Introduction: The imbalance between remineralization and demineralization leads to the formation of secondary caries. Fluoride-releasing ability has been the characteristic property of glass ionomer cement (GIC), but it is uncertain if this property alone will be sufficient for the cessation of the growth of the organisms. Therefore, a restorative material with additional bacteriostatic properties needs to be introduced. Aim: To evaluate the microhardness and solubility of the conventional GIC after adding different combinations of antibiotic powders. Materials and methods: In this study, the three groups were conventional GIC (group I), GIC + metronidazole + ciprofloxacin (group II), and GIC + metronidazole + amoxicillin/clavulanic acid (group III). The concentration of the double antibiotic combination was maintained at 1.5% w/w. The antibiotic powders were added to the GIC and evaluated for microhardness and solubility of the specimens. Results: The mean microhardness level of group II was the highest, which was statistically significant using analysis of variance (ANOVA) with a p-value of 0.022. The comparison of each group's solubility in different solutions was not statistically significant. Conclusion: Along with the conventional properties of GIC, an additional therapeutic gain can also be obtained by incorporating various combinations of antibiotics, thereby arresting the progression of caries at the site of infection itself. Clinical significance: This new approach shall help in community health programs, where treatment of a large population needs to be done within a short span of time and arrest the progression of caries activity in deep caries.

Background: It is difficult to completely eradicate microorganisms from the infected root canal system. Intracanal irrigants seem necessary for eradication of infected tissues and microorganisms in addition to mechanical debridement. Continuous use of chemical antimicrobial agents leads to serious side effects. Therefore, the need arises for alternative agents to overcome the disadvantages of their chemical counterparts. Aim: To evaluate and compare the antimicrobial efficacy of three endodontic irrigants against clinically isolated bacteria found in root canals containing necrotic pulp. Materials and methods: Preirrigation sample were collected using sterile paper points and sent for microbial count. Chemomechanical preparation was performed, and the root canals were irrigated with 5 mL of test samples. After 3 days, the patient was recalled, and a postirrigation sample was collected and sent for microbial count. Result synthesis: Both 3.8% silver diamine fluoride (SDF) and 3% sodium hypochlorite (NaOCl) showed a superior capacity to sterilize the root canals compared to the neem group. Conclusion: The use of SDF as an endodontic irrigant is feasible as it effectively removes the microbes present in the canal. Clinical significance: Silver diamine fluoride has not been shown to be cytotoxic or carcinogenic, unlike NaOCl, suggesting it could be used as a potential endodontic irrigant. However, few studies have evaluated the antimicrobial efficacy of SDF as an endodontic irrigant.

Aim and objectives: The current study is aimed to evaluate the antimicrobial and remineralizing properties of toothpaste containing nanosilver and nanohydroxyapatite (NH-NS TP). Materials and methods: The toothpaste was prepared by incorporating NH-NS TP into a toothpaste base. Following this, a physicochemical analysis of the prepared toothpaste was carried out. The toxicity against human gingival fibroblast (HGF-1) cells was assessed. The antimicrobial activity of the toothpaste was evaluated against Streptococcus mutans and Escherichia coli using the disk diffusion method. Subsequently, 15 selected human premolar teeth extracted for orthodontic purposes were used to measure the remineralization potential. The surfaces of the selected teeth were demineralized using a prepared demineralizing solution [323.4 mg of calcium chloride (CaCl₂), M450 µL of calcium acetate (CH₃COO)₂Ca, 300 mg of potassium dihydrogen phosphate (KH₂PO₄) at pH 4.4–4.7] for 72 hours and were subjected to a toothbrush simulator applying the prepared toothpaste. The remineralization potential was evaluated by measuring the microhardness of the enamel surface before and after treatment with the toothpaste. Further, the remineralization potential was assessed based on scanning electron microscopy (SEM) imaging accompanied by energy-dispersive X-ray spectroscopy. Results: The results showed that the NH-NS TP had significantly greater antimicrobial activity compared to the control toothpaste and no toxicity against HGF-1 up to 40 µg. Approximately, 7–9 mm inhibition zone against S. mutans and 4–6 mm inhibition against E. coli was achieved. Additionally, the toothpaste significantly increased (31.4%) the microhardness of the enamel surface, indicating its potential for remineralization. The SEM images revealed the presence of regular deposits, mostly pertaining to the demineralized spots, resulting in a regained smooth surface. Following this, physicochemical analysis of the prepared toothpaste was carried out, resulting in a pH of 7.38 and showing good extrusion, frothing, and organoleptic properties. Additionally, the toothpaste significantly increased the microhardness of the enamel surface, further indicating its potential for remineralization. Conclusion: NH-NS TP may provide a promising approach for improving oral health by enhancing antimicrobial efficacy and promoting enamel remineralization, while exhibiting reduced toxicity.

Isolation plays an important role in dentistry. It is mandatory to maintain isolation during various dental treatments. A simple new isolation tool (intraoral cheek and lip retractor mouth opener tool) is available, which is a multipurpose tool. The need for the study was to evaluate the functionality of the new isolation tool. Aim: The aim of the study was to compare the traditional isolation method with the new isolation tool. A questionnaire pattern was adopted for the present study. The study was then conducted to evaluate the patient acceptability and ease of access for the operator. Materials and methods: A total 200 pediatric patients were included in the study; they were divided into two groups. Group I—isolation with the new isolation tool, group II—isolation with cotton rolls and a mouth mirror. A structured questionnaire was given to the operators to evaluate the ease of use of the new isolation tool. A Likert scale was provided to the patients to evaluate the comfort of the new isolation tool during various treatments. Result: Statistical analysis shows significant results by obtaining the p-value < 0.05. Conclusion: The study clearly shows that the new isolation tool is a better option in terms of retracting soft tissue, keeping the mouth open, and maintaining isolation. Clinical significance: This new tool helps in the retraction of soft tissue as well as isolation, and it also keeps the mouth open.

Objectives: To clinically and radiographically compare the outcomes of pulpotomy with mineral trioxide aggregate (MTA) and human amniotic membrane (HAM) in primary molar teeth at 1, 3, 6, and 12 months. Materials and methods: The study was a randomized clinical trial with two arms. One arm consisted of participants whose pulpotomy was conducted using MTA, called group I, and the other arm, using HAM, was designated group II. Results: Both MTA and HAM exhibited 100% clinical success. Also, there were no signs of external resorption, periapical bone destruction, or internal resorption in both the MTA and the HAM groups at all four time intervals in this study. However, periodontal ligament widening was seen in 30% of the participants in the MTA group at 1-month and at the 12-month follow-up, whereas in the HAM group, periodontal ligament widening was found to reduce significantly from 22.2% at 1-month to 11.1% at the 12-month follow-up. Conclusion: The HAM exhibited favorable clinical and radiographic outcomes in the present study. Clinical significance: Mineral trioxide aggregate is the most preferred choice as a pulpotomy agent for deciduous teeth. However, various drawbacks associated with MTA have been fueling the need for newer, effective agents. HAM is not only easily available, cost-effective, and easy to handle but also favors tissue regeneration. The positive outcome of the present study strongly advocates the use of HAM as an alternative to MTA for pulpotomy in primary teeth.

Aims and background: Evaluation of the effects of different chelating agents on the calcium loss of root canal dentin. Materials and methods: Around 65 single-rooted teeth were collected and decoronated. The working length was determined, and biomechanical preparation was done in a crown-down fashion using the HyFlex Control Memory rotary nickel-titanium (Ni-Ti) system until apical preparation of 30.04. Canals were irrigated with chelating agents and sodium hypochlorite between each file insertion. Based on the type of chelating agents used, the samples were randomly divided into five groups (n = 13)—group I, liquid ethylenediaminetetraacetic acid (EDTA); group II, EDTA and chlorhexidine (CHX); group III, etidronic acid; group IV, SmearClear; and group V (control), distilled water. The total volume of the solution used was collected, and calcium ion release was quantified using an atomic absorption spectrophotometer. The qualitative analysis was done by observing the acetylene (C₂H₂)/air flame. Images were obtained for each sample, compared, and analyzed. Results: With respect to the control group, groups IV and I show a statistically significant difference compared to groups II and III (p < 0.05). Qualitatively, the highest intensity was observed in group IV and the least intensity in group III. Conclusion: SmearClear showed significantly higher decalcifying capability compared to EDTA, EDTA and CHX, and etidronic acid. Hence, its combined use with an organic solvent can be recommended for efficient smear layer removal. Clinical significance: Minimally invasive endodontic treatment is aimed at preserving the strength of the treated tooth without compromising cleaning effectiveness. Therefore, comparing the efficacy of different chelating agents will be promising with respect to maximum calcium loss both qualitatively and quantitatively.

Aim and background: This study aimed to assess the efficacy of root canal debris removal in primary teeth through irrigation using the Endo-Irrigator Plus (CWAIS). Materials and methods: A total of 25 primary mandibular first molars were divided into five groups, with five teeth in each group. After determining the working length and performing biomechanical preparation, groups I and II were subjected to hand and rotary instrumentation (ProTaper, Dentsply, United States of America) with conventional syringe irrigation with positive pressure, while groups III and IV were instrumented using hand and rotary instrumentation with positive and negative pressure irrigation employing the Endo-Irrigator Plus (CWAIS) system. Sodium hypochlorite (5.25%) and ethylenediaminetetraacetic acid (EDTA) (17%) were used as irrigants. Group V served as the control group, undergoing only root canal access opening. The removal of the smear layer was analyzed at the cervical, middle, and apical thirds of the canal using environmental scanning electron microscopy (SEM). Statistical significance was set at p < 0.05. Results: Statistically significant differences were observed among all groups at the cervical, middle, and apical levels (p < 0.05). Groups III and IV exhibited significantly lower smear scores at all levels, particularly in the apical third, as observed through SEM examination. Conclusion: The use of the Endo-Irrigator Plus (CWAIS) system demonstrated superior debridement of intracanal debris in primary teeth compared to the positive pressure irrigation method.

Introduction: Mandible positioning can cause global postural adaptations. Physiotherapists and dentists try to relate the mandible position and chewing side to plantar support; however, this indication is uncertain. Objectives: To check the existence of a relationship between mandible position, preferred chewing side, age, and plantar support in children. Materials and methods: This is a cross-sectional study with 93 children, aged between 4 and 11 years. Photogrammetry was used to confirm the mandibular positions (centralized, to the right, and to the left), and baropodometry was used to measure plantar support. The mandibular displacement distance to the right and left was evaluated, and the plantar support in the three mandibular positions was compared as a function of age (4–7 and 8–11 years) and preferred chewing side. Results: There was greater mandibular displacement in left laterality [13 (9–19) cm] compared to right laterality [7 (3.50–12.00) cm] (p < 0.01). Mandibular position did not alter mean pressure, maximum pressure, or plantar support surface (p > 0.05). With the mandible centralized, higher mean pressure, maximum pressure, and surface area were observed in the left foot (p < 0.01). Older children showed greater mandibular displacement to the left (p < 0.01). No differences were observed for the variables of plantar support as a function of age (p > 0.05) and chewing side (p > 0.05). There was a moderate to strong correlation between age, body mass, height, and plantar surface area (0.63 < r < 0.83; p < 0.05) and between mean and maximum pressures of plantar support (0.58 < r < 0.89; p < 0.05). Conclusion: Mandibular position, age, and preferred chewing side do not influence plantar support in children.

Background: Traumatic injuries are the most disruptive and distressing emergencies and pose a challenge for dental professionals because many different treatment protocols are currently available. They also affect the social and psychological well-being of children. A multidisciplinary approach is involved in the management of traumatic dental injuries to maintain function and esthetics. The aim of this study was to evaluate the fracture resistance of a reattached tooth fragment kept in four storage media, namely Hank's balanced salt solution (HBSS), Tooth Mousse, ginger honey, and probiotic yogurt, for 1, 6, and 24 hours. Materials and methods: The study consisted of 84 intact maxillary central incisors. All the teeth were stored in distilled water until used and were embedded in acrylic molds, 1 mm below the cervical end. The teeth were then sectioned to simulate an uncomplicated crown fracture (Ellis class II fracture), and all the teeth were randomly divided into four groups of 21 each. The teeth were then reattached using Tetric N Universal bonding agent and Tetric N Flow flowable composite. Fracture resistance was assessed using a universal testing machine. Statistical analysis was done using a one-way analysis of variance (ANOVA) test and a post hoc Tukey test. Results: The results showed that fracture resistance was highest in the Tooth Mousse group at 6 and 24 hours. Ginger honey exhibited the highest fracture resistance at 1 hour, whereas the probiotic yogurt group showed the lowest values. Conclusion: It was concluded that Tooth Mousse was the best storage medium for storing tooth fragments. Ginger honey can also be used as an alternative storage medium as it is easily available and inexpensive.

Aim and background: The Hall technique preformed metal crowns (HT-PMCs) are allegedly oversized, temporarily altering inter-arch relationships. Intra-arch dimensions and leeway space (LWS) HT effects are unknown. Aim: To study single HT-PMC intra-arch effects and treated tooth dimensional changes. Materials and methods: Split-mouth, quasi-experimental, non-randomized feasibility pilot study. Intraoral scans (iTero II®) were taken preorthodontic separator placement (scan¹), immediately post single HT-PMCs (scan²) in 13 children, and 1 month later (scan³) in eight children. Control and study quadrants’ lengths (“arcs”) and HT-PMCs/control tooth dimensions [mesiodistal (MD), buccopalatal/lingual (BP/L), diagonal (Diag1/Diag2)] were recorded in mm (OrthoCAD® software). Paired t-test, repeated analysis of variance (ANOVA) post hoc analysis statistics (p < 0.05). Results: Compared to scan¹, the mean study arc increased by 0.7 mm (±0.5) (n = 13, t-test, p < 0.001) at scan², while at scan³, it increased by 0.8 mm (±0.34) (n = 8, repeated ANOVA, p = 0.008). The HT-PMCs-treated tooth mean dimensions increased at scan² by 0.9 mm (MD), 0.8 mm (BP/L), 0.5 mm (Diag1), and 0.7 mm (Diag2) (t-test, p < 0.001) with similar observations at scan³. There were no significant changes in the control arc or the control tooth measurements. Conclusion: One single HT-PMC increased the intra-arch quadrant length by approximately up to <1 mm. The HT-PMC-treated tooth was marginally oversized. This pilot study paves the way for a more robust study with a larger sample size.

Aim and background: Silver-modified atraumatic restorative treatment (SMART) can be an alternative method for molar incisor hypomineralization (MIH)-affected cases. The purpose of this study was to assess whether tooth location and cavity preparation affect the clinical success of MIH-affected permanent molars treated with the SMART technique. Materials and methods: Modified United States Public Health Service criteria were utilized for the analyzes. The clinical records (3, 6, and 12 months) of 19 MIH-affected cases (6–12 years; no spontaneous pain and percussion/palpation sensitivity) treated with the SMART technique were assessed. The groups were allocated based on tooth location (mandibular-maxillary) and cavity preparation (class 1–2). The Fisher exact the Chi-squared test was utilized, and the p-value < 0.05 was accepted as statistically significant. Results: Overall success rates were 94.7% at 3 and 6 months and 52.63% at 12 months. Clinical success did not differ statistically regarding location (p > 0.05). The class 1 cavity preparation group was found to be significantly more successful at the 12-month assessments (p = 0.033). Conclusion: The class of cavity preparation may affect the success of the treatment in long-term assessments. The SMART technique, especially in class 1 occlusal restorations, can be recommended as a short-term alternative to traditional treatment methods for MIH-affected cases.

Background: Genetic predilection toward sweeter cariogenic foods mediated by the TAS2R38 gene, tested by phenylthiourea [phenylthiocarbamide (PTC)] compounds. Some individuals find it extremely bitter whereas some find it completely tasteless, being classified as a taster and a nontaster respectively. A majority of nontasters prefer foods with sweeter and stronger flavors, thus making them more susceptible to dental caries. Genetic taste perception is greatly influenced by prenatal androgen exposure represented by hormonal fingerprint, that is, ratio of second to fourth digit lengths (2D:4D ratio), thus making it a precise biomarker to quantify an individual's genetic taste perception and in turn their caries susceptibility. Aim: To find a correlation of genetic taste perception with the hormonal fingerprint and dental caries prevalence in children. Materials and methods: A total of 96 children were selected at random for the study and divided into two groups based on their gender. A genetic taste perception test was carried out using PTC strips, and they were classified as tasters and nontasters. Then, the hormonal fingerprint was recorded by calculating the ratio of the index finger and ring finger. Following this, decayed, missing, and filled teeth index (DMFT) was recorded. Results: A strong positive correlation was observed among nontasters, with a preference for sweeter foods associated with a high caries index. Conversely, no relationship was found between genetic taste perception and the hormonal fingerprint. Conclusion: The present study positively demonstrates an association of genetic taste perception and dental caries due to an increased preference for sweeter foods among nontasters. Although no correlation was found between the genetic taste perception, the hormonal fingerprint, and the dental caries status of an individual.

Background: Space maintainers (SMs) are used to preserve the space created by premature loss of primary teeth. The most commonly used is the band and loop (B&L) SM. As this SM has several drawbacks, such as poor esthetics and gingival health, laboratory procedures for fabrication, and multiple seating procedures, various bonded SMs were introduced. This study aims to compare the shear bond strength of bonded SMs using ormocer, nanofilled, and short glass fiber-reinforced adhesive composites with the conventional B&L SM luted with type I glass ionomer cement (GIC). Materials and methods: Sixty intact extracted primary molars were randomly divided into four groups (n = 15). In group I (control), conventional B&L SMs were luted with type I GIC, whereas ormocer, nanofilled, and glass fiber-reinforced composites (GFRC) were used to bond the SMs in groups II, III, and IV, respectively. Shear bond strength of all the specimens was analyzed using a universal testing machine, and the obtained data were subjected to statistical analysis. Results: The highest shear bond strength, that is, 68.82 ± 16.81 MPa, was exhibited by GFRC, followed by 51.04 ± 23.28 MPa with nanofilled composite, 45.3 ± 18.27 MPa with ormocer, and the least in the control group, that is, 42.17 ± 17 MPa. Conclusion: Glass fiber-reinforced resin composite has better resistance against shear force than the other three study materials, and this was significantly higher (p = 0.001) than conventional B&L SMs.

Beckwith–Wiedemann syndrome (BWS) is a genetic disorder characterized by disrupted genomic imprinting, leading to abnormal regulation of fetal growth. BWS can present at any stage of life; it is most commonly diagnosed during the neonatal period or early childhood. The cardinal features of the syndrome include macrosomia, macroglossia, abdominal wall defects, and hyperinsulinism. We have discussed the case report of a 2-year-old female patient who was diagnosed with BWS at the time of birth, with a chief complaint of a large tongue and difficulty in deglutition. We have also discussed the systemic, orofacial, and dental manifestations along with comprehensive treatment planning to aid in living an overall healthy life. Early diagnosis helps in preventing further complications of the disease and acts as a guide for future treatment planning. Dentists can provide guidance on proper oral hygiene practices, offer interventions to manage macroglossia, and collaborate with other healthcare professionals to address craniofacial abnormalities and associated functional limitations.

Aim and background: Upper canines are the second most common teeth involved in impaction after the third mandibular molar. Accurate diagnosis at an appropriate age is important to reduce complications of the impacted tooth and its adjacent teeth. We present a case of early detection of an impacted left maxillary canine, which allowed spontaneous eruption through arch expansion. Case description: An 11-year-old patient was referred for monitoring of an unerupted left maxillary canine. The tooth was palpable labially, but there was a lack of space for an eruption for the tooth, with 2 mm of discrepancy as assessed using the Tanaka and Johnston space analysis method. The patient had generalized gingivitis, multiple carious teeth, and dens evaginatus of upper incisors. An orthopantomogram (OPG) confirmed the clinical findings and impaction of the tooth. Localization of the tooth was done using the parallax technique with the addition of an intraoral periapical radiograph (IOPA). The tooth was in line with the arch. Due to this favorable position, an upper removable appliance (URA) with an acrylic plate, metal clasps on the upper first molars and premolars, and an expansion screw in the midline was constructed for the patient. The patient activated the screw with a weekly quarter turn. Preventive and caries management strategies were done simultaneously. The impacted left maxillary canine erupted after 10 months of using the URA. Conclusion: Due to the high plasticity of bone structures in a growing child, interceptive orthodontic treatment using removable appliances works well. The impacted left maxillary canine erupted in place after 10 months of using the URA without the need for surgical or fixed orthodontic treatment. Clinical significance: Early detection of impacted teeth in a growing child is important in order for us to intervene in the problem at an earlier stage to avoid further complications.

Objectives: The case report highlights the management of late-stage sequelae of preeruptive intracoronal resorption (PEIR) with molar incisor hypomineralization (MIH). Materials and methods: A 9-year-old patient presented with occlusal cavitations in her upper and lower permanent molars with vascularized tissue seen within the dentin, without any connections with the dental pulp, and no evidence of carious activity within the lesion. The affected teeth were debrided, and Biodentine™ was placed to preserve the vital pulp. The permanent molars were restored with Hall crowns, and the case was followed up for 2 years. Results: The patient remained asymptomatic throughout the follow-up period. The resulting increase in the bite following the placement of the Hall crown settled within 2 months. Pulp vitality was preserved, and no further resorptive activity was seen in the dentition. Conclusion: Preeruptive intracoronal resorption may go unnoticed and may later present with late-stage manifestations. Patients with PEIR and MIH may end up with an exposed resorptive lesion due to posteruptive breakdown, which may be managed conservatively using Biodentine™. Clinical significance: Resorptive lesions can be conservatively managed without compromising pulpal health. Their early detection and differentiation from dental caries can prove pivotal in the preservation of the affected teeth.

Aim: This case report aims to describe a rare congenital lesion of the incisive papilla with a high labial frenulum attachment, clinically mimicking congenital epulis but histopathologically diagnosed as an oral leiomyomatous hamartoma. Background: Oral leiomyomatous hamartoma is a very rare congenital lesion, mainly appearing on the median anterior maxilla/incisive papilla and tongue. Case description: This clinical paper is about a rare lesion in a 6-year-old female child whose parents reported to the department with the complaint of slow-growing soft tissue overgrowth between the front teeth of the upper jaw, present since birth. The soft tissue growth is now causing difficulty in biting food and is visible during smiling and speaking, causing an esthetically unpleasing appearance. The clinical examination also revealed a high labial frenulum attached to the lesion. The lesion was provisionally diagnosed as congenital epulis based on the clinical picture. However, after excisional biopsy and histologic evaluation with special stains, the lesion was finally diagnosed as leiomyomatous hamartoma. Conclusion: Surgical excision of the lesion followed by frenectomy was performed with no postoperative complications. Clinical significance: Owing to the rare occurrence and nature of mimicking congenital epulis, it is important for a dental practitioner to have knowledge about these types of lesions. The final diagnosis of such lesions can only be made after histopathological evaluation using special stains. This case report describes the clinical and histopathological features of a rare leiomyomatous hamartoma of the incisive papilla, along with high frenulum attachment and its management.

Odontomas are the most common odontogenic tumors and are classified into compound and complex types. They result from a combination of odontogenic epithelium and ectomesenchyme. Complex odontomas frequently occur in the posterior mandible, whereas compound odontomas are more commonly found in the anterior region of the maxilla. Due to their small size and asymptomatic nature, odontomas are often diagnosed incidentally. Typically, odontomas are <3 cm in diameter; those exceeding this size are classified as giant odontomas and may present with extraoral swelling. This case report documents an unusual instance of a giant compound odontoma, containing 156 denticles, in a 15-year-old girl. Despite the odontoma's large size in the mandibular anterior region—an uncommon site for compound odontomas—the patient was completely asymptomatic and presented with only intermittent pain in the lower right back tooth region over the past month. The denticles were extracted, and intentional root canal treatment was performed on teeth 41, 42, 31, and 32 under general anesthesia.

Myofunctional trainer for kids (T4K, Myofunctional Research Co., Australia) is a prefabricated, single-size functional appliance that claims to correct malocclusion at an early age by acting on muscular dysfunctions and repositioning the mandible in a forward direction. Myofunctional therapy through the Trainer System™ was implemented in this case for the treatment of class II malocclusion in mixed dentition. The results showed that an early approach in selected cases, taking into account patient preferences and compliance, is possible and could be considered in treatment planning and relevant future research.

Three-dimensional (3D) scanning and printing in the field of pediatric dentistry is an augmented reality that has several clinical implications and advantages. The aim of this current short communication and technical note is to discuss the possibility of various shortcomings of the current intraoral scanning and 3D printing and the various limitations a clinician can face.