Aim: To evaluate the effectiveness of oral irrigator and interdental floss as adjuncts to manual tooth brushing in 8–16 years old children with visual impairment. Materials and methods: A three-arm, parallel-group randomized controlled trial with blinded outcome assessment was carried out with the inclusion of 90 institutionalized children with visual impairment of age 8–16 years. They were equally allocated to three groups: group I: tooth brushing along with interdental flossing, group II: brushing along with a powered oral irrigator, and group III: brushing alone (control). Baseline oral hygiene index-simplified (OHI-S), gingival index (GI), and plaque index (PI) scores were recorded for all the samples and compared with post-intervention scores at 14 and 28 days intervals. Repeated measures of analysis of variance (ANOVA), one-way ANOVA, and post hoc Tukey tests were used for statistical analysis. Results: At 28 days interval, children in group II showed a highly statistically significant reduction in OHI-S (0.46; p = 0.0001), PI (0.16; p = 0.0001), and GI (0.24; p = 0.0001) scores compared to control group. They also showed a significant reduction in OHI-S (0.25; p = 0.018), PI (0.15; p = 0.011), and GI (0.15; p = 0.0001) scores compared to group I. There is no significant reduction in the scores of children of group I compared to control group except for the GI score (0.08; p = 0.02). Conclusion: Oral hygiene maintenance using oral irrigator along with brushing was found to be more effective in visually challenged children. Interdental flossing, along with brushing and brushing alone was found to be less effective. Clinical significance: This study underlines the fact that comprehensive oral hygiene care should include interdental cleaning aids for effective plaque control to prevent dental diseases in children with visual impairment. Since these children have less manual dexterity to perform good oral hygiene practices, electrically driven interdental cleaning aids like oral irrigator may help them to overcome the problem.

Aim: The aim of this study was to see the age and also the reasons for the child's first dental visit and to assess the oral health status and treatment desires. Materials and methods: The study involved 133 children aged between 1 month and 14 years, who reported to the department of pediatric and preventive dentistry. All parents/legal guardians of the study participants gave written consent for participation in the study. Information on the child's age and reason for the dental visit were collected from a questionnaire given to parents. The children's dental condition was assessed by decayed, missing, and filled teeth (dmft) and DMFT values. Statistical analysis used: Statistical Package for Social Sciences (SPSS) version 21 and categorical data were compared by using Chi-square test. The level of significance was set at 0.05. Result: Age of the child for first dental visit was male: 85.7% at 9 years and female: 75.00% at 4 years. Majority of children who visited the dentist were age 7 years. The most common chief complaint about the primary visit was caries, and the second was tooth pain. Conclusion: Children report for the primary dental visit most commonly solely after 7 years and for complaints like caries and tooth pain. Children make their first dental visit too late (usually at the age of 7 years) in reference to medical recommendations (between 6 and 12 months of life). More of restoration was the treatment of need by 47.00%. The results of this study indicate unhealthy oral health creating their first dental visit and low health awareness of parents and guardians.

Aim: The aim of this study is to compare and evaluate compressive strength (CS) and diametral tensile strength (DTS) of a conventional glass ionomer cement (GIC) and a glass hybrid GIC. Materials and methods: Five samples each were prepared of GC Fuji IX and EQUIA Forte cements for CS testing and five samples of each material for tensile strength testing. Specimens were subjected to a universal testing machine. Comparison of CS and DTS among two study groups was made using an independent t-test for each. Level of significance was set at p ≤ 0.05. Results: Both test values were on the higher side for EQUIA Forte cement as compared to conventional GIC (p ≥ 0.05). However, the differences in values were not statistically significant. Conclusion: EQUIA Forte can serve as an alternative to conventional GIC in stress-bearing primary teeth areas. Considering several factors like cost-effectiveness, surface to be restored, moisture contamination, and time considerations, the material of choice can be tailored to one's needs. Clinical significance: EQUIA Forte can serve as a viable alternative to conventional GIC because of its improved qualities.

Aim: The objective of the study was to assess the regenerative potential of advanced platelet-rich fibrin (APRF) in the regenerative treatment of necrotic immature permanent teeth (NIPT) in the maxillary incisor region. Study design: After institutional review board clearance, 10 children aged between 8 and 14 years with NIPT in the maxillary incisor region undergoing APRF treatment were enrolled in a prospective clinico-radiographic exploratory observational study. Baseline clinical, radiographic, and vitality testing before the start of treatment were noted. Patients were followed up at 3, 6, and 12 months posttreatment. Results: After 3, 6, and 12 months of follow-up, all patients (100%) showed complete resolution of clinical signs and symptoms. All patients (100%) showed periradicular healing, and 9 out of 10 patients (90%) showed a clear hard tissue bridge formation at various levels in the root canal on postoperative radiographs. None of the patients (0%) showed a positive response to vitality testing. Conclusion: APRF is a promising biomaterial in regenerative endodontic treatment (RET). Future randomized trials can be planned to establish superiority or equivalence to conventional PRF.

Background: Preschool children's oral hygiene maintenance is greatly prejudiced by their parent's knowledge and understanding regarding oral health. When parents are devoid of the basic awareness of caries-associated factors, the significance of primary teeth, and oral healthcare, it is challenging to program disease prevention strategies and apply them effectively. Aims and objectives: This pilot study aimed to assess the knowledge regarding oral health, its effects, and the influence of demographic values on the parental practices among the parents of 2–6-year-old children by using a self-administered pretested questionnaire. Materials and methods: The questionnaire was randomly distributed among parents of 2–6-year-old children who visited Buraidah Central Hospital. The sample size taken for this pilot study was 1,000. The questionnaire included 26 questions associated with the parent's knowledge about the oral health of the child, hygiene maintenance, and dietary habits. The collected data was analyzed using SPSS software. Results: In the present research, a total of 1,000 parents participated in the study. It was observed that parental knowledge and hygiene practices increased as the educational status increased. It was also observed that as the number of children decreased in the family, the dietary practices and hygiene practices improved. All these observations were found to be statistically significant (p < 0.05). Conclusion: Parent's education and knowledge reflect in their child's development of healthy practices. Thus the parents need to know about oral health, which can be put into practice in their children. Clinical significance: This research helps us to understand the significance of parental knowledge and education in the oral health practices and maintenance among the children inculcated by parents, which can help in bringing down the oral health diseases in children in future.

Aim: The aim of this in vitro study was to evaluate and compare the adhesive bond strength of conventional glass ionomer cement (GIC) and Cention N to the primary enamel and dentin using an accelerated fatigue test. Materials and methods: A total of 30 sound human primary molars were collected and were mounted on a metal cylindrical block using acrylic resin, embedding the root up to cemento-enamel junction (CEJ). Proximal box was prepared on both mesial and distal surfaces, one of the cavity was restored with GIC (Type 9) and the other proximal cavity with Cention N. A nonretentive cavity design was followed for both the materials so as to maintain the uniformity between the two specimens were then placed under a universal testing machine (Instron) and subjected to accelerated cyclic loads till a separation fracture occurs at the tooth-restoration interface. The number of endured cycles a particular restoration could withstand before getting fractured was registered. Results: Cention N resisted significantly more number of endured cycles before separation from the cavity as compared to GIC (p < 0.001). Conclusion: Within the limitations of the study, it can be concluded that newly developed material Cention N is preferred alternative over conventional GIC for the restoration of proximal cavities in primary molars.

Aim: Prevention-focused school dental health program (SDHP) is a cost-effective intervention that countries can use to lessen the problem of dental diseases by educating on oral health. The current study aims to assess the effectiveness of parental participation in an SDHP held at periodic intervals on the oral health status (OHS) of children aged 8–10 years attending a local school in Southern India. Materials and methods: The longitudinal study was scheduled between September 2018 and June 2019 (36 weeks) in 120 participants who were healthy school children aged 8–10 years at a private school in Kelambakkam. This 36-week duration study assessed the effectiveness of school dental health education program with and without parents at every 12 weeks interval. The OHS of subjects was assessed using the standard indices [i.e., Decayed, Missing and Filled permanent teeth (DMFT), decayed, extracted, and filled primary teeth (deft), and Simplified Oral Hygiene Index (OHI-S)]. Friedman's test and Mann–Whitney U test were used for analyzing the data as indicated. Results: In postintervention visits, children with parental participation had significantly lower caries increments than children without parental participation. While the oral hygiene index scores have improved significantly in both groups over time, the improvement in the parental participation group was greater. Conclusion: It can be concluded that the SDHP is an educational driver that showed a constructive impression on the oral health of children. The participation of the child's parents in SDHP has significantly improved the OHS of children.

Aim: To determine the location of mandibular foramen (MF) and mental foramen (MeF) in 8–18-year-old children using cone beam computed tomography (CBCT). Materials and methods: Hundred CBCT images of children (8–18 years) were evaluated to determine the shortest distance from MF to the anterior border of ramus (A), posterior border of ramus (P) and inferior border of the mandible (MI), most superior point of the curvature of mandibular notch (MN), occlusal plane of the mandibular permanent molars (O), and the distance from MeF to lower border of mandible (BM) and to the alveolar crest (AC). Results: There was a statistical increase in A-MF, P-MF, MI-MF, MN-MF, and O-MF values with age. MF was found to be 3.53 mm below the occlusal plane in 8–11-year-old children, and it reaches the occlusal plane by 12–14 years of age, and it moves posterior-superiorly 3.58 mm above the occlusal plane in 15–18-year-old individuals. AC-MeF value decreases whereas the BM-MeF value increases with age and there was a significant difference based on sex. Conclusion: The location of the MF is just posterior to the middle of the ramus, it reaches the level of the occlusal plane by the age of 12–14 years, and MF and MeF are shifting posterior-superiorly with increasing age. Clinical significance: The awareness of localization of MF and MeF is of greater importance when administering regional anesthesia in mandible, especially in children. Its position varies according to gender and age, especially during growth spurts. Failure to achieve proper nerve block leading to repeated injection of the local anesthetic solution will not only pose a behavior problem in children but can also lead to systemic toxic level of anesthetic solution being administered. Its accurate position enables more effective local anesthesia and improves child cooperation, minimizing the risk of complications.

Purpose: The study aims to evaluate the prevalence of dental caries and anomalies in pediatric patients undergoing chemotherapy or those who have completed chemotherapy. Methods: A total of 250 pediatric patients within the age group of 6 months to 17 years, either admitted to hospitals for chemotherapy or on follow-up, were included as a part of the study. Complete oral examination inclusive of the diet history, oral hygiene methods, past dental history, the decayed, missing, and filled teeth (DMFT), def score, and any dental anomaly was diagnosed clinically and radiographically using an orthopantomogram. The samples were further categorized under type of malignancies and duration of chemotherapeutic drug usage groups (from 6 months to 10 years and more than 10 years) to establish a correlation of these variables with the prevalence of dental caries and dental anomalies. Results: Among all patients, 108 (43.2%) had completed the treatment (chemotherapy), while 142 (56.8%) were undergoing the treatment. Forty-three (17.2%) patients showed positive findings for dental anomalies. Conclusion: The present study confirms the strong positive correlation between long-term exposure to chemotherapeutic agents and the prevalence of dental anomalies and dental caries in children.

Aim: To evaluate the oral health status of children with special healthcare needs (CSHCN) having either systemic illness or any disabilities. Materials and methods: A retrospective analysis of oral health status was done from Jan 2013 to Dec 2018 on 58 CSHCN (both genders) up to 16 years of age. The oral health status of patients was assessed with the decayed, missing, and filled teeth (DMFT/dmft) indices and simplified oral hygiene index (OHI-S) by using the World Health Organization (WHO) 2013 oral health survey criteria. Results: Fair oral hygiene was dominantly present (62%) among all the subjects. Association between oral hygiene status and systemic illness/disability was done using the Chi-squared (χ²) test and was found statistically nonsignificant. The overall mean DMFT/dmft found was 4.16. The highest mean DMFT/dmft score was recorded in nephrotic syndrome patients (16.0%), while the least score was seen among cleft anomalies (1.89%). Comparison between mean DMFT/dmft scores among various systemic illnesses/disabilities were done using Kruskal–Wallis one-way analysis of variance (Kruskal–Wallis ANOVA) test and found statistically significant (p-value 0.048). Conclusion: The majority of the CSHCN fall under fair oral hygiene status. A high caries prevalence and statistically significant value were demonstrated between mean DMFT/dmft scores of various systemic illnesses/disabilities. Clinical significance: Present study aids in understanding the needs of the community, identifying high-risk groups, planning the required treatment and prevention strategies, and thus monitoring and improving the oral health status of children with special healthcare needs.

Aim: The present study aimed to assess and evaluate oral hygiene status and oral hygiene behaviors among children with the attention-deficit hyperactive disorder (ADHD) and children without ADHD. Materials and methods: A total of 34 children of ages 6–14 years were included in the study. Groups I–17 children with ADHD and group II–17 healthy children. A visual examination of dental caries and traumatic injuries was performed, and the oral hygiene status of these children was determined. The parent/guardian completed a structured questionnaire regarding the child's oral hygiene practices and food habits. Data obtained from oral examination and questionnaires were compiled and subjected to statistical analysis. Results: The student t-test and the Chi-squared test showed that children with ADHD had significantly higher decayed, missing, and filled teeth (DMFT) scores and incidence of traumatic injuries without significant difference in oral hygiene status. Conclusion: There is no significant difference in oral hygiene status between both the groups but caries experience, and incidence of traumatic injuries are high in children with ADHD.

Aim: To investigate the cariostatic and remineralizing effect of two commercial silver diamine fluoride (SDF) preparations on enamel and dentinal caries using a plaque bacterial model. Materials and methods: Thirty-two extracted primary molars were divided into two groups (n = 16) as group I (Advantage Arrest) and group II (e-SDF). Plaque bacterial model was used to induce caries on enamel and dentin. Preoperative evaluation of samples was done using confocal laser scanning microscopy (CLSM) and energy-dispersive X-ray spectroscopy-scanning electron microscope (EDX-SEM). All samples were treated with test materials and evaluated for postoperative remineralization quantification. Results: EDX revealed that mean preoperative levels (in weight%) of silver (Ag) and fluoride (F) in enamel carious lesions were 0.0 and 0.0, which increased postoperatively to 11.40 and 31.05 for Advantage Arrest and 13.61 and 31.87 for e-SDF, respectively. For dentinal caries, EDX revealed mean preoperative levels (in weight%) of Ag and F were 0.0 and 0.0, which increased to 11.47 and 48.71 for Advantage Arrest and 10.16 and 47.82 for e-SDF, respectively postoperatively. Both groups showed evident demineralization with exposed collagen under SEM. The mean values of enamel lesion depth for the group I and II were 38.64 and 39.30 µm, that reduced to 28.02 and 28.70 µm, while for dentinal caries, the mean depth from 38.05 to 38.29 µm that reduced significantly to 28.96 and 30.10 µm, respectively (p < 0.001). Caries depth declined significantly after the application of both Advantage Arrest and e-SDF (p < 0.001). Conclusion: Advantage arrest and e-SDF show similar cariostatic and remineralization potential for dental caries. The plaque bacterial model used in this study is an efficient method to induce artificial carious lesions in teeth.

Background: Sports activities are the most important entity of human life for the holistic well-being of an individual. At the same time, it exposes them to a high risk of orofacial injuries. Aim: The study assessed the level of knowledge, attitudes, and awareness of orofacial injuries in children among sports coaches. Materials and methods: The sample of this descriptive cross-sectional study consisted of 365 sports coaches across various sports academies in the Delhi region. A questionnaire-based survey was conducted and descriptive analysis was performed. The comparative statistics were computed using the Chi-square test and Fischer exact test. A p-value of <0.05 was considered statistically significant. Results: Among participating coaches, 74.5% of the coaches agreed on the risk of trauma during sports activities that they supervise. The most common type of injury reported by the coaches was ‘cut lip, cheek, and tongue’ (72.6%), followed by ‘broken/avulsed tooth’ (44.9%). The mechanism of injury was mainly due to falls (48.8%). Nearly 65.5% of coaches were not aware of the possibility of replantation of an avulsed tooth. Also, coaches exhibited poor knowledge about an ideal storage media for carrying an avulsed tooth to the dentist. The majority (71%) of coaches agreed that their academies had no tie-ups with nearby dental clinics/hospitals. Conclusion: The sports coaches exhibited inadequate knowledge about the primary management of orofacial injuries and were unaware of the possibility of re-implantation of an avulsed tooth. Clinical significance: This study also highlights the need for educating coaches about emergency management of orofacial injuries and postponement in immediate treatment or inappropriate treatment due to lack of knowledge may lead to the futile outcome of the treated injured teeth.

Introduction: The oral cavity is colonized by various groups of microorganisms. Toothbrushing is a common method of maintaining oral hygiene and, upon regular use, can become heavily contaminated with microorganisms. To avoid contamination of the toothbrush with microorganisms from the external environment, toothbrushes can be protected by a protective cap, the significance of which is unknown. Objectives: To assess the microbial contamination of the toothbrush with and without a protective cap and to find the significance of the same against microbial contamination. Materials and methods: An ex vivo study was conducted in the Faculty of Dental Sciences, Sri Ramachandra University. A total of 40 toothbrushes were distributed among dental students aged 18–25 years; 20 were protected by a cap, 20 were unprotected, and instructions were given to recap the toothbrush after brushing. After 1 month of regular usage, toothbrushes were collected, and organisms were identified based on Gram's reaction followed by a biochemical test. Results: From the study conducted, it is evident that the microbial contamination of the unprotected toothbrush is higher than that of the toothbrushes that were protected with a cover.

Aim: This report intends to present a case of solitary median maxillary central incisor syndrome (SMMCI) and its multidisciplinary team approach for diagnosis of other associated anomalies, with special emphasis on their management. Background: Solitary median maxillary central incisor syndrome is a unique developmental condition characterized by only maxillary central incisor and a series of developmental defects, appearing as a syndrome. The appearance of a single incisor may take place due to the union of two incisor teeth or the absence of tooth germs. The mechanism of the fusion is still uncertain. Case description: A 9-year-old female child reported with a chief complaint of pain in the right lower back tooth for the past 10 days. The presence of a single maxillary central incisor was an incidental finding. Then a detailed history and multidisciplinary evaluations revealed the diagnosis of SMMCI syndrome. Conclusion: The effort in diagnosing and managing this syndrome had a strong impact on the child's life of which the parent was highly motivated and got a better understanding of associated problems of overall development. Clinical significance: In SMMCI syndrome, the patient requires a multidisciplinary health team in order to improve their quality of life. It is of greater importance to diagnose the syndrome and treatment of these median line deformities.

Aim: To present the treatment of radicular cysts with marsupialization in children and help reduce morbidity. Background: Radicular cyst is a cyst with an odontogenic origin seen more frequently in permanent dentition and seldom in primary dentition. Radicular cysts can develop due to apical infection caused by caries or can also occur as a consequence of pulp therapy in primary teeth. It may adversely affect the normal development and eruption of the permanent succedaneous teeth. Case description: We report two cases of radicular cysts in association with primary teeth with different etiologies and their conservative management with marsupialization and decompression techniques. Conclusion: Marsupialization has shown to be effective in treating radicular cysts in primary teeth. Good bone healing and normal continued development of the succedaneous permanent tooth bud were observed. Clinical significance: Marsupialization helps in preserving vital structures and reduces morbidity. It should be a preferred treatment modality for the management of large-sized radicular cysts.

Aim and objective: This case report aims to describe the management of a case of rare gingival lesion in a young pediatric patient. Background: An increase in the size of the gingival tissue is known as gingival hyperplasia. This can cause esthetic as well as functional problems, and interfere with normal functions like mastication and speech. A histological form of fibroma, fibroepithelial hyperplasia is a proliferative fibrous lesion of the gingival tissue. These lesions can be caused by trauma or persistent irritation, or they can develop from the periodontal, periodontal ligament, or periosteum cells. Case description: This paper discusses a situation in which the parents of a 4-year-old girl presented to the department with a major complaint of swelling in the upper front tooth region, who was diagnosed with fibroepithelial hyperplasia with the help of a biopsy and histologic evaluation. Conclusion: In this case surgical excision was performed under local anesthesia with no postoperative complications, and a 2-year follow-up was made with a positive outcome. Clinical significance: When these type of gingival lesions are present, they should be investigated and diagnosed properly. They should be managed as soon as possible without causing any further complications to permanent dentition.

Aim and objective: This case report aims to describe the management of alveolar cleft defect by iliac crest secondary bone grafting. Background: The secondary alveolar bone grafting performed during the mixed dentition period is an essential module of modern-day rehabilitation of cleft lip and palate patients with alveolar defects. Iliac crest bone graft is a frequent secondary graft used and is technique sensitive. Case description: A 12-year-old girl with alveolar cleft defect having problems with speech and regurgitation of fluids from nostril was presented and its management by a combination of iliac crest bone grafting and platelet-rich fibrin (PRF) was described. Conclusion: One year recall radiograph showed successful bone augmentation with this secondary alveolar bone grafting along with application of platelet rich plasma (PRP). Clinical significance: Osseous integration can be enhanced by PRP application over the graft which gives greater clinical outcome with less invasiveness.

The use of fiber optic transillumination (FOTI) has been witnessed in the clinical scenario for many decades but has not been used in in vitro studies. The present paper highlights the use of FOTI as a method of standardization while conducting fracture strength studies in vitro.