Aim: The present study was conducted to identify the main foods and beverages consumed at primary school and also to explore the information regarding cariogenic food consumption patterns of children in the school. Materials and methods: A cross-sectional descriptive study was conducted among 150 schoolgoing children of age 6–9 years of an English medium school in Karad. Respondents were asked about the type of daily food consumption at breakfast, lunch, and dinner using a 24-hour diet chart, and the lunch box of children was viewed at the time of lunch break to assess for carbohydrate-rich diet. Results: Majority of the students (58.6%) were boys, from class IV (25.4%) and class III (25.4%), and were between 20 and 25 kg (48%) and 116 and 130 cm (42%). It was observed that the most frequently consumed food in the lunch box was chapati/paratha and vegetables (45%) followed by poha/upma (28%) and biscuits (22%). Almost half of the students (46%) were in the category of “watch-out zone,” that is, >15 sugar exposure. Conclusion: Most of the food consumed in school was homemade and was less cariogenic. Beverages were less consumed by the students in the school time. Clinical significance: Since dental caries is a chronic infectious disease affecting more than two-thirds of all children and the incidence of caries is directly related to “form” or “physical consistency” of the sugar-containing foods, the content of lunch box should be considered a priority for health promotion efforts among children.

Background and objectives: The researchers have been searching for ideal restorative material for many decades. The incorporation of a remineralizing agent into a restorative material to improve its property of preventing dental caries and the occurrence of secondary caries has been investigated by various researchers. Hence, in the present study, we have incorporated two nonfluoridated remineralizing agents [theobromine and casein phosphopeptide–amorphous calcium phosphate (ACP-CPP)] into the conventional glass ionomer cement (GIC) and evaluated their mechanical properties. Results: The flexural strength, compressive strength, and microhardness values of the two test groups were more significant than the control group type IX GIC. Conclusion: With this study, we could conclude that the incorporation of theobromine and ACP-CPP into GIC increases the mechanical properties of conventional GIC.

Aim: To determine the influence of biomechanical preparation on various parameters of root canal curvature. Materials and methods: A total of 72 tooth roots with moderate (10–25°) and severe canal curvature (26–75°) were selected and embedded in autopolymerizing acrylic resin for which cone-beam computed tomography (CBCT) image analysis was performed. Schneider angle, canal access angle (CAA), and the radius of curvature were determined preoperatively using auto-computer-aided design (CAD) 2021 software. Protaper gold rotary nickel-titanium (Ni-Ti) files were used to prepare the root canals. All angular and linear values were measured in auto-CAD and compared using postoperative CBCT pictures. The difference in pre- and postoperative values was assessed using paired samples t-test and independent samples t-test. Results: There was a statistically significant difference between the Schneider angle (p = 0.002), (p < 0.001), CAA (p < 0.001), (p = 0.001), and radius of curvature (p = 0.01), (p = 0.001) pre- and postoperatively in both moderate and severe canal curvature groups, respectively. This difference was greater in the severe curvature group (p-value = 0.027) than in the group exhibiting moderate curvature. Among the parameters tested, Schneider angle has shown maximum difference pre- and post before and after mathematical processing (BMP) compared to other parameters. Conclusion: This approach is a new and objective way of measuring root canal geometric changes. The current findings suggest that the Schneider angle, CAA, and the radius of curvature can be used as parameters to evaluate the changes in canal geometry following biomechanical preparation.

Background and aim: To evaluate the efficacy of three-point acupressure therapy in decreasing the dental anxiety in children undergoing dental procedures and to introduce acupressure as a simple, noninvasive, and cost-effective technique of reducing dental anxiety in children. Materials and methods: One hundred and sixty-eight, 8–12 years participants who met the inclusion criteria were randomly allotted to either group I (three-point acupressure) (n = 84) or group II (control) (n = 84). All children were subjected to a self-report measure of anxiety [Modified Child Dental Anxiety Scale (MCDAS)] 30 minutes before starting and after completing the dental treatment. For group I children, acupressure beads were applied on selected three acupoints for approximately 10 minutes and were left adhered in place. After 20 minutes, anxiety scores were recorded for all the children and allotted treatment procedure was initiated. For group II children, the same methodology was followed except for the application of acupressure beads. Frankl behavior (FB) rating scale, pulse rate (PR), and systemic saturation levels of oxygen were also recorded as secondary outcome measures. The data obtained was analyzed statistically using Chi-squared analysis, t-test, repeated measures analysis of variance (ANOVA) along with post hoc Bonferroni test. Significance level was predetermined at p ≤ 0.05. Results: At time frame (TF)-2, significant decrease in anxiety scores was observed in acupressure group irrespective of the treatment procedure, whereas in control group, it increased significantly. PR was also increased in acupressure group and FB scale was improved. In control group, PR increased and behavior was not improved. Between TF-2 and 3, no reduction in anxiety score was observed. Conclusion: The three-point acupressure therapy reduces anxiety in children undergoing dental procedures when compared to nonacupressure group and the difference was statistically significant. Acupressure is a noninvasive stimulation technique applied to acupoints and can be easily administered by a trained pediatric dentist.

Background: Vital pulp therapy procedures in primary dentition focuses on preservation and maintenance of pulp tissue that has been compromised due to caries, trauma, etc. Several pulp dressing materials have been used in primary teeth and some natural materials from the field of traditional medicine have also been introduced as medicaments in vital pulp therapy. The understanding of biologic and cytotoxic properties of newer materials is important for safe clinical usage. The biologic compatibility of these newer materials is imperative to limit or avoid tissue irritation or degeneration. Aim: To evaluate the cytotoxic effects of Allium sativum on cultured human primary dental pulp fibroblasts. Materials and methods: Primary pulp fibroblasts were cultured from the pulp tissue obtained from extracted deciduous primary canines and central incisor teeth. The freshly prepared concentrations of 1000, 500, 250, 125, and 62.5 µg/mL A. sativum extract were added to the 96-well plate in triplicates to which culture medium containing fourth passage cell suspension was added previously. Cells without treatment served as control, while cells treated with 5% dimethyl sulfoxide (DMSO) served as toxic control. After the addition of experimental and control agents, cells were incubated for 24 and 48 hours at 37°C in 5% CO₂ atmosphere. After the incubation period, 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to determine the number of viable cells. Absorbance was read with a microplate reader at 570 nm wavelength and the relative viability of dental pulp fibroblasts at various concentrations was expressed as color intensity of the experimental wells relative to that of control. The percentage of cell viability was also calculated accordingly. Results: The MTT assay results revealed that A. sativum extract, in all the concentrations tested at both the time intervals maintained a cell viability of greater than 90%. At 24 hours, the mean absorbance value of untreated control wells was recorded as 0.84400 ± 0.00916 with 100% cell viability. Among all the concentrations of garlic extract tested, highest mean absorbance value of 0.83933 ± 0.00550 with 99.44% cell viability was recorded for 62.5 µg/mL concentration. At 48 hours, the mean absorbance value of untreated control wells was recorded as 1.22767 ± 0.01106 with 100% cell viability, and the highest mean absorbance value of 1.22567 ± 0.01006 with 99.83% cell viability was recorded for 62.5 µg/mL concentration. The cell viability did not seem to be affected by the concentration of A. sativum extract at 24 hours. However, at 48 hours, the sensitivity of the cells was observed to be dependent on the concentration of A. sativum with a decrease in the viability of cells noted with the increase in concentration. Conclusion: A. sativum extract is noncytotoxic in nature and preserves the vitality of cultured human primary dental pulp fibroblasts making it a suitable material for use in vital pulp therapy procedures of primary teeth.

Aims and background: Recording enamel rod end patterns can be considered an alternative to fingerprints, which are susceptible to decomposition or mutilation. The available literature revealed that limited research has been performed on the recording of enamel rod end patterns, and none has been performed on primary teeth. Hence, this in vitro observational study was performed with the aim of identifying and analyzing the different patterns of enamel rod endings of primary anterior teeth. The objectives of this study were to record the different patterns of enamel rod endings obtained from the enamel surface of primary maxillary and mandibular anterior teeth through biometric analysis. Materials and methods: The enamel rod end patterns of 30 noncarious primary anterior teeth with intact crown structures were recorded using the acetate peel technique. The photomicrographs of the imprints were then subjected to biometric conversion using Verifinger Standard Software Development Kit® (SDK®) version 6.5 software. Results: The enamel surface of primary anterior teeth, the following enamel rod end patterns were detected and recorded—wavy branched (WB), linear branched (LB), linear unbranched (LUB), Whorl (W), loop (L), and stem-like (SL) patterns. WB was the only pattern that predominated all of the samples. Only WB and LB emerged as a single subpattern. The patterns LUB, L, W, and SL were never observed alone; rather, they were combined with two, three, or four other subpatterns, primarily WB and LB. Conclusion: In this study, six enamel rod end patterns were identified and recorded on the enamel surface of primary anterior teeth.

Aim: The aim of the present study was to compare the clinical and radiographic success of amniotic membrane derivative (AMD), chitosan with mineral trioxide aggregate (C-MTA), diode laser (DL), and ferric sulfate (FS) as pulpotomy agents in human primary molars. Materials and methods: In this present study, pulpotomies were performed on 48 primary molars in 30 children aged between 4 and 8 years (12 teeth in each group). Following the pulpotomy procedure, teeth were evaluated clinically and radiographically at 1st, 3rd, 6th, and 9 monthly intervals. Results: After 9 months of follow-up, the clinical success was 91.6% for AMD and C-MTA and 83.3% for DL and FS. Radiographic success was 91.6, 91.6, 75, and 83.3% for AMD, C-MTA, DL, and FS groups, respectively. There is no statistically significant difference between the four groups (p > 0.05). Interpretation and conclusion: Results of our study showed that both AMD and C-MTA were equally successful compared to traditional agents like laser and ferric sulfate as pulpotomy agents. Clinical significance: Amniotic membrane derivative (AMD) and C–MTA are alternative biomimetic pulpotomy agents that can be used in pediatric primary tooth pulpotomies.

Background: A major objective in the management of deep carious lesions involving proximal surfaces of primary molars is to control marginal leakage. This could occur due to dimensional changes or failure in the adaptation of pulp capping materials to the prepared cavity. Evaluation of microleakage is important for assessing the success of newer pulp capping materials. Introduction: Biodentine exhibits good sealing ability but possesses longer setting times and handling difficulties, which might delay the placement of the final restoration. The sealing ability of newer dual-cure calcium silicate-based material in TheraCal PT in class II cavities of primary molars is not known. Hence, the current study aimed to evaluate and compare the microleakage of Biodentine and TheraCal PT in primary molars. Materials and methods: Extracted, noncarious primary molars (n = 28) were collected, and standardized class II cavities were prepared and restored with Biodentine (group I) and TheraCal PT (group II). Following this type, IX glass ionomer cement (GIC) was placed and polished. Microleakage was assessed using the dye penetration method, and data obtained through stereomicroscopic analysis were statistically analyzed. Results: The mean microleakage score observed in group I was 2.0 ± 1.3 MPa, and in group II was 1.0 ± 1.1 MPa. Comparable sealing ability was observed between both groups (p = 0.061). Conclusion: TheraCal PT could be used as a suitable alternative to Biodentine for use in vital pulp therapeutic procedures in children to reduce the treatment time and improve sealing ability.

Aim: To evaluate the effectiveness of audiovisual (AV) aids in creating awareness of toothbrush hygiene. Materials and methods: This randomized trial study was conducted on 40 children aged 6–11 years. Children were given soft toothbrushes and then collected after brushing for 14 days. The toothbrushes were collected and sent to the laboratory for microbial culture evaluation. A questionnaire consisting of various questions regarding daily toothbrush hygiene practices was filled by the parents at the same time. After 14 days, brushes were collected, and the parents were shown an AV aid regarding toothbrush decontamination, parental awareness, and supervision. Those children were given new sets of toothbrushes and instructed to decontaminate them with chlorhexidine solution. After 14 days, the same questionnaire was filled out by the parents and toothbrushes were collected and immediately sent to the laboratory for microbial culture evaluation. Results: All the sampled toothbrushes had significant (p < 0.001) bacterial growth after 14 days of use. The use of disinfectant led to a 99.98% reduction in microbial colony counts. Hence, showed a significant result. Questionnaire analysis showed a positive parental approach toward maintaining toothbrush hygiene. Conclusion: Cleaning and disinfection of toothbrushes is crucial to stop the spread of disease since bacterial contamination cannot be 100% eliminated. AV aids can be effective tools for increasing awareness. Clinical significance: Through this study, we want to emphasize toothbrush hygiene and create awareness for the same through AV aid because a healthy toothbrush leads to healthy oral health.

Aim: The present study was conducted to compare three obturating materials—zinc oxide eugenol (ZOE), zinc oxide (ZO) powder with aloe vera gel, and Endoflas powder with aloe vera gel in primary molars. Materials and methods: The study was conducted on 45 primary molars with chronic infection. A total of 45 primary molars were divided into three groups of 15 each. Group I was obturated with ZOE paste, group II was obturated with ZO powder and aloe vera gel, and group III was obturated with Endoflas powder with aloe vera gel. Clinical and radiographic success and failure at 3, 6, and 9 months were evaluated. Results: A total of 15 molars in group I, 15 molars in group II, and 14 molars in group III showed clinical and radiographic success at the 9th-month follow-up. However, there was only one failure in group III during the 9th-month follow-up. Conclusion: It was concluded that all three groups showed promising results; ZOE is still considered standard material, whereas ZO powder with aloe vera gel can be used as an alternative to ZOE. Endoflas with aloe vera gel can also be used as an obturating material.

Background: The presence of melanin pigmentation of the gingiva has unfavorable effects on esthetics in children. Although there are several local and systemic factors that cause melanin pigmentation, they may also be induced by the stimulation of melanocytes by stimuli present in tobacco smoke. Aim: The aim of the study was to correlate the effect of parental smoking on the pigmentation of gingiva in children of Modinagar, Uttar Pradesh, India. Materials and methods: The study was a cross-sectional observational study. The study sample was formed by all children between 8 and 14 years of age. Only medically compromised children were excluded from the study. The children were examined for the presence of gingival melanin pigmentation. The status was recorded as present or absent. Determination of the smoking status of family members was done by a self-formulated questionnaire. Results: The presence of pigmentation was seen in 114 (82%) children, whereas pigmentation was absent in 26 (18%) children. Out of the total sample of 140 children, 95 had one or more family members who were smoking. The Chi-squared test performed to form an association between pigmentation and the type of tobacco used revealed high significance (p = 0.00) for the father who smokes bidi. Conclusion: There is a correlation between parental smoking and melanin pigmentation in the gingiva of children, and the correlation is very high when the father is a smoker, especially when he smokes bidi.

Introduction: The primary intent of this scientific research is to effectively assess and collate the inherent potentiality of the two selected investigative composite materials in effectual maintenance of their standard color following subsequent and consistent submersion in customary available pediatric liquids consumed by children. The above investigation will be effectively estimated using the Commission Internationale de IEclairege (CIE) L*a*b* system-based spectrophotometer. Materials and methods: A total of 100 composites of spheroidal plates were fabricated accordingly. A total of 50 nanohybrids and microhybrids of 8 × 2 mm were fabricated and timely cured using a light cure unit for an approximated time period of 40 seconds. This was then trialled by subsequent sample submersion in the specified five immersive media, which include mineral water, tea, Mirinda, pomegranate juice, and iron syrup, respectively, for a definitive and habitual time of thrice daily up to 15 minutes for a duration of 28 experimental days. The respective marked readings were recorded on the 7th, 14th, 21st, and 28th days by utilization of a CIE L*a*b* system-based spectrophotometer. Results: Mann–Whitney U test and Friedman's Test were utilized for statistical evaluation of the above-described experimental research. The p-value was statistically found to be significant at (p < 0.001). Conclusion: The conclusive findings from the above-defined experimental research were that iron syrup was found to cause the most noticeable and definitive staining in comparison to other immersive media. Nanohybrid composite restorative material was hence identified as being highly resistant to staining and possessing an undeniable ability to maintain the persistent color, unlike its microhybrid counterpart. Clinical significance: The esthetic appearance is an important factor for both the parents and children; hence, this determines that the longevity of color stability of restorative materials is of valid significance.

Introduction: Mandibular fractures in children, when compared to adults, are quite less common. Treatment approaches for mandibular fracture differ in children due to their growth and developing dentition. Minimal manipulation of bony architecture is done to achieve a stable position. Case description: An 8-year-old girl with right-side condylar fracture with dislocation reported to the emergency trauma unit, Post Graduate Institute of Dental Sciences, Rohtak. Result: The case was well managed by a conservative approach whereby orthodontic treatment along with guiding elastics was used in the reduction of unilateral condylar fractures.

Background: Ewing sarcoma (ES), a rare malignancy, comprises whatever the age, 4–15% of all primary bone tumors. It represents 1% of all malignant tumors in children and is the fourth most common bone malignancy after myeloma, osteosarcoma, and chondrosarcoma. Case description: A 12-year-old boy came to the Oral Surgery Department of Bretonneau Hospital referred by his dentist with a rapidly evolving swelling in the left mandibula for 6 weeks, which was initially diagnosed as a facial cellulitis. Cone beam computed tomography (CBCT) showed a poorly defined, expansile, and osteolytic tumor on the left side of the mandible. Clinical and radiographic findings were in favor of an aggressive primitive bone tumor. A mandibular biopsy under general anesthesia was performed in the Department of Surgical Oncology at Institut Curie in Paris, revealing an ES. Conclusion: Mandibular ES can mimic dental infections when swelling is the main clinical manifestation, which can lead to a delayed diagnosis. A correlation between clinical, radiological, histopathological, and immunohistochemical with cytogenetics is needed to confirm the diagnosis. Moreover, smaller tumors have better survival. Dentists must therefore be aware of the clinical signs of ES in order to quickly refer patients to a specialized department.

Premature loss of primary teeth in children may lead to space loss in the arch, which leads to the collapse of vertical and horizontal occlusal relationships in primary and permanent dentitions. The ideal method to preserve the space in the arch in such a scenario is to use a space maintainer appliance. Conventionally, band and loop space maintainers are the most commonly used space maintainers. However, these are associated with certain drawbacks, such as multiple appointments and extended time for fabrication. A novel invention in the form of prefabricated bands and loops has been made to offset these disadvantages. Placement of prefabricated bands and loops decreases the chairside time and omits multiple visits, hence aiding in better behavior management for the child. The present case series discusses five cases of prefabricated band and loop placement in pediatric patients.

Having just one root canal in a primary mandibular first molar is an extremely unusual congenital defect. One possible cause of this odd root shape is the invagination of Hertwig's epithelial root sheath (HERS) failing. A pediatric dentist may successfully provide root canal therapy by drawing on extensive knowledge of root canal evaluation, morphological and anatomical differences of primary teeth, and other relevant topics. Herein, we detail the treatment of a singular root, single canal primary mandibular first molar that presented with a unique morphology. The patient underwent pulpectomy, obturation, and restoration.

Tuberculosis (TB), also known as Koch's disease, is a chronic granulomatous disease typically caused by Mycobacterium tuberculosis (M. tuberculosis). On 24^th March 1882, Dr Robert Koch discovered M. tuberculosis that caused TB. In humans, M. bovis and atypical mycobacterium may also cause this disease. According to the World Health Organization (WHO) Global Report 2022, published on 27^th October 2022, the incidence of TB in India for the year 2022 is 210/100,000 population. Primarily, TB affects the pulmonary region in humans, whereas secondarily, it may affect extrapulmonary sites such as the bones and intestines via lymph nodes. In this article, we are reporting a rare case of tubercular osteomyelitis of the mandible, in which the patient reported swelling of the cheek, mimicking an odontogenic infection that led to mandibular osteomyelitis. The definitive diagnosis of tubercular osteomyelitis was made by cartridge-based nucleic acid amplification test (CB-NAAT) when the cheesy material was found during surgical debridement and curettage of the mandible. Following that diagnosis, antitubercular treatment (ATT) was started immediately for the patient, which led to the complete resolution of the disease. The patient has been on regular follow-up for the last six months with no evidence of relapse of disease. Primary TB of the mandible is very rare, with only a few reported cases in the literature.

This article reports an infant presented with multiple congenital abnormalities, which is considered a rare case. A 2-month-old girl presented with cleft palate, lobulated tongue, frontal bossing, postaxial polydactyly of hands, and other clinical manifestations involving oral, facial, and digital malformations. Hence, a provisional diagnosis of oral-facial-digital syndrome (OFDS), a rare genetic disorder, was contemplated. A genetic test was undertaken, and a confirmatory diagnosis of OFDS type-V (Thurston syndrome) was made. A brief description of the case and literature review of OFDS, including various aspects like etiology, inheritance, clinical features, and management, are discussed here.

Seckel syndrome, also commonly called Seckel dwarfism, is a rare congenital disorder and always associated with severe growth retardation in utero. This retarded growth lingers on and causes serious developmental deformities ensuing to short stature, microcephaly, mental retardation, and a beak-like nose. This case report intends to present an interesting case of a 14-year-old female patient with various clinical manifestations, typical radiographic features, and characteristic dental manifestations correlated with the literature. A detailed understanding of the present case would assist pediatric dentists in correct and prompt diagnosis, precise treatment, and the prevention of severe consequences caused by Seckel syndrome.

This article aims to describe purposeful reimplantation and inflammatory fibrous hyperplasia cases caused due to poor dental health and malpositioning of teeth. A 17-year-old male patient was referred to a dental specialty hospital for soft tissue growth in the lower anterior tooth region. Anamnesis and clinical examination revealed that tooth #31 was severely hypoplastic. A surgical procedure and purposeful reimplantation were carried out, and a histological examination revealed inflammatory fibrous hyperplasia. During the follow-up appointments, it was feasible to see progress and the patient's satisfaction. Despite the low occurrence of inflammatory fibrous hyperplasia, it is important to note that tooth positioning outside of its normal alignment in the arch can contribute to plaque and calculus accumulation, which can then become etiological factors for inflammatory fibrous hyperplasia. As a result, dentists must be attentive in order to establish a diagnosis and therapeutic therapy as well as monitor these instances.

Aim: This systematic review was designed to compare the clinical effectiveness of high-viscosity glass ionomer cement (HVGIC) restorations to direct composite resin (CR) restorations in single- or multisurface cavities in primary teeth. Background: Restorative procedures are typically used to treat caries in primary teeth. Due to their improved preservation of the natural tooth structure and their adhesion to the remaining tooth structure, CR and GIC have drawn attention as the preferred restorative materials. In the literature, over the past 20 years, the term HVGIC has developed. Compared to C-GICs, HVGICs appear to have a higher survival rate. However, isolated studies provide contradictory findings regarding the durability of restorations in primary teeth. Materials and methods: Major electronic databases were thoroughly searched to find publications from the years 2000 to 2021. Studies included were randomized and nonrandomized clinical trials on children aged 3–13 years, in which restoration of primary teeth using HVGIC and CR was performed. Results: This systematic review includes four studies [three randomized controlled trials (RCTs) and one nonrandomized controlled trial]. No statistically significant difference between these materials was seen in any of the included studies. Conclusion: This systematic review of findings supports the assertion that both HVGIC and CR restorations deliver satisfactory outcomes in terms of clinical efficacy and overall survivability. It was found that, for both materials, class I restorations had statistically higher survival rates than class II restorations. Long-term studies are essential to evaluate the clinical efficacy of both restorations. Clinical significance: This systematic review outlines the application of HVGIC and CR as restorative materials for pediatric dentists to use in their everyday dental practices.

Despite a large number of trials conducted on the use of herbal oral care products to reduce dental plaque or gingivitis, the results are conflicting and inconclusive. This systematic review aimed to evaluate the effectiveness of herbal dentifrices in caries prevention in children and adolescents and to ascertain the potential of herbal dentifrices to remineralize white spot lesions, reduce halitosis, and improve gingival and periodontal health in children with special healthcare needs (SCHN) and among orthodontic patients. A comprehensive search was designed and conducted using several databases. The articles were independently screened for eligibility by two reviewers. Seven of the 6,940 studies were found to meet the eligibility criteria. A meta-analysis showed that for bacterial scores, the standard mean difference was estimated to be 0.6 [95% confidence interval (CI): −0.78, 1.99] and was statistically insignificant (p = 0.39). Herbal dentifrice is evidenced as equally effective in reducing bacterial count and altering bacterial plaque when compared to nonherbal dentifrices within the confines of the included studies. To verify the definitive use of herbal dentifrices for daily use, further research, including randomized controlled trials (RCT) of sufficient quality, would be recommended.