Introduction: Dental caries is a site-specific, multifactorial chronic disease affected globally. The prevalence of dental caries is strongly associated with social and economic disadvantage, and also the susceptibility of children to dental caries. Dental caries prevention can be achieved with topical fluoride agents. Topical fluoride promotes the remineralization of early carious lesions and reduces the demineralization of healthy enamel. Aim: The aim of this randomized clinical trial was to compare the effectiveness of silver diamine fluoride (SDF) and sodium fluoride varnish (FV) in preventing new carious lesions in preschoolers. Materials and methods: This randomized clinical trial was conducted on 285 children aged 3–6 years. Children were randomly allocated into three groups namely, group I—deionized distilled water (DIW), group II—sodium FV, and group III—SDF. The biannual application was performed at an interval of 6 months. New carious lesions were recorded using defs and International Caries Detection and Assessment System (ICDAS II) under LED magnifying loupes. Descriptive and inferential statistics were applied and tabulated using Statistical Package for the Social Sciences (SPSS) 23.0 software. Result: There was a significant difference seen in the mean values of group III (SDF) when compared with group II (FV) and also between group III (SDF) and group I (DIW) when defs index was used. The mean score of ICDAS II after 12 months in group I (DIW) was −1.171, group II (FV) was −0.690, and group III (SDF) was −0.374. Conclusion: silver diamine fluoride (SDF) was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy.

Aim and objectives: Dental caries is currently considered an ecological imbalance within the oral biofilm leading to the dissolution of the tooth's hard tissues. It has been traditionally thought that two species belonging to the Streptococci group, Streptococcus mutans (SM) and Streptococcus sanguinis (SS), are the etiologically responsible for the onset of dental decay. Materials and methods: The present in vivo study was conducted on 40 children with caries-active (CA) and caries-free (CF). They were allocated into two groups, group I (CA) = 20 and group II (CF) = 20. The whole saliva was collected into the vials with buffer solution and was stored in cold storage. Polymerase chain reaction (PCR) was done to identify and correlate SM and SS in CA and CF children. Results: Comparison of mean SM level between CA and CF groups showed a statistically significant result at p = 0.001. Spearman's correlation between caries score and SM showed a strong correlation of 0.77 between caries score and SM, which was statistically significant at p = 0.001. Similarly, SS and caries scores showed a weak correlation of 0.22. Simple linear regression analysis to SM and caries score showed a significant increase of 4.74 units for 1 score increase in caries score, which is statistically significant. Conclusion: The presence of SM levels in children with caries is significant, whereas, in CF children, SS levels are present in increased levels. A strong correlation was seen between caries scores and SM. The simple linear regression analysis predicts a statistically significant increase by 4.74 units per increase of 1 score of caries at p < 0.001. As caries increase, SM count increases, but SS count decreases; as SS count increases, there is a reduction in SM counts.

The most common pathological condition, dental caries when remain untreated which shows pulpal involvement and may lead to invasive treatment, such as crown placement followed by pulp therapy. Larger carious lesions on primary molars stainless steel crowns (SSCs) placement by means of conventional tooth preparation. The modern approach to managing carious lesions concentrates on using less invasive treatment techniques, with the focus being on biofilm change. One among such alternative method of managing the primary molars is the Hall's technique. Another most important factor for the survival of a crown is its sealing ability, in which luting cements, such as adhesive cements, have a crucial role as they help in providing a suitable marginal seal and thereby cause a reduction in the microleakage. Silver diamine fluoride (SDF) has proven anticariogenic activity in arresting carious lesions. Hence the aim was to evaluate and compare the microleakage of SSCs placed by Hall's technique, Hall's technique with SDF, and the conventional crown technique using different luting cements. A total of 60 primary first and second molars with occlusoproximal caries, which were initial and moderate in nature. The blocks were randomly divided into three groups, in which precontoured SSCs were applied by using either the Hall's technique or the conventional technique. After subjecting tothermocycling, the samples were examined under stereomicroscopic for microleakage evaluation. A few samples were randomly selected from each subgroup, and a scanning electron microscopic (SEM) examination was done. Highest values of microleakage were noted with Hall's technique resin-modified glass ionomer cements (RMGIC) luting cement group. It can be concluded from the present study that the conventional technique was found to be superior over the Hall's technique with SDF and then by the Hall's group alone. SDF application beneath the Hall's crown appears to be promising approach for the reduction of microleakage.

Purpose: To evaluate and compare the clinical and radiographic success of Kedo-S pediatric rotary files vs manual K-Files for pulpectomy in primary mandibular molars. Materials and methods: A sample of 30 primary mandibular molars with irreversible pulpitis was taken per group. The groups were divided as below mentioned—group I (n = 30) was treated using the Kedo-S file system. Group II (n = 30)—treated using manual stainless steel K-File. The clinical and radiographic success was compared of both techniques. Statistical analysis involved t-test, Chi-squared test, and Cochran's Q test. Results: The overall clinical success at 3, 6, and 9 months in group I were 72.4, 89.7, and 93%, respectively and in group II were 82.1, 92.9, and 92.9%, respectively. The overall radiographic success in group I at 3, 6, and 9 months were 6.9, 17.2, and 69%, respectively and in group II were 0, 7.1, and 35.7%, respectively. According to the Frankl behavior rating scale, 19 children in group I (65.5%) showed negative behavior, and 15 children in group II (53.57%) showed positive behavior. The mean instrumentation time in group I (Kedo-S pediatric rotary file group) and group II (hand K-File group) was 8.03 ± 0.823 and 11.25 ± 0.928, respectively. Conclusion: There was a statistically significant/highly significant difference in intergroup comparison postoperative behavior among the children in the two study groups. There was a statistically significant difference between the two study groups with relation to instrumentation time. The trend that was observed in the clinical and radiographic profile was that group I (Kedo-S rotary files) cases had more success when absolute numbers and figures were compared than group II (hand stainless steel K-File) in which success rates were comparable; however, the difference between the groups were found to be statistically nonsignificant.

Aim: A comparative evaluation of children's anxiety with the use of nitrous oxide–oxygen (N₂O–O₂) inhalation sedation during the administration of inferior alveolar nerve block (IANB). Materials and methodology: A total of 60 children between 3 and 12 years of age, with Frankl's behavior rating of 2–3 requiring IANB for any dental procedure were enrolled in this randomized clinical study. Group I (n = 30) received N₂O and oxygen inhalation sedation at a concentration in the range of 25–50%, whereas group II (n = 30) received 100% O₂ as a placebo. The physiological parameters like pulse rate, respiration, blood pressure, and O₂ saturation were measured at the baseline, intraoperatively [during and after administration of local anesthesia (LA)] and postoperatively after the termination of the gases in both groups. The sedation level was measured intraoperatively (before administration of LA) using the Ramsay Sedation Score (RSS). The discomfort and anxiety were measured at the baseline, intraoperatively, and postoperatively using the Face, Legs, Activity, Cry, Consolability (FLACC) behavior scale. The data were evaluated using the statistical software International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) statistics 20.0. Results: There was a significant difference in the FLACC scores between the two groups, intraoperatively (p-value—0.002), and postoperatively (p-value—0.049). The mean of the RSS for group I was 2.80 + 1.03, and for group II was 1.80 + 0.81. All the physiological parameters recorded were within the normal range. Conclusion: The use of N₂O–O₂ inhalation improved the anxiety levels in children while receiving the IANB and showed significant anxiolytic and sedative effects as compared to O₂ inhalation. Clinical significance: Nitrous oxide–oxygen (N₂O–O₂) inhalation can be used as a nonpharmacological behavior management adjunct for invasive treatments for children with utmost comfort for the child.

Aim: The aim of this study was to evaluate the in vitro effects of topical fluoride varnish and fluoride-releasing adhesive on the shear bond strength (SBS) of orthodontic brackets. Materials and methods: A total of 60 extracted premolars were bonded to 0.022, stainless steel brackets and equally divided into three groups (n = 20) based on the adhesive used—Group I- Transbond XT Plus color change (3M Unitek), Group II- Transbond XT followed by application of fluoride varnish, and Group III- Transbond XT (3M Unitek) adhesive and their bond strengths were compared. Brackets were debonded with a universal testing machine. The modified adhesive remnant index (ARI) was also recorded. Data were analyzed by using an analysis of variance, and a post hoc test was performed for multiple comparisons among the groups. Results: There were no significant differences between the SBSs (p = 0.91) between the groups. Also, no significant difference was found in the modified ARI (p = 0.093). Conclusion: The orthodontic adhesives used in our study, with or without the application of topical fluoride varnish, did not have a significant effect on the bond strengths of brackets. Clinical significance: Adhesives evaluated in this study can be successfully used for bonding brackets.

Introduction: Dental caries is a globally prevailing condition. It is a common finding in all age-groups, whether it is young children or adults. Caries not only affects the oral health of an individual, but also the overall health of the individual. Aims and Objectives: This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in age group of 3 to 6 year old children. Material and methods: The study was planned and conducted in the Department of Pedodontics and Preventive Dentistry, Government College of Dentistry, Indore, Madhya Pradesh, India. The study consisted of 200 samples, including both groups. Group I included 100 patients with ECC and group II included 100 patients caries free. Children of age 3–6 years were randomly selected and evaluated for ECC and parameters like weight, height, number of siblings, birth order, SES status, and mothers’ education. Results: Body mass index (BMI) had no significant association with the occurrence of ECC. Statistical significant association was observed between the number of siblings and ECC. The “no caries” was significantly associated with “no sibling” or “one sibling”. A significant association between SES status and ECC was observed. The upper and upper middle class had more number of caries free children, whereas the number of participants with ECC was significantly more in the upper lower class. There was a pronounced association between ECC and maternal education. Conclusion: Researches like these help us to broaden our aspects of understanding that caries is not caused by only one factor but a magnitude of factors. It's prevention should take into consideration not only the dietary habits but also on increasing awareness about importance of oral hygiene and how it can be affected by other social varients. This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in 3–6-year-old children.

Aim: To evaluate and compare the shear bond strength (SBS) of Embrace WetBond^TM (EWS) Pit and Fissure Sealant (PF sealants) with or without the use of a universal dental adhesive system Scotchbond^TM Universal Adhesive (SBU) using different bonding and curing protocols and to assess and compare the mode of failure as determined by visualization of the fractured surfaces of the test specimens after shear testing under an optical microscope at a magnification of 20×. Materials and methods: A total of 85 samples were prepared for testing SBS on enamel on caries-free, extracted permanent human molars. The specimens were randomly divided into five groups based on different bonding and curing protocols. A knife-edge blade in a universal testing machine was used to perform the SBS test with a crosshead speed of 1 mm/minute. Then the mode of failure was assessed. Statistical analysis: Results were analyzed using a one-way analysis of variance with Tukey's post hoc test and Chi-squared test. A probability value 0.05 (p ≤ 0.01) was regarded as significant. Results: Scotchbond^TM Universal Adhesive (SBU) in total-etch (TE) mode/etch-and-rinse (ER) mode with individual light curing of the sealant and adhesive showed the highest SBS to enamel (5.40 ± 2.51 MPa). A predominance of cohesive mode of failure was observed for all the test groups. Conclusion: Embrace WetBond^TM (EWS) PF sealants with SBU in the ER mode of application, with either curing mode, can be used as an alternative to a conventional technique for sealant placement for improving interfacial bond strength to enhance sealant retention and efficacy. Clinical significance: Embrace WetBond^TM (EWS) PF sealants with SBU in the ER mode of application can be used as an alternative to a conventional technique for sealant placement for improving interfacial bond strength.

Aim: Assessing the efficacy of cocoa bean husk extract (CBHE) particles with different vehicles as a mouthrinse in children aged 7–12 years in comparison to chlorhexidine (CHX) and sodium fluoride (NaF) mouthrinse. Materials and methods: A total of 80 children aged 7–12 years residing at a residential school/orphanage in Bengaluru city were selected and randomly allocated into five groups—group I: 0.1% CBHE with distilled water (DW); group II: 0.1% CBHE with Ringer's lactate (RL); group III: 0.12% CHX; group IV: 0.1% CBHE with normal saline (NS); and group V: 0.05% NaF. A Simplified Oral Hygiene Index (OHI-S) was recorded, salivary pH was assessed, and unstimulated saliva samples were collected at baseline (BL) after 30 minutes of rinsing on day 7 and day 14. These saliva samples were subjected to microbiological analysis, and all the data from five groups at four different time intervals was tabulated and statistically evaluated. Results: Nearly 0.1% CBHE with NS as vehicle showed maximum antibacterial properties among all the groups at all time intervals. The addition of RL to CBHE provided better anti-plaque efficacy than 0.1% CBHE with DW and 0.12% CHX mouthwash. All three combinations of 0.1% CBHE and 0.12% CHX mouthwash proved to be better anti-plaque agents than 0.05% NaF. Improving the preparation of CBHE mouthwash by using NS, RL, and with the addition of saccharin sodium also improved the patient's compliance. Conclusion: Thus, preparing chocolate/CBHE mouthwash with NS or RL instead of plain DW increased the salivary pH, anti-plaque efficacy, and antibacterial property by reducing Streptococcus mutans growth. Clinical significance: Cocoa bean husk extract (CBHE) mouthwash is a better anticariogenic and nonalcoholic mouthwash compared to CHX and NaF, which can be safely used in children as a routine oral rinse and also for those with gingivitis and high-risk of caries.

In diabetic patients, maintaining blood glucose levels as close to normal as possible is an objective in dental management especially in pediatric ones. Patients with poorly controlled diabetes are at greater risk of developing infections. Therefore, the prescription of antibiotics may be necessary for some dental procedures. Aim: The aim is to optimize the benefit and minimize the risk of antibiotics in dental treatments performed in diabetic children. Materials and methods: A cross-sectional approach was conducted on 155 type 1 diabetic children (72 controlled and 83 uncontrolled). The types of dental acts held for the study were pulpotomies, pulpectomies, pediatric crowns, scaling, and extraction. For the balanced diabetic patients, no antibiotics were prescribed except for infected teeth. In the unbalanced diabetic group, for the acts causing bleeding, prophylactic antibiotics were administered. In presence of dental infection, antibiotics were administered for at least 5 days. Results: The analysis of data was carried out using Statistical Package for the Social Sciences Computer Software (SPSS 21.0, Inc., Chicago, Illinois, USA). A probability value of <0.05 was regarded as statistically significant. Around 126 acts in the balanced group and 145 in the unbalanced ones were performed. In balanced diabetic children, 125 successes and one failure were noted. In the unbalanced group, 142 successes and three failures were recorded. The comparison between variables did not show any statistical significance (p-value = 0.382). Conclusion: This study demonstrated that working with diabetic young patients is possible and safe as long as some measures are considered. It is crucial to identify the dental acts that necessitate antibiotics administration and to differentiate between balanced and unbalanced diabetic children for the same dental procedure.

Objectives: Türkiye has implemented an open-door policy for Syrians since the beginning of the Syrian crisis in 2011 and has been providing medical and dental services for Syrian asylum seekers. Bursa, being the 5th largest city in the Western region of the Turkish Republic, hosts 1,83,355 registered Syrians. The present study was designed to analyze the caries-related dental services and preventive applications among 5-, 12-, and 15-year-old Syrian patients admitted to a state-affiliated dental hospital in Bursa, Türkiye. Design: This study comprises retrospective data analysis. Place and duration of study: The data from 1^st January 2016 to 1^st September 2021 were derived from the Bursa Oral and Dental Health Training and Research Hospital. Materials and methods: The dental records of Syrian patients aged 5, 12, and 15 years were reviewed for caries-related (restorations, extractions, and root canal treatments) and preventive applications (fissure sealants and topical fluoridation); others were excluded. Results: A total of 3,388 dental records of 1,179 Syrian children aged 5 (N = 369), 12 (N = 498), and 15 (N = 312) years were analyzed. The highest percentages of dental services offered to 5-, 12-, and 15-year-old were ”tooth extractions” (n = 369; 42.2%), ”fissure sealants” (n = 555; 33.7%), and ”restorative treatments” (n = 384; 44.4%), respectively (p < 0.001). Considering all years (2016–2021), male subjects [odds ratio (OR)—1.42, 95% confidence interval (CI) 1.09–1.85; p = 0.01] and 12-year-old (OR—1.87, 95% CI 1.31–2.66; p = 0.001) were more likely to visit a dentist more than once per year. Conclusion: Caries-related dental services, which are an indicator of poor oral health, are common in 5-, 12-, and 15-year-old Syrian patients.

Aim: To determine the presence of Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) and their association with extrinsic and intrinsic variables in 6–18-month-old infants. Methods: This was an analytical, cross-sectional study of 65 6–18-month-old infants who visited the Centers for Early Childhood in Buenos Aires City. Three groups were established according to the presence of teeth—group I (GI)—edentulous infants, group II (GII)—infants with 1–8 teeth, and group III (GIII)—infants with 9–16 teeth. Data on the variables, diet, use of artificial teats, and oral hygiene were gathered using a self-administered questionnaire. An oral examination was performed according to the International Caries Detection and Assessment System (ICDAS II) criterion. A saliva sample was taken by aspiration with a sterile plastic syringe. Cariogenic Streptococci (CS) were counted using the adherence test in modified gold broth (AT-MGB). Molecular detection and quantification were performed by quantitative polymerase chain reaction (qPCR) (gtfB, gtfT, and tuf). Results: A total of 12% of infants received oral hygiene, 38% used bottles, 30% used pacifiers, and 55% had sugar intake. S. sobrinus and S. mutans were detected in 57.1 and 28.6% of the children with caries, respectively. Groups I, II, and III had CS counts of log 2, 3.4, and 3.7, respectively. S. sobrinus was detected in 26.7% of GI, 52.9% of GII, and 85.7% of GIII, while S. mutans was detected in 13.3%, 35.3%, and 57.7%, respectively. Conclusion: The prevalence of S. sobrinus was higher than S. mutans in all groups. The presence of CS was significantly associated with sugar intake. No association was found between S. mutans and S. sobrinus and the presence of caries, hygiene habits, or use of artificial teats. Clinical Significance: This study supports the role of diet in developing a cariogenic biofilm in children under 2 years of age.

Introduction: Early detection of carious lesions paves the way for the preservation of tooth structures by remineralization strategies. Visual examination using international caries detection and assessment system (ICDAS) II has been validated with the gold standard of histological classification. A fluorescence camera is yet another diagnostic aid for the early detection of carious lesions based on the autofluorescence of the enamel and dentin. This study was done to evaluate the validity of the fluorescence camera (Soprocare and Acteone) in detecting early carious lesions. Materials and methods: A total of 690 occlusal surfaces of non-cavitated premolars and molars were examined by examiners 1 and 2, trained in the ICDAS II grading system. The photographs of the occlusal surface and the fluorescence images, which were taken using a Soprocare (Acetone) intraoral camera, were examined by examiners 3 and 4. The scoring was tabulated and correlated. Results: The κ values for interexaminer reproducibility of indirect visual was 0.841 (good), and his fluorescence camera was 1.00, which is very good. The correlation analysis revealed that there was a higher correlation between direct visual and indirect visual for both examiners when compared to direct and fluorescence cameras. There was a positive relationship between indirect visual and fluorescence cameras for both the experimenter). The indirect visual method for the detection of carries has high sensitivity and specificity irrespective of the examiner. Examination by fluorescence camera has a low sensitivity and high specificity. Conclusion: The specificity of the caries detection method by indirect visual examination based on ICDAS II coding that of the Soprocare fluorescence camera was consistent and reliable, whereas indirect visual examination had a high sensitivity for detecting ICDAS codes 1 and 2. Soprocare showed a very low sensitivity in detecting ICDAS code 1 and 2 lesions.

Aim: Bacterial colonization of infants’ oral cavities is a key factor for future caries risk. This study sought to longitudinally assess oral bacterial colonization in a group of predentate infants in relation to some mother and infant factors. Materials and methods: A total of 50 mother-infant pairs were enrolled. When infants were 3-month-old, data were collected about some infant and mother factors; additionally, maternal Decayed, Missing, and Filled Teeth (DMFT) scores and salivary samples of mothers and infants were obtained. At 6 months of infant's age, another infants’ salivary samples were obtained. Saliva was cultured to detect and quantify Streptococcus mutans (S. mutans) and Streptococcus mitis (S. mitis). Results: Streptococcus mitis (S. mitis) was detected in all infants at 3 months. 74 and 96% of infants acquired S. mutans at 3 and 6 months, respectively. S. mutans detection was significantly higher with higher maternal DMFT scores, salivary S. mutans counts, and lower S. mitis counts, as well as when infants were given sugar-containing complementary foods/drinks. At 3–6 months, infants’ S. mutans counts were significantly positively correlated with maternal S. mutans counts and DMFT scores and negatively correlated with maternal S. mitis counts. The opposite was evident for infants’ S. mitis counts. Regression analysis showed that increased maternal DMFT scores and S. mutans counts, and Cesarean delivery were strong predictors for increased infant's S. mutans counts. While increased DMFT scores and maternal S. mutans counts were strong predictors for reduced infant's S. mitis counts. Conclusion: Poor maternal oral health, early introduction of sugars in the diet, and probably Cesarean delivery can negatively impact infants’ oral bacterial colonization and possibly future caries risk. Clinical significance: Understanding factors associated with oral colonization of both caries-producing and protective flora in infants of different populations is important for caries prevention. This, in turn, can aid tailoring oral health promotion programs for expectant mothers.

Aim: To evaluate the effect of antioxidants on the shear bond strength of composite resin to bleached enamel. Materials and methods: A total of 120 extracted permanent anterior teeth were split into four major groups, one among them being a control group. Group I (bleaching + without antioxidant), group II (bleaching + 10% sodium ascorbate), group III (bleaching + 5% grape seed extract), and group IV (bleaching + 5% pine bark extract). All of the groups were bleached using a gel containing 35% carbamide peroxide, and then they were divided into two subgroups depending on when the bonding operation was to be completed—subgroup A was done in 24 hours, while subgroup B took 3 weeks. The universal testing machine was used to measure the shear bond strength. Results: Subgroup IA showed poor shear bond strength than other groups, there was no statistically significant difference between subgroup IB, IIA, and IVA. Subgroup IIIA showed the highest shear bond strength than the remaining groups. Between subgroups IIA and IIB, IIIA and IIIB, and IVA and IVB there was no statistically significant difference. This shows that delaying the bonding procedure for 3 weeks shows similar shear bond strength when compared to groups that were immediately bonded after antioxidant applying groups. Conclusion: All the antioxidants’ immediate application could reverse compromised bond strength. Among them, 5% grape seed extract shows the highest increase in shear bond strength.

Aim: To assess the oral hygiene status and prevalence of dental caries and trauma to anterior teeth among visually impaired children in Chennai city. Settings and design—a cross-sectional study was conducted in institutionalized blind schoolchildren. Materials and methods: A total of 130 children from two blind schools were selected based on the inclusion and exclusion criteria. Oral hygiene status was assessed using the oral hygiene index-simplified (OHI-S). Dental caries were assessed using decayed-missing-filled teeth (DMFT) and decayed, extracted due to carries, filled teeth (deft) index for permanent and primary dentition, respectively. Trauma to anterior teeth was assessed using Ellis and Davey classification. Statistical analysis used—all the data were analyzed using the Statistical Package for the Social Sciences (SPSS) software 20.0. Results: The assessment of oral hygiene status showed that 54.6% of children had good oral hygiene, 45.4% had fair oral hygiene, and none had poor oral hygiene. The prevalence of dental caries in permanent and primary dentition was found to be 40 and 63.1%, respectively. The prevalence of trauma to anterior teeth was found to be 35.4%. Conclusion: Primary prevention approaches should be taught to parents and school teachers for early intervention of oral health problems.

Objectives: The aim of this study is to evaluate the microhardness of remineralized bleached surface subjected to erosion. Materials and methods: Fifteen samples were divided into three groups and subjected to bleaching and erosion treatment. Group I—treated with 30% hydrogen peroxide then treated with 1% citric acid solution; group II—treated with 30% hydrogen peroxide and a remineralizing agent followed by 1% citric acid solution; group III—without bleaching with 1% citric acid solution. Five samples per group, GI, GII, and GIII were subjected to the Vickers microhardness analysis. Loss of surface hardness loss (% SHL) was analyzed followed by one-way ANOVA test, post hoc multiple comparison test, Bonferroni test to compare the various group. Result: Group II showed the lowest % SHL after the erosive phase when compared with group I. Conclusion: Erosion which usually occurs as a consequence of bleaching can be minimized by the application of remineralizing agents after bleaching.

Introduction: Coronavirus disease 2019 (COVID-19) pandemic has affected all spheres of life and work. Children have been deeply affected, with >3.34 billion affected learners in India. The present study aimed to assess the awareness regarding social distancing strategies in schools among teachers of Delhi. Further, it explores the attitudes and perceived challenges toward various practical strategies in schools. Materials and methods: A cross-sectional study (formative research design) was conducted through an online survey. Teachers during the first nationwide lockdown period were contacted through the snowball method. Quantitative analysis was done using Statistical Package for the Social Sciences (SPSS) version 21. For the qualitative responses, summative content analysis was conducted by a data coder who was blinded to the identity of the respondent. Results: A total of 199 school teachers from various government schools of Delhi participated in the study. Around 49.7% of teachers suggested that online classes would be the best way for appraising children and parents about social distancing, while 24.1% (n = 48) of them insisted on the use of social media. A total of 11.05% of the respondents were of the view that preventive strategies are incredibly difficult to implement and execute. Conclusion: Teacher training and sensitization of parents and children can help overcome the perceived challenges. Clinical and public health significance: Appropriate COVID-19 preventive strategies implementation remains the mainstay for preventing the transmission of the pandemic among the most vulnerable group—school children. Attempts should be made to tailor-made changes required at the policy as well as school level, understanding the probable school environment and psychological impact, keeping abreast with the local challenges.

Aims and objectives: Pulpectomy is one of the most commonly rendered treatment modalities in primary teeth wherein the pulp is irreversibly inflamed. To evaluate the sufficiency of calculated obturating material and quality of obturation in primary teeth using an obturagun device. Materials and methods: Average root canal volume of 65 and 75 was calculated from cone beam computed tomography (CBCT) scans of children in the age-group of 5–9 years. Based on the average root canal volume and density of obturating material (Vitapex), quantity of obturating material required to obturate a single primary mandibular second molar was calculated. Computer-aided design (CAD)/computer-aided manufacturing (CAM) software was used to design obturagun, which was three-dimensional (3D) printed for study purposes. An in vitro pilot study (pulpectomy) was conducted on 20 extracted primary mandibular second molar to evaluate the efficacy of the obturagun. Results: Average root canal volume of 75 was larger than 65. Approximately 68% of the root canals showed optimal obturation. Distal root canals were more void free as compared to mesial. In 70% of the cases, the calculated obturation material was sufficient to obturate a single primary mandibular second molar. Conclusion and clinical significance: Average root canal volume can be used to determine the quantity of obturating material. Obturagun can be used as an alternate obturating technique for primary teeth.

Background: Preventive therapies rely on effective behavior change. Motivational interviewing (MI), has been the most recent advancement in behavior therapies that have been successful in tobacco cessation. The effectiveness of MI needs to be evaluated in caries prevention. Objectives: To evaluate the effectiveness of MI on the reduction of new carious lesions in children with early childhood caries (ECC). Materials and methods: The two authors independently searched data from Cochrane Library, PubMed, Google Scholar, J gate, and Quintpub. Selection criteria—interventional studies written in the English language with MI as an intervention, a mean follow-up period of atleast 2 years, ECC with decayed, missing, and filled primary teeth/decayed, missing, and filled primary surfaces (dmft/dmfs) as the outcome measures, in the age group of 0–6 years. We excluded cross-sectional studies. Information regarding methods, participants, interventions, outcome measures, and results were extracted. A risk of bias assessment within and across studies was conducted. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied to generate quality evidence. Results: Six studies with a total of 2,663 participants were included in the review, and meta-analysis was conducted on 4; 3 studies had a high risk of bias. A mean reduction of 2.16 (−5.06, 0.75) was observed with MI as an intervention. A sensitivity analysis revealed a mean reduction of 3.64 (−5.77, −1.51) in favor of MI. Conclusion: There is some evidence with moderate certainty that MI is beneficial in the reduction of new carious lesions in children with ECC.

Aim and objective: To report on the prevalence and patterns of orofacial clefts (OFC) among Saudi Arabian children by analyzing the results of the studies that have been reported in the literature. Materials and methods: A data search was carried out for the articles that had reported on the prevalence of OFC among the Saudi Arabian population in databases like Web of Science, PubMed, Google Scholar, Scopus, and Saudi Digital Library. Articles that were published over the last 15 years were included in this study, following which 13 studies were assessed for qualitative data. Newcastle–Ottawa Quality Assessment Scales for cross-sectional studies were used for analyzing the methodological quality of these studies. Results: The prevalence of OFC was within the range of 0.65–1.9/1,000 live births. The highest was witnessed in the Medina region. Parent's consanguinity was the most common risk factor in OFC cases in the included studies. OFC was found to be higher among the male population in comparison with the female. Conclusion: The prevalence of OFC in Saudi Arabian children follows the global patterns of OFC. Isolated cleft lip (CL) and cleft palate (CP) are the most common forms of OFC. The prevalence of orofacial anomalies was reported more among children born to parents who had consanguineous marriages. Considering the higher rate of consanguinity among this population, there is an urgent need of developing educational and counseling programs to address the genetic consequences.

Nitrous oxide inhalation sedation (NOIS) has been the backbone of anxiety alleviation in dentistry for a long time. Advantages of nitrous oxide (N₂O) include anxiolysis, mild analgesia, and amnesia. It also has the ability to raise the patient pain threshold, providing rapid analgesia (RA), thus enhancing the action of any local anesthesia used. This paper describes the technique of NOIS in detail and highlights its objectives, advantages, indications, monitoring, and safety profile. Other than the specialty of pediatric dentistry, this paper also highlights the applications and merits of NOIS in adult, geriatric, and special healthcare needs dentistry. Away from dentistry, it also brings to light the multidisciplinary applications of NOIS in other medical streams. This review could be a valuable interpretation on the present position of N₂O sedation in dentistry and a valuable starting point for future perspectives.

Aim: To report a unique case of Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) in a young boy and discuss the oral health impact and management of the disease. Background: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare autoimmune disorder with various clinical manifestations. Biallelic mutations in the autoimmune regulator (AIRE) gene lead to impairment of central immune tolerance and a targeted attack on various endocrine and non-endocrine organs. Patients classically suffer from a triad of disorders, including chronic mucocutaneous candidiasis (CMC), hypoparathyroidism, and adrenocortical failure (Addison's disease). Results: In recent times, it has been observed that oral manifestations of the disorder, such as enamel hypoplasia, appear early and frequently. Affected individuals require a comprehensive preventive and minimally invasive approach for oral health along with follow-up throughout their lifespan to manage potentially life-threatening disease manifestations. Conclusion: Prompt recognition by a pediatric dentist can facilitate an earlier diagnosis and allow for screening, preventive and therapeutic services. Clinical Significance: To deliver oral health care in an effective and comprehensive manner, clinicians should be able to recognize, diagnose and manage the signs and symptoms of the disease.

Hartsfield syndrome is a rare and unique clinical combination of ectrodactyly and holoprosencephaly (HPE) with or without cleft lip and palate, as well as various additional characteristics. Although several genes responsible for HPE and ectrodactyly have been identified, the genetic origin of Hartsfield syndrome remains unknown, as there are few reports in the literature. The objective of this case report is to present dentofacial abnormalities in an 11-year-old boy with Hartsfield syndrome, who presented mental retardation, hearing loss, bilateral hand and foot ectrodactyly, HPE, and solitary median maxillary central incisor (SMMCI) besides 12 dental ageneses.

Aim: The aim of this case report is to highlight the importance of presurgical nasoalveolar molding (PNAM) in cleft lip and palate (CLP) cases and its impact on primary surgical outcomes. Background: Cleft lip and palate (CLP) is one of the most common congenital malformations of the maxillofacial complex. Of all congenital malformations, it ranks third and has a multifactorial etiology. Such anomalies can have several consequences, such as impaired suckling, defective speech, deafness, malocclusion, gross facial deformity, and bring tremendous stress on the entire family. Surgical correction is required to restore the form and function of the affected area; however, surgery has to be usually deferred due to the age of the newborn patients. Case description: A 12-day-old neonate born with a bilateral cleft of lip and alveolus was referred from the Department of Plastic Surgery. PNAM was planned in consultation with the plastic surgeon. A customized nasoalveolar molding plate was fabricated, and tissue molding was carried out. Following nasoalveolar molding, primary surgical repair was done. Conclusion: Significant reduction in cleft width, approximation of soft tissue of the lip, and improvement in nasal tip alignment were achieved following PNAM. It favorably positioned the tissue segment and minimized the extent of the local tissue dissection and advancement. The synchronous prosthodontics and surgical treatment resulted in optimal treatment outcomes. Clinical significance: The higher level of estrogen and hyaluronic acid in the newborn that remodels the cartilage can be utilized through the light application of forces, and hence hard and soft tissue molding can be achieved without surgery. PNAM acts as a promising adjunct prior to primary surgical closure of the CLP. Thus, PNAM immediately after the birth can serve to significantly augment the surgical outcomes and the extent and/or the number of surgeries can be reduced.

Introduction: Dental caries has been the most common disease affecting the human population. Once cavitated, the disease requires restoration. Dental adhesives used to bond composite resins to tooth structure have evolved over the last several decades. Composites were developed to meet the requirements of durable esthetics restorative material. The process of bonding occurred due to micromechanical interlocking between hydroxyapatite of enamel and resin. Over a period of time, bonding to enamel has become a reliable procedure. However, bonding to dentin has proven to be less predictable. In order to overcome the challenges, dental adhesive systems have evolved through several generations with changes in chemistry, mechanism, number of bottles, application techniques, and clinical effectiveness. Case details: The “self-etch” system is especially attractive to pediatric dentistry because of its “fewer steps” and “lesser time.” One product launched as a self-etching self-adhesive flowable composite Constic (DMG, Germany), a new three- in -one flowable composite that combines etching gel, bonding agent, and flowable composite in one single product which has multiple benefits over conventional products. Such a material can be of true advantage as it allows for single-step application, less technique sensitivity, and reduced chair time. In light of this knowledge, this paper will focus on two commonly performed procedures in the general practitioner's office, that is, the placement of small class I composite resin restorations and the placement of pit and fissure sealants on permanent molars in pediatric patients. Clinical significance: The advantage of this material is less technique sensitivity and reduced chair time.

Aim: To highlight the effectiveness of Presurgical Nasoalveolar Molding (PNAM) technique and the appliance used prior to the surgical reconstruction of cleft lip and palate in newborns. Background: In underdeveloped and developing countries, babies born with oral clefts, are generally anemic with low birth weight and may be unfit for surgery immediately. Feeding these babies is also difficult as the air leaks through the cleft and they cannot create the suction needed for suckling. Case description: Two newborn babies, presented with unilateral midfacial clefts involving the lip, alveolus and palate. Conclusion: The PNAM appliance enabled breast Feeding while lessening the soft tissue and cartilaginous deformity and allowing surgical soft tissue repair with minor scar formations. Clinical significance: PNAM can reduce the surgical burden and reduce the number of surgical revisions when initiated early.

Traumatic fibroma is a benign reactive exophytic oral lesion in response to local trauma in the oral cavity. The article presents the case of an 11-year-old boy patient with a month-long proliferation on the left lateral margin of the tongue. Upon detailed history and clinical examination, it was determined that the sharp cusps of the mandibular posterior were the etiological component. Here a soft tissue laser was used for the complete excision of the lesion. The main advantages of using a soft tissue laser in pediatric patients are effective hemostasis that can be achieved in a short span, is less invasive, and better postoperative phase. It is a safe and fast procedure that allows easy manipulation of the tissue without scarring. The excised lesion was then sent to histopathology for analysis. After clinical and histological examinations, the case was diagnosed as a traumatic fibroma.

Epilepsy is a chronic neurological disorder characterized by recurrent seizures. Epilepsy generally begins in childhood, potentially impeding education, employment, social relationships, and the development of a sense of self-worth. The number of decayed and missing teeth, the degree of abrasion, and periodontal indices are significantly worse in patients with epilepsy. Epileptic patients require special care during dental treatment. A seizure episode in a dental clinic is a medical emergency, and it is imperative as an oral health care provider to have adequate knowledge about this condition in order to render safer dental care to epileptic patients. There is a paucity of information in the medical literature on the dental management of epileptic patients. The purpose of this case series is to elaborate on the oral health considerations in epileptic patients and educate oral healthcare providers on the diagnosis, treatment, and emergency management of epilepsy, along with special dental treatment needs in epileptic patients. The case series is a compilation of two cases of petit mal epilepsy and one case of generalized tonic-clonic seizure with detailed descriptions of preventive seizure measures and dental management undertaken during the treatment of patients.

Aim: Surgical correction of median mandibular cleft with ankylossia. Background: Orofacial developmental abnormalities that involve the upper lip and face are the most common variety. The midline cleft of the mandible is one of the rarest categorized as Tessier #30, which extends along the midline of the mandible, along with ankyloglossia or aglossia. The morphogenesis of craniofacial clefts could be due to the lack of fusion or normal development of the facial processes in the first branchial arch or failure of the mesodermal penetration into the midline. Case description: This article presents a case of a 3-year-old female child with complete median cleft of the mandible and tongue with ankyloglossia. Single-stage mandibular cleft union with the concept of osteosynthesis and surgical correction of ankyloglossia was performed to restore function and esthetics at the earliest. Clinical significance: This case signifies the rarity, and as very few cases have been reported worldwide, it is mandatory and worthwhile bringing to light whenever it occurs.

Aim: To design and fabricate an innovative appliance for the purpose of diminishing treatment duration and enhancing patient compliance in non-complaint patients. Background: A patient reported to the orthodontic department for conventional orthodontic treatment but as the treatment progressed, he started loosing motivation which was followed by the deficiency in adherence to the treatment protocol and became less concerned. In few months, he stopped following proper instructions on taking care of the appliances leading to increase in the chances of frequent appliance breakage at every appointment. Case description: A patient reported with Class I molar and end-on canine relationship on both sides, retained deciduous second molar in upper and lower arches, increased overjet, mild generalized spacing in upper anteriors with severe crowding in lower arch anterior region and incompetent lips. On Cephalometric analysis, it showed Class I skeletal pattern with bimaxillary dentoalveolar protrusion. Conclusion: Orthodontic Retractor (innovative appliance) effectively helped in completing the orthodontic treatment in a non-complaint patient without delay as was seen during the retraction phase of the treatment. Clinical significance: “Orthodontic Retractor” can be used and advised for patients who are either less motivated or non-complaint. This appliance is simple and does not require any use of mini-implants, which is an invasive surgical procedure, which many patients does not consent for.

Background: Children with missing anterior teeth have physiological and psychological problems. Out of the many treatment options available, dental implants have advantages in replacing teeth. But, conventional implants in growing individuals are contraindicated due to their osseointegration property. Newer literature suggests transitional implants in growing individuals, which may allow easy removal of requirements in the future. Case description: A 12-year-old female patient visited the department with esthetic concerns. The orthodontic treatment was carried out to correct the malocclusion. An MS transitional implant was used to rehabilitate the missing maxillary left lateral incisor. After 24 months of follow-up, the transitional implant provided optimal esthetic and patient compliance. Conclusion: Transitional implant is a possible mode of rehabilitation in children and adolescents with missing teeth. Systematic planning of treatment can lead to desired esthetic and functional results.

A rare dental developmental anomaly known as regional odontodysplasia (RO) manifests itself in hypoplastic and hypomineralized teeth with discolored yellow to brown enamel. Radiographically, the affected tooth appears as a shell tooth with a large pulp chamber and a thin layer of teeth structure. The treatment plan is not well-established, and a multidisciplinary approach is often needed. However, a literature review revealed that most of the studies regarding RO are case reports, and more research, including epidemiological, genetic, and experimental studies, is needed to understand this condition better. Additionally, the cause of this anomaly is currently unknown. Removing the affected tooth is a controversial matter, and the treatment options should be chosen on an individual basis, considering the patient's goals for treatment. This report describes an uncommon case of an 8-year-old girl who has RO affecting the front teeth in the upper jaw and a long-standing infection caused by actinomycosis.