Background: Dental anxiety assessment for blind children is important. Appropriate knowledge of the patient's anxiety will help to review management options specific to every child. Aim: The aim of this study was to evaluate the anxiety level using the Raghavendra, Madhuri, Sujata (RMS) tactile scale (RMS-TS) of visually impaired children after explaining the oral prophylaxis procedure verbally and by the verbal-tactile method followed by performing the oral prophylaxis procedure. Materials and methods: A total of 30 children aged between 6 and 13 years were included in this study from a residential school for visually impaired children. These children were divided into two equal groups. One group was explained oral prophylaxis by verbal method and another was explained in a verbal-tactile method, preintervention and postintervention anxiety of the children was checked on the RMS-TS. Results: A comparison of mean values between the two groups was done using a t-test. Comparison of mean values in each group for before and after values were done using paired t-test and was found that anxiety had reduced in the verbal-tactile group more significantly than that of the verbal group. Conclusion: The study shows that the combination of verbal and tactile models for explaining the dental procedure is an effective way to reduce anxiety in blind children.

Purpose: Vital partial pulpotomy (PP) or cervical pulpotomy (CP) in carious pulp-exposed permanent teeth preserves tooth vitality, promotes pulp healing, decreases treatment costs, and shortens treatment duration, which is a significant factor in treating noncooperative children. The aim of this retrospective study was to compare clinical and radiographic outcomes of partial and CP in vital carious-exposed permanent teeth. Materials and methods: All vital permanent teeth with carious pulp exposure, treated by pulpotomy using mineral trioxide aggregate (MTA) during 2017–2019, by two operators in one dental center, were included in the study. Around 118 permanent teeth in 97 children and adolescents (mean age 10.9 years) were evaluated 6–57 months postoperatively. Results: The total success rates of CP and PP were 82.5 and 80.8%, respectively (p = nonsignificant). The only factor that significantly affected the success rate was the presence of preoperative periapical pathology. Teeth without such pathology showed an 87.3% success rate compared to 74.1 and 58.3% in teeth with preoperative enlarged periodontal ligament (PDL) or with periapical radiolucency, respectively (p = 0.0301). Demographic variables, maturation state of the tooth, type of tooth (incisor, premolar, molar), postoperative variables, such as the presence of radiographic dentinal bridge, partial or full obliteration of the pulp during the follow-up period, and the integrity of the final restoration during the recall examinations did not affect the success rate of the treatment. Conclusion: Partial and CP in vital permanent teeth with carious pulp exposure in children and adolescents might be a reliable alternative to full root canal treatment (RCT).

Introduction: Pulpal status is best determined by assessing the pulp vitality, which proves to be important yet sceptical with the use of conventional thermal and electrical testing methods. The use of pulse oximetry helps to arrive at a definitive diagnosis by detecting the pulpal oxygen saturation. Aim: To assess and compare the pulpal oxygen saturation in caries-free and carious maxillary primary central incisors using a customized dental pulse oximeter sensor probe. Materials and methods: A total of 225 maxillary primary central incisors were selected from children aged 3–6 years. Teeth were categorized into group I—caries-free teeth, group II—deep caries lesion, and group III—pulpectomized teeth (n =75 in each group). Pulpal oxygen levels were assessed using a three-dimensionally (3D) designed custom-made probe, and the readings were tabulated. The values were subjected to statistical analysis using paired t-test, analysis of variance (ANOVA), and Tukey's HSD post hoc test. Results: The mean oxygen saturation levels of teeth in group I (92.03%) were statistically significantly high compared to group II (64.36%), that was statistically significant. Readings noted from group III, which was kept as control, was 0%. Conclusion: The obtained results showed that the caries-free group exhibited higher saturation compared to the carious group. 3D designed customized pulse oximeter can be used as an adjunct to assess the pulp vitality in primary teeth.

Introduction: One of the most prevalent oral diseases affecting preschoolers, early childhood caries (ECC), can significantly lower a child's quality of life. The pain and discomfort that ECC causes will alter the child's eating habits, which will have an impact on both their physical and mental health, as shown by the deviation from the body mass index (BMI). Dental caries and deviation from the normal BMI are both significantly influenced by children's eating habits and socioeconomic status (SES). Aim: To determine the association of ECC with BMI, dietary habits, and SES among 3–6-year-old preschool children. Materials and methods: A cross-sectional study was conducted among 375 preschool children of 3–6 years of age. The decayed, missing, or filled teeth (deft) index was used to determine the caries status. Measurement of height (m) and weight (kg) was done using a stadiometer and electronic weighing machine. For each child, the BMI (kg/m²) was calculated, and the child's body weight status was assessed using Centers for Disease Control and Prevention (CDC)-based classification. Questionnaires were collected with demographic details, 3 days diet diary, and the SES of parents. The dietary habit and SES were obtained from the healthy eating index-2005 (HEI-2005) score and Modified Kuppuswamy's Scale 2018. All the data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) software V 20.0. Result: The prevalence of ECC was 44.8%. On comparison of mean height, weight, and BMI scores, there was a significant difference in mean weight (p = 0.006) and BMI (p = 0.001) among the two study groups. Children with ECC had a lower HEI-2005 score and belonged to a lower social class compared to caries-free children (p = 0.001). Conclusion: Children with ECC are significantly associated with BMI being overweight, or risk of being overweight; lower grades of SES and lower total score of HEI-2005 with poor diet and diet that needs improvement.

Aim: “Comparative evaluation of three different microabrasion techniques in esthetic management of fluorosis”—an in vivo study. Materials and methods: A total of 48 permanent incisors in children between the age-groups of 8–12 years with Dean's fluorosis index modified criteria 1, 2, and 3 were included. The patients were randomly divided into three groups; each group included 16 samples. Group I—phosphoric acid and pumice microabrasion (37% phosphoric acid and pumice as abrasive), group II—opalustre microabrasion [6.6% hydrochloric (HCL) acid and silicon dicarbide (SiC₂)], and group III—icon etch microabrasion (15% HCL acid gel as icon etch, pumice, and resin infiltrate). Preoperative sensitivity and pulp vitality of each tooth were evaluated. Standardized preoperative photographs were captured for the evaluation of color parameters L1, a1, and b1 by Adobe Photoshop 7 software and an assessment of color enhancement was carried out. Preoperative surface roughness was evaluated with two methods like, cellulose acetate replicating tape and confocal microscope, and Epoxy resin replica obtained from the preoperative impression of teeth using additional silicone and contact profilometer. Microabrasion was done accordingly. Postoperative values of all the parameters were evaluated. Results: Phosphoric acid and pumice showed the best color change, followed by icon etch resin infiltrate. Opalustre (6.6% HCL acid and SiC₂) and was unsuccessful as it had less concentration and was more abrasive. Conclusion: Phosphoric acid and pumice showed the best color enhancement, followed by icon etch resin infiltrate and opalustre. Icon etch resin infiltrate showed minimal surface roughness followed by phosphoric acid and pumice and opaluster group.

Background: Silver diamine fluoride (SDF) solution has been used clinically to prevent and arrest dental caries. To evaluate the microtensile bond strength between silver-modified atraumatic restorative technique (SMART) and glass ionomer cement (GIC) applied to carious primary teeth and also the mode of restoration failure. Materials and methods: A total of 40 carious primary molars were equally allocated into test and control groups after sectioning through the middle of the carious lesion. The test specimens were treated with one drop of 38% SDF and the control with deionized water. The samples were stored in artificial saliva for 14 days at 37° C and the dentin surfaces were conditioned and restored with Fuji IX GP Extra. After 24 hours storage in artificial saliva, the specimens were prepared for testing of microtensile bond strength. Paired t-test was used to compare the mean bond strengths. The mode of failure was assessed with a stereomicroscope under 40× magnification. Results: The mean microtensile strength for the test group was 7.39 MPa [standard deviation (SD ± 2.3)] and 7.20 MPa (SD ± 1.98) for the control group (p > 0.05). The most common mode of failure was the mixed failure mode in both groups. Conclusion: Silver diamine fluoride (SDF) does not adversely affect the bond strength between GIC applied to carious dentin.

Background: Saliva is one of the most important aids in the diagnosis of various oral diseases. Few physicochemical properties of saliva such as flow rate, pH, and buffering capacity often vary with the occurrence of dental caries, fluorosis, and other systemic conditions. Purpose: The aim of the study was to evaluate the relationship between the salivary flow rate, pH, and buffering capacity in healthy children, children with caries, children with fluorosis, and children with both caries + fluorosis. Materials and methods: The study population consisted of 144 children aged 7–14 years and were divided into four groups of 36 children each. Group I, 36 healthy children with no caries and fluorosis; group II, 36 children with caries (dmfs ≤ 10); group III, 36 children with fluorosis (moderate to severe); and group IV, 36 children with caries + fluorosis. Unstimulated saliva is collected from all the selected subjects and evaluated for the salivary flow rate, pH, and buffering capacity. The recorded data were tabulated and statistically analyzed using a paired t-test. Results: The mean salivary flow rate and buffering capacity were found to be highest in group III when compared with all the other groups. The mean pH was greater in group I when compared with groups I, II, and III. Conclusion: The physicochemical properties of saliva like pH, buffering capacity, and salivary flow rate alter with caries and fluorosis conditions. Hence, more clinical and laboratory studies are needed to determine the exact relationship between these physicochemical properties of saliva in dental caries and fluorosis.

Background: In order to compare the clinical and radiographic success of three treatment modalities—conventional restoration (CR), nonrestorative caries treatment (NRCT), and Hall technique (HT), with a 3-month to 1 year follow-up in deciduous molars with occlusal or proximal carious lesions. Design: Children between the ages of 5 and 8 were chosen for the study, having a total of 120 teeth. They were split into three groups, each with 40 participants—CR, HT, and NRCT. Clinical and radiographic evaluation was done at 3, 6, 9, and 12 months. Data were statistically analyzed. Results: The Chi-squared value and p-value were found to be insignificant when comparing clinical and radiographic ratings of all three groups at 3, 6, 9, and 12-month intervals. Conclusion: Hall technique (HT) performed better than CR. NRCT was more acceptable to patients than CR.

Aim: To evaluate the effectiveness of the audiovisual distraction (AVD) technique and filmed modeling (FM) on anxiety and fear in pediatric dental patients. Materials and methods: This experimental in vivo study was conducted on 80 subjects of age-groups 5–8 years coming to the Department of Pediatric and Preventive Dentistry for their first dental visit. Study subjects were subjected to noninvasive restorative treatment under AVD in group I, FM in group II, and a combination of AVD and FM in groups III and IV (control 0). To assess the level of pre and postoperative anxiety and fear, various biological parameters like pulse rate, oxygen saturation, body temperature, respiratory rate, and salivary cortisol estimation along with facial image scale (FIS), and fear assessment picture scale (FAPS) were used. Results: Group III (a combination of AVD and FM) came out to be better than other experimental groups and control groups in reducing dental anxiety and fear in pediatric dental patients. Conclusion: A combination of AVD and FM techniques can be recommended to be used as an effective behavior management technique. Clinical significance: A child's disruptive behavior due to dental anxiety causes difficulty in delivering effective dental treatment. Thus, a child's behavior management is of paramount importance in the pediatric dental setup. Nonpharmacological behavior management techniques, that is, a combination of AVD and FM techniques can be recommended to be used as an effective behavior management technique to reduce dental anxiety and fear in pediatric dental patients.

Introduction: Skeletal maturity assessment involves radiographic analysis and visual inspection of developing bone and their initial appearance or sequential ossification and related changes in size and shape along with the expression of various biomarkers in body fluids. Aim: To investigate the correlation of biomarkers such as salivary alkaline phosphatase (S-ALP) and salivary total protein (STP) with skeletal maturity assessment and growth prediction in growing children. Materials and methods: A total of 8–15-year-old 150 healthy children were divided into five groups depending upon radiographic stage maturity of the middle phalanx of the left hand's third finger according to the Hagg and Taranger method. Radiographs were taken using intraoral periapical (IOPA) radiographic films. Results: Salivary alkaline phosphatase (S-ALP) activity in the MP3 G group was significantly higher than MP3 F group and MP3 I group. Total protein levels in MP3 F were significantly lower than in MP3 G. The mean value of S-ALP (33541.45 IU/L) and that of STP (2.77 mg/mL) was observed to be highest in the MP3 G group (G3) group. Conclusion: Salivary total protein (STP) and S-ALP may be used as an additional diagnostic tool to assess skeletal maturation and optimize growth prediction during myofunctional orthodontic treatment. Clinical significance: Skeletal maturity assessment plays a significant role in orthodontic diagnosis, treatment planning, and stability of orthodontic treatment. Radiographic parameters involve radiographic exposure; hence in this study noninvasive biomarkers such as S-ALP and STP have been evaluated for skeletal maturity assessment and growth prediction.

Aim: This study was conducted to observe and assess the dental and facial parameters of esthetics in children with healthy dentition and evaluate whether they are comparable to those of adults. Materials and methods: An observational study included 70 children with ages ranging from 5 to 6 years who had come to the Department of Pediatric & Preventive Dentistry, Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh, India, with intact primary dentition. Standardized photographs of the children were taken and evaluated. Their facial and dental parameters were recorded and compared to that of those of adults. Result: The relation of tooth and facial components was established, and it was found that they were not in the same proportion as those of adults. Conclusion: The proportions of facial and dental parameters of esthetics of children at 6 years of age are different from those of adults. Clinical significance: Since esthetic rehabilitation of primary teeth is becoming an important requisite of successful dental treatment, it is important to establish a standard guideline of dental and facial parameters for children for prosthetic rehabilitation.

Aim: Considering the advantages of the nonpharmacotherapeutic techniques over the disadvantages of the pharmacotherapeutic agents, there is a need to evaluate clinically as well as radiographically various nonpharmacotherapeutic techniques to fortify them as replacements to the traditional pulpotomy. This study was conducted to evaluate and compare the clinical and radiographic outcomes of low-level diode laser (LLDL) and electrosurgical pulpotomy in primary molars. Materials and methods: Seventy primary molars were allocated to group I (n = 35) and group II (n = 35), which underwent LLDL pulpotomy and electrosurgical pulpotomy, respectively. Clinical and radiographic analysis of all the teeth in the two groups was performed at 1, 3, 6, 9, and 12 months, respectively. Pearson's Chi-squared test was utilized to evaluate the success of both treatment procedures (p < 0.05). Results: During the 12-month follow-up period, the differences between the groups pertaining to clinical and radiographical evaluation were statistically nonsignificant, although enhanced results were seen in the laser pulpotomy group. There was no significant difference in the success rate observed between the LLDL pulpotomy and electrosurgical pulpotomy group at the end of the 12-month follow-up period. Conclusion: The two pulpotomy techniques were found to be successful enough in strengthening the concept of a potent and safe nonpharmacotherapeutic approach in the management of pulpally involved primary molars. Clinical significance: This study further establishes nonpharmacological pulpotomy techniques as a favorable alternative to traditional pulpotomy methods.

Aim: The aim is to assess the awareness and professional responsibilities of pedodontists, general dentists, and dental students concerning suspected child abuse and to explore their professional experiences with this issue. Material and methods: A cross-sectional questionnaire study was conducted among 400 conveniently selected general dentists, pedodontists, and dental students in Bengaluru city. Self-administered, structured, both open- and closed-ended questionnaires were used to elicit information about their experience (if any) with suspected/confirmed cases of Child Abuse and Neglect (CAN). Responses to open-ended items were grouped based on common responses. Descriptive statistics and Chi-squared tests were used to analyze the data. Results: About 15.6% suspected a case of CAN based on physical indicators, and 8% reported a confirmed case of CAN that was based on conflicting history from child to parent. Counseling of both child and parent, followed by a proper recording of history, was the action taken for suspected cases. In addition, counseling of parents followed by reporting to concerned authorities was done for confirmed cases. About 18.4% observed a change in the child's behavior that was predominantly scared and submissive. Counseling of the child/parent/caretaker was the preferred approach, followed by reporting to concerned authorities. Pedodontists preferred to create public awareness, and dental students preferred to report to concerned authorities. Conclusion: The exposure to a suspected or confirmed case of CAN was very less in the present study. Not many participants who encountered a child abuse case opted to report it to higher authorities and rather focused on counseling the parent/family. The role of pedodontists was found to be crucial since most reported cases were from their end; however, dental students showed a greater interest in managing a case of CAN. There is a need to create more awareness regarding the management of CAN cases among dentists and students. Clinical significance: CAN is a major problem around the world that can have long-term adverse effects on Children. The first step in intervention is awareness and identification of CAN cases.

Aim: The aim of our study was to assess the prevalence of dental caries and the body mass index (BMI) in included school-going children. Moreover, to examine the relationship between the prevalence of dental caries, BMI, and socioeconomic (SES) status and to evaluate sugar consumption and other dietary habits as risk factors for dental caries. Materials and methods: The present cross-sectional study was performed among 400 school-going children aged 6–12 years from Faridabad city, Haryana. Parents filled out questionnaires for their respective children. The clinical examination of dental caries was performed according to World Health Organization (WHO) 1997. The BMI calculation was done by measuring height and weight. Statistical analysis: The collected data were analyzed statistically using parametric and nonparametric tests. Results: The prevalence of dental caries in deciduous teeth was 95.5% and in permanent teeth was 47.3%, respectively. Conclusion: This study displayed the positive correlation of dental caries to BMI, oral hygiene practices, beverages, aerated drinks, chips, candy, and tea/coffee. Whereas the SES status and dietary habits Jam group variable had no significance in relation to dental caries.

Aim: The purpose of the study is to compare and evaluate the efficacy of different root canal irrigants—100, 75, 50, and 25% neem extract, 100, 75, 50, and 25% apple cider vinegar (ACV), a combination of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and saline on smear layer removal using a scanning electron microscope (SEM). Materials and methods: A total of 80 freshly extracted single-rooted teeth were collected and divided into 10 groups—group I: normal saline (negative control), group II: NaOCl with EDTA (positive control), group III: 100% neem extract, group IV: 75% neem extract, group V: 50% neem extract, group VI: 25% neem extract, group VII: 100% ACV, group VIII: 75% ACV, group IX: 50% ACV, and group X: 25% ACV. The samples were irrigated with a specific group of irrigants, then split in a longitudinal axis and processed for analysis in an SEM. Microphotographs were obtained and scored according to Torabinejad et al. Results: Microphotographs were assessed and showed that 100% neem extract was similar to NaOCl with EDTA, followed by 75% neem extract and 100% ACV. Conclusion: This study showed that 100% neem extract removed the smear layer, similar to the NaOCl with EDTA.

Background: Dental pain due to pulpal involvement is difficult to diagnose due to the apparent inaccessibility of pulp to the clinical tests, indistinct symptoms, and referred toothache originating from the periodontal tissues. Though we have various clinical classification systems to categorize pulpal diseases, we are yet biased about the exact pathophysiology and pain pathway associated with it. Dental pulp has a complex physiology, and so is its pathophysiology. Aims & objectives: To concisely reviews the basic understanding of the pathophysiology of pulp, pain pathway, and its correlation with the classification of various clinical conditions of pulpal inflammation and periapical diseases. Methodology: Literature search on pulpal diseases and pathophysiology from the sources: MEDLINE, PubMed, Web of Science and Cochrane Databases dated from 1965 till December 2020 was carried on to collect 163 articles. Results: Filtered search on the pathophysiology of pulp, pain pathway, and classification of various clinical conditions of pulpal inflammation resulted us to precise 36 articles required for our understanding and demystifying the correlation. Conclusion: The emphasis should be laid on understanding the minute changes occurring inside the pulp in due course of inflammation to aid its diagnosis and a treatment plan accordingly.

Mandibular fractures in children, when compared to adults are quite less common. The treatment approaches for mandibular fractures differ in children due to their growth and developing dentition. Minimal manipulation of bony architecture is done to achieve a stable position. Thus a closed reduction is preferred in children. This article presents a case of an 8-year-old boy, mandibular left parasymphysis fracture with displacement of the left dentoalveolar segment which was managed by a novel treatment approach using a unilateral cap splint with interelastic traction.

Background: Pediatric dentists face significant challenges when treating a child with anodontia. Early intervention is essential to ensure the normal physiological and psychological development while also promoting normal jaw development. Case Report: This report describes a 4-year follow-up case of a child with complete anodontia. Prosthetic rehabilitation during the primary and mixed dentition period improved the facial esthetics, self-esteem, speech, and masticatory function of the child. Conclusion: This case report summarizes the treatment procedure, challenges faced in clinical management and the various prosthetic options with its advantages and disadvantages for a child with anodontia.

Introduction: Stainless steel crowns (SSCs) are the popular restorative technique for the young permanent first molars treated endodontically. However, these restorations are not esthetically appealing and need replacement once adjacent teeth erupt and occlusion is stabilized. Aim: Digitally customized aesthetic restoration constitutes as a reliable approach for restoring decayed young permanent molars. Materials and methods: Here we present an innovative treatment approach for endodontically treated permanent young molars using a digital workflow with Intraoral scanners (IOS) and computer-aided design/computer-assisted manufacturing (CAD/CAM) fabrication of the restoration. IOSs include scanning of the prepared tooth, its antagonist, and the bite. CAD/CAM preparation of the customized restoration is followed by cementation and follow-up. Result: IOSs are well tolerated by children, easily and swiftly implemented. Digital workflow should be considered for endodontically treated permanent young molars in contrast to prefabricated unaesthetic options.

Aim and objective: The present clinical report describes management of complete unilateral cleft lip and palate with presurgical nasoalveolar molding (NAM) therapy for infants. Background: Orofacial clefts have a negative impact on the health and social integration of individuals affected. Patients undergo numerous procedures until they reach adolescence. The ultimate focus of surgical intervention is to improve the esthetic appearance of the lip and nose by improving the lip scar, nasal tip projection, and symmetry of the nasolabial complex. Case description: This paper discusses a situation in which the parents of a three days old baby with the chief complaint of regurgitation of milk while feeding. On examination, baby had complete left-sided cleft lip and cleft palate (CL+CP). Conclusion: Before surgery, nasoalveolar molding has been shown to be a useful adjunctive therapy for reducing hard and soft tissue cleft deformity. Clinical significance: Passive preoperative intervention of the lip and alveolar segments helps to reduce tissue tension and is thought to improve surgical outcomes by minimizing wound healing disturbances and scarring.