Aim: The aim of this study was to determine the oral hygiene facilitators and barriers for 10 years old Greek children, via a questionnaire and clinical examination. Materials and methods: This was a cross-sectional study of 266, 10 years old, children recruited from schools in 3 locations in Greece. Data were collected via questionnaires and clinical examination. Questionnaires referred to Children's oral hygiene knowledge, behavior and attitude as well as parents’ oral hygiene behavior and educational level. Children were clinically examined by two calibrated pediatric dentists using a WHO probe and artificial light to assess dental plaque (hygiene index-HI), gingivitis (simplified gingival index-GIs) and dental caries (DMFT-BASCD criteria). Results: Regarding oral hygiene knowledge, although 80% of the children were literate of the proper means of oral hygiene, only 58.64% brushed their teeth twice daily and 36.84% used dental floss. Children's oral hygiene knowledge was positively correlated with both parental brushing frequency (ρ = 0.175, p < 0.05) and educational level (ρ = ‒0.216, p < 0.05). Toothpaste use was reported by 92.11% of the children. Regarding Children's attitude, 62.28% were concerned whether their teeth were clean, with girls showing greater concern than boys (p < 0.001). Their reported beliefs regarding brushing avoidance were boredom (84.06%), low oral health literacy (73.91%) and forgetfulness (56.52%). Conclusion: Oral hygiene facilitators were found to be the concern about how clean were their teeth, oral health literacy of both children and parents and toothpaste appeal to children. Oral hygiene barriers were Children's boredom, low oral health literacy, forgetfulness and low socioeconomic level. How to cite this article: Angelopoulou M, Kavvadia K, Oulis C, Reppa C. Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren. Int J Clin Pediatr Dent 2015;8(2):87-93.

Aim and objective: The purpose of this study was to compare the pulp testing methods (pulse oximetry and electric pulp test) in primary and young permanent teeth of children. Materials and methods: The study included a total of 155 children aged 4 to 15 years. Twenty children formed control group I. Study group included all healthy, 85 primary 2nd molars in group II and 85 permanent 1st molars in group III. Fifty children needing endodontics treatment formed test group IV. The readings were recorded as true positive (TP), false positive (FP), true negative (TN), false negative (FN). Based on this, the sensitivity, specificity, positive predictive value and negative predictive value were calculated for each method. The results were statistically analyzed using Chi-square test. Results: On comparing pulse oximetry with electric pulp test ‘p-value’ was found to be 0.487 and 1.00 for groups 1 and 2 respectively and was statistically not significant. Whereas ‘p-value’ for groups 3 and 4 was < 0.0001 and 0.003 respectively and was statistically highly significant. Conclusion: The present study indicates that pulse oximetry can be used as a routine method for assessing the pulp vitality in primary, young permanent and mature permanent teeth. How to cite this article: Shahi P, Sood PB, Sharma A, Madan M, Shahi N, Gandhi G. Comparative Study of Pulp Vitality in Primary and Young Permanent Molars in Human Children with Pulse Oximeter and Electric Pulp Tester. Int J Clin Pediatr Dent 2015;8(2):94-98.

Aim: To analyze the efficacy of three different concentrations of Ocimum sanctum extract against various microorganisms, Streptococcus mutans, Streptococcus mitis, Streptococcus sanguis, Lactobacillus acidophilus. Materials and methods: Ethanolic extract of Ocimum sanctum was prepared by the hot extraction method. The extract was diluted with an inert solvent, dimethyl sulfoxide to obtain 3 different concentrations (2.5, 5 and 10%) of the extract. 0.2% chlorhexidine was used as a positive control and dimethyl sulfoxide was used as a negative control. The extract, along with the controls, was then subjected to microbiological investigation to determine which concentration among the 3 different concentrations of extract gave a wider inhibition zone against S. mutans, S. mitis, S. sanguis, L. acidophilus. The zones of inhibition were measured in millimeters. Results: Ocimum sanctum leaf extract demonstrated maximum antimicrobial activity against microorganisms responsible for dental caries at the 10% concentration level although 5 and 2.5% were also effective. Maximum activity was seen against S. mutans and S. sanguis with 10% extract. Conclusion: Ocimum sanctum leaf extract was effective against all the microorganisms. How to cite this article: Pai RK, Bhat SS, Salman A, Chandra J. Use of an Extract of Indian Sacred Plant Ocimum Sanctum as an Anticariogenic Agent: An in vitro Study. Int J Clin Pediatr Dent 2015;8(2):99-101.

Background: Before arrival into doctor's clinic, child might have acquired an impression of a clinical environment and doctor's appearance. Different kind of doctor's attire may evoke different reactions. By understanding children and parent's perception and preferences about dentist's attire, a suitable dress code could be adopted to establish good rapport with children. Aim: To evaluate children and parental perceptions and preferences towards dentist attire. Materials and methods: A questionnaire designed with series of photographs of male and female dental students in different attires was responded by 150 parents aged 29 to 63 years and 150 children aged 9 to 13 years. Results: Seventy percent of children participants (n = 104) and 42% of parents participants (n = 63) favored the traditional white coat attire. However, 58% parents (n = 87) significantly preferred non-white coat attires in comparison to 30% of children (n = 46) (χ² = 21.61, p < 0.001). No statistical significant difference was noted among the children and the parents, both favoring the use of protective wear (χ² = 0.99 p > 0.05), no-significant association was found between parents and children response to white coat (χ² = 0.39, p = 0.53). A highly significant difference was found between the male participants, who favored the male dentist and female participants preferring the female dentist (χ² = 47.16, p < 0.001). Conclusion: Our study attempted to rule out the stereotyped concept of ‘white coat fear’ among children, both children and parents favored traditional white coat attire, contrary to popular misconception ‘white coat syndrome’. However, use of child friendly attires could be useful in anxious children for better practice management. How to cite this article: Ellore VPK, Mohammed M, Taranath M, Ramagoni NK, Kumar V, Gunjalli G. Children and Parent's Attitude and Preferences of Dentist's Attire in Pediatric Dental Practice. Int J Clin Pediatr Dent 2015;8(2):102-107.

Composite restorations are popular because of their superior esthetics and acceptable clinical performance. But shrinkage is still a drawback. Polymerization shrinkage results in volumetric contraction, leading to deformation of the cusps, microleakage, decrease of marginal adaptation, enamel micro-cracks and postoperative sensitivity. A new class of ring opening resin composite based on silorane chemistry has been introduced with claims of less than 1% shrinkage during polymerization. The present study was conducted to evaluate and compare the ability of low shrink silorane based material, a packable composite and a compomer to resist microleakage in class II restorations on primary molars and evaluate marginal ridge fracture resistance of these materials. Sixty human primary molars were selected. Class II cavities were prepared and the teeth were divided into three groups of twenty each. Groups were as follows group I: low shrink composite resin (Filtek P90). Group II: packable composite (Filtek P60) and Group III: compomer (Compoglass F). Half of the teeth were used for microleakage and the rest for marginal ridge fracture resistance. For microleakage testing, dye penetration method was used with 1% methylene blue dye. Followed by evaluation and grading under stereomicroscope at 10× magnification. Fracture resistance was tested with universal testing machine. It was concluded that low shrink silorane based composite resin showed the least amount of microleakage, whereas compomer showed the highest microleakage. Packable composite resisted fracture of marginal ridge better than other composite resins. Marginal ridge fracture resistance of packable composite was comparable to the intact side. How to cite this article: Yeolekar TS, Chowdhary NR, Mukunda KS, Kiran NK. Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study. Int J Clin Pediatr Dent 2015;8(2):108-113.

Background: As the technological level of healthcare increases, it is important not to lose sight of the basics of patient care. No matter how sophisticated dental techniques have become, preventive dentistry still remains the foundation for oral health. Therefore, antimicrobial mouthrinses are developed to provide an effective means of preventing colonization by micro-organisms. Aim: The aim of this study was to evaluate and compare the antimicrobial activity of oil pulling, herbal mouthrinses and fluoride mouthwash on the caries activity and S. mutans counts in the saliva of children, using Oratest and Dentocult SM kit. Design: Fifty-two healthy children between the age group of 6 to 12 years were selected for the study and divided into four groups based on the mouthrinse used as group 1: fluoride, group 2: herbal, group 3: oil pulling and group 4: control. The estimation of caries activity and S. mutans was done prior to and after the subjects were instructed to use the mouthrinse twice daily for a period of 2 weeks. Statistical analysis: The comparisons were made by applying paired ‘t’ test with the level of significance set at p < 0.05. Difference between more than two mean values was done by using ANOVA and Post hoc Bonferroni test was used for multiple comparisons. Results and conclusion: The efficacy of fluoride and herbal mouthrinses was found to be comparable while oil pulling did not provide any additional benefit to be used as an effective antimicrobial agent in reducing the bacterial colonization of an individual. How to cite this article: Jauhari D, Srivastava N, Rana V, Chandna P. Comparative Evaluation of the Effects of Fluoride Mouthrinse, Herbal Mouthrinse and Oil Pulling on the Caries Activity and Streptococcus mutans Count using Oratest and Dentocult SM Strip Mutans Kit. Int J Clin Pediatr Dent 2015;8(2):114-118.

Topical anesthesia is widely advocated in pediatric dentistry practice to reduce pain and anxiety produced by administration of local anesthesia. Cryoanesthesia to lessen the injection pain has also been reported to be promising. However, sparse literature reports exist regarding clinical efficacy of these agents. Aim: The purpose of this study was to compare the efficacy of the refrigerant (1,1,1,3,3-pentafluoropropane/1,1,1,2-tetrafluoroethane), benzocaine and ice on the pain perception during intraoral injection using visual analog scale (VAS) and sound, eye, motor (SEM) scale. Study design: In this Spit-mouth design study, a total of 160 patients between the age group of 5 and 8 years were selected and were randomly divided into two equal groups having 80 patients in each group. Results: Ice cone has shown lower mean scores (p < 0.001) as compared to benzocaine and refrigerant whereas no significant difference was observed between refrigerant and benzocaine (p > 0.05) on both the scales. Conclusion: Ice cone had shown significantly higher efficacy as compared to benzocaine and refrigerant. How to cite this article: Lathwal G, Pandit IK, Gugnani N, Gupta M. Efficacy of Different Precooling Agents and Topical Anesthetics on the Pain Perception during Intraoral Injection: A Comparative Clinical Study. Int J Clin Pediatr Dent 2015;8(2):119-122.

Aim: To compare the effectiveness of conventional and game-based teaching on the level of knowledge and practice regarding oral hygiene among 7 to 10-year-old school children. Materials and methods: A total of 60 children aged 8 to 10 years were randomly divided into two groups: groups A and B. The intervention was started after the pretest evaluation of their knowledge regarding oral health and estimation of Debris Index-simplified (DI-S). Children in group A were given oral health education through flash cards once daily for 7 days. Children in group B were educated through the play-way method, i.e. connect the dots game combined with flash cards. The evaluations, regarding oral hygiene and DI-S were recorded on the 8th day after intervention. A follow-up score was also recorded after 1 and 3 months. Statistical analysis was done using paired t-test and Chi-square test. Results: There was significant increase in oral hygiene scores and decrease in debris scores compared to baseline in both groups at 1 week and 1 month. At 3 months interval, both groups showed a decrease in oral hygiene scores from baseline with group B showing highly significant reduction. The mean increase in knowledge score was also significantly better in group B (p < 0.05). Conclusion: The connect the dots game that includes oral health guidelines including good dental hygiene and dietary habits can thus be an effective intervention aid for teaching the basic oral health concepts among school going children. How to cite this article: Kumar Y, Asokan S, John B, Gopalan T. Effect of Conventional and Game-based Teaching on Oral Health Status of Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2015;8(2):123-126.

Objective: The aim of this study was to assess the safety and efficiency of MacLennan splint in symphysis and parasymphysis mandibular fractures in children. Study design: Six patients (four boys and two girls, mean age 3 years, range between 2 and 5 years) were operated on parasymphysis fractures of children. The mean follow-up time was 12 months. MacLennan splint was applied in these case upto 3 weeks. Results: Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operation was not endangered. Adverse tissue reaction like infection, malocclusion, swelling and growth restrictions did not occur during observation period. Conclusion: MacLennan splint is having various advantages like faster mobilization and the avoidance of secondary removal operations. Based on this preliminary results MacLennan splints are safe and efficient in the treatment of pediatric mandible fracture. How to cite this article: Khairwa A, Bhat M, Sharma A, Sharma R. Management of Symphysis and Parasymphysis Mandibular Fractures in Children Treated with MacLennan Splint: Stability and Early Results. Int J Clin Pediatr Dent 2015;8(2):127-132.

Periapical lesions develop as sequelae to pulp disease. Periapical radiolucent areas are generally diagnosed either during routine dental radiographic examination or following acute toothache. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, lesion sterilization and repair therapy and the apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations. The ultimate goal of endodontic therapy should be to return the involved teeth to a state of health and function without surgical intervention. All inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Surgical intervention is recommended only after nonsurgical techniques have failed. Besides, surgery has many drawbacks, which limit its use in the management of periapical lesions. How to cite this article: Sood N, Maheshwari N, Gothi R, Sood N. Treatment of Large Periapical Cyst Like Lesion: A Noninvasive Approach: A Report of Two Cases. Int J Clin Pediatr Dent 2015;8(2):133-137.

Brief background: Oroantral communication (OAC) is the space created between the maxillary sinus and the oral cavity, which, if not treated, will progress to oroantral fistula (OAF). Several methods of surgical OAC repair have been described, but only a few have gained recognition. Materials and methods: A 13 years old male child patient with complaint of difficulty in drinking water and change in voice diagnosed as OAF managed with closure with buccal fat pad (BFP). Discussion: Oroantral fistula is an abnormal communication resulting most frequently from extraction of the upper posterior teeth. Many techniques have been proposed for the closure. The preferred technique may vary from one surgeon to another. Conclusion: The adequate availability of BFP in children, effortless mobilization excellent blood supply and minimal donor site morbidity make it a perfect flap for OAF closure in pediatric patient. How to cite this article: Agrawal A, Singhal R, Kumar P, Singh V, Bhagol A. Treatment of Oroantral Fistula in Pediatric Patient using Buccal Fat Pad. Int J Clin Pediatr Dent 2015;8(2):138-140.

Sickle cell anemia is a genetic disease that primarily affects the black population. This anemia is due to a homozygous state of the abnormal hemoglobin S. An alteration occurs on the DNA molecule involving the substitution of the amino acid valine for glutamic acid at the sixth position on the beta polypeptide chain. This biochemical variation on the DNA molecule creates a physiological change that causes sickle-shaped red blood cells to be produced. The sickle-shaped cells are the result of the hemoglobin S being deoxygenated. This case report presents a case of 16-year-old female with sickle cell disease and its dental management. How to cite this article: Acharya S. Oral and Dental Considerations in Management of Sickle Cell Anemia. Int J Clin Pediatr Dent 2015;8(2):141-144.

Dental traumas are one of the most frequent facial traumas especially in children. Maxillary incisors are the most frequently involved teeth. Here we present, a report of a child who sustained a crown fracture with lost portion of tooth embedded in her lower lip for 6 months. The fragment was surgically retrieved and successfully reattached to the fractured 21 using acid-etch resin technique. How to cite this article: Marwaha M, Bansal K, Srivastava A, Maheshwari N. Surgical Retrieval of Tooth Fragment from Lower Lip and Reattachment after 6 Months of Trauma. Int J Clin Pediatr Dent 2015;8(2):145-148.

Robinow syndrome is an extremely rare genetic disorder. Short-limbed dwarfism, abnormalities in the head, face, and external genitalia, as well as vertebral defects comprise its distinct features. This disorder exists in dominant and recessive patterns. Patients with the dominant pattern exhibit moderate symptoms. More physical characteristics and skeletal abnormalities characterize the recessive group. The syndrome is also known as Robinow-Silverman-Smith syndrome, Robinow dwarfism, fetal face, fetal face syndrome, fetal facies syndrome, acral dysostosis with facial and genital abnormalities, or mesomelic dwarfism-small genitalia syndrome. Covesdem syndrome was the name entitled for the recessive form previously. Here, we report a case of 8-year-old female with a autosomal recessive Robinow syndrome having skeletal and vertebral defects. How to cite this article: Soman C, Lingappa A. Robinow Syndrome: A Rare Case Report and Review of Literature. Int J Clin Pediatr Dent 2015;8(2):149-152.

Sodium hypochlorite (NaOCl) is the most common and effective intracanal medicament used in root canal treatments, because of its low-cost and a very effective antimicrobial activity against microbiota of infected root canals. Sodium hypochlorite is an effective intracanal irrigant and is used in concentrations ranging from 0.5 to 5.25%. At these concentrations, it is highly hypertonic and strongly alkaline with pH 11 to 13. Despite its safe properties, serious complications can result from inadvertent use due to its cytotoxic features. Most of the complications are the result of accidental extrusion of the solution from the apical foramen or accessory canals or perforations into the periapical area. Although it is an effective solution for disinfection of root canal system, fewer incidence of complications are reported, especially in primary teeth. Present article highlights one of such cases of NaOCl accident and its successful management in a 4-year-old child. How to cite this article: Chaugule VB, Panse AM, Gawali PN. Adverse Reaction of Sodium Hypochlorite during Endodontic Treatment of Primary Teeth. Int J Clin Pediatr Dent 2015;8(2):153-156.

Non-bullous congenital ichthyosiform erythroderma (NBCIE) is an autosomal recessive form of inherited icthyosis appears as fine white scales that gradually replace collodion membrane. This case report describes management of 5 years and 11-month-old child with NBCIE suffering from early childhood caries (ECC) under general anesthesia. How to cite this article: Choudhary R, Satish V. Dental Treatment of a Child Suffering from Non-bullous Congenital Ichthyosiform Erythroderma under General Anesthesia. Int J Clin Pediatr Dent 2015;8(2):157-162.

Duchenne muscular dystrophy (DMD) is an recessive X-linked mediated, musculoskeletal disorder that affects only males. It is the most common and severe form of muscular dystrophy where there is failure to manufacture dystrophin. Clinically, it is characterized by progressive muscle wasting eventually leading to premature death. This case report describes the genetic, oral and systemic findings in two cases of DMD in male siblings. How to cite this article: Suneja B, Suneja ES, Adlakha VK, Chandna P. A Rare Case Report of Neurodegenerative Disease: Duchenne Muscular Dystrophy in Two Male Siblings. Int J Clin Pediatr Dent 2015;8(2):163-165.