6%) or undergraduates or postgraduates (42.8%). The duration of breastfeeding was 0–3 months in 9.1%, 3–6 months in 23%, 6–12 months in 30.5%, and >12 months in 37.5%. Bottle-feeding was reported by 21.4%. Only 52.4% of the mothers were aware about caries, and 66.2% were aware of malocclusion. The prevalence of malocclusion was 63.6% in study population, and the prevalence of caries was 30.5%. The most common type of malocclusion was overjet seen in 20.9% of study subjects. The proportion of children with crowding, open bite, and crossbite was 17.1, 15, and 10.7%, respectively. There was a gradually increasing trend in malocclusion awareness with increasing educational status of the mother which was statistically not significant (p value = 0.119). The proportion of malocclusion was highest in children who received breastfeeding between 3 months and 6 months and was highest (69.8%) in children who received bottle-feeding for more than 12 months. None of the factors had shown a statistically significant association with malocclusion in study population. Conclusion: The prevalence of malocclusion is high in children, and mothers’ awareness regarding malocclusion is poor. Clinical significance: There is a need to educate mothers about proper feeding practices to prevent dental malocclusion.


Original Article

Sakshi Tyagi, Ekta Choudhary, Rajat Chauhan

A Comparative Evaluation of Two Commonly Used GP Solvents on Different Epoxy Resin-based Sealers: An In Vitro Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:3] [Pages No:35 - 37]

Keywords: Endodontic solvents, Microhardness, Resin-based sealers

   DOI: 10.5005/jp-journals-10005-1741  |  Open Access |  How to cite  | 


Aim: This study evaluates epoxy resin-based sealers after their final set, immersed in Endosolve-R or xylene for 1–2 minutes, for its easy removal mechanically after softening. Materials and methods: Sixty Teflon molds were grouped with 20 samples in each of the three commercially available sealers, i.e., AH 26, AH Plus, and Adseal. The sealers were put in the specific molds after their manipulation as per the instructions given in the literature by the manufacturer. They were allowed to harden for 2 weeks at 37°C in 100% humidity. Two subgroups, A-Xylene and B-Endosolv-R, of 10 samples each, were formed from 20 set specimens based on solvents to which they were immersed for 1 and 2 minutes, respectively. The data obtained was subjected to the Mauchly's test one-way ANOVA and two-way ANOVA for analysis. Results: It was proved that for all the sealers immersed in solvents, there was a significant reduction in the mean Vickers hardness as the time increases. There was a significant difference in the initial hardness between the mentioned sealers with AH plus showing the highest followed by AH 26 and Adseal showing the lowest. AH Plus and Adseal sealers were softened by xylene after 2 minutes of their initial microhardness (p < 0.001); least effect was seen on AH 26. After 2 minutes, Endosolv-R softened initial microhardness of all the three sealers (p < 0.001). Conclusion: It was concluded that Endosolv-R was more effective in softening the epoxy-based resin sealer than xylene, after 2 minutes of exposure.


Original Article

Apra Butail, Sheeba Saini, Ananya Chauhan, Swati Rana

Evaluation of Marginal Microleakage and Depth of Penetration of Different Materials Used as Pit and Fissure Sealants: An In Vitro Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:38 - 42]

Keywords: Microleakage, Penetration depth, Pit and fissure, Sealants

   DOI: 10.5005/jp-journals-10005-1742  |  Open Access |  How to cite  | 


Objective: Fissure sealants hold a great significance in the preclusion of inception of caries process. The present in vitro study assesses the marginal sealing ability and penetration depth of various dental products used as pit and fissure sealants. Study design: Sixty freshly extracted human non-carious premolars were arbitrarily categorized into four groups of 15 samples. Prophylaxis of occlusal surfaces of sample teeth was done with pumice slurry and sealant was applied. Later, the teeth underwent thermocycling and immersion in 5% methylene blue for 24 hours. Sectioning of teeth samples was done buccolingually and they were analyzed under stereomicroscope. Statistical analysis used: Nonparametric tests Kruskal–Wallis and Mann–Whitney were applied to carry out microleakage comparison. The percentage penetration depth was compared using the one-way analysis of variance (ANOVA) test. Tukey's post hoc test was applied for multiple analogies. Results: Highest microleakage was seen in glass ionomer-based sealant followed by flowable composite and least for classical sealant. Flowable nanocomposite gave comparable results with that of the classical sealant. No statistical difference was found with respect to depth of penetration between different tested materials. Conclusion: Flowable nanocomposite can be considered as a promising substitute for sealing fissures and thus can be endorsed to caries-susceptible pediatric patients.


Original Article

Swapna V Devarasanahalli, Ranjini M Aswathanarayana, Ashwath H Venkateswara, Roopa R Nadig

Microtensile Bond Strength of Composite Resin Following the Use of Bromelain and Papain as Deproteinizing Agents on Etched Dentin: An In Vitro Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:43 - 47]

Keywords: Adhesion, Bromelain, Papain

   DOI: 10.5005/jp-journals-10005-1743  |  Open Access |  How to cite  | 


Aim and objectives: The aim of this study was to evaluate and compare the deproteinizing effect of sodium hypochlorite, bromelain, and papain on microtensile bond strength of composite resin to etched dentin. Materials and methods: Eighty freshly extracted permanent molars were wet grounded into a flat surface using a diamond disk to expose the superficial dentinal surface. Teeth were etched with 37% phosphoric acid for 15 seconds and rinsed with water and blot dried. Teeth were divided into four groups (n = 20) based on the method of dentin deproteinization. Group I: only etching; group II: deproteinized with 5.25% sodium hypochlorite for 1 minute; group III: deproteinized with 8% bromelain enzyme for 1 minute; and group IV: deproteinized with 8% papain enzyme for 1 minute. All the samples were washed off with distilled water to remove deproteinizing agents. Sample surfaces were blot dried and bonding of the dentin surface was performed and restored with light cure bulk fill composite. Samples were stored in distilled water (37°C/24 hours) and thermocycled. Then, the teeth were longitudinally sectioned and individually fixed to a sectioning block using acrylic resin. The block was mounted on hard tissue microtome and sectioned to get one to three slabs of 1 mm thick sections. The beam was then attached to a custom-made jig using screws subjected to the Instron universal testing machine. A tensile load was applied at a crosshead speed of 0.5 mm/minute until the beam fractured. Results: Higher mean bond strength was recorded in group IV followed by group III, group II, and group I, respectively. Group III presented a statistically significant highest mean score compared to other study groups with group I and group II (p < 0.001), followed by group IV having significantly higher mean score compared to group I and group II (p < 0.001) and finally a significant difference was observed between group II and group I (p < 0.001). However, the mean microtensile bond strength score did not differ significantly between group III and group IV (p = 0.20). Conclusion: Within the limitations of this present in vitro study, the following conclusions were drawn. The microtensile bond strength of dentine tested in various deproteinizing agents is as follows: 8% bromelain > 8% papain > 5.25% NaOCl > control group. Naturally occurring deproteinizing agents, such as bromelain and papain, used in this study have resulted in greater bond strength values when compared to that of traditionally used chemical agent such as NaOCl.


Original Article

Madan M Niranjan, Preetika Chandna

Assessment of Intraoral Findings of Neonates, Born in and around Meerut City

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:48 - 52]

Keywords: Anterior open bite, Epstein's pearls, Fordyce's spots, Maxilla-mandibular relationship, Gum pad relationship, Oral mucosal cyst

   DOI: 10.5005/jp-journals-10005-1584  |  Open Access |  How to cite  | 


Aim: The aim of this study is to evaluate the occlusal relationships between the gum pads of neonates and to record intraoral findings in neonates and compare with the existing findings. Materials and methods: The oral cavities of 1,000 healthy neonates from birth to 1 month of age were examined to evaluate the occlusal relationships between the gum pads and to record other intraoral findings in neonates and compare with the existing findings. Oral findings recorded were oral mucosal cysts, Fordyce's spot, Epstein's pearls, Bohn's nodules, ankyloglossia, natal or neonatal teeth and attachment of the upper midline frenum. Relationship between the alveolar ridges was also recorded. Obtained data were evaluated and statistically analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0 and Epi-info version 3.0. Results: The maxillo-mandibular relationship of gum pads in approximately 97% cases, the mandible was found distal and lingual to maxilla. The presence of anterior open bite was observed in 9.1% cases. The most common intraoral finding in examined neonates was an oral mucosal cyst, 61.2%. The presence of Epstein's pearls was the next most common finding 38.3%. Fordyce's spots were found only in 1.2% of cases, while the presence of natal/neonatal teeth was only in 0.6% of cases. Ankyloglossia was present in only 0.5% neonates. Maxillary frenum was present in 79.1% of cases and it was attached on the alveolar crest. Conclusion: The results of the present study were in accordance with the pre-existing data. However, anterior open-bite was seen in significantly less percentage of the population.


Original Article

Jasmin Winnier, Rupesh Suresh

A Comparative Evaluation of a Labial Approach with a Conventional Palatal Approach for Endodontic Access in Primary Maxillary Incisors: A Pilot Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:4] [Pages No:53 - 56]

Keywords: Cohort study, Early childhood caries, Labial endodontic access, Primary anterior teeth, Pulpectomy

   DOI: 10.5005/jp-journals-10005-1704  |  Open Access |  How to cite  | 


Aim: A straight-line access provides an uninterrupted path for a successful endodontic procedure and traditionally a palatal approach was used to achieve the same. A labial access opening may provide a straight-line access to the root canal more consistently than the conventional palatal access opening in primary maxillary incisors; its advantages being improved visibility and direct access to the root canal. This study was designed to compare and evaluate the time taken for pulpectomy in primary maxillary incisors with conventional palatal access and labial access as well as time taken for the postendodontic restoration. Materials and methods: A cohort study was conducted wherein pulpectomy was performed on primary maxillary anterior teeth with labial endodontic access (group I—40 teeth) and palatal endodontic access (group II—40 teeth). Each group was further subdivided into two subgroups of 20 teeth each, requiring postendodontic composite restoration and requiring postendodontic strip crown restoration. Time taken for pulpectomy with both methods and for postendodontic restoration was evaluated. Results: The mean time (in seconds) taken for pulpectomy and postendodontic composite restoration was significantly less with a labial access than a palatal access (p = 0.000). Although the time required for postendodontic strip crown restoration was less with a labial access compared with a palatal access, this difference was not statistically significant (p = 0.907). Conclusion: From the results of this study, it can be suggested that labial endodontic access may be routinely used for pulp therapy of primary anterior teeth. Clinical significance: A labial endodontic access for primary anterior teeth provides a straight-line access and improves operator convenience and patient compliance when compared with a palatal access.


Original Article

Eswar Kandaswamy

A Comparative Evaluation of Fracture Toughness of Composite Resin vs Protemp 4 for Use in Strip Crowns: An In Vitro Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:4] [Pages No:57 - 60]

Keywords: Composite resin, Fracture toughness, Primary incisors, Protemp 4, Strip crowns

   DOI: 10.5005/jp-journals-10005-1711  |  Open Access |  How to cite  | 


Aim: The aim of this study was to compare the fracture toughness of pedo shade packable composite resin (Z100, 3M ESPE, St. Paul, USA) vs Protemp 4 (3M ESPE, Seefeld, Germany) when used inside a strip crown to restore primary incisors. Materials and methods: Thirty-six exfoliated noncarious human primary central and lateral incisors were randomly divided into two equal groups. The teeth were prepared to standardized dimensions to receive a strip crown. All the teeth were etched, rinsed, and dried following which bonding agent was applied and light cured. In group I, pedo shade packable composite resin (Z100, 3M ESPE, St. Paul, USA) was packed into strip crowns, placed on the prepared tooth, and light cured. In group II, the strip crowns were filled with Protemp 4 (3M ESPE, Seefeld, Germany), placed on the prepared tooth, and left to autopolymerize for 10 minutes. The strip crowns were removed, and the teeth were tested using the universal testing machine until fracture. Fracture toughness of the two groups was recorded and analyzed statistically using Student's “t” test. Results: The mean force required to fracture strip crowns restored with Protemp 4 (416.89 ± 124.58 N) was higher when compared with pedo shade packable composite resin (338.27 ± 130.99 N). However, statistical analysis did not show a significant difference in the fracture toughness between the two groups (p = 0.074), based on Student's “t” test results. Conclusion: The fracture toughness of teeth restored with Protemp 4 was comparable with pedo shade packable composite resin when used inside a strip crown. Clinical significance: The use of Protemp 4 is a possible alternative to pedo shade packable composite resin in restoring the primary anterior teeth, when used inside the strip crowns. The data also showed that the fracture toughness of Protemp 4 was comparable with pedo shade packable composite resin.


Original Article

Darshana Vinod, Saravanakumar M Subramani, Muralikrishnan Balachandran, Vidya Manoharan, Amrutha Joy

A Comparative Evaluation of Remineralizing Potential of Three Commercially Available Remineralizing Agents: An In Vitro Study

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:61 - 65]

Keywords: Casein phospho peptide–amorphous calcium phosphate, Casein sucrose phosphate, DIAGNOdent, Laboratory research, Silver diamine fluoride

   DOI: 10.5005/jp-journals-10005-1715  |  Open Access |  How to cite  | 


Aim: An in vitro study to evaluate and compare the remineralization potential of commercially available remineralizing agents containing silver diamine fluoride (SDF), casein sucrose phosphate (CSP), casein phospho peptide-amorphous calcium phosphate (CPP-ACP) using DIAGNOdent. Materials and methods: Thirty freshly extracted premolars for orthodontic treatment were collected. Specimens were randomly divided into 3 groups of 10 each: group I: SDF, group II: CSP, group III: CPP-ACP. The samples were subjected to DIAGNOdent analysis for recording the baseline values. Specimens were placed in demineralizing solution incubated at 37°C for 72 hours. DIAGNOdent values were recorded after demineralization. Following this, remineralization procedure was carried out using 3 different remineralizing agents: group I samples with SDF, group II with CSP, and group III with CPP-ACP. The remineralization procedure was performed to group I once and repeated for 14 days for group II and group III and storage solution was changed every 24 hours. The samples were subjected to DIAGNOdent analysis after 72 hours, 7 days, and 14 days and values were recorded. Results: The data were analysed using Statistical Package for the Social Sciences (SPSS) with analysis of variance (ANOVA) and post hoc test. Intragroup comparison of DIAGNOdent readings showed a highly significant difference between baseline, postdemineralization, and postremineralization values. Among intergroup comparison, SDF showed maximum remineralization values followed by CSP and CPP-ACP, respectively. Conclusion: Silver diamine fluoride, CSP, and CPP -ACP are proven to possess remineralization potential. Clinical significance: A comparative evaluation of these three remineralizing agents will aid in identifying most potent and effective agent in treating initial caries lesions in an effective noninvasive and child-friendly manner.


Original Article

Subramania PK Kannan, Suliman F Alfahaid, Abdulaziz S Alharbi, Bader S Almutairi, Abdulrahman H Alanazi, Fahad A Alsaab, Saud S Alatallah, Sami D Aldhuwayhi

Oral Hygiene Behavior of School Children in Saudi Arabia: A Descriptive Cross-sectional Survey

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:6] [Pages No:66 - 71]

Keywords: Attitude, Dental caries, Dentistry for children, Knowledge, Oral hygiene practice

   DOI: 10.5005/jp-journals-10005-1710  |  Open Access |  How to cite  | 


Aim: Oral health is an integral part of general health, and good knowledge and oral hygiene practices are the key to achieving oral health. This study assessed the knowledge, attitude, and oral hygiene practices of school children in Saudi Arabia and the need for dental health education and intervention. Materials and methods: This descriptive cross-sectional study was conducted among male school children (n = 451), aged 6–12 years, in the Al-Zulfi region of Saudi Arabia. Participants were included in this study using one-stage cluster sampling. The subjects completed a questionnaire, and the oral hygiene index-simplified was recorded. The collected data were statistically analyzed using SPSS version 21. Results: Only 41.9% of the children had good oral hygiene. Of the sampled children, 72.7% used a toothbrush and toothpaste, but only 2.2% were aware of dental floss; 62.7% children brushed for 1–2 minutes and had good oral hygiene, but 55.9% of children had no knowledge about periodontal health. Only 30.1% parents observed their children during tooth brushing. Conclusion: Use of a toothbrush and toothpaste is the most commonly used and most effective oral hygiene aid. Brushing twice a day for 1–2 minutes seems to be effective. Oral health care education should be included in the school curriculum, and a parental awareness program is needed to emphasize their role in the dental health of their children.


Original Article

Dipanshu Kumar, Kapil Gandhi, Shraddha Maywad, Ritika Malhotra, Shilpa Ahuja, Rishabh Kapoor

Prevalence and Correlation of Dental Caries with its Specific Risk Factors in 5–15-year-old School-going Children in Urban Population of Ghaziabad

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:7] [Pages No:72 - 78]

Keywords: Age, Caries prevalence, Drinking water fluoride, Socioeconomic status, Sugar exposure

   DOI: 10.5005/jp-journals-10005-1714  |  Open Access |  How to cite  | 


Dental caries is a rapidly emerging oral health problem amid the children with differing prevalence rate in different states of India. The data available from Ghaziabad city regarding dental caries are scarce; therefore, the study was conducted in 5–15-year school-going children in urban population of Ghaziabad. Purpose: The objectives of this study were to determine the prevalence of dental caries in school-going children of 5–15-year age groups in urban population of Ghaziabad and to assess and intercorrelate its relationship with the form, frequency and total sugar exposure, socioeconomic status (SES) of family, and fluoride in drinking water. Materials and methods: The study was conducted in 3,000 school-going children aged 5–15 years (divided into three age groups of 5–6, 7–12, and 13–15 years) studying in the government and private schools in the urban area of Ghaziabad city. A specifically designed pro forma was used for recording the personal data; sociodemographic profile; World Health Organization oral health assessment form for dental caries; 24-hour dietary recall to record the form, frequency, and total number of sugar exposure; and SES of the family (Kuppuswamy scale) of children. The concentration of fluoride in collected samples of drinking water was measured by the visual spectrophotometric method test. The results were tabulated and statistically analyzed. Results: The overall caries prevalence in 5–15-year age group was found to be 54.6%. There was a statistical significant difference found when the age-group comparison (p = 0.001), gender-wise comparison (p = 0.001), SES comparison (p = 0.002), the physical form of sugar intake (p = 0.038), frequency of sugar consumption at/between meals (p = 0.001), and total number of sugar exposure during last 24 hours (p = 0.001) were evaluated with caries prevalence. The mean water fluoride level in the surveyed area was found to be 0.48 ppm and was found to be nonsignificantly (p = 0.248) associated with caries prevalence. Conclusion: The risk factors, such as age, gender, physical form of sugar, frequency of sugar consumption at and between meal and total number of sugar exposure during the last 24 hours, and SES of parents, were found to be associated with the prevalence of dental caries in school-going children of 5–15-year age group.


Original Article

Sarliza Y Sanusi, Siti A Jamaludin, Mohd Z Sinor, Mohd F Khamis

Fate of Pulpotomized Teeth in Pediatric Patients: A 3-year Case Series in a Malaysian Dental Teaching Hospital

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:6] [Pages No:79 - 84]

Keywords: Ferric sulfate, Formocresol, Primary molar, Pulpotomy, Success rate

   DOI: 10.5005/jp-journals-10005-1712  |  Open Access |  How to cite  | 


Aim: This 3-year retrospective case series evaluated the clinical and radiographic outcome of ferric sulfate and formocresol pulpotomy in primary molar teeth in a dental teaching hospital in Malaysia. Materials and methods: Clinical and radiographic records of all pediatric patients who had pulpotomy of primary molar teeth between July 2005 and October 2008 were evaluated. A total of 55 pulpotomized primary molars were observed. Clinical assessments were carried out during the second visit to assess the presence of sinus tract, gingival swelling, excessive tooth mobility, tenderness to percussion, and abnormal exfoliation of the treated teeth. Periapical radiographs were reviewed for evidence of pathologic root resorption, radicular and/or periapical radiolucency, and abnormal pulp canal calcification. Treatments were regarded as failure in the presence of one or more of the above clinical and/or radiographic signs and symptoms. Results: Of 55 pulpotomized teeth, 26 (47.3%) remained free from any clinical signs and symptoms and 48 (87.3%) showed no pathological radiographic findings. The clinical success rates of ferric sulfate and formocresol pulpotomy were 44.4% and 60.0%, respectively, whereas the radiographic success rates of ferric sulfate and formocresol pulpotomy were 86.7% and 90.0%, respectively. Although teeth treated with formocresol had higher both clinical and radiographic success rates compared with those treated with ferric sulfate, it was not statistically significant. Conclusion: The clinical success rates of pulpotomy were lower compared with radiographic success rates. Ferric sulfate is an alternative to formocresol; however, the use of both agents in the dental undergraduate teaching at Universiti Sains Malaysia can still be recommended. Clinical significance: Formocresol and ferric sulfate are advocated as pulpotomy agents in primary molar teeth since both agents showed comparable clinical and radiographic success rates.



Jyothi S Bommangoudar, Shashidhar Chandrashekhar, Shruti Shetty, Sandeep Sidral

Pedodontist's Role in Managing Speech Impairments Due to Structural Imperfections and Oral Habits: A Literature Review

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:6] [Pages No:85 - 90]

Keywords: Cleft lip and palate, Oral habits, Speech, Speech impairments

   DOI: 10.5005/jp-journals-10005-1745  |  Open Access |  How to cite  | 


Speech is one of the oldest media of communication of thoughts. It has affected human behavior and progress so greatly that it has been one of the important determinants of psychosocial health of the human beings. The dental profession, as a guardian of oral health, is engaged to a great extent in altering and restoring structures within the oral cavity, to alleviate the ravages of disease and developmental abnormalities. A major portion of speech articulation takes place within the oral cavity, and any alteration or restorations of structures therein will adversely affect speech proportionate to the location and magnitude of alteration. This article provides an updated literature review on the role of pedodontists in early diagnosis and intervention of speech impairments.



Nanthini K Chinnasamy, Divyambika C Venugopal, Sathasivasubramanian Sankarapandian

Oral Lichen Planus in a 7-year-old Child: A Rare Case Report

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:3] [Pages No:91 - 93]

Keywords: Children, Lichen planus, Oral mucosa

   DOI: 10.5005/jp-journals-10005-1713  |  Open Access |  How to cite  | 


Lichen planus is a chronic inflammatory mucocutaneous disease reported most frequently in adults and relatively rare in children with the prevalence being 0.03%. This article reports a case of oral lichen planus (OLP) in a 7-year-old girl without any attendant skin lesions, diagnostic workup, and management protocol for the same. This article also emphasizes the need to consider OLP as a differential diagnosis for white lesions of oral mucosa in children.



Arshad Eranhikkal

Neglected Torticollis: A Rare Pediatric Case Report

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:4] [Pages No:94 - 97]

Keywords: Craniofacial, Sternocleidomastoid, Torticollis, Wry neck

   DOI: 10.5005/jp-journals-10005-1730  |  Open Access |  How to cite  | 


Torticollis is commonly termed as “wry neck”. In torticollis, there is abnormal posturing of the head and neck due to the shortening of sternocleidomastoid muscle. Torticollis causes tipping of the head towards the shortened sternocleidomastoid which results in rotation of chin to the opposite side. It is a common disorder which can occur at all ages, from newborns to adults. It can develop prenatally (congenital) or postnatally (acquired). This case report highlights the various craniofacial features in a 5-year-old male patient presented with torticollis. During examination, patient had asymmetry of face, short and tight sternocleidomastoid which was band shape in affected site, spastic contralateral sternocleidomastoid and decreased range of motion of neck. Intraorally, patient had multiple carious tooth and macroglossic tongue. The craniofacial features play a significant role in the identification of torticollis and hence, can be helpful in early detection. It requires a multidisciplinary approach for its treatment.



NB Nagaveni, P Poornima, Ashu Jagdish Soni, Md Muzammil Khan

A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:5] [Pages No:98 - 102]

Keywords: Nonvital teeth, Open apex, Platelet-rich fibrin, Revascularization, Traumatized necrotic teeth

   DOI: 10.5005/jp-journals-10005-1738  |  Open Access |  How to cite  | 


The aim of this paper is to present two methods of revascularization done in traumatized immature, nonvital anterior teeth using platelet-rich fibrin (PRF) and natural blood clot as a scaffold material. This was performed after disinfection of the root canal space using tri-antibacterial paste. In one tooth, PRF prepared from autologous blood was placed in the canal and in the other tooth, natural bleeding was induced to obtain a fresh blood clot. The patient was recalled regularly at 1, 3, 6, 9, and 12 months’ interval for evaluation. After 12 months, on clinical examination, both teeth showed negative response to percussion and palpation tests but positive response to cold and electric pulp tests. On radiographic examination, the tooth treated with PRF exhibited comparatively faster root lengthening, complete closure of the root apex, more thickening of the root dentinal walls, and narrowing of root canal space compared to conventionally revascularized tooth.



Anish Poonia, MM Dempsy Chengappa, Rajat Mitra, Parul Jain, Tarannum Ghavri

Full-mouth Rehabilitation of a Ventriculoperitoneal Shunt-treated Hydrocephalic Pediatric Patient: A Case Report

[Year:2020] [Month:January-February] [Volume:13] [Number:1] [Pages:4] [Pages No:103 - 106]

Keywords: General anesthesia, Hydrocephalus, Pediatric patient

   DOI: 10.5005/jp-journals-10005-1744  |  Open Access |  How to cite  | 


Hydrocephalus is characterized by accumulation of cerebrospinal fluid in the lateral ventricles of the brain, which results in progressive ventricular dilatation and an increased intracranial pressure. A ventriculoperitoneal shunt (VPS) is the most common treatment for hydrocephalus. Delayed development, behavioral disturbance, chronological changes in the eruption of their teeth, changes in the occlusion, greater accumulation of plaque, and increased caries prevalence are some of the clinical manifestations in these patients, which are encountered by a pediatric dentist. Behavioral disturbance in these patients makes sedation or general anesthesia the most feasible behavior management technique. During dental treatment of shunt-treated patients, care should be taken to avoid applying excessive force on the catheter. A referral to a neurosurgeon is recommended for patients with shunts undergoing invasive dental procedures for assessment of the need for prophylactic antibiotics. The present case report discusses full-mouth rehabilitation of a pediatric patient under general anesthesia who presented with severe early childhood caries and a medical history of ventriculoperitoneal shunt-treated hydrocephalus.


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