Introduction: The decreased rate in dental caries cases across the world has created an enthusiasm in many clinicians to relate and study different developmental disorders. In past years, defects that are commonly associated with dentistry are hypomineralized areas commonly seen in central incisors and first molars. Molar incisor hypomineralization (MIH) is a defect of the enamel, which is qualitative in nature and systemic in origin characterized by advanced and concurrent hypomineralization of the enamel affecting the first permanent molars together with frequent association of the incisors. Aim: To evaluate the prevalence of molar incisor hypomineralization (MIH), its possible risk factors and its association with dental caries and enamel surface defects (attrition and abrasion) in schoolchildren aged between 8 and 16 years in Lucknow district. Methodology: Indexed teeth (first permanent molars and incisors) of 5,585 schoolchildren, selected by stratified random sampling technique between the age-group of 8 and 16 years, were examined by a trained and calibrated examiner. The data was recorded in a predesigned pro forma by examiner, which consisted of mainly two parts. The first part comprised of general information, while the second part comprised of questions related to risk factors related to MIH (prenatal, perinatal, and postnatal history). For the diagnosis of MIH, the Developmental Defects of Enamel (DDE) Index was used for diagnosis of MIH, while the decay-missing-filled teeth index (DMFT) criteria were used for assessing dental caries. Enamel surface defects were recorded using the Smith and Knight tooth wear index. Results: A prevalence of 7.6% was reported wherein females were found to be more affected by MIH. A strong significant correlation was found between MIH prevalence and childhood infection. Conclusion: Early diagnosis of MIH is necessary to prevent the rapid destruction of the tooth morphology resulting in complicated treatment. Further studies with greater samples are needed to investigate the different etiological factors and determine the biological molecular mechanism that they may cause. Clinical significance: The data obtained from the current study does not portray a clear consideration of the infants’ medical history in the initial 4 years of life. Further studies may be performed to surpass these shortcomings by using more elaborate medical records of the child in addition to profound recollection of the parents. Due to paucity of literature on this issue in Lucknow District, our current study may provide some information at a baseline level for conducting an extensive research involving different regions pan-India.

Objective: To clinically evaluate and compare the performance of posterior pediatric zirconia crowns with stainless steel crowns. Materials and methods: Twenty nine children [3–9 years] were selected and given 70 preformed crowns [35: preformed zirconia crowns, Kinderkrown; 35: stainless steel crowns, KIDZ CROWN]. Crowns were evaluated for retention, marginal integrity, opposing tooth wear, plaque accumulation, gingival inflammation, and proximal contact at 3, 6, 9, and 12th month. Results: At the end of follow-up period overall success rate with zirconia crown was 93.5% and that of stainless steel crown was 96.7%. Statistical analysis showed no difference between the groups. Conclusion: Posterior preformed zirconia and stainless steel crowns showed good clinical performance. Preformed zirconia crowns can be an option for posterior full coronal restoration when esthetics is of prime concern for the parent and child.

Aim: The objective of this clinical trial was to evaluate and compare two full-coronal restoration [stainless steel crowns (SSCs) and zirconia crown] in carious primary posterior teeth. Materials and methods: Forty endodontically treated primary teeth in children within the age-group of 3–9 years were selected and divided into two equal groups (20 SSCs and 20 zirconia crown). The two crowns were evaluated for retentivity of crown, temporomandibular joint (TMJ) problem, gingival response, plaque accumulation, and tooth wear in opposing teeth after 1^st and 3^rd month follow-up. Results: Both the crowns showed 100% results regarding TMJ problems, but SSCs performed better in terms of retention of crown, gingival response, plaque accumulation, and tooth wear in opposing teeth. The statistics showed significant result by using Mann–Whitney U test and Wilcoxon signed-rank test. Conclusion: Stainless steel crowns performed better among both the full-coronal restoration for posterior primary teeth. Clinical significance: Stainless steel crowns remain “Gold Standard”, for posterior full coverage restorations in primary molars as compared to zirconia crowns.

Background: Newer minimally invasive treatment options for improvement in appearance of dental fluorosis stains are gaining popularity in recent years. Objective: To evaluate and compare the clinical success in esthetic improvement of resin infiltration, in-office bleaching with 35% hydrogen peroxide, enamel microabrasion, and resin infiltration with double infiltrant application on nonpitted fluorosis stains. Materials and methods: Seventy two patients aged between 6 and 12 years with nonpitted dental fluorosis stains on the upper anterior teeth were randomly selected and divided into four interventional groups: group 1- resin infiltration (RI), group 2- in-office bleaching using 35% hydrogen peroxide (B), group 3- enamel microabrasion (M), and group 4- resin infiltration with double infiltrant application (2RI). In each group, standardized photographs were taken preoperatively, immediate postoperatively and after 1, 3, and 6 months time interval postoperatively to assess the esthetic improvement (EI) and changes in white/brown surface opacities/stains (SC) using a Visual Assessment Scale (VAS). Results: RI and 2RI showed statistically significant results (p ≤0.05) followed by microabrasion and bleaching, for both the evaluation criteria (EI and SC) at all the follow-up intervals. Conclusion: Resin infiltration is a promising procedure that demonstrated remarkable clinical success for improvement in esthetics of nonpitted fluorosis stains with stable long-term positive outcome.

Mercury toxicity from amalgam dental fillings and their potential for creating problems in the environment and for human health have prompted the development of new restorative materials. The leading alternatives among these are glass ionomer cements. According to current understanding, restorative materials that slowly release fluoride exert a local cariostatic effect. For this purpose, glass ionomer cements have desirable properties in that they help prevent recurrence of caries by releasing fluoride over a long period. Thus, they function in accord with the major cariostatic mechanism of fluoride, which is believed to be its action to promote remineralization and to influence the morphology of teeth by reducing enamel solubility and by suppressing oral cariogenic bacteria. Although the minimum local concentration of fluoride release required to inhibit demineralization has not been determined, it is reported that the cariostatic ability of fluoride releasing restorative materials is significant. Zirconomer defines a new class of restorative that promises the strength and durability of amalgam with the protective benefits of glass ionomer while completely eliminating the hazards of mercury. The inclusion of specially micronized zirconia fillers in the glass component of zirconomer reinforces the structural integrity of the restoration and imparts superior mechanical properties for the restoration of load-bearing permanent teeth. Combination of outstanding strength, durability, and sustained fluoride protection deems it ideal for multiple applications. The aim of the present study was to determine the fluoride release from glass ionomer cements and compare it with new material zirconomer. Materials and methods: Sample preparation: Tablets of glass-ionomer cements and zirconomer were prepared. A dental floss was incorporated into the tablets during fabrication to allow suspension into the test medium. Each disk specimen was immersed in airtight polyethylene bottle containing 20 mL of deionized water and incubated at 37°C and stored for 24 hours. Determination of fluoride ion release: Fluoride ion measurement was performed after 6 hours, 24 hours, 48 hours, 7 days, and 14 days under normal atmospheric conditions by fluoride ion selective electrode connected to an ion selective electrode meter. Result and conclusion: Both the material tested in the study had the ability to release fluoride but higher fluoride release was observed by zirconomer as compared to GIC at all time intervals. Clinical significance: From a clinical point of view, both the restorative materials release fluoride at all time intervals; however, addition of zirconia particles in zirconomer increases its strength and provides superior mechanical properties. Therefore, due to the combination of both good structural integrity and fluoride releasing properties, zirconomer can be used for restoration of load bearing teeth.

Background: The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim: This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods: A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N–Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results: The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N–Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31–0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N–Adh was used (HR = 0.46; CI = 0.26–0.81; p = 0.008). Conclusion: All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance: Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements. Trial registration number RBR-9nqszr

Aim: “Today's adolescents are tomorrow's citizens.” Tobacco use in children and adolescents is reaching pandemic levels as they are the most vulnerable population to initiate tobacco use. It is well established that most of the adult users of tobacco, start the use of tobacco either in their childhood or adolescence. Parents are the best route to reach a child and can help lead to bring better outcomes for children. Hence, the aim of this study is to assess the knowledge, attitude, and behavior regarding the hazards of tobacco use and Cigarette and Other Tobacco Products Act (COTPA) among the parents visiting pediatric dental clinic. Materials and methods: A cross-sectional survey was conducted using a self-administered questionnaire regarding knowledge, attitude, and behavior regarding the hazards of tobacco use and COTPA law. Samples size of 400 parents of adolescents aged between 10 and 16 years visiting to the department of Pediatrics and Preventive Dentistry were included in the study, data thus obtained was subjected to statistical analysis. Results: Smoking tobacco product known to the parent population in the present study is cigarette (88.8%) and smokeless tobacco product is pan masala (65.2%). The tobacco health hazard known is cancer by 70.5 and 85.3% parent populations were aware of mandatory display of pictorial health warnings in COTPA law. Strict implementation of COTPA law was opted by 61.8%. Conclusion: Knowledge, attitude, and behavior of parents is required to educate and motivate adolescents. Parents have given their positive attitude regarding the strict implementation of COTPA law in India and realize the role of tobacco as a causative factor for health hazards both in children and adults. COTPA law should be made aware for both young and old to educate and motivate and to prevent the use of tobacco in India.

Aim: The aim of this study was to evaluate the effect of using audio-visual entertainment aids and print format entertainment aid (comics) on children's pain and anxiety. Materials and methods: This randomized parallel trial was performed on 60 patients aged 5 and 9 years, who required pulp therapy. The study consisted of three study groups, Group 1- treatment along with PlayStation, Group-2 treatment along with comic group, and Group 3- control group (treatment without any entertainment). Results: Mean age was 7.1 ± 0.29 years. There was a significant improvement in the patients who were given treatment along with PlayStation. (p < 0.001) Statistically significant differences were found (p < 0.001) in terms of parental perception of the patient's anxiety during the visits. Conclusion: It was concluded from the study that use of distraction method techniques is effective in reducing situational anxiety and parental perception of pain distress in younger children. Clinical relevance: Entertainment while treating pediatric patient can help in improving the comfort level of patient in a clinical setup.

Introduction: Human tooth banks (HTBs) are philanthropic institutions that assist to alleviate academic pressure by supplying human teeth essential for preclinical laboratory activities and experimental research. The primary focus of this research was to assess the knowledge and attitude of undergraduate students and interns who have taken up dentistry as their field of study in Jazan University, Saudi Arabia, about HTB. Materials and methods: An online structured self-explanatory questionnaire containing 16 questions was sent via email to the undergraduate students and interns. The Google e-forms questionnaire contained a consent attached for participating in this cross-sectional observational study. Results: A good response rate of 93.3% was recorded, but the results were surprising as 66.43% of the participants did not have the slightest idea regarding the concept of a tooth bank, while only a meager 17.4% of them supported the idea of getting the teeth preauthorized from HTBs before using it on patients. A majority (80.36%) of students unanimously promoted the idea of having facilities like HTBs, but only 15.36% of students had stored teeth at a teeth bank previously. Conclusion: There is an overwhelming lack of awareness among students regarding HTBs and the legal procedures involved in procuring teeth from them. It is necessary to do all that's required to create awareness about the perks of linking HTB with various dental institutions and the legal process involved to use human teeth.

Aim and and objective: To evaluate the influence of the clinical characteristics inherent to Molar Incisor Hypomineralization on the values and scores of the DMF-T and ICDAS indexes. Materials and methods: Eight hundred and eight seven teeth were examined, from 39 individuals aged 3–14 years (8.95 ± 3.26), who had at least one first permanent molar (FPM) or second primary molar with signs of hypomineralization, according to the criteria of the European Academy of Paediatric Dentistry. Hypomineralized teeth were evaluated for the presence of restorations, post-eruptive breakdowns (PEB), and dental caries, being considered sound for the DMF-T when there was the presence of PEB without caries lesion. Chi-square and Kruskal Wallis tests (p ≤ 0.05) were used to detect differences. Results: Two hundred and five teeth showed signs of hypomineralization. The average number of opacities was influenced by the period of dentition, with more opacities when the primary dentition and the eruption of FPM and permanent incisors were complete (p ≥ 0.05). Hypomineralized teeth showed a higher DMF-T value, mainly of the decayed component (12%), in contrast to 2.5% of nonhypomineralized teeth. It was not possible to associate ICDAS scores 1 and 2 to hypomineralized surfaces, due to the overlap with the diagnosis of early enamel caries. The values of this index changed in the presence of cavitation by caries (scores 3,4,5,6), but not in the presence of PEB. Conclusion: Due to the impossibility of differential diagnosis with caries lesion, PEB, and opacities present in hypomineralized teeth tend to overestimate the values and scores of the DMF-T and ICDAS, respectively. Clinical significance: Make future suggestions for epidemiological studies in the area.

Aim and objective: To evaluate and compare the remineralization potential of CPP–ACP, nano-hydroxyapatite, and calcium sucrose phosphate toothpaste on artificial enamel caries lesions by means of microhardness testing. Materials and methods: Twenty sound human primary molars, extracted for therapeutic reasons were selected for this study. From each tooth, two enamel specimens were prepared and embedded in acrylic resin blocks, and each block contains five tooth samples. After polishing, the baseline hardness of the enamel surface (KHN) was determined by Knoop microhardness testing. Then the specimens were randomly assigned into four groups (n = 10), according to the remineralizing agent used: group I: Control, group II: GC Tooth Mousse^TM (CCP-ACP), group III: Acclaim^TM (nano-HAP), and group IV: EnaFix (CaSP). The specimens were then immersed in a demineralizing solution and post-lesion KHN values were obtained as baseline measurements. Later remineralizing agent was applied and after 7 days of remineralization, posttreatment KHN tests were conducted. Results: Data were analyzed using paired t-test, analysis of variance, and Tukey HSD test. Mean enamel surface microhardness (KHN) values after remineralization shows that group IV (EnaFix^TM) had maximum hardness number (114.71 ± 12.27) followed by group III (Acclaim) (85.14 ± 22.82) and group II (GC Tooth Mousse) (56.42 ± 19.90). The difference was statistically significant (p < 0.001). Similarly the %SMHR was also highest in group IV (EnaFix), followed by group III (Acclaim) and group II (GC Tooth Mousse). Conclusion: EnaFix (calcium sucrose phosphate) shows a maximum increase in the enamel surface microhardness followed by Acclaim (nano-HAP) and GC Tooth Mousse. Clinical significance: Calcium Sucrose Phosphate in toothpaste strengthened the enamel more than nano hydroxyapatite and CPP-ACP, and can be an alternative to the use of fluoride toothpaste in children.

Aim and objective: This study was conducted to microbiologically evaluate cotton, PTFE tape, and foam pellets as endodontic spacer in primary teeth. Materials and methods: Thirty primary second molars indicated for pulpectomy were included in this study. Followed by the completion of pulpectomy in each teeth cotton, PTFE tape, and foam pellets were placed as endodontic spacers randomly in 10 teeth each. The samples were collected from the pulp chamber at baseline and after 7 days to evaluate for microbial contamination of the same. The data obtained was tabulated and subjected to appropriate statistical analysis. Results: There was a statistically significant increase in the colony forming unit after 7 days in cotton and foam pellet group. But PTFE tape group showed very minimal contamination of the pulp chamber after 7 days. Conclusion: Within the limitations of this study, it can be concluded that PTFE tape found to be the best alternative to cotton as an endodontic spacer. Clinical significance: In case of multiple visit pulpectomy procedure, the state of sterility must be maintained in between the appointments until a definitive coronal restoration is placed following root-canal obturation. So it is mandatory to place an endodontic spacer under a provisional restoration to maintain the patency of the root canals and prevention of the microbial growth. The PTFE tape is inorganic, nonfibrous material which can be tightly packed without any voids under the provisional restoration. So PTFE tape is the best material to maintain the root canal patency and to provide a sterile environment by preventing the microbial growth under the provisional restoration as an endodontic spacer material in between the appointments.

Background: A toothbrush is one of the most important aids used for cleaning teeth by most people in the world. So, knowledge regarding toothbrush disinfection is of utmost importance to everyone, especially the dental fraternity. With this in mind this study aims to understand the Knowledge Attitude and Practice of dentists regarding toothbrush hygiene and disinfection in private dental colleges of Lucknow City. Materials and methods: This was a cross-sectional questionnaire-based study, which included the undergraduates (UGs, interns), postgraduates (PGs), and faculty members of the four private dental colleges who gave the consent to participate in the study. The statistical analysis was done using SPSS version 22, the Chi-square test was used and p-value <0.05 was considered statistically significant. Results: There was a statistically significant difference regarding toothbrush contamination, mode of storing the toothbrush, and the various practice used for toothbrush disinfection among the interns, postgraduates, and faculty members who participated in the study. It was also seen that the general awareness and practice of toothbrush disinfection was higher among the female participants in the study, which was also a statistically significant result. Conclusion: There was a statistically significant difference in the perceptions about toothbrush contamination and disinfection among postgraduates and interns that might be attributed to their higher academic knowledge and clinical experience.

Background: To evaluate the knowledge perspective and trainings among gynecologists’ considering oral health of pregnant mothers of South Bengaluru city, by questionnaire. Materials and methods: A total of 60 gynecologists are included in the study. Prior to the study, the questionnaire was pretested by Pedodontist. The questionnaire was administered on the first day of visit, and on the next day it was collected back. Results: The research unveiled that a greater number of gynecologists had satisfactory knowledge attitude and training concerning oral health of expectant mothers. Conclusion: The predominance of gynecologists has satisfying knowledge perspective as well as practices, but still there is a demand for better effective attendance and involvement of medical specialists like gynecologists and pediatricians in continuing the education programs and forums on dentistry.

Aim and objective: To determine the prevalence of malocclusion in the Mewat district of Haryana. Materials and methods: A cross-sectional study was conducted in government/private schools of Mewat district. A total of 3,042 subjects were selected, age ranging from 11–18 years. Parameters studied were molar relationship, facial profile, overjet, overbite, reverse overjet, open bite, and supernumerary teeth. The Chi-square test was used for calculating the p-value. Results: The prevalence of normal occlusion was seen in 77.4%, Angle's class I malocclusion was present in 13.5%, class II in 7.7%, and class III was seen in 2.8% of the study population which is statistically significant. Straight facial profile was observed in 91%, 7.9% had convex and 1.08% had a concave profile. Increased overjet was present in 33.5% of cases and reverse overjet was seen in 1.08%. The normal overbite was recorded in 70%, increased bite was seen in 29% and the open bite was present in 0.95% of the examined population, supernumerary teeth were seen in 18 children. Conclusion: There is a high prevalence of normal occlusion in the Mewati population. The results may provide baseline data for research and planning orthodontic services.

Aim and objective: Local anesthesia (LA) administration is an anxiety-provoking phenomenon in patients. Several alternative and advanced techniques make LA administration patient-friendly. This study assesses the knowledge, attitude, and practices of these advances, creating awareness and encouraging further studies and innovations to make these techniques more accessible, available, and economical to be utilized in the Indian population for controlling pain by targeting the budding dentists who actively imbibe and are abreast with the current state of affairs. Methods and materials: A descriptive cross-sectional questionnaire-based study was conducted among the undergraduate and postgraduate students of a private college in Navi Mumbai. The self-administered questionnaire contained 13 questions. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 17 software and a Chi-square test were applied. Results: A majority of the respondents were unaware of the alternative techniques (59.4%) with a significant difference between undergraduates and postgraduates. 95.7% thought conventional methods caused dental anxiety and 55.1% thought alternatives would be better. The pain management techniques currently used were mostly reassurance and distraction (84.2%) and Topical anesthesia (74.9%). Only 9.6% had actually practiced these techniques, the reason for inexperience being inadequate knowledge. Out of those who had used these techniques, 47.82% saw positive results with patients experiencing less pain. Conclusion: Knowledge of advanced local anesthetic techniques in the dental fraternity is necessary to enhance practice and provide the best care to the patients. Its inclusion in the curriculum with adequate practical training shall ensure its use efficiently. Clinical significance: Today dentistry is propelling toward minimally invasive, painless, and patient-friendly procedures. The incorporation of advanced LA techniques to help achieve this goal begin with assessing its awareness among future dentists which would help make them accessible and affordable and contribute toward providing patients a holistic treatment.

Aim and objective: Streptococcus mutans (S. mutans) shows increased resistance to currently available antibiotics and chemotherapeutics. The present study compares the effectiveness of chlorhexidine and Herbal mouth rinse against salivary S. mutans in children with mixed dentition. Materials and methods: Subjects (n = 60) with mixed dentition were selected for the study. Caries status was recorded using Nyvard's criteria. Baseline saliva samples were collected and assessed for quantifying S. mutans. Subjects were instructed to rinse their mouths with 0.2 % w/v chlorhexidine and herbal mouth rinse for 7 days. Saliva samples were collected after 7 days and assessed for S. mutans. After a run-in period of 21 days, both the mouth rinses were crossed over according to the Latin square design, and a similar procedure was carried out. Later, determination of mean colony-forming units (CFU/mL) from the saliva samples was done. For statistical analysis, Kolmogorov and Mann–Whitney U tests were applied. Results: Both the groups showed a significant reduction in S. mutans count, at baseline and 7 days (p = 0.0001), and the reduction of S. mutans count in herbal mouth rinse as compared to chlorhexidine mouth rinse (p = 0.0209) was statistically significant. Conclusion: Herbal mouth rinse proved to have better antimicrobial efficacy than Chlorhexidine mouth rinse.

Background/aim: Dental trauma draws attention in special children due to its risks and consequences. The aim of this study was to estimate the prevalence, etiology, and risk factors of traumatic dental injuries in children with special healthcare needs of Puducherry. Materials and methods: A cross-sectional survey among 121 special children aged 4–18 years was carried out in Puducherry. The children were examined for the presence of traumatic dental injuries (TDI) and associated risk factors for the occurrence of trauma and classified according to the WHO epidemiological field survey classification. Results: Prevalence of TDI was 40.5%.The majority of them were restricted to enamel fractures and the most commonly affected were permanent maxillary central incisors. The most common cause of injury was “falling over” and home was the frequent place of injury to occur. The risk factors associated with TDI were mesoprosopic facial form, convex facial profile, increased overjet, Angles Class II molar relationship, posterior facial divergence, and incompetent lips which were statistically significant. Conclusion: The study concludes the prevalence of TDI is more prevalent in CSHCN, thereby it is necessary to create awareness, health education, and periodic screening for efficient treatment.

The aim and objective of this study was to compare the antimicrobial efficacy of 0.2% chitosan, 3% sodium hypochlorite, 2% chlorhexidine against Enterococcus faecalis, alone and in conjunction with diode laser. Materials and methods: The root canals of 72 extracted intact human single-rooted teeth with single canals were prepared, and E. faecalis was incubated in the root canals for 7 days. The teeth were then randomly divided into the following four experimental groups: group I: Saline, group II: 0.2% Chitosan, group III: 3% Sodium hypochlorite, and group IV: 2% Chlorhexidine. These groups were further subdivided into three groups: (1) 10 mL irrigant only, (2) 10 mL irrigant, dried and irradiation with diode laser, (3) Diode laser was used for activation of irrigant solution. Samples were obtained from subgroups in each group and checked for turbidity. The effect of each irrigant was evaluated by counting the number of colony-forming units observed on inoculation with samples taken from the irrigated canal on bile esculin azide agar. The data thus obtained was recorded and put to statistical analysis. Results: Significant reductions were noted in E. faecalis colony counts in all groups (p < 0.05). The greatest reduction in colony count (0%) was noted in group IV followed by group II. Also, samples disinfected with diode laser after root canal irrigation showed less number of colony-forming units per mL as compared to the samples irrigated with root canal solutions alone or diode laser alone. Conclusion: Chitosan has the capability for use as an accessory for disinfection of the root canal system. The application of an 810-nm diode laser by itself did not have the adequate antimicrobial activity to be used as an adjunct in root canal therapy. Irradiation with diode laser ought to be used in conjunction with the irrigant to gain maximum antibacterial effect against E. faecalis.

The cutaneous sinus of dental origin represents a skin disorder that appears due to an infection accompanied by bony changes. The remote location of the lesion relative to the primary site of the disease leads to its presumption of a skin etiology by the individual. Inadequate knowledge on the part of the physician followed by faulty management complicates the situation further. However, unless the dental cause is not addressed, the lesion does not resolve. The following case report discusses the dental management of an extraoral sinus with the aim of guiding the general public, physicians, and dentists with its accurate and timely assessment so as to avoid additional financial costs, futile antibiotic therapy courses, and unnecessary surgical excisions.

Pediatric subcondylar jaw fractures in the mixed dentition phase present a unique challenge as immobilization of the jaw is indicated but arch bars are contraindicated due to fear of damage to underlying tooth buds. No definite guidelines are present in the management of pediatric subcondylar jaw fractures. We report a case in which a patient in mixed dentition with undisplaced fracture of neck of condyle which was managed with Intermaxillary fixation.

Amelogenesis imperfecta (AI) is an inherited dental condition affecting enamel, which can result in significant tooth discoloration and enamel breakdown, requiring lifelong dental care. Distal renal tubular acidosis (dRTA) is a condition in which the kidneys are unable to acidify the urine to a pH < 5.5 in the presence of systemic metabolic acidosis. Management of AI and dRTA patients requires both medical and dental expertise to achieve long-term successful results. The aim of this paper is to present the dental management of a child with AI and dRTA.

Background: Traumatic dental injuries (TDIs) are impact injuries to the teeth and surrounding hard and soft tissues. It can range from minor tooth fracture to extensive dentoalveolar damage. It affects not only the physiology and function but also the esthetics of the child. They have a high prevalence among children. Children living in orphanage institutions due to parental absence or abandonment are more prone to TDI due to inadequate individualized attention, neglect toward oral health, and lack of awareness regarding TDI among the caretakers. However, the data about the prevalence of TDI among institutionalized orphan children are limited and lacking. Aim and objective: To determine the prevalence of TDIs in institutionalized orphan children. Materials and methods: A cross-sectional study was conducted in six institutions for orphan children in New Delhi, India. A total of 500 institutionalized orphan children in the age group of 5–14 years were included in the study. A single calibrated examiner performed the clinical examination in the study sample to evaluate the dental trauma status using the WHO oral health assessment form for children 2013. Data analysis was performed using the Statistical Package for the Social Science-21 (SPSS-21). Results: The prevalence of TDI was found to be 5.8% among the institutionalized orphan children with a higher prevalence among boys when compared with girls. The most common tooth involved was maxillary central incisors. Enamel and dentin fractures were the most prevalent TDIs. Conclusion: It is the need of the hour to gather more data regarding TDI and assess their risk factors. This can help in the formulation of plans to raise awareness regarding the prevention and management of TDIs in orphan children with special needs. Adequate knowledge regarding TDI among caretakers can also help prevent these injuries and provide timely intervention for the same.

Aim: To systematically identify and evaluate the available literature based on the sedative effect of oral midazolam compared with midazolam administered intranasally and also compare their effect on behavior of pediatric dental patients. Objective: This systematic review compares the sedative effect and the effect on behavior with oral midazolam and intranasal midazolam. Methods: A search was undertaken through PubMed Central, Cochrane Database of Systematic Reviews, LILACS, Science Direct and SIGLE. All the studies included the comparison of the sedative effect of oral and intranasal midazolam. Database search identified 178 articles. 165 articles were excluded based on titles and duplication. Abstract and complete text of 13 articles were thoroughly evaluated. Four articles were included based on the inclusion criteria to meet the criteria. The selected studies analyzed the children's behavior or anxiety by oral midazolam in comparison to intranasal midazolam administration. Results: Among the four studies included in the present review, risk of bias was high in all the articles. The high risk was obtained due to inadequate blinding of personnel and participants in the study, improper allocation concealment and inadequacy in blinding of the outcome assessment. Also, difference observed between oral and intranasal midazolam routes on behavior and sedation level in the studies included in this review was not statistically significant. Conclusion: Studies comparing the effect on behavior of oral and intranasal midazolam in children are limited. More number of high-quality clinical trials evaluating the sedative effect and effect on behavior of oral and intranasal midazolam in pediatric dental patients is required.