In this in vitro study, the effects of a Cola drink, and fresh fruit juice (citrus) on the surface roughness on flowable composite and resin-modified glass ionomer cement (RMGIC) each was evaluated and compared. Using a brass mold 70 pellets each of flowable composite (Filtek™ Flow) and RMGIC tricure restorative material were prepared according to the manufacturer's instructions. Two groups (groups I and II) were formed containing 30 pellets of each material. Remaining 10 pellets of each restorative material did form the control group [water (group III)]. Experimental group pellets were again divided into three subgroups (mild, moderate and severe) containing 10 pellets each and were kept in plastic containers with 30 ml Cola drink (group I) and fresh fruit juice (group II) respectively. Immersion regime was followed according to Maupome G et al. Baseline and final surface roughness (Ra) value for each pellet was evaluated using a profilometer. Statistical analysis was done with Wilcoxon's signed rank test and analysis of variance (ANOVA) followed by Mann-Whitney test. Results showed that the erosive effect of both Cola drink and fresh fruit juice caused significant surface roughness on both flowable composite and RMGIC restorative materials in the mild, moderate and severe immersion regimes. How to cite this article: Maganur P, Satish V, Prabhakar AR, Namineni S. Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials. Int J Clin Pediatr Dent 2015;8(1):1-5.

Aims: To compare the three different methods of caries removal, conventional method using Airotor and chemomechanical method using Carisolv and Papacarie. Settings and design: The patients with multiple carious teeth were selected either in the deciduous dentition or mixed dentition. Ninety primary molars were selected from 30 children (10 males and 20 females) between the age group 6 and 9 years. Materials and methods: After caries excavation, cavities were evaluated for caries removal or clinical efficacy by the tactile and visual criteria, microbiological efficacy, time taken for the procedure. Patient acceptability toward the treatment was also checked with the help of a visual analog scale (VAS). The observations thus obtained were subjected to statistical analysis using analysis of variance (ANOVA), Mann-Whitney U-test and Kruskal-Wallis test. Results: The clinical efficacy of caries removal was highest with Airotor while the microbiological efficacy of caries removal was almost comparable with Airotor, Carisolv and Papacarie caries removal methods. The time taken to remove caries by Airotor method was observed to be least while the patient acceptance was found to be highest with Papacarie method. How to cite this article: Chowdhry S, Saha S, Samadi F, Jaiswal JN, Garg A, Chowdhry P. Recent vs Conventional Methods of Caries Removal: A Comparative in vivo Study in Pediatric Patients. Int J Clin Pediatr Dent 2015;8(1):6-11.

Aim: To evaluate the effects of postbleaching antioxidant application fluoridation treatment on the surface morphology and microhardness of human enamel. Materials and methods: Ten freshly extracted human maxillary central incisors were cut at cementoenamel junction. Crown portion was sectioned into six slabs which were divided into five groups: group A—untreated controls; group B—35% carbamide peroxide (CP); group C—35% CP and catalase; group D—treatment with 35% CP and 5% sodium fluoride; group E – 35% CP, catalase and 5% sodium fluoride. Thirty-five percent carbamide peroxide application included two applications of 30 minutes each at a 5-day interval. After treatment, the slabs were thoroughly washed with water for 10 seconds and stored in artificial saliva at 37°C until the next treatment. Two percent sodium fluoride included application for 5 minutes. Three catalase included application for 3 minutes. Results: After 5 days, groups B and C showed significantly decreased enamel microhardness compared to control. Group D specimens showed relatively less reduction in enamel microhardness than group C specimens. There is a marked increase in enamel microhardness in group E specimens. Conclusions: Fluoride take up was comparatively enhanced after catalase application resulting in less demineralization and increased microhardness. How to cite this article: Thakur R, Shigli AL, Sharma DS, Thakur G. Effect of Catalase and Sodium Fluoride on Human Enamel bleached with 35% Carbamide Peroxide. Int J Clin Pediatr Dent 2015;8(1):12-17.

Background: Vital pulpotomy is a single-stage procedure of surgical amputation of the coronal portion of exposed vital pulp, usually as a means of preserving the vitality and function of the remaining radicular portion. Aims and objectives: The aim of this study was to compare the clinical and radiographic success rates for ferric sulfate (FS), electrosurgery (ES) and laser pulpotomy in human primary molars. Materials and methods: In a randomized clinical trial, 30 primary molars indicated for pulpotomy in children aged 4 to 10 years were treated using either a FS (10 teeth), ES technique (10 teeth) and laser (10 teeth). Following the pulpotomy, the teeth were evaluated for clinical and radiographic success at 3, 6, 9 and 12 months on the basis of the presence of pain, sinus, mobility, internal and external resorption, periapical radiolucency, calcification in the canal and bone loss. Statistical analysis: The data were assessed with Chi-square test. Results: After 12 months of follow-up, both clinical and radiographic success rates were 100% in the laser group but only 80% in both ES and FS groups. There was statistically significant difference between the success rates of three groups (p < 0.05). Conclusion: Laser pulpotomy showed better clinical as well as radiographical results than ES and FS pulpotomy. Laser pulpotomy was also found superior in terms of operating time, patient cooperation, ease of use and pain. Although results of the study showed the failure rates for electrosurgical pulpotomy to be equal to those for FS pulpotomy, electrosurgical pulpotomy being a nonpharmacological technique considered more favorable. Further studies using larger sample size and longer evaluation periods are suggested. How to cite this article: Gupta G, Rana V, Srivastava N, Chandna P. Laser Pulpotomy—An Effective Alternative to Conventional Techniques: A 12 Months Clinicoradiographic Study. Int J Clin Pediatr Dent 2015;8(1):18-21.

Objectives: The aim of this study was to evaluate and compare the load-bearing capacity of fractured incisal edge of maxillary permanent central incisors restored with a nanocomposite and a glass fiber-reinforced nanocomposite. Materials and methods: Thirty-six extracted sound maxillary central incisors randomly divided in three groups were used for the present study. Group I (control) contained untreated teeth. Samples in experimental groups II and III were prepared by cutting the incisal (one-third) part of the crown horizontally and subjected to enamel preparations and restored with a nanocomposite and a glass fiber-reinforced nanocomposite respectively. All restored teeth were stored in distilled water at room temperature for 24 hours. Fracture resistance was evaluated as peak load at failure (Newton) for samples tested in a cantilever-bending test using Hounsfield universal testing machine. Failure modes were microscopically examined. Results: Highest mean peak failure load (Newton) among experimental groups was observed in glass fiber-reinforced nanocomposite group (863.50 ± 76.12 N) followed by nanocomposite group (633.67 ± 40.14 N). One-way analysis of variance (ANOVA) revealed that the restoration technique significantly affected the load-bearing capacity (p < 0.001). Scheffe's post-hoc comparison test (subset for α = 0.05) revealed that there was significant difference in the mean peak failure load values of nanocomposite and glass fiber-reinforced nanocomposite groups when considered together (p < 0.001). Experimental groups showed similar types of failure modes with majority occurring as cohesive and mixed type. Fifty-eight percent of the teeth in glass fiber-reinforced nanocomposite group fractured below the cementoenamel junction. Conclusion: By using fiber-reinforced composite substructure under conventional composites in the repair of fractured incisors, the load-bearing capacity of the restored incisal edge could be substantially increased. How to cite this article: Kumar PSP, Srilatha KT, Nandlal B, Dhull KS. Evaluation of the Load-bearing Capacity of Fractured Incisal Edge of Maxillary Permanent Central Incisors restored with a Glass Fiber-reinforced Nanocomposite: An in vitro Study. Int J Clin Pediatr Dent 2015;8(1):22-29.

Objective: Early childhood caries is now affecting the children in dangerous proportions. There is a wide spread loss of the tooth material irrespective of the type of the carious lesion. Restoration of such lesions with a strong permanent bond between the dental tissues and the restorative dental materials would be a highly desirable requisite. Ultramorphological characterizations show that the interfacial morphology and the chemical characterization of the bonding systems appear to be strongly associated with each other and, therefore, observing and understanding the interfacial phenomenon and its quality would be of great importance in the selection of a dental adhesive for its use in pediatric restorative dentistry. Study design: Human primary molars, which were indicated for extraction, for an array of reasons like caries, normal exfoliation, pathological root resorption, over-retained and serial extraction, were collected for the study purpose. Total number of teeth was then equally distributed into two subgroups, each namely A1 (Prime and Bond NT) and A2 (Xeno III). Results: The type of etching pattern that was observed in group A1 (Prime and Bond NT) of Silverstone's type II compared to the Silverstone's type III observed in group A2 (Xeno III). Conclusion: Results of this study indicate that the use of an etchant separately followed by the application of the bonding system—Prime and Bond NT—would provide a better quality of adhesion thus improving the quality and longevity of the restoration done within the limits of enamel in primary dentition. How to cite this article: Mithiborwala SH, Chaugule V, Katge F, Poojari M, Pujari P, Pammi T. A Comparative Evaluation of the Efficacy of Etching by the Total Etch and Self-etch Dentin Bonding Systems in the Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2015;8(1):30-36.

Objective: The aim of the study was to compare and evaluate the in vitro biodegradation of nickel and chromium from space maintainers, made of three different companies, i.e (Dantaurum, Rocky mountain and Dtech) in artificial saliva. Materials and methods: The study comprised of 30 space maintainers out of which 10 were fabricated using Dantaurum, 10 using Rocky mountain and 10 using Dtech band materials. Stainless steel wire (Dantaurum, Rocky mountain and Konark) was used for making loops and Leone solder and flux was used for soldering. Each group was further divided into four subgroups containing 1, 2, 3 and 4 space maintainers respectively. The space maintainers in each subgroup were placed in separate glass beakers containing 100 ml of artificial saliva at 37°C for 4 weeks. Salivary samples from each beaker was analyzed for nickel and chromium ions separately on days 1, 7, 14, 21 and 28 days using inductively coupled plasma-optical emission spectrophotometer. Results: Total release of nickel and chromium from all band and loop space maintainers ranged from 0.020 to 1.524 ppm and 0.002 to 0.289 ppm respectively. The release of nickel and chromium between the groups and within the groups was not significant (p < 0.5). Conclusion: There was no substantial release of nickel and chromium from space maintainers made of Dantaurum, Rocky mountain and Dtech which could cause any toxicity. How to cite this article: Anand A, Sharma A, Kumar P, Sandhu M, Sachdeva S, Sachdev V. A Comparative Study of Biodegradation of Nickel and Chromium from Space Maintainers: An in vitro Study. Int J Clin Pediatr Dent 2015; 8(1):37-41.

Aim: To compare and evaluate the remineralizing potential of four commercially available products namely SHY-NM, GC Tooth Mousse Plus, ReminPro and Colgate strong teeth on demineralized human teeth. Materials and methods: The study included 50 extracted premolars having 3 × 3 mm window prepared on the middle third of the tooth, which was then subjected to demineralization for 48 hours at 37°C. Teeth were randomly selected and grouped into five study groups of 10 teeth in each. Each group was treated with respective remineralizing agent and sectioned using hard-tissue microtome. Each section obtained was visualized under polarized light microscope and analyzed using Image J software. Results: The statistically evaluated results revealed that SHY-NM has the most remineralizing potential followed by ReminPro, GC Tooth Mousse Plus and fluoridated toothpaste. Conclusion: Based on the study, the SHY-NM was superior to the GC Tooth Mousse Plus, ReminPro and Colgate strong teeth on demineralized human teeth. How to cite this article: Rajan R, Krishnan R, Bhaskaran B, Kumar SV. A Polarized Light Microscopic Study to Comparatively evaluate Four Remineralizing Agents on Enamel viz CPP-ACPF, ReminPro, SHY-NM and Colgate Strong Teeth. Int J Clin Pediatr Dent 2015;8(1):42-47.

Aim: To assess how the various methods of intracanal reinforcement (short root canal posts) performed in their clinical and radiographic outcomes for restoring grossly broken down primary anterior teeth after pulpectomy for 1 year or longer follow-up period. Materials and methods: Literature search of electronic databases (Sept 2013) and various journals (1980-Sept 2013) using medical subject headings and free text terms was conducted. For inclusion in quality assessment, prespecified inclusion criteria were applied. Quality assessment was performed by using ‘The Cochrane collaboration's tool for assessing risk of bias’. Results: Seven relevant papers were selected for full text evaluation. After applying the inclusion criteria, only two trials could be considered for quality assessment. Both of these were classified as having high risk of bias. Conclusion: The evidence to support any method of intracanal reinforcement for restoring grossly broken down anterior teeth is presently lacking. Further trials with well-defined methodology are needed. How to cite this article: Mittal N, Bhatia HP, Haider K. Methods of Intracanal Reinforcement in Primary Anterior Teeth— Assessing the Outcomes through a Systematic Literature Review. Int J Clin Pediatr Dent 2015;8(1):48-54.

Amniotic band syndrome (ABS) is a congenital disorder caused by entrapment of fetal parts in fibrous amniotic bands while in utero. The syndrome is underdiagnosed and its presentation is variable. The syndrome has been well described in the pediatric, orthopedic and obstetric literature; however, despite the discernable craniomaxillofacial involvement, ABS has not been reported in the dental literature very often. The present report describes a case of a patient with ABS and concomitant dental findings. How to cite this article: Hotwani K, Sharma K. Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation. Int J Clin Pediatr Dent 2015;8(1):55-57.

Aim of this article is to present a case wherein single visit apexification of a traumatically injured tooth was done with a bioactive material—Biodentine. An injury sustained between the ages of 6 and 14 can adversely affect pulpal health and interrupt root development. In these instances, apexification is generally the preferred treatment. A 10 years old male patient presented with coronal fracture of the left upper central incisor. Clinical and radiographic assessment showed negative pulpal sensibility and arrested apical root development. Artificial apical barrier induction with Biodentine followed by endodontic treatment and prosthetic rehabilitation was decided as the line of treatment. To conclude, this bioactive and biocompatible calcium-based cement can regenerate damaged dental tissues and represents a promising alternative to the conventional multivisit apexification technique. Clinical significance: Biodentine which is a biologically active cement can be an efficient alternative to the conventional apexification materials which were hitherto recommended. How to cite this article: Bajwa NK, Jingarwar MM, Pathak A. Single Visit Apexification Procedure of a Traumatically Injured Tooth with a Novel Bioinductive Material (Biodentine). Int J Clin Pediatr Dent 2015;8(1):58-61.

A number of treatment options, ranging from Maryland bridges to implants, are available for the replacement of congenitally or traumatically missing permanent anterior teeth. But, there are several limitations of these therapeutic options when they have to be used before the completion of the growth, particularly in children. Reinforcement of composite resins with polyethylene fibers significantly improves their mechanical properties. Fiber-reinforced composite (FRC) bridge can offer a good alternative to conventional treatment options in replacing a missing permanent anterior tooth until a more definitive prosthesis can be provided at the end of the growth period. The purpose of this article is to present a clinical case of a single tooth replacement utilizing noninvasive and metal free fixed FRC bridge in a 13 years old child as an interim treatment option. How to cite this article: Gupta A, Yelluri RK, Munshi AK. Fiber-reinforced Composite Resin Bridge: A Treatment Option in Children. Int J Clin Pediatr Dent 2015;8(1):62-65.

Anterior sectional twin bracket appliance (ASTBA) is a sectional mechanism that involves two brackets on upper central incisors. This appliance is previously been used for correction of rotated incisors and midline spacing. But, detail biomechanics for single tooth crossbite correction is not previously explained. Here, in this article, we are presenting a detailed biomechanics of ASTBA for anterior single tooth crossbite correction along with case report. How to cite this article: Verma RK, Raghav P, Reddy MC, Kanwal R. Anterior Sectional Twin Bracket Appliance— Innovative Use for Correction of Single Tooth Crossbite: A Case Report with Biomechanics. Int J Clin Pediatr Dent 2015;8(1): 66-69.

Radicular cysts are by far the most common cystic lesions of the jaw. However, those arising from primary teeth are comparatively rare, comprising only 0.5 to 3.3%. The aim of this paper is to present clinical, radiographic and histopathological characteristics of radicular cyst associated with a primary mandibular molar causing unusual displacement of the permanent successor. Extraction of primary tooth along with extirpation of cyst was done under local anesthesia. The displaced premolar was also extracted and then replanted in the socket after proper alignment. Healing was uneventful and the space of missing primary molar was maintained by band and loop space maintainer. The relationship between intracanal medicaments and rapid growth of cyst, as mentioned in literature was observed in our case too. Thus, pulpotomy treated primary teeth should receive periodic postoperative radiographic examination and absence of clinical symptoms does not mean that a pulpotomy treated tooth is healthy. How to cite this article: Lamba G, Ravi GR. Replantation of Displaced Underlying Successor and Marsupialization of Radicular Cyst associated with a Primary Molar. Int J Clin Pediatr Dent 2015;8(1):70-74.

First described in 1932 by Dearborn as ‘congenital pure analgesia’, congenital insensitivity to pain and anhydrosis (CIPA) or hereditary sensory and autonomic neuropathy (HSAN) type IV is an extremely rare autosomal recessive disorder. A 7-year-old female child who is an established case of congenital insensitivity to pain and anhydrosis visited the department of pediatric medicine with osteoarthritic neuropathy. A multidisciplinary team approach was utilized to treat the child under general anesthesia. This article also discusses the diagnostic and therapeutic dilemmas involved in treating this type of children. How to cite this article: Ravichandra KS, Kandregula CR, Koya S, Lakhotia D. Congenital Insensitivity to Pain and Anhydrosis: Diagnostic and Therapeutic Dilemmas revisited. Int J Clin Pediatr Dent 2015;8(1):75-81.

Thumb and digit-sucking habits or non-nutritive sucking are considered to be the most prevalent among oral habits. Most children stop thumb sucking on their own. If the habit continues beyond 3 to 4 years of age, it not only affects the dental occlusion, but the shape of the thumb/digit may be altered as well. This article presents the management of thumb sucking by modified RURS, elbow guard incorporated with revised ‘three-alarm’ system. How to cite this article: Shetty RM, Shetty M, Shetty NS, Deoghare A. Three-Alarm System: Revisited to treat Thumbsucking Habit. Int J Clin Pediatr Dent 2015;8(1):82-86.