Journal of the Indian Society of Pedodontics and Preventive Dentistry最新文献

Abstract: Skepticism about the long-term stability of immediate results achieved due to ongoing changes in craniofacial structures till growth completion is perhaps one of the reasons why very early treatment of Class III malocclusion is often not considered by many clinicians. This paper highlights the positive growth changes in the long-term, post-correction, in different types of developing Class III relations in children aged 2-5 years. The favorable outcomes may urge a more significant number of pediatric dentists to undertake this initiative for the benefit of young child patients and the orthodontists to guide timely referrals.

Background: Hospitalized children find difficulty in performing regular oral hygiene procedures. In such cases, direct application of herbal oils such as olive oil, Azadirachta indica (AI) (neem), and Curcuma zedoaria (CZ) (white turmeric) as antiplaque agents could be beneficial in maintaining oral hygiene.

Aim: The aim of the study was to evaluate the efficacy of normal saline, extra virgin olive oil (EVOO), EVOO with 35% CZ, and EVOO with 30% AI on dental plaque and the count of Streptococcus mutans, Lactobacillus, and Candida albicans in hospitalized children.

Settings and design: This was a randomized control trial.

Materials and methods: 84 hospitalized children of age group 3-14 years were randomly divided by computer-generated random allocation into Group A-EVOO, Group B-EVOO + 35% CZ, Group C-EVOO + 30% AI, and Group D-normal saline with 21 participants in each group and applied with sterile gauze. The plaque score was recorded and analyzed by Loe and Silness plaque index. In addition, plaque sample for microbial analysis was collected from buccal/lingual surfaces, and CFU count was measured at baseline, 24 h, 48 h, and 72 h.

Results: The four groups showed a reduction in plaque score and CFU counts from baseline to 72 h with P < 0.05 indicating a statistically significant difference. Group C has shown significant antimicrobial activity against Group A, Group B, and Group D (P = 0.0001) at 72 h.

Conclusion: EVOO + 35% CZ showed the best treatment outcome in the reduction of microbial count followed by EVOO + 30% AI and EVOO. All the preparations including normal saline have antiplaque properties with the best outcome achieved in EVOO + 35% CZ and EVOO + 30% AI preparations.

Background: Despite the clinical success of existing pulpotomy medicaments, the search for novel and economically viable alternatives continues. This study aimed to evaluate and compare the efficacy of eggshell-derived nano-hydroxyapatite (EnHA) and amniotic membrane (AM) as pulpotomy agents in primary teeth.

Materials and methods: The study included 44 primary molars from 21 children aged 5-10 years, each presenting with at least two decayed primary molars requiring pulp therapy. The teeth were randomly assigned to two groups: Group I (EnHA) and Group II (AM), with 22 molars in each group. The standard pulpotomy procedure was performed on all selected teeth, and the clinical and radiographic outcomes were evaluated at 3, 6, and 9 months posttreatment. The data were statistically analyzed using the Chi-square test and Cochran's Q test to determine intergroup differences.

Results: At the 9-month follow-up, Groups I and II showed a clinical success rate of 90%, and 85% respectively. Radiographically, the success rate was 85% for Group I and 75% for Group II. No statistically significant difference (P > 0.05) was noticed between the clinical and radiographic outcomes in both the groups, indicating similar efficacy between the materials.

Conclusion: Both EnHA and AM demonstrated comparable clinical and radiographic success rates. These findings suggest that both materials may serve as promising, cost-effective alternatives to conventional pulpotomy agents in primary teeth, offering a biologically based approach to pulp therapy.

Context: Thalassemia is a genetic blood disorder caused by gene mutation leading to chronic anemia, and patients will need routine blood transfusions as a lifetime supportive therapy. Previous studies show high prevalence of periodontal disease in patients who receive routine blood transfusions. Recent studies found probiotic supplementation as an adjuvant therapy in managing periodontal disease.

Aims: This study aimed to analyze the effect of Lactobacillus reuteri probiotic consumption on gingival index and salivary interleukin-1β levels of children with thalassemia experiencing gingivitis.

Settings and design: This was an evaluative study conducted at a tertiary care hospital in Jakarta, Indonesia.

Participants and methods: In this study, 16 children aged 6-12 with thalassemia major were recruited in Instalasi Pelayanan Terpadu Kesehatan Ibu dan Anak RSUPN Dr. Cipto Mangunkusumo. Dental health education and Lactobacillus L. reuteri probiotics supplementation 1×/day for 14 days were given to all participants. The gingival index by Lobene was measured at baseline and day 14. Salivary interleukin-1β levels were tested by ELISA Kit in a laboratory.

Statistical analysis used: Dependent t-test.

Results: There was a significant difference in gingival index and salivary interleukin-1β levels of children with thalassemia after consuming L. reuteri probiotics for 14 days.

Conclusion: L. reuteri probiotic consumption for 14 days significantly reduced the gingival index and salivary interleukin-1β levels of children with thalassemia experiencing gingivitis.

Background: Children from tribal regions in remote geographic locations face several health-related challenges that often remain unnoticed due to a lack of reporting. Untreated dental caries is one such problem with inadequate data from the Himalayan region of Ladakh in north India. This may portray a wrong picture to the policymakers and hence, inadequate efforts to mitigate oral health issues.

Aim: This cross-sectional epidemiological study aimed to evaluate the prevalence of Early Childhood Caries (ECC) among three to 6-year-old children in the Leh district of the union territory of Ladakh.

Setting and design: This cross-sectional community (school) based study was conducted among the preschool children of Leh Ladakh.

Methodology: The study included 402 preschool children from private and government schools. Oral health status was evaluated in the school premises after consent from the school and parents. The status of ECC was recorded using International Caries Detection and Assessment System II criteria (2005) and oral hygiene by using the Plaque Index (1967).

Statistical analysis: The association between the variables was assessed using the Chi-square test. The probability was set at 0.05 to be statistically significant.

Result: The overall prevalence of ECC was recorded as 94% (95% confidence interval, 91%-96%). It was found to be 94% in government and 93% in private schools. The most frequently involved teeth were in the mandibular posterior region, whereas maxillary anterior teeth showed the most extensive involvement. The prevalence of ECC is directly proportional to plaque index scores.

Conclusion: The prevalence of ECC was found to be very high (94%) among the preschool children of the tribal region in Leh district. It followed the usual pattern of involvement among different dental segments and association with the accumulation of plaque.

Background: Local anesthesia administration is associated with pain, resulting in dental anxiety in children. Various techniques have been tried to minimize this discomfort such as topical anesthetic gel, spray, Vibration of tissue, and distraction techniques. Literature has shown lesser evidence for photobiomodulation (PBM) in pain reduction for pediatric patients.

Aim: To compare the efficacy of PBM 810 nm versus topical local anesthetic spray in reducing injection pain in children of age 6-12 years.

Materials and methods: Fifty-four children aged 6-12 years who visited the outpatient department, department of pediatric and preventive dentistry, requiring local anesthetic administration during invasive procedures were randomly allocated into three groups, namely Group 1 - topical spray (lignocaine hydrochloride 2%), Group 2 - PBM (810 nm, 0.6 W, 40 s), and Group 3 - PBM (810 nm, 0.6 W, 3 min). Pain was assessed subjectively and objectively using the Wong-Baker Faces Pain Rating Scale (WBS) and Sound-Eye-Motor (SEM) Scale, respectively. Objective and subjective pain scores were evaluated using One way ANOVA and jaw wise comparison of PBM efficacy done using independent t-test.

Results: The mean WBS scores for Group 1, Group 2, and Group 3 were 3.8 ± 2.21, 1.77 ± 2.81, and 4.11 ± 3.1, respectively, and the difference was statistically significant (P = 0.025) between Group 1 (control) and Group 2 (PBM 40 s). However, no significant difference was found in considering SEM scores. Irrespective of bone topography, PBM was effective in reduction of injection pain, though it was not significant during local infiltration.

Conclusion: PBM with 810 nm laser, 0.6 W for 40 s is more effective in reducing the injection pain compared to topical anesthetic spray and PBM for 3 min.

Background: Nano silver fluoride (NSF) can be used to prevent and arrest caries. The release of silver, fluoride combined with calcium, phosphate ions within the saliva will reinforce the antimicrobial and remineralization of carious lesion.

Aim: The aim of this study was to evaluate the bioavailability of ions in saliva of children with early childhood caries (ECC) at different time intervals at pre- and post-application of NSF varnish.

Materials and methods: Sixty saliva samples were collected from 20 ECC children as follows: pretreatment before the application of NSF (T0), posttreatment after the application of NSF at 1 day (T1), and posttreatment after the application of NSF at 15 days (T2). Samples were then subjected to ion analysis (fluoride ion in ppm using ultraviolet-visible spectrophotometer and silver, calcium, phosphorous ion in ppm using inductively coupled plasma optical emission Spectrophotometry.

Results: The results of the study showed that the mean ions concentration was significantly higher in T1 >T2>T0 which is statistically significant at P < 0.001.

Conclusion: The bioavailability of ions increased after application of NSF in the present study. In conclusion, NSF is an effective anti-caries agent in young children.

Context: Effective pain management in children during local anesthetic administration would be a key to a successful and painless dental procedure. Precooling (PC) has emerged as pain control tool in dentistry.

Aims: This study aims to evaluate and compare the efficacy of lidocaine Ice button and lidocaine gel as topical anesthesia during maxillary buccal infiltration in children.

Settings and design: Randomized crossover trial, department of pediatric and preventive dentistry.

Subjects and methods: Thirty children [60 local anesthesia (LA) injections] aged 6-10 years requiring bilateral maxillary buccal infiltration for dental procedure, divided into 2 groups with equal distribution for this split-mouth study. The study group was lidocaine ice button topical anesthesia; the control group was the lidocaine gel group. Subjective pain was evaluated using Wong-Baker Faces Pain Rating Scale, objective pain evaluation was done using Sound Eye and Motor (SEM) scale. Anxiety assessment using Venham picture test (VPT) and physiologic parameters such as SpO2 and Heart rate were evaluated before, during, and after administration of LA. Acceptance of lidocaine ice button was evaluated using a customized validated questionnaire.

Statistical analysis used: Data recorded in Microsoft Excel 365 and subjected to statistical analysis using Statistical Product and service solution SPSS version 21.0 with P value considered statistically significant at < 0.05.

Results: A significant reduction in pain on injection for both objective and subjective evaluations in the Lidocaine Ice Button group, as topical anesthesia was seen (P < 0.00011) Majority of the children preferred the use of Lidocaine ice button as a topical anesthetic. No difference in pain was observed in groups based on treatment sequence.

Conclusions: Less pain on injection was observed, proving the efficacy of lidocaine ice button as topical anesthesia for maxillary infiltration in the study. Lidocaine ice button was well accepted by the children as topical anesthesia.

Context: Balancing and compensating extractions (BCEs) of primary teeth are widely practiced in pediatric dentistry to prevent space loss and midline deviations. However, pediatric dentists' preferences regarding BCEs may be influenced by various demographic and professional factors. Understanding these preferences is essential for standardizing guidelines and optimizing clinical decision-making.

Aims: This study aims to investigate whether pediatric dentists' preferences for BCEs of primary teeth within the British Society of Paediatric Dentistry (BSPD) are influenced by age, gender, clinical work setting, and referral practices to orthodontists.

Settings and design: A survey of the total population of BSPD members was conducted to explore variations in BCE practices based on demographic and professional characteristics.

Subjects and methods: A structured online survey was distributed to 288 BSPD members. The questionnaire included demographic questions and clinical case scenarios related to BCEs. The survey was pilot-tested and validated before distribution. The study adhered to national clinical guidelines, and ethical approvals were obtained.

Statistical analysis used: Categorical data were analyzed using descriptive statistics. Contingency tables were generated to compare groups, and statistical significance was assessed using Chi-square or Fisher's exact tests, where appropriate. Cramér's V (CV) test was used to determine effect sizes. Statistical significance was set at P < 0.05.

Results: Over 80% of pediatric dentists adhered to national guidelines for BCEs, with secondary care practitioners exhibiting a slightly higher adherence rate (86%) compared to primary care practitioners (66.7%). Significant differences in BCE practices were found for primary canines in crowded arches by clinical setting (P = 0.001, CV = 0.493), for first molars in crowded arches by gender (P = 0.05, CV = 0.319), and for primary canines in spaced arches by age (P = 0.001, CV = 0.463). For children aged 6-9 years, differences were significant for primary canines in crowded arches by clinical settings (P = 0.004, CV = 0.436) and for first molars in spaced arches by gender (P = 0.034, CV = 0.376). Older pediatric dentists (over 50 years) were significantly less likely to refer patients for orthodontic opinions than younger dentists (P = 0.019, CV = 0.317).

Conclusions: Pediatric dentists' BCE preferences are influenced by their clinical work settings, age, and gender. The study highlights the need for standardizing BCE guidelines and emphasizes the importance of interdisciplinary collaboration with orthodontists to ensure evidence-based, uniform decision-making.