International Journal of Clinical Pediatric Dentistry

Register      Login

Table of Content

2021 | January-February | Volume 14 | Issue 1

Total Views

Expert Review

Marwa Abdelrahman, Kuei-Ling Hsu, Mary Anne Melo, Vineet Dhar, Norman Tinanoff

Mapping Evidence on Early Childhood Caries Prevalence: Complexity of Worldwide Data Reporting

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:7] [Pages No:1 - 7]

   DOI: 10.5005/jp-journals-10005-1882  |  Open Access |  How to cite  | 


Objective: This review aims to identify variances and research gaps in the early childhood caries (ECC) prevalence within countries and the global community by mapping current evidence. Materials and methods: We performed a literature search in PubMed/MEDLINE and Web of Science to identify English-language, peer-reviewed epidemiologic studies published from January 1999 to January 2019. Abstracts and full-text articles were dual-screened based on predefined eligibility criteria. We classified outcomes by children's age and countries based on economic status. Ranges of reported caries prevalence and median values by country and age were calculated and evidence-mapped. Results: Out of 915 studies, 59 studies met the inclusion criteria. The most significant number of reports were from the USA, Brazil, and India. The ranges of prevalence (1–96%) among the studies were large. The calculated median caries prevalence values may better estimate countries’ prevalence than the reported ranges. Early childhood caries prevalence's highest median values were found for South Korea studies (54%) for children <3-year-old and from Bosnia (81%) for children 3–6 years old. No apparent difference was found in the prevalence of ECC from developed and developing countries. Conclusion: This mapping review reflects the ranges and median values of ECC worldwide. Overall, the reported prevalence of ECC in most countries is very high. No apparent difference was found in the prevalence of ECC from developed and developing countries. Reported ranges of ECC, as well as heterogeneity and methodological issues, hamper comparisons across studies globally. Clinical significance: The global ECC prevalence ranges are extreme. Median data may provide a structure for future epidemiological studies to optimizing healthcare resources for caries interventions globally.


Systematic Review And Meta Analysis

Nambi Natchiyar, Sharath Asokan, Pollachi Ramakrishnan Geetha Priya, Thoppe Dhamodharan Yogesh Kumar

Comparison of Clinical and Radiographic Success of Rotary with Manual Instrumentation Techniques in Primary Teeth: A Systematic Review

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:6] [Pages No:8 - 13]

   DOI: 10.5005/jp-journals-10005-1879  |  Open Access |  How to cite  | 


Aim and objective: A systematic review was planned to compare the clinical and radiographic success rate of pulpectomy in primary molars using a rotary system and hand files system. Study design: The literature search was undertaken in electronic databases from January 2000 to December 2019 using keywords. Four hundred and forty-two studies were identified after applying limits. Three hundred and thirty-one irrelevant articles were eliminated. Among the 111 articles obtained, 90 articles were eliminated after reading the titles and abstracts. After assessing the full text, 18 articles were eliminated. Randomized controlled trials (RCTs) published in the English language on pulpectomy of primary molars, using hand files and rotary files and with a follow-up period of 12 months were included. Results: Three RCTs comparing the clinical and radiographic pulpectomy success rates using rotary and hand files instrumentation were finally selected. Qualitative assessment with RoB 2.0 showed one study had a low risk of bias and two studies had a high risk of bias. Conclusion: Pulpectomy procedures in primary teeth using rotary and hand files instrumentation techniques were equally effective in terms of success rates.


Systematic Review And Meta Analysis

Deise RA Kastelic, Luiz ER Volpato, Ana TS de Campos Neves, Andreza M Aranha, Carolina Castro Martins

Do Children and Adolescents Prefer Pediatric Attire over White Attire during Dental Appointments? A Meta-analysis of Prevalence Data

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:16] [Pages No:14 - 29]

   DOI: 10.5005/jp-journals-10005-1861  |  Open Access |  How to cite  | 


Purpose: To evaluate the preferences of children and adolescents regarding the professional attire used by dentists (pediatric or white attire). Materials and methods: Seven electronic databases were searched without restriction regarding language and publication date. The primary outcome was the preference of patients regarding pediatric or white attire; secondary outcomes were preference for a female or male dentist and the use of personal protective equipment or not. We ran a meta-analysis of prevalence data of preferences, calculating effect estimate (ES), 95% CI, subgrouped by anxiety status and sex of the patient. Z-test of interactions was used to compare prevalence between groups (p < 0.05). Results: Fourteen cross-sectional studies were included, consisting of 5,756 patients with ages ranging from 2 to 15 years. Anxious children preferred more pediatric attire (ES: 0.03; 95% CI: 0.02, 0.03) than non-anxious children (ES: 0.02; 95% CI: 0.01, 0.02) (p = 0.0085). Female dentists were preferred (ES: 0.62; 95% CI: 0.52, 0.72) over male dentists (ES: 0.40; 95% CI: 0.30, 0.49) (p = 0.003) in general and by the girls (ES: 0.41; 95% CI: 0.25, 0.56) but not by boys (ES: 0.20; 95% CI: 0.09, 0.30) (p = 0.036). Conclusion: There is no difference in the preferences of children and adolescents regarding a specific attire. Anxious children and adolescents preferred dentists using pediatric attire. In general, female dentists were preferred over male dentists and also were preference among girls.


Systematic Review And Meta Analysis

Uma Dixit, Rucha Shivajirao Bhise Patil, Rupanshi Parekh

Cytotoxicity and Bioactivity of Mineral Trioxide Aggregate and Bioactive Endodontic Type Cements: A Systematic Review

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:10] [Pages No:30 - 39]

   DOI: 10.5005/jp-journals-10005-1880  |  Open Access |  How to cite  | 


Background: Knowledge of the cytotoxicity and bioactivity of endodontic materials may assist in understanding their ability to promote dental pulp stem cell activity and pulp healing in primary teeth. Materials and methods: This systematic review was carried out by searching the electronic databases such as PubMed, Google Scholar, and Cochrane reviews for the articles published between January 2000 and December 2018 using the appropriate MeSH keywords. An independent investigator evaluated the abstracts and titles for possible inclusion, as per the stipulated inclusion and exclusion criteria. The topics considered for extracting data from each study were: cell lineage, cytotoxicity assay used, and type of material tested. Results: Seven eligible studies were selected for assessing the quality of evidence on the bioactivity of bioactive endodontic cements (BECs) (1 human cell line, 2 animal cell lines, and 4 in vitro, animal, and human studies) and 13 studies were selected for reviewing the quality of evidence on cytotoxicity (7 human cell lines, 4 animal cell lines, and 2 animal model studies). Very limited studies had been conducted on the bioactivity of materials other than mineral trioxide aggregate (MTA). With regards to cytotoxicity, the studies were diverse and most of the studies were based on MTT assay. Mineral trioxide aggregate is the most frequently used as well as studied root-end filling cement, and the literature evidence corroborated its reduced cytotoxicity and enhanced bioavailability. Conclusion: There was a lack of sufficient evidence to arrive at a consensus on the ideal material with minimal cytotoxicity and optimal bioactivity. More focused human/cell line-based studies are needed on the available root filling materials. Clinical significance: The present systematic review provides an update on the available literature evidence on the cytotoxicity and bioactivity of various BECs including MTAs and their influence on the different cells with respect to their composition and strength.



Fatih Ozcelik, Seyda Ersahan

Importance of Paired t-test in Time-based Comparison of Obturation and SealBio Techniques in Root Canal Treatment

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:1] [Pages No:40 - 40]

   DOI: 10.5005/jp-journals-10005-1891  |  Open Access |  How to cite  | 



Mimoza Canga, Giulia Malagnino, Vito A Malagnino, Irene Malagnino

Effectiveness of Sealants Treatment in Permanent Molars: A Longitudinal Study

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:41 - 45]

   DOI: 10.5005/jp-journals-10005-1878  |  Open Access |  How to cite  | 


Background: Our study gives a clear result about sealants treatment in preventing dental caries manifestation and reducing its prevalence in children aged 6–11 years old. Aim and objective: This study aims to compare and evaluate the progress of dental caries in the first and second permanent molars and also to evaluate, within a period of 24 months, the clinical effects of dental sealants, used in the treatment of occlusive cavities, among children 6–11 years old. Materials and methods: Participants: The overall sample was composed of 120 children, to whom we randomly chose 480 posterior teeth, which were divided into two groups. Intervention: The first group was the control group with 240 untreated teeth, while the second group had an equal number of teeth, which underwent the sealant treatment. The study participants were evaluated within the periods 0, 6, 12, 18, and 24 months. The study participants were checked every 6 months. Basic design: This observational, analytical, and descriptive research was designed as a longitudinal study. The study started in January 2019 and ended in January 2020. The study was conducted in five dental clinics in the city of Vlore, Albania. Results: After 24 months of observation, we noticed that the number of dental caries in the untreated group is three times higher than the number of dental caries in the treated group. In the group of teeth treated with sealant, 189 (78.8%) teeth remained unaffected by dental caries. The present study showed that there is a significant correlation between period and caries manifestation (p < 0.05). It also proved that sealant treatment is an important measure and it is highly significant in the caries reduction (p = 0.000). Conclusion: This study proved that sealant treatment is highly successful in reducing dental caries. In the future, it is worthwhile to go further in this research. Clinical significance: Dental caries is a problem in children aged 6–11 years old and not only. That is why this study recommends that sealants treatment should be used to prevent and reduce the prevalence of dental caries.



N Aishwarya, Shwetha Poovani, Prafulla Thumati

Comparison of Bite Force and the Influencing Factors Pre- and Post-cementation of Stainless Steel Crown in Children Using T-Scan

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:46 - 50]

   DOI: 10.5005/jp-journals-10005-1900  |  Open Access |  How to cite  | 


Background: In children, stainless steel crowns (SSCs) have become an invaluable restorative option for grossly decayed primary teeth. The crowns are manufactured in different sizes with preformed anatomy which requires trimming or contouring as a necessary step to fit an individual tooth. Initially, this may produce variation in the occlusal contact points yet may not result in pain or discomfort. Little research exists regarding bite force equilibration measurements in children after placing SSC, and its influencing factors such as age and gender. Aim and objective: To evaluate and compare the measurements of bite force pre- and post-cementation of SSC using the conventional technique at maximal intercuspal position (MIP) on primary molars at different time intervals and whether age and gender influence bite force measurements. Design: Bite force and occlusal contacts during occlusion were made using T-Scan III. Twenty children scheduled for treatment who needed SSCs were included. T-Scan measurements of the bite force and occlusal contacts of the maxilla and mandibular teeth were recorded and analyzed before and immediately after cementation of SSC later 4 weeks during the follow-up period. These measurements were correlated with age and gender influence. Results: There was no significant result in the percentage of bite force on the crowned tooth (placement of SSC) at different time intervals. Prematurities were present in all the groups but a significant reduction was seen on the crowned tooth from baseline to 1-month follow-up (p = 0.03). Also, a statistically significant increase in the bite force was seen in >7 years of age (p = 0.006) and no statistical significance among the gender. Conclusion: Following the standard tooth preparation, the SSC will continue to appear clinically acceptable for many years. Our study children showed an adaptable masticatory system irrespective of age and gender during growth and development.



Buneet Kaur, Sunil Gupta, Rashu Grover, Gunmeen Sadana, Teena Gupta, Manjul Mehra

Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Restored with Different Core Build-up Materials: An In Vitro Study

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:8] [Pages No:51 - 58]

   DOI: 10.5005/jp-journals-10005-1901  |  Open Access |  How to cite  | 


The aim is to evaluate the fracture resistance of endodontically treated teeth restored with posterior direct composite (PRC) resin, bulk-fill composite resin, dual-cure composite (DCC) resin, and short fiber-reinforced composite (SFC) resin material. Materials and methods: Ninety sound maxillary premolar teeth were divided into 6 groups which comprised 15 teeth each. Group I was a negative control group where neither cavity preparation nor root canal treatment was done on the specimen. Group II was named positive control group as it was left unrestored after mesio-occluso-distal (MOD) preparation and root canal treatment. Groups III to VI were filled with PRC, bulk-fill composite, DCC, and SFC, respectively, and subjected to fracture testing in a universal testing machine. Results: After statistical analysis, it was seen that group VI had increased mean fracture resistance as compared to other groups. Conclusion: It was concluded that short fiber-reinforced composite proved to have superior properties that other experimental groups and hence can be used as a core build-up material. Clinical significance: The core build-up is requisite as the residual tooth structure after endodontic procedure decreases and core build-up supplements the resistance and retention of the tooth structure.



Jagadish Gowda, Ananda Tavarageri, Rajesh T Anegundi, Apoorva Janardhan, Manohara A Bhat

Comparative Assessment of the Antimicrobial Efficacy of Triclosan, Amoxicillin and Eugenol against Enterococcus faecalis

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:4] [Pages No:59 - 62]

   DOI: 10.5005/jp-journals-10005-1869  |  Open Access |  How to cite  | 


Aims: Elimination of microorganisms and prevention of recurrence of infection from the complex root canal system of primary teeth requires an obturating material with broad antimicrobial activity. Hence, the purpose of the study is to assess and compare the antimicrobial efficacy of Triclosan, Amoxicillin and Eugenol individually and in combinations against a resistant microorganism viz., Enterococcus faecalis. Materials and methods: A two-fold serial dilution method was used to check the minimum inhibitory concentration (MIC) of triclosan, amoxicillin and eugenol against thirty E. faecalis (isolated from oral lesions). The resistant strains were subjected to different combinations of three agents by modified checkerboard method. MIC was determined after incubation for 24 hours at 370°C. Then the three dilutions from MIC were inoculated on BHI agar plates and incubated overnight to determine minimum bactericidal concentration (MBC). Results: The mean MIC and MBC of triclosan was 3.43 μg/mL and 3.75 μg/mL respectively. Whereas for amoxicillin, it was 3.43 μg/mL and 3.85 μg/mL. Eugenol did not show any inhibition up to a concentration of 3200 μg/mL. In combination, eugenol showed good synergistic effect with both triclosan and amoxicillin. In combination with triclosan, eugenol showed much promising result as compared with amoxicillin. But triclosan and amoxicillin combination showed inhibition at higher concentrations. Conclusion: Triclosan and eugenol combination showed better effectiveness against E. faecalis in comparison to amoxicillin and eugenol. Triclosan and amoxicillin showed antagonism when used in combination against E. faecalis.



Ashwitha C Belludi, Arvind Sridhara, Narayana Chandra Kumar, Sunil Raj Noojadi

Dermatoglyphics: A Noninvasive Diagnostic Tool in Predicting Class III Skeletal Malocclusion in Children

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:7] [Pages No:63 - 69]

   DOI: 10.5005/jp-journals-10005-1934  |  Open Access |  How to cite  | 


Background: Dermatoglyphics is a scientific study that deals with the epidermal ridges and their configurations on certain body parts such as fingers, palms, and soles. In humans, during the intrauterine life (IUL) the primary palate, lip, and dermal ridges are formed during the same period, the genetic code engineered in the genome normal or abnormal is mirrored on these developing structures. Thus making dermatoglyphic a preceding tool in dental diagnosis. Aims and objectives: The study aimed at evaluating dermatoglyphics as a tool in diagnosing malocclusion by comparing qualitative and quantitative dermal patterns in class I and class III skeletal malocclusion. Materials and methods: Sixty subjects fulfilling inclusion-criteria were segregated into two groups, group I (class I skeletal malocclusion) and group II (class III skeletal malocclusion) with 30 subjects in each group. Dermatoglyphic patterns were recorded using ink method following rolling impression technique on recording sheets. The dermatoglyphic data were assessed for different finger ridge patterns, total finger ridge count, a–b ridge count, and atd angle. Results: The data were analyzed using Chi-square and paired t tests. In skeletal class III malocclusion, there was an increase in loop count and a decrease in the count of whorls and arches as compared to class I malocclusion (p = 0.037). However, in relation to total finger ridge count, a–b ridge count, and atd angle, there was no statistically significant difference found between the groups. Conclusion: The end of the study derived that the fingerprint patterns are valuable and ineradicable markers of malocclusion. Thus, the dermatoglyphics can be utilized as a screening tool for early prediction of skeletal class III malocclusion at a younger age-group. Further studies are suggested with the inclusion of other parameters using the inkless biometric method in different populations.



Murali K Dindukurthi, Jyothsna V Setty, Ila Srinivasan, Anjana M Melwani, Kuthpady Manasa Hegde, Sreeraksha Radhakrishna

Restoration of Proximal Contacts in Decayed Primary Molars Using Three Different Matrix Systems in Children Aged 5–9 Years: An In Vivo Study

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:70 - 74]

   DOI: 10.5005/jp-journals-10005-1929  |  Open Access |  How to cite  | 


Aims and objectives: Proximal contacts and their interdigitation through occlusal contact with opposing teeth play a major role in children, for the eruption of permanent teeth into normal position. Determining the ideal matrix band system for proximal restorations helps in the construction of contacts and contours. This study is designed to determine the most suitable matrix band system for proximal restorations. Materials and methods: A total of 96 proximal cavities were selected among patients aged 5–9 years and were equally divided into three groups. Group I: T-band, group II: ProMatrix, and group III: FenderMate. Pre- and postoperative radiographs were taken to evaluate carious lesions and restorations. Class II cavity was prepared and glass ionomer restorations were done using matrix systems. The efficacy of matrix bands was evaluated through the operator's questionnaire and postoperative radiographs. Results: No statistical significance was found between the three matrix bands but FenderMate showed few clinical drawbacks that were statistically significant (p < 0.005). Interpretation and conclusion: Matrix systems used in this study showed good results in restoring proximal contacts and contours. FenderMate showed few drawbacks when compared with the other two matrix systems. None of the matrix systems used in the present study were able to create 100% accurate proximal contacts and contours.



Sumaiya Nezam, Chitrita G Mukherjee, Jeevendra N Shukla, Anju Jha

Comparative Evaluation of Efficacy of Obturation Techniques in Deciduous Teeth Using Cone-beam Computed Tomography: An In Vivo Study

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:6] [Pages No:75 - 80]

   DOI: 10.5005/jp-journals-10005-1897  |  Open Access |  How to cite  | 


Introduction: Pediatric dentistry has evolved from extraction acclimatized practice to prevention and preservation. Successful endodontic treatment is mandated for retention of pulpally involved primary teeth. Aim and objective: To comparatively evaluate the obturation techniques namely lentulospiral and skini syringe with NaviTip in primary teeth using cone-beam computed tomography (CBCT). Materials and methods: The study was carried out among children ranging between the ages of 4 years and 8 years of either sex with pulpal involvement of primary molars which were indicated for pulpectomy. The study population was divided into two groups according to the type of obturating technique used. Group I included samples obturated with lentulospirals while group II samples were obturated using skini syringes with NaviTip. Postoperatively, CBCT imaging was used to evaluate the quality of fill of both the obturation techniques by determining the presence of voids in the root canals. Results: The total number of voids present in group I were 48, in which, 8 were in the coronal third, 16 in the middle third, and 24 in the apical third. On the other hand, the total number of voids present in group II was 21, out of which 7 were in the coronal third, 10 in the middle third, and 4 in the apical third. A statistically significant difference was noted between the two groups in terms of the overall voids present. Conclusion: Within the limits imposed by the conditions used in the present study, both techniques can be used for obturation in the root canals of primary molars. Voids were observed with both the techniques, but minimum in group II, i.e., skini syringe with NaviTip.



Ippili AmruthaVarshini, Chaitanya Penmatsa

Effectiveness of Pre-cooling the Injection Site, Laser Biostimulation, and Topical Local Anesthetic Gel in Reduction of Local Anesthesia Injection Pain in Children

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:3] [Pages No:81 - 83]

   DOI: 10.5005/jp-journals-10005-1913  |  Open Access |  How to cite  | 


Aim and objective: Evaluation of the effectiveness of laser biostimulation (LBS), ice, and local anesthetic (LA) gel in reducing the injection pain during administration of local anesthesia in children. Materials and methods: A 3-arm, crossover randomized controlled trial included 30 children of age 9–12 years requiring extraction of primary maxillary posterior teeth. Children were randomly allocated to 3 groups of 10 each. After proper isolation and drying of the buccal mucosa, one of the three techniques, i.e., either LBS or ice or LA gel was applied for 1 minute followed by administration of the LA solution. The pain response was assessed using Wong-Baker Faces Pain Rating Scale and the Sound Eyes Motor scale (SEM). Kruskal–Wallis ANOVA and Mann–Whitney U tests were performed for intragroup and intergroup comparisons, respectively. Results: Lower pain score of zero suggesting no hurt was given by more children in the ice group, followed by LA gel and LBS groups in both the scales. The differences in pain scores recorded were found to be statistically significant. Conclusion: Ice is found to be equally effective as LA gel, whereas low-level laser therapy is less effective compared to the other two techniques in reducing the injection pain during administration of maxillary posterior buccal infiltration in children. Clinical significance: Pain management during LA injection is a critical step in gaining initial trust and during the subsequent treatment visits. The present study suggests that simple methods like pre-cooling the injection site with ice can be used as an effective non-pharmacological technique to reduce injection pain.



Anusha Mohan, Padmanabhan Ramachandran, Padmasani V Ramanan, Selvakumaar Haridoss, Subbalekshmi Natesh

Impact of Pediatric Dentistry Residents Posted in Pediatrics Department: A Retrospective Assessment of 6 Years

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:4] [Pages No:84 - 87]

   DOI: 10.5005/jp-journals-10005-1890  |  Open Access |  How to cite  | 


Aim: To measure the influence of rotatory pediatrics postings for dental residents on the outpatient census of the pediatric dentistry department. The secondary aims were to assess the change in trend toward the number of preschool children visiting the department before and after the initiation of pediatrics posting and also to find the percentage of children affected with caries among children visiting the pediatricians. Materials and methods: Retrospectively, the census of the pediatric dentistry department was calculated from 2010 to 2016. The number of preschool children who visited the pediatric dentistry department during this period was determined. From the pediatrics posting records, the dental status of the children, the number screened, the number referred, and the number reported to dentistry following referral were tabulated. Descriptive statistics and Chi-square tests were performed. Results: After the initiation of pediatrics postings for residents, the outpatient census has increased by 26%. There was a significant increase in the number of preschool children visiting the pediatric dentist. About 57.09% of children screened in the pediatrics department had dental disease. Conclusion: There is an increase in the patient flow of the pediatric dentistry department with a greater number of preschool children visiting the pediatric dentist after initiation of the pediatrics postings for residents. More than half the children visiting pediatricians had dental disease requiring professional care. Clinical significance: Pediatrics postings for residents can be used in teaching centers as an opportunity to spread awareness and increase the number of preschool children visiting pediatric dentists, thereby increasing prevention and early intervention of early childhood caries.



Pragyna Priyadarshini

Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:9] [Pages No:88 - 96]

   DOI: 10.5005/jp-journals-10005-1895  |  Open Access |  How to cite  | 


Background: One of the cardinal points to be considered during endodontic procedures in children is the measure of postoperative pain. Aim and objective: To evaluate the quality of obturation and its effect on postoperative pain with three file systems in primary mandibular molars during 1 week follow-up. Materials and methods: The study was conducted as a double-blinded randomized controlled trial. The participants between 6 years and 9 years old requiring a pulpectomy were recruited for the trial. Forty-five primary mandibular molars were randomly allocated into 15 teeth each in Hand K-files; Kedo-SH and Kedo-SG Blue groups. Wong Baker's FACES Pain Rating Scale was used for assessing the postoperative pain in the children for 1 week. Pearson's Chi-square test, Kruskal–Wallis test, and Mann–Whitney U test were used for analyzing the data statistically. Results: Optimal fillings were observed more in the Kedo-SG Blue group (80.0%) compared to the other two groups (p < 0.017). On intergroup analysis, the Kedo-SG Blue group reported less postoperative pain compared to Kedo-SH group on day 1 while on day 7 no postoperative pain was experienced in either of the groups. Less postoperative pain was reported by the children in whom the canals were optimally filled compared to overfilling and underfilling. Conclusion: Kedo-SG Blue resulted in less postoperative pain when compared to Kedo-SH and hand K-files, whereas optimally filled children experienced less postoperative pain compared to overfilling and underfilling. Clinical significance: A felicitous pediatric dental practice includes appropriate assessment and management of postoperative pain in children. Hence, the present study is important in highlighting the affiliation of postoperative pain with quality of obturation following an endodontic intervention in children.



Ankita R Verma

Knowledge, Attitude, and Practices of Tobacco Vendors toward Selling Tobacco Products to Young Children and Adolescents in Central Delhi

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:3] [Pages No:97 - 99]

   DOI: 10.5005/jp-journals-10005-1914  |  Open Access |  How to cite  | 


Background: Tobacco consumption by youth is a serious public health problem. Regulation on tobacco sales has been given enough attention in our country, but very less information exists about the knowledge and attitude regarding tobacco laws by tobacco vendors. Aim and objective: To study the knowledge, attitude, and practices of tobacco vendors regarding the selling of tobacco to children and adolescents up to 18 years of age in the Central Delhi area. Materials and methods: A total sample size of 60 tobacco vendors was selected by random sampling method. The procedure and objectives of the study were explained to them and written informed consent was obtained. A casual interview of the tobacco vendor was taken and answers given by them were recorded using a questionnaire. After completing the data, statistical analysis was performed. Results: The mean age of children and adolescents visiting tobacco shops was 11.83 years and the minimum age was 8 years. It was reported that 19 (31.7%) vendors always asked the age of the child while none of them asked for proof of age. Forty-two (70%) of them reported these children and adolescents visit their shop alone while 18 (30%) reported that they visit with friends. Khaini was the commonest form of tobacco bought/consumed by children and adolescents. Twenty-seven (45%) vendors reported that these children consume tobacco publically. Conclusion: Despite knowing various anti-tobacco laws, tobacco vendors are selling harmful tobacco products to children and adolescents.



Fatimah Saud Alshammari, Rehab Ali Alshammari, Motieah Hathal Alshammari, Malak Farraj Alshammari, Azhar Khairallah Alibrahim, Faisal Abdullah Al sineedi, Khlood Abdulkader Alkurdi, Abdullah Faraj Alshammari

Parental Awareness and Knowledge toward their Children's Oral Health in the City of Dammam, Saudi Arabia

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:4] [Pages No:100 - 103]

   DOI: 10.5005/jp-journals-10005-1894  |  Open Access |  How to cite  | 


Introduction: Two main factors have a great influence on the youth's oral well-being. These are their dental health and age. These two factors are significantly directed by parents through establishing a system of proper oral hygiene and a preventative routine for those young adults. Aim and objective: The following study was run in the Dammam region, Saudi Arabia, to assess guardian awareness of youngster's dental health. Materials and methods: This community-based study was designed in a cross-sectional pattern, where a sample size of 248 parents who fulfilled inclusion criteria was selected and a well-designed validated questionnaire was used for the collected database using SPSS (VER. 24). Results: The main found included that, about 51% of participants were fathers and 49% were mothers, 90% of them above the age of 26 years old and most of the participants had a secondary certificate or university degree, 38% and 45%, respectively, only 64% of parents have checked their children teeth, the average of overall knowledge of parents toward dental health was medium 7.97 points out of 16.0 points and there was a statistically significant relationship between parents type, educational level, and overall knowledge related to oral health. Conclusion: From our study, it was acknowledged that the perception of children's oral health status by their parents in the Dammam region is relatively medium, so general awareness of parents’ knowledge should be raised by conducting effective oral health programs and interventions.



Vishu Midha, Vasu Midha, Rohini Dua, Anuraj S Kochhar, Gulsheen K Kochhar

Auxiliary Aids to Alleviate Pain and Anxiety during Local Anesthesia Administration: A Comparative Study

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:104 - 108]

   DOI: 10.5005/jp-journals-10005-1935  |  Open Access |  How to cite  | 


Introduction: In dentistry, pain and anxiety have been the most challenging aspect in the management of a pediatric patient. When every effort to perform local anesthesia (LA) is not successful, the result would be more stressful for both the dentist and the patient. The so-called clichéd paradigm that “pain and dentistry are inseparable” can be resolved by updating the knowledge and skills of the practitioner by using the more advanced techniques in controlling and managing the pain. An array of techniques for administering the LA to improve the comfort level of our patients has been the area of interest. Aim and objective: To evaluate and compare the efficacy of various adjunctive aids of LA in reducing pain and anxiety in pediatric patients of the 6–8 years age-group. A total of 90 child dental patients were selected and randomly divided into six groups, i.e., control, topical gel, audio, audiovisual, transcutaneous electric nerve stimulation (TENS), and Vibraject group. Physiological parameters, psychological parameters, and pain assessment were recorded. Results: As reflected by the results, the minimum pulse rate “during” and “after” LA administration is seen in A/V (D) and TENS (E) “during” LA administration. Children were less anxious and more relaxed in the audiovisual group and TENS group. Transcutaneous electric nerve stimulation and Vibraject groups showed maximum reduction in pain. Conclusion: A/V (D) and TENS (E) groups exhibited the least anxiety. Also, the minimum pain was felt using TENS (E) and Vibraject (F) and hence, may be considered as adjunctive aids in pain reduction during LA administration.



Singh V, Devi Dayal, Savita Verma, GS Prasad

Effect of an Oral Health Preventive Protocol on Salivary Parameters and Gingival Health of Children with Type 1 Diabetes

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:6] [Pages No:109 - 114]

   DOI: 10.5005/jp-journals-10005-1871  |  Open Access |  How to cite  | 


Context: Type 1 diabetic children exhibit poorer oral health than general population. However, no oral health preventive protocol exists for attending to the oral health needs of such children. Aim: To evaluate the effect of an oral health preventive protocol on salivary parameters and gingival health of children with type 1 diabetes mellitus over a period of 6 months. Materials and methods: Fifty diabetic children, aged 6–12 years were selected and divided into two groups. Children in group I received a comprehensive oral health preventive protocol. The parameters recorded were oral hygiene practices, salivary flow rate, pH, buffer capacity, viscosity, electrolytes, and plaque and gingival indices. These were compared at baseline, 3-, and 6-month intervals. Statistical analysis: Statistical analysis was done using IBM SPSS STATISTICS (version 22.0). Tests were based on the type of data. Results: The intervention group (group I) showed favorable improvements in the parameters assessed. A greater number of participants adopted the correct oral hygiene methods. Unstimulated salivary flow rate increased from 0.36 ± 0.21 to 0.82 ± 0.16 mL/minute in group I and from 0.32 ± 0.24 to 0.58 ± 0.16 mL/minute in group II after 6 months (p = 0.001). Salivary buffer capacity increased from 3.07 ± 2.64 to 10.40 ± 0.82 in group I while in group II, it improved from 3.20 ± 1.47 to 9.33 ± 1.44 (p = 0.02). Salivary viscosity decreased in group I from 1.97 ± 0.42 to 1.15 ± 0.06 and from 1.97 ± 0.35 to 1.23 ± 0.11 in group II after 6 months (p = 0.02). Gingival scores changed from 1.07 ± 0.35 to 0.20 ± 0.23 in group I and from 1.04 ± 0.28 to 0.85 ± 0.25 in group II (p = 0.001). Conclusion: The preventive protocol used in the present study showed a significant (p < 0.05) improvement in the parameters assessed.



Ashish Katiyar, Sukriti Gupta, Kirtija Gupta, Bhoomika Tripathi

Comparative Evaluation of Chemo-mechanical and Rotary-mechanical Methods in Removal of Caries with Respect to Time Consumption and Pain Perception in Pediatrc Dental Patients

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:115 - 119]

   DOI: 10.5005/jp-journals-10005-1896  |  Open Access |  How to cite  | 


Aim and objective: • To compare the clinical efficiency in removal of caries by the two different methods of caries removal. • To compare the treatment time between chemomechanical and rotary mechanical methods of caries removal. • To compare the pain perception of the patient during the two different methods (chemomechanical and rotary mechanical) of dentin caries removal. Materials and methods: The Carisolv system for caries removal, consisting of a solvent gel and a specially designed hand instrument, as compared to the conventional method of caries removal, i.e., Airotor. Sixty patients in the age-group of 6–14 years, having Black's class I dentinal caries with the cavity in the molars, were enrolled for the study. Results: The time for caries removal with Carisolv and Airotor was, respectively, 7.17 ± 1.57 and 8.00 ± 1.56 minutes. Thus, the mean time taken was also significantly higher in group II as compared to group I (t = 4.805; p < 0.001).



Saida Reddy, Vasepalli Madhu, Rachuri Punithavathy, Martha Satyam, Uday Kumar Chowdary, Raparla Mythraiye

Comparative Evaluation of Efficacy of Kefir Milk Probiotic Curd and Probiotic Drink on Streptococcus mutans in 8–12-year-old Children: An In Vivo Study

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:8] [Pages No:120 - 127]

   DOI: 10.5005/jp-journals-10005-1883  |  Open Access |  How to cite  | 


Aim and objective: To compare the effect of probiotic products in reducing the levels of salivary Streptococcus mutans before and after their consumption. Materials and methods: Eighty school children with initial carious lesions in the age group of 8–12 years were selected and divided into four groups. Children in group I (control) were undergone with restorations without supplementation of probiotics. Children in group II (kefir milk), group III (probiotic curd), and group IV (probiotic drink) supplemented 100 mL of their respective probiotics for 1 month. Assessment of saliva sample was done at baseline, 1 hour after administration of probiotics followed by weekly intervals till 1 month. Results: The study showed a marked reduction in colony-forming units (CFUs) at a 1-hour time interval in all four groups when compared to baseline. On the 30th-day, children in group II and group III have shown an equal reduction of CFUs when compared to group IV and group I. Conclusion: Probiotic products like kefir milk and probiotic curd have shown an equal and marked decrease in CFUs when compared to the probiotic drink group. Clinical significance: The administration of probiotics along with dairy products can be used as an adjuvant to routine preventive treatment procedures in the prevention of dental caries along with the remineralization of the demineralized tooth structure.



Nitin Gautam, Rajat R Khajuria, Rimsha Ahmed, Sunny Sharma, Sarah Hasan, Saad Hasan

A Comparative Evaluation of Marginal Accuracy of Co–Cr Metal Copings Fabricated Using Traditional Casting Techniques and Metal Laser Sintering

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:128 - 132]

   DOI: 10.5005/jp-journals-10005-1888  |  Open Access |  How to cite  | 


Aims and objectives: The aim and objective of the study were to determine the amount of marginal discrepancy produced by cobalt–chromium (Co–Cr) copings fabricated using two different fabrication methods, i.e., traditional casting and direct metal laser-sintering (DMLS), and compare the values obtained between each fabrication technique and to evaluate if the fabrication technique can produce prosthesis that is within the standards of clinical acceptance of marginal discrepancy. Materials and methods: Twenty metal copings each were fabricated by laser sintering and traditional casting method. The marginal gap at the buccal, lingual, mesial, and distal areas was measured using the silicone replica technique. The stereomicroscope and optical microscope were used to measure the marginal discrepancy between the working die and the copings. Statistical analysis was done using a t-test using Open-epi calculator software. Results: The values indicate that the marginal gap was less for the copings fabricated using Co–Cr alloy crowns that were fabricated with direct metal laser-sintered technique than Co–Cr alloy crowns fabricated with conventional casting technique.



Beatriz KB Lopes, Gabriel V Scheicher, Mirian AN Matsumoto, Fábio L Romano

Rapid Palatal Expansion and Utilization of E-space in Mixed Dentition: Mechanics that Helps in the Corrective Orthodontic Treatment

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:7] [Pages No:133 - 139]

   DOI: 10.5005/jp-journals-10005-1904  |  Open Access |  How to cite  | 


Aim and objective: The objective of this article was to report two clinical cases, showing the benefits of interceptive treatment using rapid palatal expansion (RPE) and the preservation of E-space. Background: It is important to follow-up child throughout its development to detect irregularities in their occlusion and to avoid or attenuate orthodontic treatments in the future. Posterior crossbite and transverse maxillary deficiency can easily be corrected by RPE that enhances the width of the maxilla and promotes a gain of space in the arch. Another way to gain space in the arch is by using the E-space, which is the difference between the mesiodistal distance of the second primary molar in relation to the second premolar. This additional space can be used to resolve negative, mild, or moderate crowding. Case descriptions: Two clinical cases that presented malocclusions due to lack of space and maxillary deficiency, along with clinical technic of how the RPE and E-space can be used to bring those patients back to normality. Conclusion: We concluded that with a right diagnosis, correct interceptive timing, and using what growth provides, the development can be reestablished. Clinical significance: The clinical importance of this report is that RPE and E-space are efficient interceptive orthodontic treatments to correct skeletal posterior crossbite (SPC) and gain space in dental arches.



Aline F Justulin, Paulo H Rossato, Ana CCF Conti, Marcio R Almeida, Paula Vanessa Pedron Oltramari, Thais MF Fernandes

Relapse of Anterior Open Bite: A Case Report

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:140 - 144]

   DOI: 10.5005/jp-journals-10005-1893  |  Open Access |  How to cite  | 


The aim and objective of this study is to report the recurrence of the treatment of the anterior open bite after 5 years of treatment. A female patient aged 8 years 6 months old had a negative vertical crossing of −4.7 mm. Early treatment with a fixed palatal grid was performed for 1 year. At the end of the treatment, the vertical overpass was 1.1 mm and after 2 years of control, the vertical overpass remained positive with 1.7 mm showing the stability of the treatment. After 5 years, and due to the sucking and lingual interposition habit, there was a recurrence of the open bite. Interdisciplinary follow-up is extremely important to eliminate the factors responsible for the origin of deleterious habits, thus solving the changes resulting from these habits and providing long-term stability.



Pooja N Mapara, Swapnil M Taur, Savita G Hadakar, Shashikiran N Devendrappa, Namrata N Gaonkar, Sachin Gugawad, Dhanshri S Khade

Sturge–Weber Syndrome: Roots to a Cure a Nightmare in Pediatric Dentistry

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:4] [Pages No:145 - 148]

   DOI: 10.5005/jp-journals-10005-1928  |  Open Access |  How to cite  | 


Aim and objective: This article aims to report a case of Sturge–Weber syndrome (SWS) in a pediatric patient and its systematic dental management to add to the existing literature. Background: Sturge–Weber syndrome is one of the vascular disorders, known for its stupendous scope of clinical manifestations and life-threatening complications. The substantial prevalence of oral manifestations in SWS makes it crucial to have a comprehensive knowledge of this rare congenital disorder. Case description: This case report represents a case of SWS in an 11-year-old boy with oral, ocular, and neurological features who reported due to pain, unilateral gingival enlargement associated with spontaneous bleeding in the mandibular left region. A multidisciplinary team approach having comprehensive knowledge regarding such rare congenital disorder is a must to prevent its life-threatening complications. Conclusion: Sturge–Weber syndrome often affects the oral cavity through vascular lesions. Hence, deep knowledge is immensely important to provide an appropriate dental treatment without complications. Clinical significance: Port-wine stains should not be considered as just birthmarks and should be further investigated for its systemic involvement to arrive at a confirmatory diagnosis and treated accordingly with special precautions.



Shubhangi Jain, Monis Raza, Payal Sharma, Piush Kumar

Unraveling Impacted Maxillary Incisors: The Why, When, and How

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:9] [Pages No:149 - 157]

   DOI: 10.5005/jp-journals-10005-1903  |  Open Access |  How to cite  | 


Failure of eruption of maxillary incisors requires careful diagnosis and treatment planning. The cause of impaction may vary from physical obstruction in the path of eruption, tooth material arch length discrepancy to malformation of the tooth. General principles of management of the condition include removal of physical obstruction, creation of space, and surgical exposure with or without traction. The treatment of an unerupted tooth depends upon its age, position, etiology, and amount of space in the dental arch. This case series elaborates on three different cases of incisor impaction with different etiologies and varying ranges of complexity. Three-dimensional radiography was utilized in all cases to accurately visualize the impacted tooth and its relation to adjacent structures. All the cases required different approaches and were completed in varying time durations. Meticulous treatment planning resulted in well-aligned satisfactory functional and esthetic results.



Amrita Kumari, Malvika B Bansal, Karan H Asrani

Nonsyndromic with Recurrent Idiopathic Gingival Fibromatosis: A Rare Case Report

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:3] [Pages No:158 - 160]

   DOI: 10.5005/jp-journals-10005-1933  |  Open Access |  How to cite  | 


Idiopathic gingival fibromatosis is a genetic rare disorder, which is characterized by a progressive enlargement of the gingiva. Gingival enlargement is an overgrowth of the gingiva, which can be caused by various etiological factors such as poor oral hygiene, plaque accumulation, inadequate nutrition, hormonal stimulation, several blood dyscrasias, or long-term intake of certain drugs like phenytoin, nifedipine, or cyclosporine. A 14-year-old female patient reported to the Department of Periodontology, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan with her chief complaint of swollen gums in both upper and lower arches since 3 years, which was gradual in onset and increased in size since 4 months which covered almost half of the surface of each tooth. Also reported that 3 years ago, there was similar swelling for which surgical intervention in form of gingivectomy was carried out. The treatment plan for this case was followed by phase 1 therapy (scaling and root planing) and after completion of phase 1 therapy, the labial tissue from the mandibular anterior region was excised and sent for histopathological examination. Histopathological appearance revealed idiopathic gingival fibromatosis. Thereafter, the conventional gingivectomy under local anesthesia was performed to remove excess gingival overgrowth.



Bourane Ambriss, Carla Moukarzel, Mohamed Ezzeddine, Riad Bacho

Management of Maxillary Premolar with Pre-eruptive Intracoronal Resorption: A 5-year Follow-up Case

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:6] [Pages No:161 - 166]

   DOI: 10.5005/jp-journals-10005-1881  |  Open Access |  How to cite  | 


Aim and objective: The present article aims to describe and discuss the preventive clinical management of a pre-eruptive intracoronal resorption (PEIR) defect on a maxillary right second premolar of an 11-year, 5-month-old girl. Background: Pre-eruptive intracoronal resorption is described as an abnormal, well-circumscribed, radiolucent area, occurring within the coronal dentinal tissue close to the dentinoenamel junction of unerupted teeth and extending into various depths of the dentin. It is a rare anomaly occurring in primary and permanent dentitions. In the past, these defects were misdiagnosed as caries, and were therefore called “pre-eruptive caries” or “hidden caries”. Currently, the most acceptable etiological hypothesis for PEIR is intracoronal resorption by the invasion of resorptive cells into the dentine through breakdowns in the enamel during crown formation. These lesions are often detected accidentally during routine dental radiographic examination. Case description: A fissure sealant was applied to the affected tooth shortly after its eruption. Clinical and radiographical assessments were scheduled every 6 months for a period of 5 years and 5 months. Conclusion: The preventive approach proved to be effective in preserving the tooth vital and asymptomatic with normal root development for the entire follow-up period. Clinical significance: This article raises awareness about misdiagnosed PEIR in primary and permanent dentitions. A close inspection of radiographs, taken during routine visits and orthodontic check-ups, is important for early detection and proper management of such defects.



Gajula S Prathima, Gurusamy Kayalvizhi, Venkatachalam Vinothini

Incidental Finding of an Odontome Attached with Primary Teeth: A Rare Case Report

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:3] [Pages No:167 - 169]

   DOI: 10.5005/jp-journals-10005-1899  |  Open Access |  How to cite  | 


Odontomes are hamartomatous developmental malformation of dental tissues which causes disturbances in the eruption of teeth. In general, odontomes occur frequently in permanent dentition and are seldom associated with primary dentition. This case report presents an odontome attached with primary tooth which was incidentally found during routine radiographic diagnosis and it spotlights the significance of early diagnosis and management of odontome to prevent future complications such as retained deciduous teeth and impaction of permanent teeth, malocclusion, etc.



Geethanjali Gowdham, Amarshree A Shetty, Amitha Hegde, Lekshmi R Suresh

Impact of Music Distraction on Dental Anxiety in Children Having Intellectual Disability

[Year:2021] [Month:January-February] [Volume:14] [Number:1] [Pages:5] [Pages No:170 - 174]

   DOI: 10.5005/jp-journals-10005-1902  |  Open Access |  How to cite  | 


Aim and objective: To analyze the impact of Indian instrumental music on children with intellectual disability (mild) exhibiting dental anxiety during dental procedures using electrical skin resistance measured by a biofeedback machine. Materials and methods: A total of 20 children of 6–14 years having an intellectual disability (mild) were randomly divided into two groups comprising of 10 each. The study was carried out in a cross-over design, with and without music distraction in two appointments spaced out at a gap of 1 month. The children were subjected to a dental examination, oral prophylaxis, and auditory operative stimuli in both appointments. The electrical skin resistance during each procedure was measured using a galvanic skin response (GSR) biofeedback machine and the values were statistically analyzed using paired and unpaired t-tests. Results: A statistically significant increase in electrical resistance was observed during music distraction, which indicated an anxiety reduction when music distraction was employed. Conclusion: The increased electrical skin resistance due to low anxiety proves the positive impact of music distraction in intellectually disabled children. Clinical significance: Music can be employed as a distraction technique to reduce anxiety in intellectually disabled children.


© Jaypee Brothers Medical Publishers (P) LTD.