Aim and objective: This study assesses the efficacy of mineral trioxide aggregate (MTA), biodentine, and calcium phosphate cement (CPC) as single visit apexification agents for nonvital immature permanent teeth, both clinically and radiographically. Materials and methods: The study was conducted as a double-blinded randomized, controlled clinical trial after approval of the Institutional Ethical Committee of King George's Medical University, Lucknow, Uttar Pradesh, India, the approval letter (Ref. no. 81st ECM II B-Thesis/P24). A total of 60 patients in the age group of 6–15 years, fulfilling all the inclusion and exclusion criteria were enrolled for the study. Patients were randomly divided into three groups having 20 in each group. Results: On the basis of present study, it can hence, be inferred that clinical success for MTA, biodentine and calcium phosphate cement in apexification was 100%. The radiographic outcomes of calcium phosphate cement showed better results as compared to MTA and biodentine at 9 months of follow-up periods. Conclusion: These finding suggest that calcium phosphate cement can be used as a substitute for MTA and biodentine because of its comparable clinical and superior radiographic success.

Aim and objective: The aim and objective of this study was to do a comparative evaluation of microhardness and enamel solubility (ES) of the treated surface enamel with resin infiltrant, fluoride varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). Materials and methods: An in vitro study was conducted on freshly extracted 85 sound permanent teeth of which 5 teeth were subjected to check for microhardness by the Vickers microhardness tester and the remaining teeth were exposed to demineralizing solution to create initial enamel lesions. These 80 teeth were assigned to four groups: group I—negative control (n = 20), group II—resin infiltrant (n = 20), group III—fluoride varnish (n = 20), and group IV—CPP-ACP (n = 20), and microhardness was checked after application. These teeth were exposed to caries attack three times a day for three consecutive days. The ES of these four groups was checked by calcium ion loss in the artificial cariogenic solution and whole saliva by an atomic absorption spectrophotometer. Results: It was found that none of the experimental groups reached the microhardness values of sound intact teeth. At 3rd day, the values of microhardness were: group II = group III > group IV > group I. Maximum ES was found for group I (control) followed with group IV. Conclusion: All agents used in study remineralized initial carious lesion. Fluoride varnish has the highest microhardness and showed least ES compared to other remineralizing agents. Clinical significance: Fluoride varnish can be regarded as the choice of material to be used for the treatment of incipient carious lesions because of the low application frequency (once every 3–6 months), requires minimal patient compliance as it is a noninvasive procedure and less time consuming.

Aim and objective: To compare arch forms between Mongoloid race and Dravidian race in 11–14-year-old children. Materials and methods: Total 10 subjects from each study group were selected. Impression of both maxillary and mandibular arches were taken of all the subjects. Dental casts were poured. Intercanine measurement can be termed as the distance across two canine cusp tips, and intermolar measurement can be termed as the distance across two mesiobuccal cusp tips. This distance was recorded for maxillary and mandibular casts by making use of digital Vernier caliper. Data were tabulated. Statistical analysis: To note the statistical impact, a Chi-square test was applied. Results: The difference across the two groups was found to be statistically significantly noteworthy (independent t test p < 0.001). Conclusion: Group I (Mongoloid race) showed significantly larger intercanine to intermolar width compared to Dravidian race with wide flaring arches. Clinical significance: The size and forms of dental arches exhibit considerable variability within and among human groups. This research demonstrated that while considering Mongoloid patients, we must make use of prior formed orthodontic wires for ovoid shaped arches in a trivial fraction of patients.

Introduction: Pit and fissures of permanent dentition are considered to be highly vulnerable to the adhesion of cariogenic microorganisms and consequently result in caries formation. The main problem associated with sealant failure will be microleakage. Therefore, sealants can be considered to be an effective preventive procedure for dental caries, only if it strongly bonds to the tooth, and protect the pit and fissures from the oral bacterial environment. Aim and objective: To compare and assess the microleakage of two different pit and fissure sealants on permanent molars. Materials and methods: A total of 20 extracted third molars were randomly divided into two groups where group I is conventional sealant and group II is hydrophilic sealant. Occlusal surfaces of permanent molars were treated with 37% orthophosphoric acid before sealant placement. Tooth samples were subjected to 0.1% rhodamine dye immersion, thermocycling, and tooth samples were sectioned and evaluated under a confocal laser microscope for dye penetration. A non-parametric test (Mann–Whitney U) was performed to compare the mean microleakage score difference between the groups. Results: Group II (hydrophilic sealant) showed a minimum level of the microleakage score when compared to group I (conventional sealant) and was found to be statistically significant using the Mann-Whitney U test with a p value <0.05. Conclusion: The less the microleakage, the better will be the retention of the sealant for a longer duration and cariostatic action.

Aim and objective: The study was conducted to assess and compare the remineralization ability of fluoride varnish, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), bioactive glass-ceramic, and nanohydroxyapatite crystals using a confocal microscope. Materials and methods: Eighty premolars and 80 deciduous central incisors were included in this study. Two windows of approximately 3 × 3 mm were created on the labial surface of the premolars and 2 × 2 mm on deciduous maxillary incisors. Artificial caries like lesions was created by demineralizing the sample windows. The teeth sections were then randomly assigned into four groups (n = 20). Specimens of the first group were once painted with fluoride varnish, while those in CPP-ACPF, bioactive glass-ceramic, and nanohydroxyapatite were brushed twice daily for 2 minutes each for 40 days, respectively. 150–200 μm longitudinal sections were obtained and were photographed under a confocal laser scanning microscope. They were quantified using a computerized imaging system for demineralization and later for remineralization. The recorded values were tabulated and analyzed using Fisher's test, analysis of variance (ANOVA), and post hoc Bonferroni's test. Results: All the materials used in the study showed remineralization potential at the end of 40 days in both permanent and deciduous teeth. The highest remineralization potential was observed in the fluoride varnish group followed by bioactive glass, CPP-ACFP, and nanohydroxyapatite in both permanent and deciduous teeth. In permanent teeth, the difference in the remineralization potential of fluoride varnish and bioactive glass was not statistically significant. Conclusion: The present study showed that self-applied bioactive glass has similar remineralization potential to fluoride varnish in permanent teeth. Therefore, bioactive glass can be used for the management of incipient caries lesions daily.

Aim and objective: This study aimed to compare the apical sealing ability and periapical extrusion in the Thermafil™ obturation technique, with and without an apical barrier of MTA, with lateral condensation technique. Materials and methods: Sixty freshly extracted human central incisors were instrumented with the crown down technique and divided into three experimental groups. Group I: lateral condensation technique obturation, group II: Thermafil obturation (DENTSPLY Tulsa), and group III: this group was obturated into two parts; first MTA (ProRoot) was placed in apical 3 mm and later the remaining canal was obturated with Thermafil™ obturation technique (DENTSPLY Tulsa). AH Plus sealer was used in all the groups. Specimens of all the groups were layered with nail paint excluding the apical 3 mm. Twenty-four hours later, all the teeth were suspended in Black India ink for 48 hours. Finally, all the teeth were decalcified, rendered transparent and linear dye leakage and periapical extrusion was measured using ×60 magnification of stereomicroscope with an in-built ruler. Results: A Chi-square test done to evaluate periapical extrusion showed there was a significant difference found among all the groups (p < 0.05), whereas in case of linear apical dye leakage using a Student's “t” test showed there was no significant difference among all the groups (p > 0.05). Conclusion: Despite showing apical leakage, the thermo-plasticized gutta-percha obturation technique can be advantageous when used with MTA as an apical barrier since there is no scope for apical extrusion along with the benefit of three-dimensional obturation of the root canal system when compared with the lateral condensation technique.

Aim and objective: To compare and evaluate the retention along with antibacterial efficacy of colored compomer and glass hybrid bulk fill glass ionomer restorative material as a conservative adhesive restoration in children of age 6–12 years. Materials and methods: Sixty children were selected fulfilling the inclusion and exclusion criteria falling in the age group of 6–12 years with mixed dentition and two groups were formed: group I—colored compomer and group II—glass hybrid bulk fill material. Initially, oral prophylaxis was carried out and baseline collection of saliva was completed. Then, the restorative treatment was completed. Retention of the material and antibacterial count [colony-forming units (CFU)/mL of saliva] was estimated at 1, 3, and 6 months after the restorative procedure. Results: It was seen that retention rate with glass hybrid bulk fill group was 100%, whereas with colored compomer group it was 90% at end of 6 months. Although good antibacterial activity was shown by both the group at 1, 3, and 6 months follow-up but statistically significant drop was seen in the glass hybrid bulk fill group at 3-month intervals than the colored compomer group with a p value of 0.0001 (p < 0.05). Conclusion: Among both the materials, glass hybrid bulk fill restorative material showed good retention compared to Colored compomer material but it was not statistically very significant. Also, both the materials have shown good antimicrobial activity at 1, 3, and 6 months follow-up.

Background: To widen the treatment option of primary teeth with mutilated crown tooth structure but having more than two-thirds of root structure were restored by using natural tooth crowns with the help of adhesive materials. Aim and objective: To restore the grossly decayed primary molars with biological crowns and to evaluate them for longevity, change in color, occlusal wear, marginal integrity, and patient/parent acceptance. Materials and methods: Twenty primary molars from 6 to 10 years old children were restored with biological crowns (extracted/exfoliated tooth crowns) and follow-up was done till 12 months. Data tabulated and results were statistically analyzed using Kaplan–Meier survival analysis. The statistical software SPSS 19.0 was used. Results: 89.47% of biological restorations survived successfully till 12 months follow-up period. No occlusal wear was found in any of the samples, a breach in marginal integrity was seen only in 16.6% of cases, and only 5.5% of biological crowns showed discoloration (darker) at 12 months intervals. 65.00% of patients well accepted the treatment and showed satisfaction while 20.0% of patients remained neutral. Only 15% of patients experienced dissatisfaction at the end of the study. Conclusion: Biological restorations proved to be a viable alternative for the restoration of grossly mutilated primary molars.

Aims and objectives: Obstructive sleep apnea (OSA) is by far the most common sleep-related breathing disorder, affecting 2–4% of the adult population. The present study aims to compare the descriptive morphology of the cervical column in subjects with normal craniofacial morphology with those having condylar hypoplasia with OSA and to evaluate a positive correlation between the cervical columns, the cranial base angle, and the posture of the head and neck in subjects of condylar hypoplasia. Materials and methods: The present study comprised of lateral cephalogram of 40 subjects divided into two equal groups—control groups (n = 20) and OSA with condylar hypoplasia (n = 20). Results and observation: The condylar hypoplasia group has fusion anomalies of 65% and 35% has a posterior arch deficiency. The cervical lordosis, inclination of the cervical column is found to have a positive statistically significant correlation in condylar hypoplasia subjects. Conclusion: Morphological deviations and deviation pattern of the cervical column occurred significantly more often in subjects with condylar hypoplasia as compared with normal craniofacial morphology which can be verified by the increased cranial base angle, cervical lordosis, the inclination of the upper cervical spine, and cranial base angle were positively correlated with a fusion of cervical column. Clinical significance: Specific types of craniofacial morphology and head postures such as a reduced posterior airway space, an abnormally long soft palate, a low position of the hyoid bone, and an extended head posture are considered predisposing factors of OSA. As posture of the head and neck is considered to be associated with OSA, OSA may be associated with fusion of the cervical column. Hence, to know the result of malformation in the cervical column prove to be important with regard to phenotypical subdivision, diagnosis, and treatment of OSA.

Aim: To assess and analyze the resin-bonded dentin in terms of shear bond strength after using deproteinizing agents 5% sodium hypochlorite, 10% sodium hypochlorite, and bromelain. Materials and methods: Overall 140 permanent and intact human premolars were split into four groups, three experimental groups and one control group. In all four groups, the occlusal surface of the teeth was wet ground to expose superficial dentin. In group I, teeth were etched and deproteinized with 5% sodium hypochlorite. In group II, teeth were etched and deproteinized with 10% sodium hypochlorite. In group III, teeth were etched and bromelain was used to deproteinize. In group IV, teeth were etched and no deproteinization was being performed and simultaneous fulfillment of the resin composite and later inserted into the plastic tube and polymerized with light. Samples were stored at 37°C for 24 hours and the later samples were transferred to the universal testing machines to shear bond strength analysis at a speed of 0.5 mm/minute. Results: The outcome of the bond strength was significantly influenced by the application of bromelain enzymes. A remarkable difference was observed between the shear bond strength of sodium hypochlorite (5 and 10%) and in the bromelain enzyme-treated group. Group III showed better results than group I and group II. Conclusion: This study concluded that bromelain shear has the maximum value for shear bond strength. Bond strength improved because of removal of unsupported collagen fiber with bromelain enzyme after acid etching. Clinical significance: Natural pineapple enzyme, i.e., bromelain improves bond strength by removal of unsupported collagen fiber. Hence, it is completely safe to use.

Introduction: The old saying “prevention is better than cure” holds true when applied to preventive dental care. It is vitally important for the general health and well-being of the individual to take the necessary steps to prevent the occurrence of major dental problems. American Academy of Pediatric Dentistry (AAPD) emphasizes the importance of initiating professional oral health intervention in infancy and continuing through adolescence and beyond. Materials and methods: Around 109 available private general dental practitioners of Durg-Bhilai city (within city limits) made up the (convenient) sampling frame of the study. These entire dentists were identified and contacted. But, out of 109 dentists, only 92 were surveyed. BDS graduates and MDS (other than pedodontists) were included in the study. Dentists who were not willing to participate were excluded from the study. The sample size was calculated based on the total number of dentists practicing in Durg-Bhilai city limits. Conclusion: A statistically significant correlation was found in-between the knowledge and practice score (0.368), knowledge and attitude (0.269); attitude and practice (−0.257).

Aim: This study aimed to study the intensity and duration of patients’ pain perception after placement of elastomeric separators and the effects of various methods to reduce the pain. Materials and methods: Elastomeric separators were placed on either side of first molars in 120 patients which were divided into 4 groups. Patients in group I were control group, group II underwent low-level LASER therapy, group III were subjected to topical anesthetic gel, and group IV underwent TENS (transcutaneous electric nerve stimulation). And then they were asked to measure pain using a visual analog scale (VAS) at 5 intervals of time, i.e., immediately after separator placement, after day 1, day 2, day 3, and day 4. Results: Turkey's post hoc test showed that pain score after immediate placement of separators was found to be the least in the anesthetic gel than that in other groups and pain score was least in the LASER group out of all four groups on day 1, 2, 3, and 4. Conclusion: It was found that low-level LASER therapy was more effective in reducing pain after placement of elastomeric separators.

Aim: This study aimed to compare the effect of different flavored kinds of milk on salivary pH value in 6 to 14 years old children. Materials and methods: The impact of these different kinds of flavored milk on the salivary pH is evaluated between two groups of children, caries-active group (n = 35) constituted children who had decayed missing filled tooth (DMFT) ≥2, and the caries-free group (n = 35) constituted children who had DMFT = 0. Four different flavors of milk are taken for the study, and plain sweetened milk is chosen as the control baseline. The endogenous pH of the salivary samples is measured at baseline and after consumption of the flavored milk immediately and then at 5-, 10-, 15-, and 30-minute intervals. The results are statistically analyzed by using the paired t-test and analysis of variance (ANOVA). Results: It is shown in the present study that caries-active group subjects had a more evident salivary pH fall than the caries-free group subjects which was statistically significant. For caries-active group, subject's salivary pH value took a longer duration to return to baseline pH as compared to caries-free subjects. However, salivary pH value is restored to standard/baseline value after 30 minutes for all the flavored milk taken in both groups; hence, their intake can be regarded safe for the oral environment. Conclusion: It is concluded from the current study that the consumption of flavored milk can be considered as non-cariogenic for children. Clinical significance: In the present study, the salivary pH fall in both caries-active and caries-free subjects was found above the critical pH level. Hence, all these flavored milk used in the study did not cause a threat to oral environment health as there was no significant decrease in salivary pH value so their consumption can be regarded as safe for children.

Aims and objectives: To comparatively evaluate the clinical efficacy of stepwise caries excavation with indirect pulp capping (IPC) in managing the young permanent teeth in pediatric patients who have deep carious lesions. Materials and methods: Eighty-eight teeth (first/second permanent molars) were included and randomly divided into two groups: group I (stepwise caries excavation) and group II (IPC). For group I, i.e., stepwise caries excavation, in the initial visit, bulk caries removal was done from walls of the cavity, however, soft and infected dentin was left untouched on the pulpal floor. The final excavation was performed after 2 months. The dentin parameters like the color, the consistency, and the humidity of dentin were noted at the first and second visits. A final follow-up to assess the primary outcome, i.e., sustained pulp vitality, was done after 1 year. Results: When both the groups were compared with each other using the Chi-squared test, a highly significant difference was found (p < 0.05) between them. The success rate of stepwise caries excavation (97.3%) was found to be significantly greater than IPC (82.4%). After doing statistical analysis, a significant difference between stepwise excavation at baseline and at re-entry for parameters like the color, the consistency, and the humidity (p < 0.05), where dentin was observed to be darker in color, harder in consistency, and drier to touch at re-entry was found. Conclusion: Stepwise caries excavation was considered a safer technique than IPC for preserving the vitality of young permanent teeth. Also, the clinical changes recorded during the re-entry in the case of stepwise caries excavation technique indicated the arrest of the carious process. Clinical significance: Pulp preservation is of utmost importance especially in the case of young permanent teeth which have open apex to aid in apexogenesis. Failure to do so in maintaining the vitality of pulp before root completion may lead to the unfavorable crown to root ratio resulting in thin dentinal walls which are prone to fracture.

Introduction: The coronavirus disease 2019 (COVID-19) epidemic began in Wuhan, China, in December 2019 on January 1, 2020. For dental practices and hospitals in countries/regions that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed.

Aim and objective: To investigate knowledge and perception of COVID-19 among pedodontists in India.
Population and methods: A quick online cross-sectional study was conducted among 335 pedodontists in India. The questionnaire was sent to 410 pedodontists in India, out of those 335 responded. The study objective and questionnaire were sent to pedodontists via “Google Forms”. The collected data were sent for appropriate statistics.
Results: Of the total participants, 82% of pedodontists think that children are silent carriers of COVID-19. Sixty-two percent of pedodontists say that it is very difficult to treat pediatric dental patients by use of a personal protective equipment (PPE) kit. Sixty-four percent of pedodontists will overcome this financial crisis by increasing working time and 36% of them by increasing the cost of treatment.
Conclusion: The role of pedodontists in preventing the transmission of COVID-19 is critically important. Pedodontists’ role in the prevention of COVID-19 is crucial.

Pediatric dentistry is a speciality of dentistry focusing mainly on oral health care of children. Early diagnosis and prompt treatment is key of a good treatment plan and effective results. Sometimes in infants, it is not possible to make a confirmatory diagnosis due to lack of cooperation, which is the biggest challenge of kids dentistry. In such cases, we need to take into consideration the psychological and physiologic aspect of child to find an alternative treatment plan, which is time saving and painless. Here, we present a unique case management of lingual swelling on the ventral surface of tongue in a 9-month-old girl child with a minimal invasive approach, thus avoiding a time-consuming and invasive surgical treatment plan.

Varicella-zoster virus (VZV) is an envelope, spherical, 150–200 nm in diameter virus, with the single, linear, double-stranded DNA molecule, 125,000 nt long. It belongs to the genus Varicellovirus, family.

Aim: This case report illustrates the multidisciplinary treatment of a 12-year-old boy with esthetic challenges and endodontic problems in his maxillary incisors after severe dental injury at the age of 2½ years. Background: The close anatomic relationship of the primary tooth to the permanent tooth germ explains why traumatic dental injuries in primary dentition may affect the development of permanent teeth especially in the maxillary anterior region. Developmental defects of enamel (DDE) as well as crown/root dilacerations are often seen after displacement injuries such as intrusion or avulsion occurring at lower age. Case description: A 12-year-old boy with severe discoloration and enamel hypoplasia of his maxillary incisors was treated with composite restorations. History of avulsion injury of teeth 51 and 61 at the age of 2½ years explained the DDE, the severe dilaceration, and delayed tooth eruption of tooth 21. Use of cone-beam computed tomography (CBCT) was decisive in diagnosis and treatment planning of esthetic concerns and endodontic complications. Conclusion: Trauma to primary teeth taking place at early childhood may have severe consequences on permanent successors. Clinical significance: Severe morphological variations in permanent incisors caused by dental injuries in the predecessor teeth require monitoring and multidisciplinary approach. Advanced three-dimensional radiographic imaging is useful in identification and treatment planning of such cases.

Langerhans’ cell histiocytosis (LCH) is a rare disease of the reticuloendothelial system in which there are abnormal proliferation and accumulation of histiocytes, abnormal cells deriving from bone marrow that can migrate from the skin to the lymph nodes. Langerhans’ cell histiocytosis has three variants: unifocal (eosinophilic granuloma), multifocal unisystem (Hand–Schuller–Christian triad), and multifocal multisystem (Letterer–Siwe disease). We present a case of oral lesions associated with LCH in a young male aged 15 years. The history, radiological appearance, histopathology, and treatment options of the patient are discussed.

Dentinogenic ghost cell tumor (DGCT) is a very rare entity with controversies in its terminology and classification. It is the neoplastic solid counterpart of the calcifying odontogenic cyst (COC), which was first reported by Gorlin et al. in 1962. There are around 31 cases reported in the literature. The mean age of occurrence is 40.27 years, although very rarely is it associated with the pediatric age group. We are reporting a case of DGCT with dysplastic changes in an 11-year-old child which is very rare. The present case deals with the clinical, radiological, and histopathological aspects of the disease and the importance of an appropriate diagnosis.

Odontomas are the most common type of odontogenic tumors. During tooth development stages, any defect in the maturation phase of morphodifferentiation leads to such anomalies. Odontomas are benign, slow-growing, and non-aggressive clinically asymptomatic. This paper describes the case of complex odontoma. A 7-year-old male child reported an asymptomatic hard growth in the right anterior region of the mandible associated with impacted deciduous canine. Radiograph revealed an amorphous mass of calcified material with a radiodensity similar to the tooth structure, with anatomically no resemblance to the tooth, surrounded by a thin radiolucent rim, suggestive of odontoma. Under local anesthesia, access to the lesion was achieved via intraoral approach and surgical excision to enable the eruption of retained permanent canine to establish harmony in the development of dental arch.

Objective: This study aims to assess the knowledge and confidence of dentists related to behavior management with extra personal protective equipment (PPE), non-aerosol-generating dental procedures in the course of the coronavirus disease-2019 (COVID-19) pandemic. Materials and methods: A cross-sectional online survey was conducted among a sample of dentists who worked in Jordan and India in June 2020 during the COVID-19 pandemic. Results: This study included a total of 177 dentists in Jordan and India that were practicing during the early months of the pandemic. Most dentists were seeing <6 patients per day. The most common emergency treatments during the pandemic by Jordanian dentists were abscesses (51.8%) and cellulitis (44.6%) vs (44.6%) abscesses and (35.5%) pulpitis in India. There was a high adoption of all elements of the PPE protocol. Most participants never or rarely used N₂O sedation to manage their patients in Jordan and India (80.4 and 71.1%), respectively. Participants in Jordan and India that considered treatment non-aerosol-generating procedures (non-AGP) were (82.1 vs 97.5%, p = 0.000), respectively. Conclusion: Most of the surveyed dentists believe the extra PPE acts as a barrier to patient communication and child behavior management and would consider modifying the PPE to be more child-friendly. Most dentists consider non-AGP procedures and silver diamine fluoride (SDF) to be practical ways to practice safer dentistry, yet more training and information is needed for dentists treating children to provide a more confident safe environment for both dentists and their patients.