International Journal of Clinical Pediatric Dentistry

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2012 | January-April | Volume 5 | Issue 1

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Usha Mohan Das

Sealing in Caries in Primary Molars? Healing redefined?

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/ijcpd-5-1-v  |  Open Access |  How to cite  | 



Prasanna T Dahake, OS Raju, N Basappa

Fluoride: Is It Worth to be added in Pit and Fissure Sealants?

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:5] [Pages No:1 - 5]

Keywords: Dental caries, Pit and fissure sealants, Fluorides

   DOI: 10.5005/jp-journals-10005-1125  |  Open Access |  How to cite  | 


Background and objectives: Fluoride is being used for the prevention of dental caries since a long time. Incorporation of fluoride in pit and fissure sealants has been found to reduce initiation and progression of pit and fissure caries. Authors conducted this study to evaluate and compare the effect of fluoride releasing pit and fissure sealants on the inhibition of demineralization of adjacent enamel and to reduce wall lesion frequency. Materials and methods: A total of 60 caries-free human third molars were randomly assigned into three groups receiving conventional resin sealant without fluoride (Group A), fluoride releasing resin sealant (Group B), glass ionomer pit and fissure sealant (Group C). Fissure cavities of 5 × 2 × 1.5 mm were prepared on buccal surfaces of teeth using fissurotomy bur and sealants were applied onto the cavities. The teeth were then thermocycled and exposed to acidified gelatin gel for 6 weeks to induce caries like lesions. A 150 μm section was taken from each tooth and observed under polarized light microscope to measure the depth of advancing front of outer enamel lesion. The outer lesion depths of all three groups were compared. Results: Enamel demineralization was least in glass ionomer pit and fissure sealant while the demineralization exhibited by nonfluoridated resin and fluoridated resin were comparable. Wall lesion frequency was found to be 0% in all groups. Conclusion and interpretation: The glass ionomer pit and fissure sealant exhibited highest anticariogenic efficacy and hence can be advocated as a means of preventing dental caries.



N Ratnakumari, Bijimol Thomas

A Histopathological Comparison of Pulpal Response to Chitra-CPC and Formocresol used as Pulpotomy Agents in Primary Teeth: A Clinical Trial

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:8] [Pages No:6 - 13]

Keywords: Pulpotomy agent, Sree Chitra-Calcium Phosphate Cement, Formocresol

   DOI: 10.5005/jp-journals-10005-1126  |  Open Access |  How to cite  | 


Preventive measures have helped to minimize the occurrence of dental caries. However, premature loss of primary teeth on account of dental caries still remains a common problem among children. The pulpotomy technique has been the choice for treating vital primary and young permanent teeth with carious, mechanical and traumatic pulp exposures. The ideal pulpotomy medicament should be bioinductive or at least biocompatible, bactericidal and harmless to the pulp and surrounding structures. It should also promote healing of the radicular pulp and prevent bacterial microleakage with the least interference in the physiological process of root resorption. Since the best criteria for judging the effectiveness of a medicament when used for vital pulp therapy is the response that it produces in the pulp. The purpose of the present study was to evaluate and compare the response of human pulp tissue to recently developed Indian material, Sree Chitra-Calcium Phosphate Cement (Chitra-CPC) and formocresol, used as pulpotomy agent in deciduous teeth. Chitra-CPC has been compared with formocresol, taking into account that formocresol is still considered the gold standard in primary tooth pulpotomy. The study was conducted among 10 children in the age group of 8 to 12 years focusing on 20 noncarious primary canines indicated for serial extraction. Each patient received two different pulpotomy procedures—one in each of the primary canines using formocresol and the other with Chitra-CPC as pulpotomy agents. After 70 days, the teeth were extracted and subjected to histological examination. The results did not reveal statistically significant difference between the two groups. But Chitra-CPC gave more favorable results, in respect of pulpal inflammation, dentin bridge formation, quality of dentin bridge and connective tissue in dentin bridge.



Pooja Malik, Usha Rehani

To Evaluate the Relationship between Mandibular Canine Calcification Stages and Skeletal Age

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:6] [Pages No:14 - 19]

Keywords: Demirjian's method, Greulich-Pyle method, Skeletal age, Canine calcification stages

   DOI: 10.5005/jp-journals-10005-1127  |  Open Access |  How to cite  | 


Aim: The purpose of this study was to assess skeletal age and establish relationship between mandibular canine calcification and skeletal age. Materials and methods: The study included 147 females aged 10 to 13 years. The subjects were divided into three groups: Group I—comprising of 10 to 11 years old female; Group II—comprising of 11 to 12 years old female; Group III—12 to 13 years female. OPG and hand and wrist radiographs of left side for each subject were taken with prior consent of their parents. The calcification status of canine was evaluated from orthopantomograms according to scores given in Demirjian's method. The stages of ossification of various carpal bones were evaluated using radiographic atlas of Greulich-Pyle and skeletal age was calculated. Results: Data collected was statistically analyzed. Conclusion: The results drawn from this study showed that a strong correlation was observed for canine calcification stage F for 10 to 11 years and for stage G in 11 to 12 years and 12 to 13 years respectively.



Tabassum Tayab, Kavitha Rai, Vasantha Kumari, Eapen Thomas

Effect of Chewing Paneer and Cheese on Salivary Acidogenicity: A Comparative Study

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:5] [Pages No:20 - 24]

Keywords: Cheese, Paneer, Salivary pH, Diet counseling, Protective foods

   DOI: 10.5005/jp-journals-10005-1128  |  Open Access |  How to cite  | 


Aim: The aim was to evaluate the salivary pH reversal phenomenon by chewing paneer and processed cheese after a chocolate challenge. Materials and methods: Thirty caries-free children were randomly selected and divided into 2 groups: Control group was given processed cheese (Amul) and the experimental group was given paneer (Amul) after a chocolate challenge. After determining the resting salivary pH using GC pH strips, the subjects were asked to eat the test foods and salivary pH was measured at time intervals of 5, 10, 15, 30 and 60 minutes to record the time taken for the salivary pH to return to baseline values after an acidogenic challenge. Results: The data was analyzed and intergroup comparison was done using paired student's t-test. The test meals increased salivary pH after chocolate challenge significantly from baseline values and neutralized the fall in pH after a chocolate challenge. The protective effect was evident after 5 minutes of consuming chocolate and was highest up to 30 minutes after which the salivary pH gradually fell but had not returned to baseline values even at 60 minutes. Conclusion: The findings suggest that chewing of paneer like cheese abolishes the fall in salivary pH caused by sugar consumption and maybe recommended as a protective food in pediatric diet counseling.



Seema Deshmukh, B Nandlal

Evaluation of the Shear Bond Strength of Nanocomposite on Carious and Sound Deciduous Dentin

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:4] [Pages No:25 - 28]

Keywords: Carious dentin, Sound dentin, Conventional composite, Nanocomposite

   DOI: 10.5005/jp-journals-10005-1129  |  Open Access |  How to cite  | 


Aim: The aim of the study was to evaluate and compare the shear bond strength of conventional composites with nanocomposites in carious and sound deciduous dentin with the use of self-etching adhesive. Methodology: Human primary molars were ground to obtain flat dentin surfaces and divided into two groups: Carious dentin and sound dentin group. The carious teeth specimens were prepared by removing infected dentin and area with affected dentin was used for bonding composite. Teeth with carious and sound dentin were subdivided in two groups (n = 15) based on the type of the composite into conventional composite group and nanocomposite group. The composite was bonded to the teeth with self-etching adhesive. All the bonded specimens were stored in distilled water for 24 hours at 37°C before shear bond testing. Independent t-test and analysis of variance were applied to the results. Results: The results indicated that the nanocomposite offered significantly higher bond strength compared to conventional composite. In addition presence of affected dentin significantly reduced the bond strength of both the composite types.



Gagandeep Mohinderpal Chadha, Pradnya Kakodkar, Vishwas Chaugule, Vidya Nimbalkar

Dental Survey of Institutionalized Children with Autistic Disorder

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:4] [Pages No:29 - 32]

Keywords: Autism, Dietary pattern, Oral hygiene practices, Oral health status, Dental needs, Institutionalized, India

   DOI: 10.5005/jp-journals-10005-1130  |  Open Access |  How to cite  | 


The objective of this study was to assess the oral hygiene practices, dietary pattern, dental caries status and needs of institutionalized autistic children. The sample consisted of 35 children (28 males and 7 females) in the age group of 5 to 10 years from two institutions in Maharashtra, India. The parents of the children were interviewed regarding oral hygiene practices of their respective ward and instructed to maintain a 4-day diet chart for their children. A clinical examination was conducted using WHO dentition status and treatment needs index and a simplified oral hygiene index for ages 4 to 6 years and 7 to 10 years (deciduous and mixed dentition) was used to assess the oral hygiene. The results of diet chart analysis according to Nizel AE and Papas AS score showed the ‘at meal’ sugar exposure close to nil, while the ‘in between’ meal sugar exposure was observed to be more than three times per day among maximum children. The oral hygiene status was poor with abundance of soft debris and fair calculus accumulation. The mean caries experience (deft) in these children was 6.4. The present study provided baseline data which has been used for planning a comprehensive oral health care program.



Anshul Chugh, Aman Arora, Vijay Pratap Singh

Accuracy of Different Putty-Wash Impression Techniques with Various Spacer Thickness

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:6] [Pages No:33 - 38]

Keywords: Putty-wash techniques, Impression techniques, Wash space, Different spacers thickness, Comparison, Accuracy

   DOI: 10.5005/jp-journals-10005-1131  |  Open Access |  How to cite  | 


One of the most important steps is accurate impression making for fabrication of fixed partial denture. The two different putty-wash techniques that are commonly used are: (1) Putty-wash one-step technique, (2) putty-wash two-step technique. A uniform wash space is needed for an accurate impression. Nissan et al recommended the use of two-step technique for accurate impression making as there is uniform wash space for the light body material to polymerize. The aim of the present study was to compare the accuracy of stone casts obtained from different putty-wash impression techniques using various spacer thickness. The critical factor that influences the accuracy of putty-wash impression techniques is the controlled wash bulk which is absent in one-step putty-wash impression technique and with polyethylene spacer was used.



Anupama Gaur, N Anup

Variation in Salivary Parameters and its Correlation with Plaque and Gingival Status among 12 to 15 Years Schoolchildren of Rural and Urban Jaipur City in Winter and Summer Seasons

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:10] [Pages No:39 - 48]

Keywords: Seasonal variations, Unstimulated and stimulated salivary parameters, GC saliva check buffer kit, Plaque and gingival index, Schoolchildren

   DOI: 10.5005/jp-journals-10005-1132  |  Open Access |  How to cite  | 


Background: Saliva circulating in the mouth at any given time is termed as whole saliva and comprises of mixtures of secretions from major and minor salivary glands and traces from gingival crevicular fluid. This saliva in the form of unstimulated/stimulated salivary parameters governs the overall homeostatic mechanism of mouth. Aim: To evaluate variation in salivary parameters and its correlation with plaque and gingival status among 12 to 15 years schoolchildren of rural and urban Jaipur city in winter and summer season. Objectives: To evaluate unstimulated/stimulated salivary parameters amongst 12 to 15 years schoolchildren of rural and urban Jaipur city in winter and summer using GC saliva check buffer kit by GC America Inc. To correlate unstimulated/stimulated salivary parameters with plaque and gingival status among 12 to 15 years schoolchildren of rural and urban Jaipur city in winters and summer season. Methodology: Eighty schoolchildren of age group between 12 and 15 years were included in this study. They were divided into two groups, group 1—comprised of schoolchildren belonging to rural area and group 2—comprised of schoolchildren belonging to urban area. Each group was further divided into government and private schoolchildren, comprising of 10 subjects in each of the two schools. Study participants underwent clinical examination, and examination of salivary samples for qualitative and quantitative analysis of unstimulated/stimulated salivary parameters in winter and summer season. Results: No difference in resting salivary flow rate was observed between the two seasons but was found to be comparatively higher among urban schoolchildren as compared to rural. Viscosity of saliva increases in winter as compared to summer among rural schoolchildren. Saliva quantity was found to be very low in summer as compared to winter among rural schoolchildren. Salivary buffering capacity was found to be lower in winter season irrespective of the difference in area. Salivary pH scores were found to be higher in summer as compared to winter among both rural and urban schoolchildren, and this difference was statistically significant (<0.05). Mean plaque scores were found to be higher in winter as compared to summer. Positive correlation (+0.063) was observed between pH and plaque scores in winter season. Positive correlation (+0.045) was observed between pH and gingival scores in winter season. Conclusion: There is a need for dietary counseling and basic oral health care in the study area irrespective of the season. Food consumption patterns differ significantly in winter as compared to summer thereby affecting the oral clearance rate which directly or indirectly affects unstimulated and stimulated salivary patterns and plaque and gingival status.



Manisha Agarwal, S Ghousia, Sunil Raj

Breastfeeding: Nature's Safety Net

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:5] [Pages No:49 - 53]

Keywords: Breastfeeding, Anticipatory guidance, Orofacial growth and development

   DOI: 10.5005/jp-journals-10005-1133  |  Open Access |  How to cite  | 


Breastfeeding is a natural safety-net for the first few months in order to give the child a fairer start to life. The American Academy of Pediatric Dentistry recognizes the distinct nutritional advantages of human milk for infants and endorsed the position of the American Academy of Pediatrics on the promotion of breastfeeding. It therefore calls for increase in need to negotiate the roles and responsibilities of pediatric dentists to eliminate the existing gaps in preventive care and anticipatory guidance. The objective of this evidence-based review is to explore the beneficial roles of breastfeeding in orofacial growth and development and endorse the same through anticipatory guidance.



Veena Arali, Srinivas Namineni, Ch Sampath

Pediatric Obstructive Sleep Apnea Syndrome: Time to Wake Up

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:7] [Pages No:54 - 60]

   DOI: 10.5005/jp-journals-10005-1134  |  Open Access |  How to cite  | 


Pediatric patients with well-controlled OSA present few difficulties for routine dental treatment. However, patients with untreated or undiagnosed OSA can present the dental practitioner with multiple issues and challenges. Dental professionals have a unique doctor-patient relationship that affords them a role in recognizing sleep disorders by exploring the history of patients who are sleepy. Aim: This paper is aimed at providing comprehensive review of pediatric obstructive sleep apnea.



Poonam Preet Bhandari, Dilip Kumar

When Nature plays upon an Ailment: A Case Report

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:3] [Pages No:61 - 63]

Keywords: Radicular cyst, Odontogenic lesion, Surgical enucleation, Marsupialization, Mixed dentition

   DOI: 10.5005/jp-journals-10005-1135  |  Open Access |  How to cite  | 


Of the most common odontogenic cysts, radicular cysts represent cystic lesions of inflammatory origin and are managed either by surgical enucleation or by marsupialization. This article aims to report a clinical case of radicular cyst of a huge proportion treated with a conservative management. An illustration of possible complete healing of such a cystic periapical lesion in mixed dentition with conservation of vital structures is covered.



Sladana Milardovic Ortolan, Mihovil Strujic, Andrej Aurer, Josko Viskic, Lana Bergman, Ketij Mehulic

Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:4] [Pages No:64 - 67]

Keywords: Complicated tooth fracture, Orthodontic extrusion, Esthetic rehabilitation, Prosthodontic restoration, Direct adhesive restoration

   DOI: 10.5005/jp-journals-10005-1136  |  Open Access |  How to cite  | 


This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth.



Shweta Jain, Vijay Agarwal, Arun Kumar Gupta, Pramod Prabhakar

Replantation of Immature Avulsed Teeth with Prolonged Extraoral Dry Storage: A Case Report

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:4] [Pages No:68 - 71]

Keywords: Replantation, Avulsion, Replacement resorption

   DOI: 10.5005/jp-journals-10005-1137  |  Open Access |  How to cite  | 


This case report presents delayed replantation of avulsed teeth after extended extraoral period and nonphysiological storage. Yet, long-term prognosis is not good, it presents alternate treatment modality to immediately restore esthetic and function as well as to promote the growth of alveolar crest for proper eruption of adjacent unaffected teeth until a definite prosthetic treatment seems appropriate.



Subash Singh, Vandana Arya, M Jonathan Daniel, Vijeev Vasudevan

Ellis-van Creveld Syndrome: A Case Report

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:3] [Pages No:72 - 74]

Keywords: Chondroectodermal dysplasia, Polydactyly, Congenital heart disease

   DOI: 10.5005/jp-journals-10005-1138  |  Open Access |  How to cite  | 


Ellis-van Creveld syndrome also known as chondroectodermal dysplasia or mesoectodermal dysplasia; a rare genetic disorder of the skeletal dysplasia. ‘Six-fingered dwarfism’ (digital integer deficiency) was an alternative designation used for this condition when it was being studied in the Amish. It is characterized by short-limb dwarfism, polydactyly, malformation of the bones of the wrist, dystrophy of the fingernails, partial hare-lip, cardiac malformation and often prenatal eruption of the teeth. A typical case of Ellis-van Creveld syndrome is reported in the present article.



Vivek Chaturvedy, Shefali Chaturvedy

Regenerative Therapy as an Adjunct to Periapical Surgery: A Case Report

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:3] [Pages No:75 - 77]

Keywords: Radicular cyst, Apicoectomy, Bone graft

   DOI: 10.5005/jp-journals-10005-1139  |  Open Access |  How to cite  | 


Large periapical defects may adversely affect the success rate of endodontic surgery. Use of regenerative therapy may enhance the prognosis of such teeth. A case of traumatized upper anterior teeth with infected radicular cyst and associated sinus tract reported to the dental hospital. A periradicular surgical procedure was performed to remove the nonhealing pathological tissue. To augment the repair a bioactive bone graft material was placed. Six months interim results showed positive outcome of application of graft.



Celur Sreelalita, K Sunil Babu

Plexiform Ameloblastoma

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:6] [Pages No:78 - 83]

Keywords: Ameloblastoma, Plexiform, Costochondral graft, Mandible rehabilitation

   DOI: 10.5005/jp-journals-10005-1140  |  Open Access |  How to cite  | 


The ameloblastoma is a benign but aggressive neoplasm of odontogenic origin. However, no enamel or hard tissue is formed by the tumor cells. Ameloblastomas are infamous for their invasive growth and their tendency to recur. Robinson (1937) as a benign tumor that is 'usually unicentric, nonfunctional, intermittent in growth, anatomically benign and clinically persistent.’ They may occur at any age, even though nearly half of the tumors do occur between the ages of 20 and 40 years. This is the most common neoplasm affecting the jaws, yet only accounts for 1% of all tumors of the maxilla and mandible and 11% of all odontogenic tumors. This report presents a case of ameloblastoma involving entire ramus and part of body of mandible with resorption of the mesial and distal root apices of second molar and distal root of mandibular first molar. The lesion extending till the base of mandible surrounding the crown of the unerupted third molar resembling the dentigerous cyst. This was surgically resected followed by harvesting the contralateral sixth costochondral rib graft.



Seema Gupta

Asymptomatic Nonsyndromic Multiple Supernumerary Premolars

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:3] [Pages No:84 - 86]

Keywords: Supernumerary premolars, Nonsyndromic, Impacted

   DOI: 10.5005/jp-journals-10005-1141  |  Open Access |  How to cite  | 


The apparently morphologically normal finding of multiple supernumerary teeth in absence of an associated systemic condition or syndrome is an uncommon phenomenon. Surgical removal of supernumerary teeth is indicated if eruption of the adjacent teeth has been delayed; altered eruption, displacement of adjacent teeth is evident or pathologies such as cystic lesion and resorption of adjacent tooth have occurred. If the risks of surgery outweigh the benefits of removal, the teeth may be left in situ and a regular radiographic monitoring should be made.



Ankita Chugh, Rashmi Aggarwal, Vinay Kumar Chugh, Puneet Wadhwa, Munish Kohli

Autogenous Tooth Transplantation as a Treatment Option

[Year:2012] [Month:January-April] [Volume:5] [Number:1] [Pages:6] [Pages No:87 - 92]

Keywords: Autotransplant, Tooth transplantation

   DOI: 10.5005/jp-journals-10005-1142  |  Open Access |  How to cite  | 


Autogenous tooth transplantation is the surgical movement of a tooth from one location in the mouth to another in the same individual. Though done for years but it has achieved variable success rates. Although the indications for autotransplantation are narrow, careful patient selection coupled with an appropriate technique can lead to exceptional esthetic and functional results. This article discusses the reviews of previous works done and highlights the criteria and factors influencing the success of autotransplant along with reports of two cases of transplantation of impacted and malposed canine.


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