International Journal of Clinical Pediatric Dentistry

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2012 | August | Volume 5 | Issue 2

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K Sundeep Hegde, Sham S Bhat

Characteristics of Primary Dentition Occlusion in Preschool Children: An Epidemiological Study

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:5] [Pages No:93 - 97]

   DOI: 10.5005/jp-journals-10005-1143  |  Open Access |  How to cite  | 


Objective: The establishment and maintenance of normal occlusion constitutes one of the important objectives of pediatric dentistry. There are very few studies assessing the occlusal characteristics of primary dentition in the preschool children. The objective of this study was to assess the occlusal characteristics of primary dentition and difference in various parameters, in children between 3 and 5 years of age. Materials and methods: Eight hundred and eight healthy children, of age group between 3 and 5 years, and having full set of deciduous dentition, were selected by random sampling. Examination and recording of occlusal characteristics were done by single examiner. Results: Flush terminal molar relationship was seen in 67.9% of children. Statistically significant (χ2 = 47.835, p = 0.001) increase in mesial step molar relationship was seen with age. The class I canine relationship was the most prevalent canine relation, however the agewise changes of canine relation were not statistically significant. Anterior open bite was observed in 0.2% of children, which was less than the prevalence reported earlier in literature. 91.2% of children had overjet of 1 to 2 mm. The incidence of anterior and posterior crossbite was 0.4%. No cases of infraocclusion and scissors bite were observed. Conclusion: There is change in deciduous molar relationship as age increases. There is a significant increase in mesial step molar relation in 5 years age group compared to 3 years. The low prevalence of posterior crossbite and anterior open bite is suggestive of lower prevalence of sucking habits in children. Larger sample size may be required to assess the prevalence of infraocclusion and scissors bite.



Vinayk Keshav

Prevalence of Spaced and Closed Dentition and its Relation to Malocclusion in Primary and Permanent Dentition

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:3] [Pages No:98 - 100]

   DOI: 10.5005/jp-journals-10005-1144  |  Open Access |  How to cite  | 


An ideal primary dentition is the indicator of future ideal permanent dentition. Absence of primate or secondary spaces in the primary dentition is expression of disproportion between jaw/tooth sizes. Little information is known on the relationship of spacing and closed dentition with malocclusion in relation to primary and permanent dentition. Hence, the present study was conducted to find the relationship of spacing and closed dentition with malocclusion in primary and permanent dentition in children during their deciduous dentition period.



Gunjan Yadav, Usha Rehani

A Comparative Evaluation of Marginal Leakage of Different Restorative Materials in Deciduous Molars: An in vitro Study

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:7] [Pages No:101 - 107]

   DOI: 10.5005/jp-journals-10005-1145  |  Open Access |  How to cite  | 


Context: Microleakage around dental restorative materials is a major problem in clinical dentistry. Inspite of many new restorative materials available in the market very few actually bond to the tooth surface. Aims: The aims of this study were: (1) To evaluate and compare the marginal leakage of newer restorative materials viz colored compomer, ormocer, giomer and RMGIC in class I restoration of deciduous molars. (2) To compare the microleakage scores between the groups of: Colored compomer and ormocer, giomer and RMGIC, ormocer with giomer and RMGIC, giomer with RMGIC. Materials and methods: A total of 40 primary molars were randomly divided into four groups of 10 each. Class I cavities were prepared and the cavities were restored with colored compomer (Group A), Ormocer (Group B), Giomer (Group C) and RMGIC (Group D). The teeth were thermocycled and subjected to 0.5% basic fuchsin dye penetration followed by sectioning. The cut sections were evaluated under a stereomicroscope and the data was subjected to statistical analysis. Statistical analysis used: Mann-Whitney U test and Student t-test. Results: No significant difference was observed when colored compomer was compared to ormocer, giomer and RMGIC. Ormocer showed significantly lower microleakage when compared to giomer. However, no significant difference was observed when ormocer was compared to RMGIC. No significant difference between giomer and RMGIC was found. Conclusion: Ormocer has proven to be an excellent restorative material as it showed least microleakage followed by colored compomer, giomer and RMGIC in increasing order.



Hind Pal Bhatia, Visuja Chaudhary, Archana Aggarwal, Ashish Kumar Singh

Comparative Evaluation of Oral Candida albicans Carriage in Children with and without Dental Caries: A Microbiological in vivo Study

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:5] [Pages No:108 - 112]

   DOI: 10.5005/jp-journals-10005-1146  |  Open Access |  How to cite  | 


Aim: The aim of this study was to examine the presence of Candida albicans in extensive carious lesions before and after treatment of the carious lesions and to evaluate the carriage of Candida albicans in children with and without caries. Materials and methods: The study was conducted on 60 childrens who were divided into two groups: Experimental group (group 1) and controlled group (group 2). Each group was further divided into 3 subgroups according to the dentition as: Group A (Deciduous), group B (Mixed) and group C (Permanent). Swab samples for mycological studies were collected from the dorsum of the tongue, vestibular sulcus and peak of the palatal vault. All samples were cultured directly on SDA plate (Sabouraud's dextrose agar). Number of Candida colonies was determined by counting colony forming unit on SDA plates. Further identification of Candida albicans was done by germ-tube test and corn-meal agar. Result: Overall prevalence of Candida albicans carriage was significantly higher and mean value of Candida albicans CFU (colony forming unit) was remarkably higher in group 1 (experimental group) as compare to group 2 (control group). Significant reduction in the frequency and mean value of Candida albicans CFU/plate was seen in children after treatment of carious lesions. Conclusion: This study supports the active role of Candida species in dental caries. Hence, Candida albicans may play an important role as a risk factor for dental caries. It was also seen that the oral environment stabilization procedures were able to reduce Candida albicans counts. Thus, these procedures can be considered efficient in the reduction of caries risk.



Mridula Trehan, Sonahita Agarwal

Applicability of Bolton's Analysis: A Study on Jaipur Population

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:5] [Pages No:113 - 117]

   DOI: 10.5005/jp-journals-10005-1147  |  Open Access |  How to cite  | 


This study was undertaken to compare the Bolton's anterior and overall ratios among males and females in Jaipur population. One hundred study models (50 males and 50 females) of orthodontic patients were randomly selected from the Department of Orthodontics, Mahatma Gandhi Dental College, Jaipur. The normative data for the mesiodistal widths of males and females were established and the anterior and overall ratios were obtained for both males and females. It was observed that were no significant differences in both the ratios in males and females. Hence, both the ratios were obtained for the sample as a whole. These ratios were found to be similar to the Boltons standard with no significant differences. Therefore, it can be concluded that Boltons standards can be applied to this population irrespective of sex or ethnic background.



Sarabjeet Singh, Navreet Sandhu, Rita Kashyap

A Study of Bite Force and Various Variables in Children Segregated by Angle's Classification

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:6] [Pages No:118 - 123]

   DOI: 10.5005/jp-journals-10005-1148  |  Open Access |  How to cite  | 


The stomatographic system has been studied by several researchers, yet it is still unclear, weather a genetically determined facial morphology decides the strength of masticatory muscles,1 or weather a strong musculature influences the form of the face. This formed the basis of present study to relate muscle activity with various malocclusions. Thus, 60 samples of younger age group were divided according to Angle classification and maximum bite force was recorded among the groups. Newly designed bite force recorder was used for recording bite force at molar and at incisal region. Influence of various independent variables like gender, overjet and overbite of the subjects on the bite force was also checked. It was concluded that maximum bite force at intercuspal position (molar) and anterior bite position (incisal) were not significantly different between normal, class I, class II div 1 and class III malocclusion groups. There was no significant correlation between incisal bite force and overjet or overbite, but there was a highly significant difference (p < 0.001) between the males and females for maximum bite force at intercuspal position, with males biting harder than the females.



Rajesh Sharma

Mutans Streptococci Colonization in Relation to Feeding Practices, Age and the Number of Teeth in 6 to 30-Month-Old Children: An in vivo Study

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:8] [Pages No:124 - 131]

   DOI: 10.5005/jp-journals-10005-1149  |  Open Access |  How to cite  | 


Background: Early childhood caries has been characterized as first affecting the primary maxillary anterior teeth, followed by the involvement of the primary molars. Other terms for dental caries in preschool children, which inappropriately may imply cause for the disease, includes baby bottle tooth decay, nursing caries, milk bottle syndrome, baby bottle caries, nursing bottle mouth and nursing mouth. Aim: To explore the relationships of feeding practices, age and number of teeth present with mutans streptococci colonization in infants. Design and setting: A comparative clinical study conducted on 160 children aged from 6 to 30 months in the Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital in collaboration with Child Health Institute and Research Center and Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere. Materials and methods: Baseline data collection included: (i) Parents of the infants were asked open ended questions about the baby feeding practices, (ii) The age of the subjects were obtained from the immunization register maintained at Child Health Institute and Research Center and were grouped into group I (6-11 months), group II (12-17 months), group III (18-23 months) and group IV (24-30 months), (iii) Clinical examination of children was done by using mouth mirror and explorer in flash light.6 For each child number and location of erupted teeth was recorded, (iv) Microbial screening for mutans streptococci involved sampling of saliva from each child was performed by placing a sterile wooden tongue blade on the dorsum of the tongue and the number of colony forming units (CFU) were recorded. Results: According to feeding practices, 34 children were in breastfed category, 39 were in baby bottle category and 87 children reported no bottle usage. Out of 160 children examined, a total 142 children were colonized with mutans streptococci. 18 children were found to be colonized with low colony forming units, 78 children were found to be colonized with moderate colony forming units and 64 children were colonized with high colony forming units. In baby bottle group, all of 39 subjects were reported to have sweetened milk, sugar in the bottle. Conclusion: Among different feeding practices, all the three subgroups viz breastfed children, children with nursing bottle usage and children with no bottle usage, all have shown mutans streptococci acquisition. But breastfed children have shown least number of high colony forming units, which is increased in the case of children using nursing bottle and is maximum in the children who were neither breastfed nor fed with nursing bottle. Percentage of children colonized with mutans streptococci increases with age and as the number of teeth increase, number of colony forming units were also found to be increasing.



Prakash Chandra

Is there an Association between Oral Health Status and School Performance? A Preliminary Study

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:4] [Pages No:132 - 135]

   DOI: 10.5005/jp-journals-10005-1150  |  Open Access |  How to cite  | 


The present cross-sectional study was carried out to assess the impact of poor oral health status on school performance of 600 primary and nursery school children of Bengaluru city, India. The data were collected using the methods and standards recommended by the WHO for oral health surveys. Oral health status was assessed using the df-t index (number of decayed and filled teeth). Academic performance was assessed based on the marks obtained. The children were divided into three groups: Excellent, average, below average (as given by the school teachers). Comparison between categorical variables was performed using one-way ANOVA using the SPSS software package (version 12.0). The mean df-t of the excellent group was 1.56 ± 2.5, for average group it was 2.05 ± 2.8 and for the below average group it was 4.47 ± 2.7. The below average group showed high caries index compared to other groups. The relation between school performance and mean df-t was found to be statistically significant (p < 0.001). The findings of this study demonstrate the impact that poor oral health has, on lowering school performance in children. It can be safely concluded that improvement of children's oral health may be a vehicle to improve their educational experience.



R Neeraja, Vizhi G Kayal

A Rare Occurrence of Geminated-Taloned Maxillary Lateral Incisor

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:3] [Pages No:136 - 138]

   DOI: 10.5005/jp-journals-10005-1151  |  Open Access |  How to cite  | 


The talon cusp is a developmental anomaly characterized by the presence of an accessory cusp like structure projecting from the cingulum area of the anterior teeth. Gemination is an anomaly caused by a single tooth germ that attempted to divide during its development. These developmental anomalies may cause clinical problems including esthetic impairment, pain, caries and tooth crowding. Co-occurrence of two anomalies in a teeth is rare. This paper presents an unusual case of talon cusp on geminated permanent lateral incisor.



Arpana V Bansal, Abhinav Bansal, Vinaya Kumar Kulkarni, Reema Sharma Dhar

Dens Invaginatus in Primary Maxillary Molar: A Rare Case Report and Review of Literature

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:3] [Pages No:139 - 141]

   DOI: 10.5005/jp-journals-10005-1152  |  Open Access |  How to cite  | 


Dens invaginatus is a rare developmental anomaly. It is unusual to find this anomaly in primary dentition. Diagnosis of this dens invaginatus is important due to possible pulpal involvement. Not only that, simultaneous presence of other dental anomaly may require long-term treatment planning. Dens invaginatus can be detected clinically in the tooth presenting unusual crown morphology or radiographically as radiopacity within tooth. This article describes one of the first case reports of dens invaginatus in primary maxillary second molar in a 5-year-old female patient.



Eesha S Jain

Management of Talons Cusp associated with Primary Central Incisor: A Rare Case Report

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:3] [Pages No:142 - 144]

   DOI: 10.5005/jp-journals-10005-1153  |  Open Access |  How to cite  | 


The talon cusp is a relatively rare dental developmental anomaly characterized by cusp-like projections, usually observed on the lingual surface of the affected tooth. Normal enamel covers the cusp and fuses with the lingual aspect of the tooth. The cusp may or may not contain an extension of the pulp. The condition can occur in both the primary and permanent dentitions. However, the occurrence of anomalous cusp is rather infrequent in the primary dentition. Little data is available about the treatment of talon cusps in the primary dentition as compared with the permanent dentition. A case of talon cusp in the primary maxillary left central incisor is reported. This dental anomaly was not associated with any other somatic or dental abnormality. The tooth was carious. Pulpal extension into the cusp was detected radiographically. Pulpectomy of the tooth was carried out and restored with composite restoration.



Sailesh Gupta, Rajesh Bansal, Ashish Kumar Pathak, Baldev Bhatia, Keshav Kumar Gautam

Rehabilitation of a One-day-Old Neonate with Cleft Lip and Palate using Palatal Obturator: A Case Report

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:3] [Pages No:145 - 147]

   DOI: 10.5005/jp-journals-10005-1154  |  Open Access |  How to cite  | 


Feeding a neonate with a complete cleft lip and palate is difficult pursuit due to communication between oral cavity and nasal cavity. A multidisciplinary approach is required to manage the complex problems involved in case of such neonates and their families. Present case is of a 1-day-old neonate having complete bilateral cleft lip and palate for which palatal obturator was constructed. A stepwise simple, easy and uncomplicated procedure for making accurate impressions, maxillary cast and fabrication of palatal obturator in infants with cleft lip and palate has been presented. The objective to present this case report is to emphasize the fact that how these palatal obturators /plates help in feeding, speech/language development, presurgical orthopedics and prevent other associated otorhinolaryngeal problems.



Shashi Bala, M Nikhil, Anshul Chugh

Prosthetic Rehabilitation of a Child Suffering from Hypohidrotic Ectodermal Dysplasia with Complete Anodontia

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:3] [Pages No:148 - 150]

   DOI: 10.5005/jp-journals-10005-1155  |  Open Access |  How to cite  | 


A 7-year-old male, described in the case report, exhibited many of the manifestations of ectodermal dysplasia as well as behavioral problems. The treatment to improve his appearance and oral function included a removable prosthesis. The results were significant improvements in speech, masticatory function, and facial esthetics, contributing to the development of normal dietary habits, and the improved and more rapid social integration of the child.



Kanwar Deep Singh Nanda

Building-up a Smile in a 5-Year-Old Child: A Case Report

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:4] [Pages No:151 - 154]

   DOI: 10.5005/jp-journals-10005-1156  |  Open Access |  How to cite  | 


A variety of therapeutic modalities, from removable partial dentures to conventional fixed space maintainer can be used for the replacement of traumatically missing or carious lost primary anterior teeth. Dentistry has advanced to a point where it is undesirable for children to be partially edentulous or to have unattractive anterior teeth. The introduction of new materials and adhesive systems in dentistry, offers a new reconstructive alternative for severely destroyed or lost primary anterior teeth. The purpose of this article was to present a clinical case of four primary anterior teeth replacement by means of fiber-reinforced composite bridge. This technique offers a conservative, esthetic and noninvasive treatment. It can be considered, as a longlasting reversible provisional treatment.



Naina Talwar, Pooran Chand, Raghuwar D Singh, Sunit Kumar Jurel, Durga Shanker Gupta

Customization of Stock Eye Prosthesis for a Pediatric Patient by a Simplified Technique

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:4] [Pages No:155 - 158]

   DOI: 10.5005/jp-journals-10005-1157  |  Open Access |  How to cite  | 


The unfortunate loss or absence of an eye may be caused by congenital defect, irreparable trauma, tumor or blind eye. The role of the maxillofacial prosthodontist in fabricating an ocular prosthesis to restore facial symmetry and normal appearance for the anophthalmic patient becomes essential. A custom-made ocular prosthesis is an excellent alternative for the people who lose their eye especially in young age. It has acceptable fit, retention and esthetics but is technically difficult to fabricate. On the other hand the stock eye has compromised fit and poor esthetics. Our case report presents a simple technique of customization of stock eye prosthesis to provide accurate fit and acceptable esthetics.



Glassfiber Post: An Alternative for Restoring Grossly Decayed Primary Incisors

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:4] [Pages No:159 - 162]

   DOI: 10.5005/jp-journals-10005-1158  |  Open Access |  How to cite  | 


Restoration of primary incisors, which have been severely damaged by rampant caries or trauma, is a difficult task for the pediatric dentist. With the introduction of new adhesive systems and restorative materials, alternative approaches for treating these teeth have been proposed. This paper discusses the restoration of carious primary maxillary incisors using composite resin restoration reinforced with fiberglass post. Two case reports are presented here to describe the procedure. Over a 1 year period, the crowns have demonstrated good retention and esthetic results.



Narendra S Sharma, Pushpa V Hazarey

Mastering Interproximal Stripping: With Innovations in Slenderization

[Year:2012] [Month:] [Volume:5] [Number:2] [Pages:4] [Pages No:163 - 166]

   DOI: 10.5005/jp-journals-10005-1159  |  Open Access |  How to cite  | 


Crowding and irregularity remain a consistent problem for children. Management of space problems continues to play an important role in a dental practice. It also represents an area of major interaction between the primary provider and the specialists. Proximal stripping is routinely carried out to avoid extraction in borderline cases where space discrepancy is less and in cases where there is a discrepancy between the mesiodistal width of maxillary and mandibular teeth to satisfy Bolton ratio. Proximal stripping is carried out using of metallic abrasive strip, safe sided carborundum disk, or with long thin tapered fissure burs with air rotor. The use of rotary cutting instrument can harm the pulp by exposure of mechanical vibration and heat generation (in some cases). Whereas, the large diameter of the disk obstructs vision of the working area. Also fracturing away a portion is a common problem with disk. Tapered fissure burs cut the tooth structure as the width of bur or overcutting may occur of the tooth structure due to high speed. The use of metallic abrasive strip is the safest procedure amongst the above. The strip can be placed in the anterior region without any difficulty but using it in the posterior region is difficult as, it is difficult to hold it with fingers while stripping the posterior teeth. To avoid this inconvenience here with a simple and economical way of fabricating strip holder from routine lab material is presented. Clinical implications: Proper management of space in the primary and mixed dentitions can prevent unnecessary loss in arch length. Diagnosing and treating space problems requires an understanding of the etiology of crowding and the development of the dentition to render treatment for the mild, moderate and severe crowding cases. Most crowding problems with less than 4.5 mm can be resolved through preservation of the leeway space, regaining space or limited expansion in the late mixed dentition. In cases with 5 to 9 mm of crowding, some can be approached with expansion after thorough diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth to preserve facial esthetics and the integrity of the supporting soft tissue. Sequential proximal stripping is routinely carried out to avoid extraction in borderline cases where space discrepancy is less and reserved for treatment of mild tooth-size/arch-size discrepancies.


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