Background: In a quest a search for newer obturating materials, trends have now shifted from more harmful chemical-based compounds to less toxic and more natural Ayurvedic or herbal materials. Curcumin—a natural extract from turmeric rhizomes, possesses anti-inflammatory and antimicrobial properties and thus may be used as a novel obturating material in the primary teeth. Objective: To evaluate and compare the efficacy of curcumin powder mixed with zinc oxide-eugenol (ZOE) and ZOE as obturating materials in primary molars. Materials and methods: A total of 30 primary molars indicated for pulpectomy were selected from 4–8-year-old children and divided into two groups. Group 1—ZOE group included 11 teeth, and in group II, 19 teeth were obturated with—curcumin mixed with ZOE mixed (ZOE + C). The efficacy of these obturation materials was evaluated both clinically and radiographically after 3, 6, and 9 months. Results: At 9 months, there was a significant reduction in preoperative clinical signs and symptoms. Mobility was absent in all the teeth in group I, while 5 teeth presented with mobility in group II after 9 months. On radiographic assessment, at the end of the 9 months, material resorption was similar to physiological root resorption in 40% of teeth in group I and 22.2% in group II. Interradicular radiolucency increased in 66.7% of teeth in group II when compared to 20% of teeth in group I. Pathological root resorption was seen in 10% of roots in the ZOE group and 55.6% of the roots in the ZOE+C group. Conclusion: Despite the well-documented antibacterial and anti-inflammatory properties of curcumin powder in literature, considering the results of the present study, we cannot suggest curcumin powder as successful alternative obturation material for treating deciduous teeth.

Introduction: Endodontics in primary teeth has brought a revolution in preserving the primary teeth until it is physiological exfoliation. However, reinfection and failure of the pulpectomy-treated teeth should not be neglected. This raises the need for the best root canal filling material with the strongest antibacterial capabilities for primary teeth. The current study set out to assess the antimicrobial efficacy of different concentrations of the novel obturating material against Streptococcus mutans and Enterococcus faecalis, the two most common microorganisms found in primary tooth infections. Materials and methods: The antimicrobial efficacy of the novel obturating material was evaluated against Streptococcus mutans and Enterococcus faecalis using Mueller–Hinton agar (MHA) for 24 hours at 37°C. Twelve distinct concentrations of the material were prepared by varying the proportions of calcium hydroxide, zinc oxide, and metronidazole. After a day, the zone of inhibition was measured in millimeters. After entering the input into a Microsoft Excel spreadsheet, the values underwent statistical analysis. Results: The mean zone of inhibition against Streptococcus mutans and Enterococcus faecalis was greater with 2% 60–40 concentration of the novel obturating material. However, no statistically significant difference was noted (p = 0.74, 0.22, respectively). Conclusion: The most effective formulation of the novel obturating material with the greatest antimicrobial property was determined to be 2% 60–40 concentration of metronidazole, calcium hydroxide, and zinc oxide.

Background: Bite force is an important indicator of the clinical state of mastication and its efficiency. Bite force measurement using a gnathodynamometer is a reliable method to assess the biomechanical properties of the masticatory system. It varies with different geographic populations and physiological and environmental factors. Aim: To estimate the maximum occlusal bite force (MOBF) in school-going children of Hyderabad city at different dentition periods and to correlate with different variables. Materials and methods: a total of 392 school-going children in the age range of 3–13 years were selected following selection criteria (214 males and 178 females). They were divided on the basis of the dentition period. Demographic details along with general physical parameters such as height, weight, and maximum mouth opening (MMO) were recorded in a predesigned proforma. Maximum bite force was measured using a digital bite force instrument. Results: Maximum occlusal bite force (MOBF) was 18.04 N in primary dentition of age 3–5 years, 47.64 N in mixed dentition of age 6–11, and 108.39 N in permanent dentition of age 12–13 years. The magnitude of bite force was observed to be directly proportional to age, height, weight, and dentition period. Males had greater bite force than females in all three dentitions. However, the difference was significant only in mixed dentition (p < 0.05). Of all the dentition bite force was significantly higher in permanent dentition. Bite force showed an inverse relation with body mass index (BMI) in primary and mixed dentition but a positive correlation was seen with permanent dentition. The mean MMO in males was slightly higher when compared to females. It increased with an increase in the dentition stage. Conclusion: Bite force is multifactorial. It has a significant correlation with physiologic and morphologic factors that influence the values of bite force.

Objective: To evaluate and compare the efficacy of 3Mixtatin and mineral trioxide aggregate (MTA) for pulpotomy in primary teeth by assessment of pre- and postoperative clinical and radiographic data. Materials and methods: In this randomized clinical trial, 50 primary molars from 48 healthy children aged 3–8 years were randomly allocated into two groups. Deep dentinal caries approaching pulp in primary teeth were treated by pulpotomy using MTA and 3Mixtatin. Over the intervening period, restoration was done using glass ionomer cement (GIC) and composite, followed by stainless steel crown. Clinical and radiographic examinations were conducted at 3, 6, and 12 months after treatment. The data were compared using Chi-squared test at a significance level of 0.05. Results: A total of 39 patients were available for follow-up study. By the end of 12 months, the overall success rates were 95.5% in MTA and 91.3% in 3Mixtatin. No statistically significant difference was found among the outcomes of MTA and 3Mixtatin groups (p > 0.05). Conclusion: Radiographic and clinical outcomes in MTA and 3Mixtatin group in this study show 3Mixtatin as a suitable alternative for pulpotomy medicament in primary teeth.

Objective: To assess the presence of Enterococcus faecalis in root canals of deciduous molars with necrotic pulp by agar culture and polymerase chain reaction (PCR) assay. Materials and methods: This is an experimental study, where a total of 120 endodontic samples were taken from deciduous molars with necrotic pulps. The presence of Enterococcus faecalis was assessed by culture, using Enterococcus confirmatory agar, and by PCR assay. Statistical analysis of the results was performed using McNemar's test. Results: The presence of Enterococcus faecalis was detected in 20 samples (16.67% of total) by microbial culture and in 45 samples (37.5% of total) by PCR assay, with a statistically significant difference between the two methods (p < 0.001). Microbial culture and PCR both detect Enterococcus faecalis, with the latter detecting an additional 25 positive samples. Conclusion: In this study, PCR assay was significantly more sensitive than agar culture method in detecting the presence of Enterococcus faecalis in root canals of deciduous molars with necrotic pulp, that is, 37.5% of all samples. Clinical significance: Importance of presence of Enterococcus faecalis in necrotic pulps of deciduous teeth, as it is primarily responsible for failure of endodontic treatment, thus helping clinicians to advocate the use of local drug delivery in primary teeth endodontics and also aids clinicians in choosing the most effective intracanal medication.

Aim: To assess the effectiveness of distraction with virtual reality (VR) eyewear along with modified tell-show-do (MTSD) on anxiety levels of 6–11-year-old children with hearing impairment (HI) during the noninvasive dental procedure. Materials and methods: The randomized controlled trial included 40 children with HI aged 6–11 years requiring oral prophylaxis. The children were randomly allocated into two groups. Oral prophylaxis was carried out in both groups, where in group I (VR + MTSD, n = 20), distraction with VR eyewear was performed along with MTSD, and in group II (MTSD, n = 20), MTSD alone was used. Pre and postoperative anxiety levels were assessed using facial image scale (FIS) (subjective) and pulse rate (PR) (objective) measures. Paired t-test and unpaired t-test were used to analyze the obtained data. Results: Postoperative (post-op) PR readings in the VR + MTSD group were reduced by 6.95, whereas it was increased in the MTSD group by 8.55, and the difference was statistically significant (p = 0.001). Post-op FIS scores were found to be reduced in the VR + MTSD group by 2.15, whereas it was increased in the MTSD group by 0.10, and the difference was statistically significant (p = 0.033). Conclusion: Distraction using VR eyewear along with MTSD is effective in reducing anxiety levels in 6–11-year-old children with HI during noninvasive dental procedures. Clinical significance: Hearing-impaired children are usually anxious about the unknown and have unmet oral health needs due to communication barriers. This study provides evidence that the distraction using VR eyewear along with MTSD is effective in reducing anxiety levels in children with HI.

Aim: To evaluate the knowledge and experiences of undergraduate dental students and interns toward research at Jazan University, Saudi Arabia. Materials and methods: A cross-sectional observational study was conducted by using a self-explanatory questionnaire consisting of 14 questions and was mailed as Google e-forms. Results: The response rate for the survey was 72.1%. A vast majority (97.5%) considered conducting research very important and agreed that research learning constituted a part of their dental curriculum. A significant fraction of the population (73.8%) did not conduct any research during their undergraduate course, and the majority (75.5%) agreed that they enjoyed doing research. Disappointingly, a very small fraction of the study participants (8.9%) had knowledge about scientific manuscript writing. The majority (89.6%) interestingly stated that they would undertake research in the future. Conclusion: The findings of this study demonstrated that dental students at the University of Jazan exhibited a high level of interest and knowledge in the realm of research. Despite the recognition of research's significance in education, the study revealed that a relatively small proportion of students actually engaged in research activities. To foster a favorable attitude toward scientific research among undergraduate students, it is crucial to cultivate critical thinking and reasoning skills.

Aim: The study aimed to evaluate and compare the clinical and radiographic success rate of Ketac Universal (3M), GC 9 EXTRA (GC), and Cention N (Ivoclar) restorative materials in primary molars. Materials and methods: The study was conducted as randomized clinical trial in children aged 3–8 years old, out of which a total of 75 primary molars were selected in 43 patients who met the inclusion criteria. The sample size was further divided into three groups of restorative materials, which included group I—Ketac Universal (n = 25), group II—GC 9 EXTRA (n = 25), and group III—Cention N (n = 25). Class I restorations were placed randomly according to the computerized randomization in primary molars and evaluated at baseline (1 week), 6 months, and 12 months according to modified United States Public Health Service (USPHS) criteria and bitewing radiographs. Results: On intercomparison of three groups at 12 months, there was no significant difference found, while on pairwise comparison of Ketac Universal and Cention N, there was a significant difference in relation to surface texture (p = 0.04*) and anatomic contour (p = 0.04*) at 12 months. Conclusion: Newly introduced restorative material Cention N exhibited improved physical and mechanical properties and can be recommended as a cost-effective restorative and easy-to-use material in posterior load-bearing primary molars. Clinical significance: Restoration of primary teeth continues to be an important aspect of restorative dentistry. The longevity of restorations in primary teeth is significantly different for all materials compared to permanent dentition. This makes the assessment of these restorations as a separate group meaningful.

Aim and objective: To assess the association, if any, between oral health-related quality of life (OHRQoL) measured using child oral impact on daily performances (C-OIDP) index and dental caries and gingival bleeding status among 12-year-old school children of Bhubaneswar city. Materials and methods: A cross-sectional descriptive study was conducted, and the data were collected using child oral impacts on daily performances index, a closed-ended questionnaire among the 12-year-old school children of Bhubaneswar, Odisha, India, to find out the association between dental caries prevalence among gingival bleeding status. Data were analyzed using descriptive statistics, and Chi-squared tests were used to determine the significant differences in the variable of interest. Results: The study population consists of 1,034 students, out of which 457 (44.2%) are males and 577 (55.8%) are females. A total of 463 (44.8%) children belonged to private schools, and 571 (55.2%) children belonged to government schools. The prevalence of dental caries among males was found to be 49.8% among males and 49.5% among females. A total of 58.8% of the school children presented the impact of oral problems in at least one of the eight daily performances evaluated by C-OIDP. Conclusion: According to the current study, eating was the most negatively impacted of the eight daily performances; it was also evident that dental caries, gingival bleeding, and OHRQoL were associated.

Aim: To analyze the efficacy of platelet-rich plasma (PRP) in contrast to platelet-rich fibrin (PRF) along with synthetic nanocrystalline hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) bone graft in the regeneration of bone defects in children. Materials and methods: A total of 20 children in whom bone defect was present were selected and divided into two groups of 10. In group I, the bone defect was filled with PRP + nanocrystalline HA with β-TCP and group II, with PRF + nanocrystalline HA with β-TCP. Radiographs using VistaScan with a mesh grid were taken to analyze the bone density and bone regeneration. Clinical evaluation with respect to the color of overlying mucosa, sinus formation, pus discharge, and seepage of bone graft was done. The parameters used to analyze the radiographs included gray scale analysis, residual bone defect calculation in pixels both performed in CorelDraw version 13 software, and radiopaque scoring scale. Results: The mean bone defect density measured using gray scale was higher in the PRF than PRP group. The percentage of bone formation analyzed using residual bone defect calculation and mean radiopaque score revealed that the PRF group showed better outcomes compared to the PRP group. Conclusion: Both PRP and PRF are equally effective in promoting bone regeneration with PRF showing slight superiority over PRP.

Aim: Intracanal posts enhance the resistance of the restoration to mechanical loads and masticatory forces in primary teeth with extensive carious breakdown. This study was done to investigate the clinical performance of composite resin restoration retained by either glass fiber post or biological post in the restoration of primary anterior teeth with extensive carious lesions. Materials and methods: A total of 21 children (with 82 primary anterior teeth) who met the inclusion criteria were involved in the study. The 82 primary maxillary incisors were randomly allocated into two equal groups: groups I (glass fiber post) and II (biological post). All the teeth underwent pulpectomy, followed by glass fiber post or biological post, followed by celluloid strip crown restoration. Clinical analysis of all the teeth in the two groups was performed at 1, 3, 6, 9, and 12 months to assess the success of treatment procedures. Statistical Package for the Social Sciences (SPSS) software version “17” was used for statistical analysis. Pearson's Chi-squared test and Fisher's exact test were utilized to evaluate the success of both treatment procedures. The significance level was predetermined at p < 0.05. Results: At the end of the 12-month follow-up period, 89.4 and 84.2% of composite resin restorations of primary incisors with extensive carious lesions were retained by glass fiber and biological posts, respectively. The intergroup comparison revealed no statistically significant differences pertaining to retention loss, marginal discoloration, and marginal adaptation at all follow-up intervals (p > 0.05). Conclusion and clinical significance: Since biological posts are inexpensive and economical, they may replace the commercial post systems available to pediatric dentists.

Aim: To evaluate the remineralizing potential of glass ionomer cement (GIC) and silver diamine fluoride (SDF) on artificially induced enamel caries lesions in primary teeth. Materials and methods: The initial baseline surface microhardness (SMH) of 40 primary teeth was tested using Vickers hardness tester, followed by the creation of artificial caries lesions by immersion in the demineralizing solution. Microhardness assessments of demineralized samples were done, and samples were randomly divided into two groups of 20 specimens: in group I, GIC was applied on demineralized enamel, and in group II, SDF was applied on demineralized enamel. Samples were subjected to pH cycling. For group I, GIC from the enamel samples was carefully removed using a surgical blade, and changes in the SMH from both groups were analyzed using Vickers microhardness test. Result: Surface microhardness (SMH) value after pH cycling of GIC (45 ± 10.23) and SDF (47.76 ± 6.69) is statistically highly significant (<0.001) compared to the baseline SMH of both test groups. Comparison of SMH between the two groups showed statistically nonsignificant results. Conclusion: The remineralization potential of SDF is comparable to GIC. So, SDF can be used as a remineralizing agent for incipient enamel caries. Clinical significance: Owing to the remineralizing ability of GIC underneath the restorations, it can be used as a therapeutic sealant for incipient enamel caries lesions, where SDF staining is not always acceptable. A 38% SDF also can be used as a remineralizing agent for incipient enamel caries lesions in situations like noncompliant patients, inaccessibility to dental care, or conditions in which esthetics is not of concern.

Introduction: Maxillofacial trauma in children consists of >15% of all facial fractures, which is usually associated with sports injuries and falls while playing. Pediatric mandibular fractures are relatively less frequent when compared to adults, and the reason can be attributed to the child's protected anatomic features and infrequent exposure of children to alcohol-related road accidents. Management principles vary in children, and the main concern is about mandibular growth and the development of dentition. Treatment can be done by either closed reduction or open reduction and internal fixation. Case description: A 5-year-old boy reported to the Department of Pediatric and preventive dentistry with the history of falling from a bike. The patient presented with bruise over chin, deviated mouth opening and deranged occlusion. OPG revealed right condylar fracture and left parasymphysis fracture. Treatment with closed reduction was favored over open reduction in order to decrease the risk of any undue trauma to developing tooth buds and to avoid any growth-related injury in children. Hence, a new approach was performed for closed reduction. The patient was kept on follow-up for a period 6 months. Discussion: Earlier treatment options in closed reduction were limited to intraoral cap splints, circummandibular wiring, eyelet wiring, and even bridle wiring. This case report highlights the use of orthodontic archwires and elastic traction in the management of pediatric mandibular fractures, which is something new to conventional treatment methods and can be used as an alternative method.

The transitory phase of the mixed dentition to a permanent one is seldom accurate, the hurdles being space loss, tooth size arch length discrepancy, early exfoliation of primary teeth, or premature eruption of permanent teeth. Space regainers are appliances used to regain and maintain space, so as to guide the unerupted tooth into the proper position in the arch. It not only maintains function and preserves arch length, but also maintains esthetics, prevents the development of deleterious oral habits, and eliminates any potential psychological damage a child could face. This case report aims to describe an effective, easy-to-fabricated, and innovatively designed space regainer that showed excellent patient compliance and was superior to the present space regainer designs/appliances.

Aim: To describe the successful eruption of an unerupted premolar associated with a dentigerous cyst without the use of any appliances. Background: Inflammatory dentigerous cyst is a variant of dentigerous cyst occurring in the mixed dentition due to stimulation of the reduced enamel epithelium of a developing permanent tooth by periapical inflammation from its carious, nonvital deciduous precursor. Marsupialization is the preferred treatment to preserve the permanent tooth. Case description: A 10-year-old patient presented to us with a well-defined, tender swelling involving the left mandibular body with buccal cortical expansion. Following imaging, marsupialization was performed involving wide excision of the alveolar mucosa overlying the region along with the cystic lining. At follow-up, spontaneous eruption of permanent teeth into occlusion was noted. Conclusion: This suggests that marsupialization along the crest may allow for successful eruption of the associated permanent teeth with the resolution of the cyst. Clinical significance: Marsupialization along the crest provides a conservative option that allows spontaneous, unassisted eruption of permanent teeth in cases of inflammatory dentigerous cysts. Careful preoperative assessments must be used to make treatment decisions. The successful eruption of permanent teeth and the total resolution of the disease both depend on adequate follow-up.

Introduction: The median mandibular cleft (MMC) is a rare craniofacial anomaly manifesting as a cleft of the lower lip and mandible, which may extend to the neck to a variable extent and severity. Its management involves a timely, staged, and multidisciplinary approach. Unlike for maxillary cleft lip and palate, the literature on this anomaly is scarce and scattered. Also, guidelines for the management of mandibular cleft are not clearly outlined. This narrative review aims to consolidate the prevalence, classification, pathophysiology, and management of MMC. Materials and methods: A literature search was performed on PubMed, SCOPUS, and Web of Science for terms “Mandibular cleft” OR “Tessier 30.” From the preliminary search, n = 68 articles were hand-filtered as per relevance to MMC from the title and abstract. Results: Among these articles, n = 56 were case reports, n = 2 were articles related to genetic associations, n = 4 syndromes associated, n = 3 discussed the classification of craniofacial clefts, and n = 3 were literature reviews. The findings from the literature are presented under subheadings embryonic origin, clinical presentation, diagnostic workup, and multidisciplinary management of MMC. Conclusion: Traditionally, MMC was treated by multistep surgical procedures; however, the contemporary approach promotes early and single-step correction of both soft and hard tissue defects for better growth outcomes. These cases demand comprehensive workup and timely management. Newer innovations, such as the use of BMPs and resorbable reduction plates, need further validation.

Aim: To critically evaluate and review the dento-skeletal outcomes of hyrax with or without nonsurgical protraction therapy in nonsyndromic cleft lip and palate (CLP) patients. Materials and methods: Electronic databases were searched from PubMed, Cochrane, Scopus, SciELO, Lilacs, and Google Scholar from January 2005 to April 2022 to identify studies reporting on the dento-skeletal effect of hyrax with or without nonsurgical protraction therapy among children aged 7–15 years with CLP before the secondary alveolar bone grafting (SABG) procedure. Abstracts and subsequently eligible full-text articles were screened. The risk of bias in the included randomized and nonrandomized studies was assessed using Cochrane collaboration's risk of bias tool. The random-effects meta-analyses of the mean difference were carried out. Results: A total of 423 studies were identified. After a thorough screening, 19 studies met the inclusion criteria. Of these 19 studies, 13 studies were conducted with only hyrax appliances, six studies had hyrax with nonsurgical protraction therapy. Conclusion: Hyrax had increased intermolar width, anterior nasal cavity width, and posterior maxillary width compared to inverted mini hyrax with p-values = 0.027, 0.004, and 0.03, respectively. Inverted mini hyrax had more canine inclination on noncleft than hyrax. Hyrax and fan-type expanders had an equivalent effect on the dento-skeletal structures indicating that hyrax can be used as an alternative to fan-type expanders. Hyrax with protraction therapy had a remarkable change in ANB angle compared to noncleft patients.

Background: Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this malocclusion. However, the stability of this orthopedic correction remains unclear, and collective documentation of the short-, mid-, and long-term stability after FM therapy is necessary. Aim: The aim of the systematic review was to assess posttreatment stability following FM therapy in patients with skeletal class III malocclusion. Materials and methods: Through a predefined search strategy, electronic searching was conducted in PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane, Ovid, Embase, Scopus, and Web of Science until 30^th June 2022. Eligible study selection, data extraction, and evaluation of the risk of bias were performed independently by two review authors according to the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2.0 tool) and the Risk of Bias in Nonrandomized Studies–of Interventions (ROBINS-I) tool for nonrandomized trials. A total of 14 studies were finally considered eligible. The systematic review revealed that the maxillo-mandibular differential reverted to class III. The maxillary changes achieved were variable, with SNA angles ranging between −0.7° and 1.9°. Changes in the mandible were greater with an increase in the SNB angle ranging between 0.33° and 3.62°. The lower anterior facial height increased. The maxillary and mandibular incisors were proclined, and the overjet and overbite decreased. The soft tissue changes were insignificant. Conclusion: The effects of FM therapy were found to be stable in the short-term follow-up period. The long-term follow-up revealed that the effects of FM therapy remained stable for the maxilla. However, the mandible continued to grow in a horizontal and unfavorable direction until the adolescent growth spurt. Clinical significance: The major variable that determines the long-term success of FM therapy is the amount and direction of mandibular growth during the adolescent growth spurt. More focus on restricting unfavorable mandibular growth and duration of retention is needed for post-FM therapy. Others: PROSPERO (CRD42021218960).

This current clinical technique describes the case report regarding single-visit fabrication, three-dimensional (3D) printing, and delivery of space maintainers in two children with severe attention-deficit hyperactivity disorder.