International Journal of Clinical Pediatric Dentistry

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2022 | September-October | Volume 15 | Issue 5

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Bhumika Patel, Manisha Kamal Kukreja, Ambika Gupta, Seema Rohilla

Evaluation of Changes in Soft and Hard Tissues of TMJ among Class II Division 2 Patients after Prefunctional Orthodontics and Twin Block Functional Appliance Therapy: A Prospective MRI Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:10] [Pages No:479 - 488]

Keywords: Class II malocclusion, Magnetic resonance imaging, Myofunctional

   DOI: 10.5005/jp-journals-10005-2439  |  Open Access |  How to cite  | 


Introduction: No study has been conducted to explore soft and hard tissue changes brought by functional appliances within the temporomandibular joint (TMJ) after correction of class II division 2 (div 2) malocclusion. Hence, we planned this study to evaluate the mandibular condyle disk-fossa relationship before and after prefunctional and twin block therapy using a magnetic resonance imaging (MRI) scan. Methodology: This prospective observational study was conducted among 14 males treated with prefunctional appliances for 3–6 months, followed by 6–9 months of fixed mechanotherapy. MRI scan was evaluated for changes in the TMJ at baseline after completion of prefunctional phase and after completion of functional appliance therapy. Results: At pretreatment, there was a flat contour on the posterosuperior surface of the condyles and a notch-like projection on its anterior surface. After functional appliance therapy, slight convexity appeared on the posterosuperior surface of the condyle and the prominence of the notch was reduced. There was a statistically significant anterior shift of condyles both after prefunctional and twin block treatment. The meniscus on both sides had significantly shifted posteriorly over three stages with respect to the posterior condylar (PC) plane and Frankfort horizontal (FH) plane. The superior joint space had significantly increased with significant linear glenoid fossa displacement between pre and posttreatment stages. Conclusion: Prefunctional orthodontics induced favorable changes in TMJ soft and hard tissues of patients, but they were not sufficient to place the soft and hard tissues in their normal positions. A functional appliance phase is needed to place the TMJ in their respective normal positions.



Hemant Garg, Daizy Khundrakpam, Vaishali Saini, Rashmi Rukshana, Kailash Kaldhari, Jagjit Kaur

Relationship of Nasolabial Angle with Maxillary Incisor Proclination and Upper Lip Thickness in North Indian Population

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:4] [Pages No:489 - 492]

Keywords: Facial esthetics, Maxillary incisor proclination, Nasolabial angle, Upper lip thickness

   DOI: 10.5005/jp-journals-10005-2432  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate the relationship between nasolabial angle (NLA) with maxillary incisor proclination (U1-NA) and upper lip thickness (ULT). Materials and methods: Pretreatment lateral cephalometric radiographs of 120 patients were taken, and NLA, U1-NA, and basic ULT measurements were obtained for each patient. Descriptive statistics were calculated for all the variables involved in the study. The correlation was found using the Pearson correlation coefficient (r) test. p < 0.01 was considered statistically significant. Results: The mean values of NLA, upper incisor proclination, and ULT were found to be 91.38° ± 7.10°, 34.21° + 5.17°, and 15.38 ± 1.76 mm, respectively. r (r = −0.583) was found between NLA and upper incisor proclination and (r = −0.040) for NLA and ULT. Conclusion: There is a statistically significant relationship between NLA and U1-NA.



Santhosh Priya AKR, Jayanthi Mungara, Poornima Vijayakumar, Gayathri Murali, Akila Veerapandian

Assessment of Effectiveness Acceptability Complications and Parental Satisfaction of Pediatric Dental Patients Treated under Nitrous Oxide-oxygen Inhalational Sedation Using Porter Silhouette Mask

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:493 - 498]

Keywords: Children, Nitrous oxide inhalational sedation, Porter Silhouette mask

   DOI: 10.5005/jp-journals-10005-2465  |  Open Access |  How to cite  | 


Objectives: To estimate the concentration of nitrous oxide (N2O) required for effective sedation to render dental treatment for an anxious child and to assess the child's behavior, patient acceptance, parental satisfaction, postoperative complications, and ease of manipulation of Porter Silhouette mask by the dentist during N2O–O2 sedation. Study design: A total of 40 children, 6–10-year-old requiring dental treatment, were treated using N2O sedation. The level of N2O required for optimal sedation, patient behavior, level of acceptance of N2O by the patient, clinical recovery score, and postoperative complications were observed throughout the study. At the end of the treatment, a questionnaire was given to the parents to evaluate parental satisfaction. Results: The sedation was very effective, with 25–50% of N2O concentration. About 92.5% of children were fully cooperative, the dentist was able to place the mask with comfort in 92.5% of children, significant improvement was seen in the patient's behavior with minimal complications, and 100% of the parents were satisfied with the treatment under sedation. Conclusion: Inhalational sedation with N2O using Porter Silhouette mask results in effective sedation, with increased patient comfort, and parental acceptance in providing dental treatment.



Lakshmi Madhuri, Ravindar Puppala, Chadak Vibha

Comparative Evaluation of Bacterial Colonization Color Stability and Halitosis of Oral Appliances Fabricated Using Cold Cure Acrylics, Heat Cure Acrylics and Thermoforming Sheets: An In Vivo Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:499 - 503]

Keywords: Color stability, Erkodur, Erkodur–bz, Halitosis, Thermoforming sheets

   DOI: 10.5005/jp-journals-10005-2428  |  Open Access |  How to cite  | 


Aim: Removable oral appliances form an integral part of interceptive orthodontic procedures. Bacterial colonization leading to halitosis and poor color stability are the major disadvantages of the same in spite of patient acceptability. The aim of the present study was to evaluate bacterial colonization, color stability, and halitosis from the oral appliances fabricated using cold cure, cold cure under pressure pot, heat cure acrylics, thermoforming sheet, Erkodur and antibacterial thermoforming sheet, Erkodur–bz. Materials and methods: A group of 40 children was divided into five groups and the appliances were delivered. Bacterial colonization and halitosis were evaluated before giving the appliance to the patient after 1 and 2 months. Color stability was evaluated before giving the appliance to the patient and then after 2 months. This study was designed as a single-blinded randomized clinical trial. Results: Results have shown that after 1 and 2 months, bacterial colonization was higher from the appliances fabricated with cold cure and was lower for the Erkodur group, which was statistically significant. Color stability was more from the appliances fabricated with Erkodur and was less for cold cure, which was statistically significant. Halitosis after 1 month was more from the appliances fabricated with cold cure and less from Erkodur group, which was statistically significant. After 2 months, halitosis was more from the cold cure group and less from Erkodur group, which was not statistically significant. Conclusion: Thermoforming sheet, Erkodur showed better results than other groups in terms of bacterial colonization, color stability, and halitosis. Clinical significance: When removable appliances are indicated for minor orthodontic tooth movement, Erkodur is preferable due to the advantages of easy fabrication and less bacterial colonization.



Abhay Kumar Singh, Sarmeshta Soni, Deepesh Jaiswal, Pooja Pani, Rohit Sidhartha, Nishant

Prevalence of Supernumerary Teeth and Its Associated Complications among School-going Children between the Ages of 6 and 15 Years of Jamshedpur, Jharkhand, India

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:504 - 508]

Keywords: Jamshedpur city, Mesiodens, Prevalence, Supernumerary teeth, Supplementary teeth

   DOI: 10.5005/jp-journals-10005-2442  |  Open Access |  How to cite  | 


Background: Supernumerary teeth (ST) are those that exceed the normal dental formula. This phenomenon is also known as hyperdontia, and can occur in solitary or multiple forms, might be unilateral or bilateral, and affect one or both jaws. Aim: To study the prevalence, gender variations in terms of frequency, characteristic, distribution, and associated complications with the presence of ST in 3,000 school-going children of age 6–15 years in Jamshedpur, Jharkhand, India. Materials and methods: The study consisted of an examination of randomly selected 3,000 children, female (group I) and male (group II), between the age-group of 6 and 15 years, from both private and government-aided schools. Clinical examinations were carried out by a single investigator under natural daylight in a systematic manner using a mouth mirror and straight probe only. The demographic profiles and number of teeth, including the presence of any ST (site, region, eruption status, morphology, and whether it was present unilaterally or bilaterally), were ascertained. Malocclusion or any complications associated with ST were also noted. Results: ST prevalence was found to be 1.87%, with male to female ratio of 2.29:1. Out of 56 children with ST, eight children had double ST while 48 had single, 53 ST were present in maxilla, and only three in mandible. Based on the region, 51 ST were present in the midline, four in the central incisor region, and one in the molar region. According to morphology, 38 ST were conical, 11 ST were tuberculate, and seven ST were supplementary. Twenty-two ST had associated complications, while 34 ST were asymptomatic. Conclusion: ST prevalence is relatively less, but if left neglected, it can pose serious associated dental problems in the child.



T Umapathy, P Balaji, Sharon Jose

A CBCT Study to Evaluate the Root and Canal Morphology of Permanent Maxillary First Molars in Children

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:509 - 513]

Keywords: Cone-beam computed tomography, Permanent maxillary first molar, Root canal morphology

   DOI: 10.5005/jp-journals-10005-2441  |  Open Access |  How to cite  | 


Introduction: For the correct diagnosis and endodontic therapy, a complete understanding of root canal morphology is required. One of the causes of endodontic failure is the inability to identify every canal in the root canal system; the second mesiobuccal canal (MB2) in the permanent maxillary first molar is the most commonly missed canal. Studies examining the root canal differences in pediatric Indian populations’ permanent maxillary first molars are somewhat uncommon. Aim: Cone-beam computed tomography (CBCT) will be used to assess the root and canal morphology of permanent maxillary first molars in the pediatric Indian population. Materials and methods: In the age range of 7–13 years, 25 children's CBCT pictures (50 images) were gathered from the institutional database and private diagnostic facilities. SCANORA® software was used to reconstruct the CBCT pictures, and Statistical Package for the Social Sciences (SPSS) for Windows was used to evaluate and analyze the data. Results: The roots of each permanent maxillary first molar were distinct. And all of the palatal and distobuccal roots were found to have a single root canal (100%), whereas the mesiobuccal roots were found to have a single root canal in 80% of cases and a double root canal in 20% of cases. The Vertucci type II structure, followed by types IV and V, was the most prevalent in roots with two channels. Conclusion: Within the constraints of this investigation, we came to the conclusion that the permanent maxillary first molar root canal configuration varied among the patients from the pediatric Indian population.



Vinod V Panchal, Prasanna T Dahake, Yogesh Jagannath Kale, Shrikant Bhujangrao Kendre

Comparative Evaluation of Antimicrobial Efficacy of Sodium Hypochlorite, Triphala, Eucalyptus, and Carvacrol against Enterococcus faecalis: An In Vitro study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:514 - 519]

Keywords: Antimicrobial agent, Carvacrol, E. faecalis, Eucalyptus, Triphala

   DOI: 10.5005/jp-journals-10005-2440  |  Open Access |  How to cite  | 


Objective: This study aimed to evaluate the antimicrobial effect of sodium hypochlorite (NaOCl), Triphala, Eucalyptus, and carvacrol on Enterococcus faecalis as the most common microorganism isolated from infected root canals. Materials and methods: Seventy-five mandibular premolar teeth were randomly distributed into five study groups: 5.25% NaOCl, 10% Triphala, 1.25% Eucalyptus, 0.6% carvacrol, and negative control (saline) group. Samples were taken using paper points from the canal spaces and using Gates–Glidden (GG) drills from dentinal tubules; after sample culturing, the colony forming unit (CFU) were counted, which was analyzed by the Wilcoxon signed-rank test. Results: All irrigants have shown a reduction of microorganisms in the root canal space. After the use of NaOCl and Eucalyptus, the bacterial count was significantly reduced in the canal, as well as dentin sampling, as compared to Triphala and carvacrol. The antimicrobial efficiency of all irrigants against E. faecalis revealed a significant difference (p < 0.05). Conclusion: All irrigants exerted significant antimicrobial activity against E. faecalis. Around 1.25% of Eucalyptus was the most effective irrigant than 5.25% of NaOCl, Triphala, and carvacrol.



Saurabh Chaturvedi, Yogita Chaturvedi, Seema Chowdhary, Nitin Kararia, Vandana Kararia, Deepak Goyal

A Three-dimensional Analysis of Nasopharyngeal Airway Characteristics in Subjects with Cleidocranial Dysplasia: A CBCT Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:520 - 524]

Keywords: Cone-beam computed tomography, Nasopharyngeal, Cleidocranial dysplasia

   DOI: 10.5005/jp-journals-10005-2447  |  Open Access |  How to cite  | 


Introduction: Children with congenital or acquired craniofacial abnormalities exhibit an array of dental abnormalities like supernumerary teeth, failure of permanent teeth eruption, decreased alveolar bone height, etc. These subjects undergo complex corrective surgeries to improve esthetics and functional derangements, predisposing them to risks of obstructive sleep apnea due to airway obstruction. The various corrective or therapeutic procedures done might lead to airway complications in these children. The study designed was for retrospective evaluation and comparison of the nasopharyngeal (NP) characteristics and assessment of the airway volume three-dimensionally in normal vs cleidocranial subjects. Materials and methods: Cone-beam computed tomography (CBCT) scans of nine subjects with cleidocranial dysplasia (CCD) were compared with the control sample, and matched for age and sex. A 3D-DOCTOR software by Able Software Corporation was used to calculate the volumetric measurements. The correlation and differences among the values were assessed using an independent t-test and Pearson analysis. Results: The values of lower airway width, upper adenoid width, McNamara upper pharynx, retroglossal area, and total pharyngeal area were found to be reduced in the cleidocranial subjects. The NP airway volume and total airway volume also significantly decreased. Discussion: Cleidocranial dysplasia (CCD) being a rare genetic disorder, we could find only nine established cases. Hence our study can be called a pilot study but may work to establish a database of any sort of skeletal and dental anomaly with possible specific respiratory characteristics affecting airway.



Bannampalli Rohithashwa Adyanthaya, Shaista Gazal, Meetu Mathur, Aastha Srivastava, Susheel Kumar Meena

To Compare and Evaluate the Shear Bond Strength of Sixth- and Seventh-generation Bonding Agents

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:4] [Pages No:525 - 528]

Keywords: Dentin bonding agents, Shear bond strength, Universal testing machine

   DOI: 10.5005/jp-journals-10005-2422  |  Open Access |  How to cite  | 


Aim: To compare and evaluate the shear bond strength of sixth and seventh-generation dentin bonding agents. Materials and methods: Around 75 extracted permanent mandibular premolars were selected and assigned into two groups. The samples were cleaned, cavities were prepared, and the bonding agent was applied and stored in distilled water for 24 hours. Shear bond strength testing was done using a universal testing machine at the crosshead speed of 1 mm/minute. Data were analyzed statistically by one-way analysis of variance (ANOVA) and paired test. Results: The greatest mean shear bond strength to dentin was exhibited by the sixth-generation dentin bonding agent due to the solvent present, which has a low concentration and low hydrophilicity than the seventh-generation. Conclusion: Sixth-generation adhesives showed significantly higher mean shear bond strength to dentin than seventh-generation adhesives. Clinical significance: Bond strength values are gross assessing tools for evaluating the efficacy of restorative bonding materials to dentin. And as the shear bond strength is less technique sensitive to perform, it will highlight the strength at the bonded interface.



Sanjana P Soneta, Shivayogi M Hugar, Seema Hallikerimath, Riddhi S Joshi, Pooja K Dialani, Neha Kohli

An In Vivo Evaluation of Retention and Antibacterial Efficacy of Posterior High Strength Glass Ionomer Cement and Glass Hybrid Bulk-fill Alkasite Restorative Material as Conservative Adhesive Restoration in Children with Mixed Dentition: A Comparative Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:529 - 534]

Keywords: Antimicrobial, Children, Conservative adhesive restoration, Glass hybrid bulk-fill restorative material, Posterior high strength glass ionomer cement

   DOI: 10.5005/jp-journals-10005-2435  |  Open Access |  How to cite  | 


Aim: The aim of the study was to compare and evaluate the retention and antibacterial efficacy of posterior high strength glass ionomer cement and glass hybrid bulk-fill alkasite restorative material as a conservative adhesive restoration in children with mixed dentition. Materials and methods: A total of 60 children of age 6–12 years with mixed dentition were selected and divided into group I (control group n = 30): posterior high strength glass ionomer cement and group II (experimental group n = 30): glass hybrid bulk-fill alkasite restorative material. Restorative treatment was carried out using these two materials. Retention of the material and salivary Streptococcus mutans and Lactobacillus species count was estimated at baseline, 1, 3, and 6 months. The collected data were statistically analyzed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software (version 20.0 Chicago, Illinois, USA) Results: About 100% retention of glass hybrid bulk-fill alkasite restorative material, and 90% retention of posterior high strength glass ionomer cement was observed according to United State Public Health Criteria. The * signifies statistically significant results, i.e. p < 0.0001 reduction in salivary S. mutans colony count and Lactobacillus species colony count was seen in both groups at different time intervals. Conclusion: Both the materials showed good antibacterial properties, but glass hybrid bulk-fill alkasite restorative showed better retention, that is, 100% when compared to posterior high strength glass ionomer cement, which showed 90% retention at the end of 6 months follow-up.



Tanuja Prabahar, Kiran Ningappa Konkappa, Rajashekar Reddy Vundela, Subaranjana Balamurugan

Evaluation of Microleakage of Different Types of Pit and Fissure Sealants: An In Vitro Comparative Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:535 - 540]

Keywords: 3M ESPE Clinpro, Filtek Z350 XT (3M ESPE), GC Fuji Triage capsule, Microleakage, Pit and fissure sealants

   DOI: 10.5005/jp-journals-10005-2436  |  Open Access |  How to cite  | 


Aim: Compare and evaluate the microleakage of different types of pit and fissure sealants, 3M ESPE Clinpro, GC Fuji Triage Capsule, and 3M ESPE Filtek Z350 XT. Materials and methods: A total of 54 freshly extracted maxillary and mandibular premolar teeth were used and randomly divided into three groups of 18 teeth each, and the following pit and fissure sealants were used: group I—Clinpro, group II—GC Fuji Triage Capsule, and group III—Filtek Z350 XT. Samples underwent thermocycling at 5° and 55°C with a dwell time of 10 seconds for 250 cycles. The apices of the teeth were sealed with impression compound, and two coats of fingernail polish were applied and immersed in 5% methylene blue dye for 24 hours and then sectioned. The sectioned specimens were then analyzed at 4× magnification under a stereomicroscope for dye penetration and were evaluated based on Williams and Winters’ criteria. Results: The data were collected for statistical analysis. Descriptive statistics included mean, standard deviation (SD), frequency, and percentage. Inferential statistics included the Chi-squared test and one-way analysis of variance (ANOVA), followed by the post hoc Tukey's test. The level of significance was set at 0.05 at a 95% confidence interval, and the results revealed that the mean difference of the sealants was GC Fuji Triage (2.1667), Clinpro (0.7778), and Filtek Z350 XT (0.1667). Conclusion: Filtek Z350 XT exhibited the least microleakage when compared to Clinpro and GC Fuji Triage, with their mean difference statistically significant. Hence, Filtek Z350 XT can be a promising sealant and a restorative material.



Kimaya K Kade, Shweta Chaudhary, Smita Patil, Alok Patel, Amol Kamble

Comparative Evaluation of the Remineralization Potential of Fluoride-containing Toothpaste, Honey Ginger Paste and Ozone. An In Vitro Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:8] [Pages No:541 - 548]

Keywords: Ginger, Honey, Ozone oil, Preventive, Remineralization, Surface roughness

   DOI: 10.5005/jp-journals-10005-2445  |  Open Access |  How to cite  | 


Introduction: A drop in pH of the oral cavity results in demineralization, which, if continued, leads to loss of minerals from tooth structure, resulting in dental caries. A goal of modern dentistry is to manage noncavitated caries lesions noninvasively through remineralization in an attempt to prevent disease progression. Materials and methods: A total of 40 extracted premolar teeth were selected for the study. The specimens were divided into four groups, group I, the control group; group II, remineralizing agent as fluoride toothpaste; group III, the treatment material as ginger and honey paste; and group IV, the treatment material as ozone oil. An initial reading of surface roughness and hardness was recorded for the group (control group). Repeated treatment has continued lasting 21 days. This saliva was changed each day. Following the lesion formation procedure, the surface microhardness was measured for all specimens. The parameters were 200 gm force for 15 seconds with a Vickers indenter and the roughness of the demineralized area of each specimen was obtained by using the surface roughness tester. Results: Surface roughness was checked by using a surface roughness tester. Before starting the pH cycle, the baseline value for the control group was calculated. The baseline value for the control group was calculated. The surface roughness average value for 10 samples is 0.555 µm and the average surface microhardness is 304 HV; the average surface roughness value for fluoride is 0.244 µm and the microhardness is 256 HV, 0.241 µm, and 271 HV value for honey-ginger paste. For ozone surface roughness average value is 0.238 µm and the surface microhardness average mean value is 253 HV. Conclusion: The future of dentistry will rely on the regeneration of tooth structure. There is no significant difference seen between each treatment group. Considering the adverse effect of fluoride, we can consider honey-ginger and ozone as good remineralizing agents for fluoride.



Siji E Saji

Knowledge, Attitude and Practices of Parents toward the Oral Health of their School-going Children in Faridabad City

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:549 - 553]

Keywords: Attitude and awareness, Oral health, Parental knowledge, Pediatric dentistry

   DOI: 10.5005/jp-journals-10005-2438  |  Open Access |  How to cite  | 


Aim: To determine the knowledge, attitude, and practice of parents toward the oral health of their school-going children in Faridabad city. Materials and methods: A cross-sectional study was conducted among 312 parents who reported in the outpatient department of Pedodontics and Preventive Dentistry at Sudha Rustagi College of Dental Sciences & Research, Faridabad, Haryana, India. Data was collected through a self-administered questionnaire. The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) (version 18) software for descriptive and multivariate analysis, and the level of statistical significance used in this study was chosen at p < 0.05. Result: The results of this study showed that the sample selected had relatively good knowledge regarding the number of teeth present in the mouth of their child, the importance of filling the primary teeth, and trauma-related knowledge. Parents were aware that excess sugar intake, germs/bacteria, and sticky food are responsible for causing caries. On the contrary, a few of the parents were not aware of the ideal time for the first dental visit. Parents showed a positive attitude regarding the importance of supervised brushing twice with fluoridated toothpaste. Conclusion: We concluded in the present study that the knowledge of parents regarding the oral health of their children in Faridabad city is relatively good, but in a few aspects, it's been observed that this knowledge is not implemented, and the attitude of the parents toward good oral health practices needs to be improved more. As pedodontists, we can help to bring this change to the present society as we can counsel parents to take appropriate care of their children's oral health. Clinical significance: This article will help to assess the awareness of parents toward the oral health of their school-going children, which will further help in improving their knowledge, attitude, and practices, hence improving the oral hygiene of children.



Mitali R Shinde, J Jasmin Winnier

Correlation between Aerosol Therapy and Other Associated Factors in Early Childhood with Molar Incisor Hypomineralization

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:4] [Pages No:554 - 557]

Keywords: Aerosol therapy, Antibiotics, Molar incisor hypomineralization

   DOI: 10.5005/jp-journals-10005-2429  |  Open Access |  How to cite  | 


Context: The etiology of molar incisor hypomineralization (MIH) has been extensively explored. Recently, the effect of drugs used in aerosol therapy in childhood has been implicated as a possible factor in the development of MIH. Aim: A case-control study was conducted in children aged 6–13 years to determine the association between aerosol therapy and other factors in the development of MIH. Materials and methods: A total of 200 children were examined for the presence of MIH according to the European Academy of Paediatric Dentistry (EAPD) criteria (2003). Their mothers or primary caregivers were interviewed regarding the preterm history and perinatal, and postnatal history of the child up to 3 years of life. Statistical analysis: The collected data were subjected to statistical analysis using descriptive and inferential analyses. The p-value ≤ 0.05 was considered statistically significant. Results: Statistically significant association was observed between the development of MIH and exposure to aerosol therapy in childhood and the use of antibiotics before 1 year of life. Conclusion: Exposure to aerosol therapy and antibiotics before 1 year of age are risk factors in MIH. Children who had aerosol therapy and antibiotics are 2.01 times and 1.61 times more prone to MIH.



Rashi Singh, Nidhi Gupta, Natasha Gambhir

Comparative Evaluation of Reduction in Pain Perception Using 5% Topical LA vs Freezed Cone as a Preparatory Agent for Intraoral Injection in Children and Effect of VRD as Distraction Technique

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:558 - 563]

Keywords: 5% lidogaine gel, Distraction technique, Freezed cone, Intraoral injection, Pain Perception, Wong–Baker Faces Pain Rating Scale

   DOI: 10.5005/jp-journals-10005-2453  |  Open Access |  How to cite  | 


Aim: To compare freezed cone and 5% lignocaine as a numbing agent before intraoral injection and evaluate the effect of virtual reality distraction (VRD) as a distraction technique in reducing pain perception in children. Study design: Around 60 children of 6–11 years old undergoing treatment for the extraction or any pulp therapy of primary tooth were selected. Freezed cone and 5% lidocaine were used to decrease the pain during local anesthesia (LA). VRD was used as a distraction method and to analyze the pain perception, Wong–Baker Faces Pain Rating Scale was used. Materials and methods: Each child was randomly assigned to receive ice as a topical anesthetic or lignocaine 5% as a topical anesthetic agent. The pain perception was evaluated after the injection of 2% lignocaine hydrochloride (HCL). The primary researcher evaluated the pain during injection using the sound, eye, motor (SEM) scale. The pain experienced during injection was evaluated using Wong–Baker Faces Pain Rating Scale. Results: In the freezed cone group with the VRD technique, maximum responded to the less pain score. On the contrary, many responded to higher pain scores in the freezed cone group without the VRD technique. Conclusion: It was concluded that the VRD technique can be used for distraction and the frozen ice cone can be an alternative method to reduce the pain perception during LA.



Nidhi Agarwal, Zohra Jabin, Nandita Waikhom

Assessing Videoconferencing as a Method of Remote Consultation in Pediatric Dentistry

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:564 - 568]

Keywords: Digital technology, Remote consultation, Telecommunication, Teleconsultation, Teledentistry

   DOI: 10.5005/jp-journals-10005-2427  |  Open Access |  How to cite  | 


Background: The oral health condition in rural areas remains compromised due to insufficient healthcare providers. Implementation of teledentistry through videoconferencing in these areas can improve this situation when trained personnel are able to carry out real-time consultations of the patients with a pediatric dentist. Aim: To observe the feasibility of using teledentistry for an oral examination, consultation, and education, and also to assess the participant's satisfaction regarding the use of teledentistry for a routine dental checkup. Materials and methods: An observational study was carried out with 150 children aged 6–10 years. About 30 primary health centers (PHC)/Anganwadi (AW) workers were trained to perform the oral examination with the intraoral camera (IOC). Four self-constructed and nonstructured questionnaires were prepared to understand the knowledge, awareness, and attitude of the participants toward pediatric dentistry and their acceptance of teledentistry. Results: A total of 83.3% of children were not scared and felt that the use of IOC was better. About 84% of the PHC/AW workers found teledentistry very convenient, easy to learn, and adapt. And around 92% thought that teledentistry is time-consuming. Conclusion: Teledentistry is a possible way to provide pediatric oral health consultation in rural areas. It can save time, stress, and money for people in need of dental treatment.



Kapil Gandhi, Ritika Malhotra, Geetika Datta, Rishabh Kapoor, Babita Jangra, Pratik Pande

Treatment Predicament for Pediatric Dentist: Gender-wise Comparative Correlation of Biological and Chronological Age in 8–15-year-old Children

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:569 - 574]

Keywords: Age assessment, Cervical vertebral stages, Chronological age, Demirjian method, Dental age, Lateral cephalogram, Orthopantomogram, Skeletal age

   DOI: 10.5005/jp-journals-10005-2434  |  Open Access |  How to cite  | 


Introduction: The chronological age (CA) of a patient does not always correspond to the events of growth surge; therefore treatment strategies need good knowledge of biological markers. Aim: The aim of the present study was to investigate the relationships between the skeletal age (SA), dental age (DA), and CA along with the stages of calcification of teeth and the cervical vertebral maturity (CVM) stages in Indian subjects. Materials and methods: A sample of 100 pairs preexisting radiographs, both orthopantomogram and lateral cephalogram, of the individuals in the age-group of 8–15 years were procured and were analyzed for the level of dental and skeletal maturity using Demirjian scale and cervical vertebral maturity index, respectively. Results: A high correlation coefficient (r) was found to be 0.839 (p = 0) between chronological and dental age (DA), 0.833 (p = 0) between chronological and skeletal age (SA), and 0.730 (p = 0) between skeletal and DA. Conclusion: The current research showed that the overall correlation between all three ages was found to be high. It was found that the SA assessed by the CVM stages had a high correlation with the CA. Clinical significance: Within the limits of the present study, there exists a high degree of correlation between biological ages and chronological age, but still it is imperative for a correct assessment of biological age of individual patients for quality treatment outcomes.



Pragadeesh A Pitchiah, Sanguida Adimoulame

Effectiveness of Video Tutorial Coaching in Improving the Knowledge of School Teachers on Child Abuse and Neglect in Puducherry

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:4] [Pages No:575 - 578]

Keywords: Child abuse and neglect, Knowledge, School teachers, Video tutorial

   DOI: 10.5005/jp-journals-10005-2430  |  Open Access |  How to cite  | 


Aim: Child abuse and neglect (CAN) is a major threat to the health and well-being of children throughout the world. Apart from healthcare professionals, teachers also play an important role in recognizing and reporting child abuse as they are in a better position to observe the behavioral changes in children as they spend substantially more time at school. The aim of this study was to evaluate the effectiveness of a video tutorial program in improving the knowledge of school teachers on CAN. Materials and results: A cross-sectional questionnaire-based study was conducted among the 79 school teachers of Puducherry. At baseline, a prevalidated questionnaire was used to assess the knowledge of the school teachers on CAN. After the intervention, the same prevalidated questionnaire was repeated. The mean knowledge score of teachers before intervention was 9.13. After video intervention knowledge score was improved to 14.46 (p < 0.05). Conclusion: The study showed that a knowledge deficit exists among teachers regarding CAN, and the video tutorial program was found to be effective in improving the knowledge of school teachers. The government, as well as the schools should take the initiative to create awareness among teachers.



Ankur Mishra, Monika Koul, Ahsan Abdullah, Nausheen Khan, Anu Bhat

Comparative Evaluation of Antimicrobial Efficacy of Diode Laser (Continuous Mode), Diode Laser (Pulse Mode), and 5.25% of Sodium Hypochlorite in Disinfection of Root Canal: A Short Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:579 - 583]

Keywords: Diode laser, Microbiological studies, Root canal disinfection

   DOI: 10.5005/jp-journals-10005-2444  |  Open Access |  How to cite  | 


Introduction: The success of endodontic treatment is achieved by the complete elimination of pulpal infection and protection from future invasion of microorganisms. Due to the complex structure of the root canal, complete eradication of microorganisms is not possible and is a major challenge for successful endodontic treatment. Therefore, microbiological studies are needed to explore the effect of various disinfection methods. Aim and objective: The aim of this study is to compare the effectiveness of root canal disinfection by using a diode laser (in pulse and continuous modes) and sodium hypochlorite by microbiological assessment. Materials and methods: Forty-five patients were selected and randomly divided into three groups. After gaining patency to the root canal the first sample from the root canal was taken using a sterile absorbent paper point and transferred to a sterile tube containing a normal saline medium. Biomechanical preparation was performed with Dentsply Protaper hand files of each corresponding group and was disinfected with group I (diode light amplification by stimulated emission of radiation (LASER) 980 nm with 3 W in continuous mode for 20 seconds), group II (diode LASER 980 nm with 3 W in pulse mode for 20 seconds), group III (irrigated with 5.25% of sodium hypochlorite for 5 minutes). Pre- and post-samples of each group were inoculated on sheep blood agar and examined for any bacterial growth. After the microbial evaluation of the total microbial count of pre- and post-samples, the data obtained were tabulated and statistically analyzed. Results: The data were evaluated and analyzed using analysis of variance (ANOVA) on Statistical Package for the Social Sciences (SPSS) software. Groups I, II, and III all three groups showed significant differences (p < 0.01) and an overall reduction in the microbial count at postbiomechanical preparation (BMP) as compared to pre-BMP with the highest being in laser in continuous mode (group I) (91.9%), followed by 5.25% sodium hypochlorite (group III) (86.5%) and LASER in pulse mode (group II) (72.0%) the least. Conclusion: The study concluded that the diode laser in continuous mode is more efficacious than the diode laser in pulse mode and 5.2% sodium hypochlorite, respectively.



Bakhshish Singh, Inder K Pandit, Neeraj Gugnani, Taranjeet K Bhatia, Monika Gupta, Vaibhav Kumar

Anterior Dental Injuries in 8–12-year-old Schoolchildren of Yamunanagar, Northern India: A Districtwide Oral Health Survey

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:7] [Pages No:584 - 590]

Keywords: Dental health, Education, Prevalence, Tooth fracture, Traumatic dental injury

   DOI: 10.5005/jp-journals-10005-2424  |  Open Access |  How to cite  | 


Background/aim: Due to its frequency, early occurrence, and severe adverse effects, if untreated, traumatic dental injury (TDI) is a public dental health issue. The purpose of this study was to investigate the prevalence of dental injuries caused by trauma in the anterior teeth among schoolchildren of Yamunanagar (Haryana), Northern India. Materials and methods: A sample of 11,897 schoolchildren in the age-group of 8–12 years from 36 urban/rural schools was examined for TDI using Ellis and Davey classification. Children with TDI were interviewed using a structured questionnaire and presented with validated motivational videos to educate them about dental trauma, the sequelae of unmet treatment, and to motivate them to undergo treatment. The subjects with trauma were reevaluated after 6 months to assess the percentage of subjects who have undergone treatment after motivation. Result and conclusion: The overall prevalence of children afflicted with TDI was 6.33%. Statistically, a significant difference of p ≤ 0.001 was noted between the percentage of boys (7.29%) and girls (4.8%) experiencing TDI. Maxillary incisors (94.3%) were the most commonly injured teeth. Falls in the playground (37.70%) were the major cause; on reevaluation, only 9.26% of the study population got their traumatized tooth treated. TDI is an existing dental problem. Motivating children at schools was found to be ineffective. There is a need to educate the parents and teachers to take appropriate preventive measures.



Sushma Mudhi Reddy, Naseemoon Shaik, Sriharsha Pudi, Vijay Kumar Yennavaram, Arpitha Kotha, Rajashekhar Avidapu

Assessing the Pediatricians’ Role in Improving Young Children's Oral Health in Telangana State: A Cross-sectional Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:591 - 595]

Keywords: Counseling, Early referral, Oral health promotion, Pediatrician, Screening

   DOI: 10.5005/jp-journals-10005-2443  |  Open Access |  How to cite  | 


Background: Primary precautionary approaches for oral health is an essential tool concerning public health, as dental caries is one of the eminently prevailing chronic diseases among children across the globe. As pediatricians and pediatric healthcare professionals are more likely to encounter children when compared to general dentists, it is crucial for them to be acquainted with possible risk factors and diseases occurring in early childhood. Therefore, it is highly advocated to take necessary steps at an initial stage to help promote pragmatic results during childhood and succeeding adulthood phases. Objectives: The pediatrician's attitude toward dental health and his dental screening, counseling, and referral practices. Material and methods: This was a cross-sectional study in the Hyderabad district, following area sampling on a sample of 200 child healthcare professionals, as calculated based on a pilot study. A definitive and validated questionnaire was used for the collection of data, and pediatric health professionals were approached in their workplaces. Results: About 44.5% of pediatricians usually check teeth during routine tongue and throat examinations. Around 59.5% of them suspect cavities when the child looks undernourished. A total of >80% of them voted that oral health cannot be neglected, as it is an integral part of a child's general health and dental screening, and referral at regular intervals of time is their responsibility. Only 8.5% advised fluoridated toothpaste, whereas only 62.5% counseled parents on the dental ill effects of nighttime bottle-feeding and digit sucking. Conclusion: Although all the pediatricians had appropriate attitudes toward oral health, they were not put into action by many. Dental public health significance: Pediatricians play a vital role as potential partners in the oral health promotion of children and their families. A pediatric primary care provider's regular screening, counseling, and referral would help his/her patients in getting the right treatment done at the right time.



Sai Sravya Panangipalli, Madhu Vasepalli, Rachuri Punithavathy, Uday C Birapu

Prevalence of Traumatic Injuries to Permanent Anterior Teeth and Predisposing Risk Factors among Government and Private School Children of Kakinada and Rajanagaram of East Godavari District

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:7] [Pages No:596 - 602]

Keywords: Cross-sectional study, Permanent anterior teeth, Prevalence, Risk factors, Traumatic dental injuries

   DOI: 10.5005/jp-journals-10005-2448  |  Open Access |  How to cite  | 


Aim: To determine the prevalence of traumatic dental injuries (TDI) in permanent anterior teeth and their association with risk factors among children aged 7–13 years of government and private schools in Kakinada and Rajanagaram of East Godavari district, Andhra Pradesh, India. Materials and methods: A cross-sectional study was carried out among 2,325 school children aged 7–13 years. Each child was examined for TDI, degree of overjet, molar relation, lip coverage, and facial profile. The results were analyzed by Statistical Package for the Social Sciences (SPSS) software and the Chi-squared test was used to compare qualitative data. Results: The results show that the prevalence of trauma was found to be 12.1%, and there was no disparity between government or private schools and urban and rural areas. There was no much sex predilection. High school children are more prone to TDI than primary school children. The most common place was found to be home, and the most common cause is unknown. Maxillary central incisors are the most commonly affected and enamel fracture is the most common fracture. Among the subjects with trauma, only 4.1% sought treatment. Conclusion: The subjects with trauma in the present study are found to be having a positive association with risk factors, such as increased overjet, class II division 1 molar relationship, convex facial profile, and inadequate lip coverage. Evidence of a lower rate of treatment outcomes shows the need for increased awareness among parents, teachers, and healthcare providers and the elaboration of prevention strategies for TDI at the population level.



Shashank Gaur, Neha Singh, Reshu Singh, Anuve H Phukan, Manoj Mittal

Mixed Dentition Analysis in and around Kanpur City: An Existential and Illustrative Study

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:7] [Pages No:603 - 609]

Keywords: Mixed dentition, Moyers analysis, Nonradiographic, Space analysis, Tanaka and Johnston analysis

   DOI: 10.5005/jp-journals-10005-2470  |  Open Access |  How to cite  | 


Context: Mixed dentition space analysis helps in determining the discrepancy between the available and required space in each dental arch during the mixed dentition period; further, it helps to diagnose and plan the treatment of developing malocclusion. Aim: The aim of this study is to evaluate the applicability of Tanaka and Johnston's and Moyer's methods of predicting the size of permanent canines and premolars and compare the tooth size between the right and left sides between males and females, and also to compare the predicted values of mesiodistal widths of permanent canines and premolars from Tanaka and Johnston and Moyer's method with the measured values. Materials and methods: The sample consisted of 58 sets of study models, of which 20 were girls and 38 were boys, that were collected from the children of the 12–15 year age-group. A digital vernier gauge, whose beaks were sharpened, was used to measure the mesiodistal widths of the individual teeth in order to increase accuracy. Statistical analysis: The two-tailed paired t-tests were used to assess the bilateral symmetry of the mesiodistal diameter of all measured individual teeth. Results and conclusion: It was concluded that Tanaka and Johnston's method could not accurately predict the mesiodistal widths of unerupted canines and premolars of children of Kanpur city due to the high variability in estimation, whereas the least statistically significant difference was obtained only at 65% level of Moyer's probability chart for male, female, and combined sample.



Sahili Mungekar-Markandey, Laresh Mistry

Clinical Success of Iatrogenic Perforation Repair Using Mineral Trioxide Aggregate and Other Materials in Primary Molars: A Systematic Review and Meta-analysis

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:7] [Pages No:610 - 616]

Keywords: Iatrogenic perforation repair, Mineral trioxide aggregate, Primary molars

   DOI: 10.5005/jp-journals-10005-2038  |  Open Access |  How to cite  | 


Aim: This study aimed at systematically reviewing the clinical success of repaired iatrogenic perforations using different materials in primary teeth. Objectives: To compare mineral trioxide aggregate (MTA) with other biomaterials for the repair of iatrogenic perforations in primary molars during endodontic procedures. Search methods: A comprehensive literature search was conducted by using three electronic databases (PubMed, Cochrane Library, Google Scholar) to identify articles that evaluated the different intervention materials for the repair of iatrogenic perforation in primary molars. Selection criteria: The articles reporting perforation repair in primary molars having clinical and radiographic success, as their outcome measures with a follow-up period of at least 1 year were included in this review. Studies and case reports with insufficient or unstated follow-up periods, in vitro, and animal studies were excluded. Data collection and analysis: Two reviewers (SM, LM) independently screened all titles and abstracts according to the inclusion and exclusion criteria. Full texts of the selected studies were obtained for the second stage screening. The consensus was achieved by discussion with the third reviewer (AJ). Data extraction included study design, sample size, age of the patient, year of the study, follow-up period, outcome assessment criteria, material for repair, and success and failure. Review results: A total of seven publications were included in this review. Of which, one was case series, three were case reports, and three were interventional studies. The combined success rate of MTA (80.55%) was inferior to other materials-premixed bioceramics, Atelocollagen, and calcium-enriched mixture (96.07%); the same being statistically significant (p = 0.011). Conclusion: Within the limitations of our study, it can be concluded that newer biomimetic materials are superior to MTA for iatrogenic perforation repair in primary molars in terms of clinical success. Clinical significance: This paper is a first-of-its-kind investigation comparing different materials used in the repair of perforations in primary molars. It can be a foundation for further research on the topic. In absence of any available guidelines, the above study can be applied in clinical situations with appropriate judgment and caution.



Shruti Balasubramanian

Rapid Maxillary Expansion and Upper Airway Volume: Systematic Review and Meta-analysis on the Role of Rapid Maxillary Expansion in Mouth Breathing

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:14] [Pages No:617 - 630]

Keywords: Mouth breathing, Palatal expansion technique, Systematic review, Upper airway

   DOI: 10.5005/jp-journals-10005-2421  |  Open Access |  How to cite  | 


Objective: Rapid maxillary expansion (RME) has been extensively used in orthodontic practice for over a century, and it is claimed to benefit upper airway morphology. However, its effect in actually alleviating mouth breathing has remained unexplored. This systematic review was planned with an objective to provide a comprehensive synthesis of the effects of RME on upper airway volume and most importantly, its role in alleviating mouth breathing. Methods: A literature search of electronic databases were done for the time period of 2000–2018. Randomized controlled trials (RCTs) and non-RCTs conducted on 8–15-year-old children who received bonded or banded RME and upper airway measured using three-dimensional (3D) imaging were included. Results: Twelve studies (two RCTs, nine nonrandomized clinical trials, and one non-RCT) were included in this systematic review, and nine studies were included for meta-analysis. Among the evaluated parameters, nasal cavity volume showed a significant increase which was maintained even after the retention phase, whereas nasopharyngeal and oropharyngeal volume did not report a significant change. Conclusion: Based on this systematic review, it can be concluded that RME causes a significant increase in nasal cavity volume, but its effect on nasopharyngeal and oropharyngeal volume is not statistically significant in majority of studies. This increase in volume may not be considered as an equivalent for enhancement of airway and function unless proven so. In order to establish its significance in the improvement of breathing, it is necessary to conduct more well-designed RCTs with samples actually comprising mouth breathers.



Sotiria Davidopoulou, Anna Bitzeni-Nigdeli, Chrysoula Archaki, Aristidis Arhakis

Oral Health Implications and Dental Management of Diabetic Children

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:5] [Pages No:631 - 635]

Keywords: Children, Dental management, Diabetes mellitus type 1, Oral health

   DOI: 10.5005/jp-journals-10005-2426  |  Open Access |  How to cite  | 


Aim: To review the effect of diabetes mellitus (DM) on the oral health status of children. Background: Diabetes mellitus (DM) is one of the most severe chronic diseases in children and adolescents. It appears as type 1 DM and type 2 DM. Children are mainly diagnosed with type 1 DM. Genetic, as well as environmental factors, contribute to disease risk, indicating a multifactorial etiology. Early symptoms may vary from polyuria to anxiety or depression disorders. Review results: A variety of signs and symptoms have been reported regarding the oral health of DM children. Both dental and periodontal health is compromised. Qualitative and quantitative changes in saliva have also been reported. Moreover, there is a direct effect of type 1 DM on oral microflora and increased sensitivity to infections. A variety of protocols have been developed regarding the dental treatment of diabetic children. Conclusion: Children with diabetes, due to the increased risk of periodontal disease and dental caries, are recommended to follow an intensive prevention program and a diet with strict instructions. Clinical significance: The dental care provided to children with DM should be personalized, and all patients should follow a strict program of reexaminations. Moreover, the dentist may evaluate oral signs and symptoms of inadequately controlled diabetes and, in coordination with the patient's physician, can play a crucial role in maintaining oral and general health.



Deise Kamanski, Julieta G Tavares, Joao BB Weber, Carlos A Feldens, Eduardo G Reston, Patrícia FJS da Cunha, Paulo F Kramer

Crown Fracture of an Unerupted Incisor in a Young Child: Case Report and Restorative Protocol

[Year:2022] [Month:September-October] [Volume:15] [Number:5] [Pages:6] [Pages No:636 - 641]

Keywords: Case report, Composite resins, Computer-aided design, Tooth, Tooth injuries, Unerupted

   DOI: 10.5005/jp-journals-10005-2437  |  Open Access |  How to cite  | 


Aim: This case report describes a protocol for restoring a crown fracture of an unerupted permanent incisor in a child. Background: Crown fractures are an important concern in pediatric dentistry due to the negative impact on oral health-related quality of life (OHRQoL) in children and adolescents resulting from functional limitations as well as consequences related to social and emotional well-being. Case description: An enamel and dentin fracture of the crown of unerupted tooth 11 due to direct trauma is being presented in a 7-year-old girl. The restorative treatment involved minimally invasive dentistry, including computer-aided design (CAD)/computer-aided manufacturing (CAM) technology and direct resin restoration. Conclusion: The treatment decision was essential for maintaining pulp vitality and continued root development, as well as ensuring esthetic and functional results. Clinical significance: Crown fracture of an unerupted incisor may occur in childhood, requiring a long-term clinical and radiographic follow-up. Predictable, positive, and reliable esthetic outcomes can be achieved using CAD/CAM technology combined with adhesive protocols.


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