International Journal of Clinical Pediatric Dentistry

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2023 | August | Volume 16 | Issue S1

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Pasupuleti Swathi

Effectiveness of Laser-activated and Ultrasonic Irrigation Techniques in Removal of Calcium Hydroxide and Modified Triple Antibiotic Paste from the Root Canals: An In Vitro Evaluation

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:5] [Pages No:S1 - S5]

Keywords: Calcium hydroxide, Laser-activated irrigation, Root canals, Triple antibiotic paste, Ultrasonic irrigation

   DOI: 10.5005/jp-journals-10005-2568  |  Open Access | 


Aim: To evaluate the effectiveness of laser-activated irrigation (LAI) and ultrasonic irrigation (UI) in the removal of calcium hydroxide [Ca(OH)2] and modified triple antibiotic paste (MTAP) from the root canals. Materials and methods: Root canals of freshly extracted human permanent maxillary incisors (n = 80) were prepared. The root canals of half sample (n = 40) were filled with Ca(OH)2 and the other half (n = 40) with MTAP, in which propylene glycol was used as a vehicle. After 14 days, roots were randomly assigned to four groups (n = 20) according to the irrigation technique used—group I [Ca(OH)2 with UI], group II (MTAP with UI), group III [Ca(OH)2 with LAI], group IV (MTAP with LAI). The roots were sectioned, and the intracanal medicament residues were evaluated at 25× magnification under stereomicroscope using 4-grade scoring system. Statistical analysis: One-way analysis of variance (ANOVA) and post hoc Tukey tests were performed. Results: Laser-activated irrigation (LAI) was found to be superior compared to UI. Ca(OH)2 was better removed compared to MTAP with either of the irrigation techniques. A statistically significant difference was found between the Ca(OH)2 with LAI and MTAP with UI groups in all the regions, that is, coronal, middle, and apical thirds. Conclusion: Laser-activated irrigation (LAI) was superior to UI in removing Ca(OH)2 and MTAP. Ca(OH)2 was better removed than MTAP, irrespective of the technique used. However, none of the irrigation techniques could completely remove the intracanal medicament from the root canals.



Raviraj S Dhumal, Rashmi S Chauhan, Vishwas Patil, Krishnapriya Nene, Lalit Patil, Meenakshi Y Nankar, Ankita P Khandelwal

Comparative Evaluation of Fluoride Release from Four Commercially Available Pediatric Dental Restorative Materials

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:7] [Pages No:S6 - S12]

Keywords: Beautifil®,BioActive-restorative,Zirconomer,Glass ionomer,Fluoride release,Restorations

   DOI: 10.5005/jp-journals-10005-2621  |  Open Access | 


Objectives: The aim of this study was to evaluate the fluoride-releasing abilities of commercially available restorative materials such as—Activa™ BioActive-restorative™ material, Zirconomer (Shofu Inc), Beautifil® II (Shofu Inc), GC Gold Label 9 high strength posterior restorative glass ionomer cement (GIC Corp).
Materials and methods: A total of 40 disk specimens (10 of each material) were placed into distilled/deionized (DI) water and the fluoride release was measured for 30 days. Fluoride ion measurement was performed at the end of the 1st, 3rd, 7th, 15th, and 30th day under normal atmospheric conditions by fluoride ion selective electrode (F-ISE) (Orion 9609 BNWP, Ionplus SureFlow fluoride electrode, Thermo Scientific, United States of America) coupled to a benchtop analyzer (Hachsen Ion+).
Results: All the materials included in the study exhibited fluoride release. Although there were differences in the amounts of fluoride released between Activa™, Zirconomer, and GC Gold Label 9 the mean difference between these three groups was not found to be statistically significant. Beautifil<sup>®</sup> II showed low amounts of fluoride released at all time intervals.
Conclusion: Among the above-compared materials Activa™ and Zirconomer exhibit both improved mechanical properties as well as they have fluoride-releasing ability so can be preferred over conventional glass ionomer restorations.



Poonam Sharma, Preeti Dhawan, Sumeet K Rajpal

A Comparison of Antimicrobial Efficacy of Silver-based Preventive Restorations (Silver Nitrate, Silver Diamine Fluoride, and Silver Nanoparticles) against Streptococcus mutans Monospecies Biofilm Model

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:7] [Pages No:S13 - S19]

Keywords: Early childhood caries, Fluoride, Nanoparticles, Oral biofilm, Streptococcus mutans

   DOI: 10.5005/jp-journals-10005-2575  |  Open Access | 


Aim: The ability of the Streptococcus mutans (S. mutans) to form biofilms is not only crucial in the initiation of early childhood caries (ECC) but is also a challenge to its treatment. The current management protocols focus on remineralization and use of antimicrobial formulations which penetrate biofilms, control their formation, and decrease the incidence of caries in children. The paradigm shift toward preventive protocols and increasing antibiotic resistance rekindled the use of silver as a promising antibacterial agent. To gain further insight into the therapeutic potential, aim of the present study was to compare the antibacterial efficacy of silver-based preventive restorations [silver nitrate (AgNO3), silver diamine fluoride (SDF), and silver nanoparticles (AgNPs)] against S. mutans species. Materials and methods: Using an ex vivo monospecies biofilm model of S. mutans; the antimicrobial efficacy of three treatment groups (SDF, AgNO3, and AgNPs) was evaluated. Results: There was a significant difference between the negative control and three treatment groups (SDF, AgNO3, and AgNPs). The results showed that the mean diameter of inhibition zones obtained in biofilms treated with AgNPs was 40.3 ± 0.25 mm which was greater than both SDF (37.7 ± 0.18 mm) and AgNO3 (36.26 ± 0.18 mm). Conclusion: The study concluded that the number of viable bacteria was significantly reduced by all three medicaments (p < 0.05). However, AgNPs showed the highest antimicrobial activity in comparison to SDF and AgNO3 against S. mutans biofilm. Clinical significance: The present study thus supports that AgNPs are a promising preventive anticaries agent due to their better antibacterial activity in comparison to other silver-based preventive restorations and can be effectively used as an alternative to SDF or AgNO3 for the noninvasive treatment of ECC in the young.



Vigneshwar Raman, Daya Srinivasan, AR Senthil Eagappan, SS Harish

A Comparative Evaluation of Dissolution Rate of Three Different Posterior Restorative Materials Used in Pediatric Dentistry: An In Vitro Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:7] [Pages No:S20 - S26]

Keywords: Cention N, Composite, Zirconomer

   DOI: 10.5005/jp-journals-10005-2577  |  Open Access | 


Aim: The study aimed to compare and assess the dissolution rate, color stability, and other mechanical parameters, such as compressive and flexural strength, of three distinct posterior restorative materials used in pediatric dentistry. Materials and methods: The three posterior restorative materials used in pediatric dentistry are divided into group I—Zirconomer, group II—Composite, and group III—Cention N. Around 111 cylindrical specimens were grouped into three groups of 37 each. According to the manufacturer's standards, all materials were proportioned and handled. The materials were thermocycler in a chewing simulator and were subjected to various tests to estimate the dissolution rate, compressive strength, flexural strength, and color stability of the three individual groups. Results: The dissolution rate was highest in Zirconomer, followed by Cention N and Composite, which were highly significant (p = 0.05). Compressive strength was highest with Cention N, followed by Composite and Zirconomer, which was highly important (p = 0.05). Cention N had the greatest flexural strength, followed by Composite and Zirconomer, which were highly significant (p = 0.05). Finally, the Composite had the highest color stability, followed by Cention N and Zirconomer among the three groups. Conclusion: It is concluded that resin-based restorative materials outperform glass ionomer-based Zirconomer cement in terms of dissolution rate, compressive strength, flexural strength, and color stability. Clinical significance: Because of the widespread improvement in dental materials, many dental restorative types of cement have emerged on the market. The features of good restorative materials are mechanical strength, fluid dissolution rate, and retention.



Márjully ER da Silva, Marina D de Sena, Natália H Colombo, Jesse A Pereira, Daniela A Chrisostomo, Sandra MHCÁ de Aguiar, Robson F Cunha, Cristiane Duque

Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S27 - S32]

Keywords: Chlorhexidine, Dental atraumatic restorative treatment, Dental caries, Resin-modified glass ionomer cement

   DOI: 10.5005/jp-journals-10005-2612  |  Open Access | 


Aim: This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. Materials and methods: The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal–Wallis/Mann–Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). Results: The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. Conclusion: A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Clinical significance: Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment.



HR Pooja, Andrea N Mascarenhas, KCH Chandana, N Vatsala, UGK Pallavi

Effect of Liquorice Candies on Remineralization of Initial Enamel Carious Lesion

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S33 - S38]

Keywords: Confocal microscopy, Demineralization, Enamel carious lesions, Liquorice, Lozenges, Remineralization

   DOI: 10.5005/jp-journals-10005-2619  |  Open Access | 


Background: Glycyrrhiza glabra (G. glabra), known as liquorice root is one such herbal remedy that has been shown to have immense potential in the treatment of orofacial diseases. Aim: To evaluate the remineralizing potential of liquorice extract on initial enamel carious lesions. Materials and methods: An in vitro and in vivo study was conducted, wherein the sound-extracted human premolars were sectioned longitudinally and into enamel blocks of size 4 × 4 mm. Enamel blocks were demineralized to produce artificial carious lesions. In vitro study, the demineralized enamel block was exposed to artificial saliva for 5 minutes and artificial saliva containing liquorice for 4 minutes 14 times in a sequential manner. An in vivo study was carried out on six volunteers aged between 6 and 12 years. The demineralized enamel block was inserted into the 5 × 5 mm window created on the full palatal coverage appliance. Patients were given commercially available liquorice candies (Ricola) to consume for 7 days twice daily. The remineralization potential of liquorice on demineralized enamel block was assessed using confocal microscopy analysis. Results: Liquorice extract containing candies showed visual remineralization of the demineralized area on the enamel surface through confocal images. Conclusion: Liquorice extract possesses remineralizing potential with its other medicinal properties.



Raghdah E Abdrabuh, Omar AES El Meligy, Osama M Felemban, Najat MA Farsi

Evaluation of the Erbium-doped Yttrium Aluminum Garnet Laser and the Conventional Method on Pain Perception and Anxiety Level in Children during Caries Removal: A Randomized Split-mouth Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S39 - S44]

Keywords: Dental anxiety, Erbium-doped yttrium aluminum garnet laser, Pain, Randomized controlled clinical trial, Split-mouth

   DOI: 10.5005/jp-journals-10005-2634  |  Open Access | 


Aim and objective: To assess and compare children's anxiety level and pain perception during cavity preparation using an erbium-doped yttrium aluminum garnet (Er:YAG) laser vs traditional rotational treatment. Materials and methods: A randomized, controlled, split-mouth clinical trial was carried out in 35 healthy children with 70 carious primary molars. Teeth were divided equally into two groups according to the method of treatment. A bur was used to prepare the cavity in one quadrant, while an Er:YAG laser was used to prepare the cavity in the other quadrant. Anxiety was assessed using Venham's dental anxiety scale and a fingertip pulse oximeter. The pain was assessed using the Wong–Baker Face Pain Rating Scale, and the number of local anesthesia (LA) needed during both procedures was also considered. Results: The mean age was 9.4 ± 1.29. Males accounted for 51.4% of the participants. There were no statistically significant variations in pulse rate at the baseline between Er:YAG laser and the conventional treatments. The mean pulse rate was higher during the conventional intervention than during the laser intervention; this difference was statistically significant vs the baseline pulse rate. The mean pulse rate with the conventional method was significantly higher during and after cavity formation than with the laser method. The Er:YAG laser and the conventional groups showed statistically significant differences in the Venham's and Wong–Baker scores. The scores of both scales were much higher in the conventional group. The number of participants who requested LA during the conventional technique was significantly higher than during the laser procedure. Conclusion: Using Er:YAG lasers to remove caries produces minimal pain and anxiety and reduces the requirement for LA. Clinical significance: During cavity preparation, the Er:YAG laser helps children stay calm.



Vishnu R Chamarthi, Ponnudurai Arangannal

Prognostic Factors for Successful Dental Treatment in Autistic Children and Adolescents

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S45 - S50]

Keywords: Autism, Behavior, Cooperation

   DOI: 10.5005/jp-journals-10005-2607  |  Open Access | 


Aim: The aim of this study was to recognize and assess the prognostic factors which could predict the level of cooperation of children with autism for dental appointments. Methods: A total of 395 parents of children with autism participated in this study. Prognostic factors of cooperation were evaluated using questionnaires. Data were collected using parent surveys by a dentist. Statistical analysis: Statistical analyses used in the present study include the formation one way and two-way frequency tables, binomial tests, Pearson's Chi-squared tests, Fisher's exact test, and collation of multiple proportions tests. Results: Autistic children meeting their own needs, cooperation for nail-clipping and haircuts, smiling frequently, using toothbrushes and toothpaste and being assisted by parents for toothbrushing, and children who brushed their teeth once a day were more cooperative with the dentist. Children who had thumb-sucking and nail-biting habits were cooperative with the dentist. Children who bit their hands appeared to be more cooperative with the dentist when compared to other self-inflicting habits. Conclusion: This study identified ”prognostic factors” such as their cooperative ability during nail clipping, hair cutting, and ability to read, write, and meet their own needs that are answered by a parent and that may show a child's cooperative potential.



Prasurjya Bora, Aditya Saxena

Effect of 38% Silver Diamine Fluoride on Salivary Matrix Metalloproteinase-9 Levels in Children with Early Childhood Caries: A Clinical Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S51 - S56]

Keywords: Early childhood caries, Matrix metalloproteinases, Silver diamine fluoride

   DOI: 10.5005/jp-journals-10005-2618  |  Open Access | 


Background: Early childhood caries is a major oral health problem in most industrialized countries, affecting the overall quality of life of children. It is caused by the action of bacterial acids on the enamel surface thereby demineralizing it and progressively destroying the tooth. It presents initially as smooth-surface carious lesions affecting the primary maxillary incisors. With the advancement of the lesion, decay progresses further to involve other primary teeth as well and if not treated early, the caries may involve the pulp leading to irreversible pulpitis. Matrix metalloproteinases (MMPs) are a group of endopeptidases that degrade almost all the proteins of the extracellular matrix (ECM). Among the different types of MMP, MMP-9 (gelatinase B) is one of the chief MMPs responsible for the breakdown of the organic matrix. Traces of MMP-9 can be found in the human carious lesions, saliva, and gingival crevicular fluid. They are activated by the release of acids by cariogenic bacteria and once activated they are able to digest demineralized dentin matrix. Thus, host-derived MMPs, which are activated by bacterial acids have a crucial role in the destruction of dentine by caries. Thus, this study was undertaken to investigate the effect of 38% silver diamine fluoride (SDF) solution on MMP-9 levels. Aim: This clinical trial investigated the MMP-9 levels before and after the application of 38% SDF in children with early childhood caries. Materials and methods: About 15 children were selected and were subjected to clinical and radiographic assessment before the commencement of the procedure. After the collection of saliva, the teeth with carious lesions were isolated and SDF was applied. Saliva samples were again collected after 1, 3, and 6 months postapplication of SDF. The collected saliva samples were then analyzed for their MMP-9 levels using a human salivary enzyme-linked immunosorbent assay (ELISA) kit. Finally, the data obtained were subjected to statistical analysis by repeated measures of analysis of variance (ANOVA). Conclusion: The MMP-9 levels were found to be gradually increasing postapplication of 38% SDF and were significantly higher after 6 months and the highest mean difference in the MMP-9 levels was observed between baseline and 6th-month follow-up. Also, no new carious lesion appeared in the teeth during the experimental time period of 6 months and the decayed, extraction needed, filled teeth (deft) scores remained the same.



Kamlakant Shukla, Jaya Joshi, Deepika Jain

A Comparative Study of the Effect of Tooth Mousse Plus Remin Pro and Fluor Protector Gel on Enamel Erosion: An In Vitro Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S57 - S62]

Keywords: Dental erosion, Fluor Protector Gel, Remineralization, Remin Pro, Tooth Mousse Plus

   DOI: 10.5005/jp-journals-10005-2602  |  Open Access | 


Background: The purpose of this in vitro study was to assess the effect of Tooth Mousse Plus, Remin Pro, and Fluor Protector Gel on enamel erosion, measuring mean weight loss after exposure to a demineralizing agent. Materials and methods: A total of 60 sound-extracted permanent incisors were sectioned and enamel specimens were randomly distributed to different groups. The initial weight of all specimens was registered. The samples were randomly divided into four groups (n = 30). Group I specimens were treated with tap water (control). Groups II, III, and IV were treated with Tooth Mousse, Remin Pro, and Fluor Protector Gel application. After that, specimens were placed all together in a plastic container with 6 mL of a soft drink and immersed for 8 minutes at room temperature, dried, and weighed. Specimens were weighed after each immersion period and mean weight loss was calculated. The data was analyzed for probability distribution using the Kolmogorov–Smirnov test. The intergroup comparison was done using a one-way analysis of variance (ANOVA) followed by post hoc analysis. Results: According to pairwise comparisons in post hoc analysis, the weight of specimens at baseline was significantly greater than the weight of specimens on day 12. The difference in the mean weight of the specimen from baseline to day 12 was 2.833 mg for group I, 2.367 mg for group II, 1.467 mg for group III, and 2.133 mg for group IV. Conclusion: Tooth Mousse Plus, Remin Pro, and Fluor Protector Gel have no significant effect on dental erosion.



Mahesh C Mohan, Praveena Geetha, Drisya Soman, Radhakrishnan N Kunjusankaran, Nisha B Kurup, Krishnan Venugopal

The Effect of Salivary Contamination on the Shear Bond Strength of Seventh- and Eighth-generation Adhesive Systems

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:4] [Pages No:S63 - S66]

Keywords: Adhesive reapplication, Eighth-generation adhesive system, Natural saliva, Nanofillers, Seventh-generation adhesive system, Salivary contamination, Shear bond strength

   DOI: 10.5005/jp-journals-10005-2587  |  Open Access | 


Aim: To compare the effect of salivary contamination on the shear bond strength (SBS) of seventh- and eighth-generation adhesives. Materials and methods: Specimens were randomly divided into group I and group II, subdivided into three subgroups of 11 samples. Subgroup IA—seventh-generation uncontaminated (control); adhesive; air-dried; light cured. Subgroup IB—seventh-generation adhesive; saliva application, air-dried; light cured. Subgroup IC—seventh-generation adhesive; saliva application, air-dried, reapplication of adhesive, air-dried, light cured. Subgroup IIA— eighth-generation uncontaminated (control); adhesive, air-dried; light cured. Subgroup IIB— eighth-generation adhesive; saliva application, air-dried; light cured. Subgroup IIC—eighth-generation adhesive, saliva application, air-dried, reapplication of adhesive, air-dried; light cured. Following bonding procedure, composite resin restoration was done and subjected to SBS analysis. Results: Mean SBS of eighth-generation adhesive was higher compared to seventh with and without saliva contamination. Reduction of SBS in seventh- and eighth-generation after saliva contamination was regained by reapplication of adhesive, which was less compared to the control [statistically significant (p < 0.05) for seventh and statistically not significant for eighth-generations]. Conclusion: The eighth-generation adhesives show better SBS with and without saliva contamination and reapplication of eighth-generation adhesives significantly improved the SBS close to the control. Clinical significance: Single-step self-etch adhesives are the adhesives which are currently used for bonding composite restorations to dentin. The adhesive bond strength can be adversely affected by moisture contamination, especially by saliva, which can lead to failure of restoration. So, it is imperative to study a material which gives better bond strength and is less affected by salivary contamination and effect of decontamination to regain the bond strength. The study concluded that eighth-generation adhesives showed higher mean SBS with and without saliva contamination and reapplication of eighth-generation adhesives significantly improved the bond strength close to the control group.



Sharon Priscilla

Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:5] [Pages No:S67 - S71]

Keywords: Embrace WetBond, Fissure morphology, Pit and fissure sealant, Stereomicroscope

   DOI: 10.5005/jp-journals-10005-2601  |  Open Access | 


Introduction/background: The preventive benefits of pit and fissure sealants rely on their retention and sealing ability. The drawback of the conventional pit and fissure sealant is its poor retention due to the presence of moisture. Among the numerous pit and fissure sealants available, newer hydrophilic sealants are ideal for children. This study evaluates and compares the sealing ability of hydrophilic sealant Embrace WetBond with conventionally used glass ionomer sealant under a stereomicroscope. Materials and methods: A total of 48 extracted human premolars were randomly divided into two groups (N = 24) and sealed with Embrace WetBond and GC Fuji VII as per manufacturers’ instructions. Following thermocycling, the sectioned samples were evaluated for sealant penetration, unfilled space, and total length of fissure under a stereomicroscope at magnifications 2.5×, 4×, and 5×. The values were measured in microns and in various fissure types using the ”ImageJ app” to measure the sealant penetrability and sealing ability. The data recorded were statistically evaluated. Results: The penetrability of moisture-tolerant sealant was better (87.8 ± 10.7) compared to that of glass ionomer sealant (73.8 ± 15.5) (p = 0.002). Among the samples, U-type fissure patterns displayed greater penetrability (94.2 ± 6.2), whereas IK-type fissures revealed the lowest degree of penetrability (67.5 ± 7.3). Conclusion: Embrace WetBond is better than glass ionomer sealant with respect to penetrability and sealing ability under stereomicroscope hence recommended as a better sealant for pediatric clinical practice.



Insha Showkat, Seema Chaudhary, Ashish A Sinha, Naveen Manuja, Chaitra R Telgi, Neha Priya, Minha M Kak

Comparative Evaluation of Flexural Strength of Conventional Glass Ionomer Cement and Glass Ionomer Cement Modified with Chitosan, Titanium Dioxide Nanopowder and Nanohydroxyapatite: An In Vitro Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:5] [Pages No:S72 - S76]

Keywords: Chitosan, Flexural strength, Glass ionomer cement, In vitro study, 10% nanohydroxyapatite

   DOI: 10.5005/jp-journals-10005-2617  |  Open Access | 


Aim: To evaluate the effect of different add-ons on the flexural strength (FS) of glass ionomer cement (GIC). Materials and methods: Around 72 samples were fabricated and divided among the following six different groups: group I—control (conventional GIC—nonmodified), group II—GIC powder modified with 3% titanium dioxide (TiO2) and liquid is unmodified, group III—powder modified with 10% nanohydroxyapatite (nHA) and liquid is unmodified, group IV—powder is unmodified and Liquid is modified with 10% chitosan (CH), group V—powder is modified with 3% TiO2 and liquid is modified with 10% CH, and group VI—powder is modified with 10% nHA and liquid is modified with 10% CH. The samples were then subjected to a three-point bending test on a universal testing machine for the evaluation of FS. The results obtained were analyzed statistically using the analysis of variance (ANOVA) test. Result: The mean FS value of group V depicts significantly high FS among all groups (29.42 ± 3.35). A significant difference was present in FS amongst all the groups that is groups V>II>IV>VI>III>I. Conclusion: Glass ionomer cement (GIC) powder can be modified with nHA, nanotitanium, and GIC liquid can be modified with CH to improve its FS. Clinical significance: Glass ionomer cement (GIC) supplemented with additives like nanoparticles (NPs) and CH can be used as an enhanced filling material due to its potential antibacterial properties and in areas with a high masticatory load.



Palanisamy Sowkarthicaa, Veerabadhran M Mathian, Murugesan Gawthaman

Comparative Evaluation of Preformed Stainless Steel Crown's Crazing at Different Autoclave Cycles

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:4] [Pages No:S77 - S80]

Keywords: Autoclave, Infection control, Stainless steel crown

   DOI: 10.5005/jp-journals-10005-2608  |  Open Access | 


Aim: The study aimed to assess and compare the crazing of preformed stainless steel (SS) crowns at various autoclave cycles. Materials and methods: Around 15 SS crowns were subjected to zero (unsterilized), one, three, five, and seven autoclave cycles at 121°C, 15 psi for 20 minutes. After each autoclave cycle, the mesial surface of each crown from occlusal to cervical portions was examined under a 40× stereomicroscope. Crazing was evaluated using Wickersham's criteria. Results: One autoclave cycle does not produce any cracks, whereas the higher the number of autoclave cycles, the higher the cracks, which affects the prognosis of the SS crown treatment. Conclusion: Surface alterations of SS crowns after different autoclave cycles were significant. So, preformed SS crowns should be discarded after sterilizing once or twice during clinical practice.



Umesh Hambire

Effect of Nanohydroxyapatite, Zirconia and Glass Filler Particles on the Wear and Microhardness of Experimental Dental Composite Resin

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:4] [Pages No:S81 - S84]

Keywords: Compressive strength, Dental caries, Nanofilled composite

   DOI: 10.5005/jp-journals-10005-2591  |  Open Access | 


Objectives: To study the influence of nanoparticles of hydroxyapatite, zirconia, and glass on the wear and the microhardness of the organic matrix of experimental dental composite resin. Materials and methods: The dental composite resin matrix was fabricated from bisphenol A-glycidyl methacrylate (Bis-GMA) (40 wt%), triethylene glycol dimethacrylate (TEGDMA) (36 wt%), and camphorquinone (0.4 wt%). Nanohydroxyapatite, glass, and zirconia fillers were silane treated. Nano-hydroxyapatite, glass, and zirconia were incorporated at three different concentrations. The polymerization of the dental composite resin was done using a light curing unit. Experimental dental composite resins were evaluated for wear and microhardness. The data were analyzed by one-way analysis of variance (ANOVA) test. Results: The experimental dental composite resin composed of 32% of nanohydroxyapatite, 27% of zirconia, and 19% of glass as filler showed the minimum amount of wear. The Vickers hardness (VHN) number was observed to be minimum for the experimental dental composite resin composed of 24.1% of nanohydroxyapatite, 22% of zirconia, and 14.5% of glass. Conclusion: The inclusion of 32% nanohydroxyapatite, 27% of zirconia, and 19% of glass as filler into the experimental dental composite resin decreased the wear and increased the hardness.



VC Rebecca, Radhika Muppa, Harshini Togaru, Niharika H Mutt, Aditya Tangella

Evaluation of Iontophoresis as a Tool in Comparison to Topical Remineralization Systems by Transverse Microradiography and Polarized Light Microscopy: An In Vitro Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S85 - S90]

Keywords: Casein phosphopeptide-amorphous calcium phosphate, Iontophoresis, Polarized light microscopy, Remineralization, Transverse microradiography

   DOI: 10.5005/jp-journals-10005-2625  |  Open Access | 


Aim: To compare the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (GC Tooth Mousse) and tricalcium phosphate formulation (Clinpro) by topical application and iontophoresis. Background: Noninvasive treatment of dental caries is a major advance in the clinical management of the disease. Materials and methods: A total of 20 primary anterior and 20 primary molars were included in the study to be analyzed by transverse microradiography (TMR) and polarized light microscopy (PLM). The samples were coated with acid-resistant varnish, leaving a window on the buccal/lingual surface of enamel and immersed in demineralizing solution for 96 hours. Each sample was coated with varnish on the left half (control), and the right half served as a test. All the samples were divided into four groups. The test windows of specimens in groups I (GC Tooth Mousse) and II (Clinpro) were subjected to remineralization treatments for 10 days. Similarly, groups III and IV were subjected to iontophoresis using GC Tooth Mousse and Clinpro for 7 minutes. The samples were analyzed by TMR and PLM. Results: There was no significant difference in the mean difference of mineral loss among the four groups. There was a significant difference in the mean difference of lesion depth among the four groups. Conclusion: Both iontophoresis and topical application were equally efficient, but one remineralization by iontophoresis equals 10 topical applications.



Samarpreet Kaur

Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:6] [Pages No:S91 - S96]

Keywords: Casein phosphopeptide-amorphous calcium phosphate, Fluoride varnish, In vitro study, Remineralizing agents, Remineralizing efficacy, Silver diamine fluoride, Surface microhardness

   DOI: 10.5005/jp-journals-10005-2622  |  Open Access | 


Introduction: With the paradigm shift in the management of dental caries, the focus is now laid on remineralization therapies that can arrest the progression of the disease and remineralize the subsurface lesions. Objectives: The purpose of this study was to determine and compare the remineralizing potential of silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish (FV) on enamel surfaces in primary and permanent teeth. Materials and methods: A total of 120 primary anterior teeth and 120 premolars were used to prepare enamel blocks in acrylic resin. The mean baseline surface microhardness (SMH) for each sample was determined using a microvickers hardness testing machine. Thereafter, the samples were randomly and equally distributed into groups and subgroups based on the materials used, that is, SDF, CPP-ACP, FV, and distilled water (control). After subjecting the samples to a pH cycling regime, SMH was determined again and the percentage change in SMH was calculated. Results: The data were tabulated and subjected to statistical analysis using an independent t-test and one-way analysis of variance (ANOVA). In primary teeth, the least mean percentage reduction in SMH was observed after the application of FV followed by SDF, CPP-ACP, and control. In permanent teeth, both SDF and FV showed the least percentage reduction of enamel SMH followed by CPP-ACP and control. Conclusion: Silver diamine fluoride (SDF), FV, and CPP-ACP showed remineralizing potential in both primary and permanent teeth.



Sonali K Waghmode, Savita G Hadakar, Namrata N Gaonkar, Sachin Gugawad, Swapnil Taur

Comparative Evaluation of the Microleakage and Shear Bond Strength of Three Filled Pit and Fissure Sealants Using Subpressure and Adhesive System: An Experimental Analysis

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:4] [Pages No:S97 - S100]

Keywords: Adhesive, Microleakage, Pit and fissure sealant, Subpressure, Shear bond strength

   DOI: 10.5005/jp-journals-10005-2633  |  Open Access | 


Introduction: Pit and fissure caries account for about 90% of caries in children and adolescents. Sealant application may be a preventive conservative approach. But it's still challenging to bolster the retention of the filled sealant and to chop back the microleakage. Aim: Aim is to evaluate and compare the microleakage and shear bond strength (SBS) of three filled pit and fissure sealants (PFS) using a subpressure and adhesive system: an experimental analysis. Materials and methods: A total of 90 orthodontically extracted premolars were prepared for microleakage and SBS and divided according to materials and subgroups. Group I: resin-based filled PFS, group II: resin-modified glass ionomer-based filled PFS, and group III: giomer-based filled PFS. Subgroup 1: only sealant application, subgroup 2: subpressure application, and subgroup 3: adhesive system + subpressure application. Samples were subjected to thermocycling. Microleakage was assessed with a dye penetration method under a stereomicroscope, and SBS was assessed with a universal testing machine. Statistical analysis and results: Unpaired t-test and one-way analysis of variance (ANOVA) test were used for analysis. Significant when p < 0.05. The SBS showed significant results for subpressure application and giomer-based filled PFS with p < 0.05. The microleakages score differed significantly for the subpressure application group with p < 0.05. Giomer-based filled PFS showed the least microleakage score. Conclusion: This study concluded that giomer-based filled PFS showed statistically significant results. The subpressure technique significantly reduces microleakage and increases SBS.



Syed Gulbar Shah, Bhavna Kaul, Aishwaraya Gupta, Rumisa N Kashani, Sonam Rajput, Sambhav Kaul

Dermatoglyphics: Prediction for Prevention: An Innovative Tool in our Stash!

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:8] [Pages No:S101 - S108]

Keywords: Dermatoglyphics, Early childhood caries, Innovative tool, Prevention

   DOI: 10.5005/jp-journals-10005-2623  |  Open Access | 


Background: Early childhood caries (ECC) has created pandemonium worldwide and so in India which is alarming and accentuates the need to foster novel and effective preventive strategies that are synergistic with the current one. There are different methods to diagnose ECC. Nonetheless, up until now, there has been no method to predict ECC. Dermatoglyphics could be considered a noninvasive and early predictor of dental caries in children, as ECC is a multifactorial disease with the influence of genetic patterns. Aim: The present study was undertaken to find out a possible relation between some quantitative and qualitative dermatoglyphic variables, ECC, and salivary bacteria. Materials and methods: The study was carried out on 200 children within the age-group of 36–72 months. The study population was divided into four groups comprising 50 individuals each based on decayed, missing and filled teeth (dmft) score and gender; group I—caries male (dmft ≥ 5), group II—caries free male (dmft score 0), group III—caries female (dmft≥ 5), and group IV—caries free female (dmft score 0). Dermatoglyphic patterns of all 10 palmar digits were recorded and assessed qualitatively and quantitatively. Results: The caries group showed maximum occurrence of whorls, which were more prevalent in females and decreased frequency of loops when compared to caries free group. There was a significant association of the whorl pattern with the microbial counts of Streptococcus mutans (S. mutans) and Lactobacillus. Conclusion: There is explicit variation in dermatoglyphic patterns between the ECC and caries-free group indicating a correlation between dermatoglyphic patterns and dental caries.



Meenu Mittal, Radhika Chopra, Prashant Tomar

Diagnosis and Dental Management of a Child with Moebius Syndrome: A Case Report

[Year:2023] [Month:August] [Volume:16] [Number:S1] [Pages:4] [Pages No:S109 - S112]

Keywords: Case report, Child, Dental management, Diagnosis, Moebius syndrome

   DOI: 10.5005/jp-journals-10005-2626  |  Open Access | 


Moebius syndrome (MBS) is a rare congenital nonprogressive neuromuscular disorder characterized by partial or complete, unilateral or bilateral paralysis of the facial (VII) and abducens (VI) cranial nerves (CNs). In this syndrome bilateral facial palsy may occur with the involvement of VII CN and impaired eye movements can be there because of the involvement of VI CN. It can also be associated with other CN palsies, orofacial anomalies, and limb defects. MBS is diagnosed exclusively on the basis of clinical criteria, although causative genetic patterns are being documented in recent studies. The present case report describes the dental management of a 5-year-old child diagnosed with MBS. The child presented with the abnormal shape of legs, incomplete eye closure during sleep, inability to smile, lingual hypoplasia, microstomia, and hypoplastic teeth among other dental-skeletal abnormalities, and a clinical diagnosis of MBS was made.


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