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

Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4-6 were selected in children aged 4-8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection.

Background: Placement of intraoral appliances such as space maintainers (SMs) may be associated with the alteration of microbial and nonmicrobial parameters of saliva which may lead to the initiation of incipient caries.

Aim: The aim of this study was to compare and evaluate the changes in salivary flow rate, pH, and Streptococcus mutans levels in children undergoing fixed and removable SM therapy.

Materials and methods: The study participants comprised 40 children aged 4-10 years divided into two groups of 20 each. Children undergoing fixed (Group I = 20) and removable SM therapy (Group II = 20). Salivary flow rate, pH, and S. mutans levels were recorded just before and 3 months after the placement of SMs. Data were compared for both groups.

Statistical analysis: It was analyzed using SPSS software version 20. The level of significance was kept at 5%.

Results: A significant increase in salivary flow rate (<0.05) and S. mutans level (<0.05) was evident, however, no significant difference in pH was found in both the groups from baseline to 3 months after appliance placement. Group I showed a significant increase (<0.05) in S. mutans level as compared to Group II.

Conclusion: SM therapy allied both favorable and unfavorable changes in salivary parameters, thus emphasizing the importance of parent and patient education about maintaining proper oral hygiene during SM therapy.

Background: Over the course of four decades, the bioactive materials have changed. They have become more specialized, more manageable, possessing superior qualities. Thus, it should be encouraged to conduct ongoing research to improve these materials even further in order to meet the growing clinical and restorative needs.

Aims and objectives: To evaluate and compare bioactivity, fluoride release, shear bond strength and compressive strength of conventional GIC incorporated with three inorganic bioactive nanoparticles.

Materials and methods: For the study, total of 160 samples were included. The samples were divided in four groups (40 samples per group) i.e. 3 wt% of forsterite (Mg2SiO4) (Group 2), wollastonite (CaSiO3) (Group 3) and niobium pentoxide (Nb2O5) (Group 4) nanoparticles incorporated into GIC (Group 1). The bioactivity (FEG-SEM and EDX analysis), fluoride release (ion-selective electrode), shear bond strength testing (UTM followed by evaluation under stereomicroscope) and the compressive strength (UTM) was checked for each group.

Results: Wollastonite nanoparticles (3wt %) incorporated to GIC showed maximum increase in the apatite crystal formation,Ca and P content and highest fluoride release. Mean shear bond strength was highest in niobium pentoxide nanoparticles (3wt %) incorporated to GIC while mean compressive strength was highest in forsterite nanoparticles (3wt %) added to GIC.

Conclusion: Positive results were observed which showed increase in the bioactivity alongwith enhancement of the fluoride release, shear bond strength and compressive strength but further research on these materials is warranted before its use in clinical practice.

Background: Age estimation is an important approach in the field of forensics and medical sciences to assists in clinical practice, medico-legal cases, and in criminal cases of judicial punishment.

Aim: This study aim the applicability and comparison of four-teeth method and the alternate four-teeth method of Demirjian's approach among the Varanasi population.

Settings and design: This is a cross-sectional prospective study on the population of Varanasi region children and adolescents.

Materials and methods: Four hundred and thirty-two panoramic images of children and adolescents (237 boys and 195 girls) aged 3-16 years, from the population of Varanasi region oriental was assessed using the four-teeth method and the alternate four-teeth method of Demirjian's approach, for the estimation of dental age.

Statistical analysis: Pearson's two tailed test was applied to establish the correlation between chronological age and estimated dental age and Paired t-test was applied to check the statistical significance between mean chronological age and mean estimated dental age.

Results: The dental age of boys was overestimated by 0.39 ± 1.15 years (P < 0.001) and dental age was underestimated by - 0.34 ± 1.15 years (P < 0.001) among girls using the Demirjian's four teeth method. According to Demirjian's alternate four teeth method, the sample of boys overestimated the dental age by 0.76 ± 1.00 years (P < 0.001) with the statistically significant difference. While the sample of the girls had negligible overestimation of 0.04 ± 1.03 years (P = 0.580) with no statistically significant difference.

Conclusion: Demirjian's four teeth method is better to estimate dental age in boys, whereas Demirjian's alternate four teeth method in girls of Varanasi region.

Background: Caries management in the modern era has shifted away from the traditional surgical method toward a medical paradigm, which often includes fluoride therapy. Fluoride used in various forms has been proven to be effective in dental caries prevention. Silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish are effective in arresting caries in primary molars.

Aim: This study aimed to evaluate the effectiveness of 38% SDF and 5% NaF varnish in arresting caries in primary molars.

Settings and design: This study was a split-mouth randomized controlled trial.

Materials and methods: The randomized controlled trial comprised 34 children aged 6-9 years with teeth having caries in both right and left primary molars without pulpal involvement. Teeth were randomly allocated into two groups. In Group 1 (n = 34), 38% SDF + potassium iodide was applied and in Group 2 (n = 34), 5% NaF varnish was applied. The second application was done after 6 months in both groups. Children were recalled at 6- and 12-month intervals and evaluated for caries arrest.

Statistical analysis: Chi-square test was used to analyze the data.

Results: Caries arresting potential was found to be higher in the SDF group compared to the NaF varnish group at both 6-month (SDF - 82% and NaF varnish - 45%) and 12-month intervals (SDF - 77% and NaF varnish - 42%) and the difference was found to be statistically significant (P = 0.002 and 0.004, respectively).

Conclusion: SDF was more effective in arresting dental caries in primary molars compared to 5% NaF varnish.

Research question: To estimate the pooled prevalence of molar incisor hypomineralization (MIH) in children from India.

Research protocol: The PRISMA guidelines were followed.

Literature search: An electronic search of the databases was performed to find prevalence studies of MIH in children above age 6 years in India.

Data extraction: Two authors independently extracted the data from the 16 included studies.

Quality appraisal: The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale adapted for cross-sectional studies.

Data analysis: The pooled prevalence estimate of MIH was calculated using logit transformed data with inverse variance approach in a random-effects model with 95% confidence interval (CI). Heterogeneity was assessed with the I² statistic. The subgroups were analyzed to assess the pooled prevalence of MIH according to sex, arch-wise proportion of MIH-affected teeth, and proportion of children with the MIH phenotypes.

Results and interpretation of results: Sixteen studies included in the meta-analysis represented 7 states of India. A total of 25,273 children were included in the meta-analysis. The pooled prevalence of MIH in India was estimated to be 10.0% (95% CI: 0.07, 0.12) with significantly high heterogeneity between the included studies. The pooled prevalence did not vary according to sex. The pooled proportions of MIH-affected teeth were similar in the maxillary and mandibular arches. The pooled proportion of children with MH phenotype was higher (56%) than those with M + IH phenotype (44%). Further studies with standardized criteria for recording MIH are needed to ascertain the prevalence of MIH in India.

Context: Early childhood caries is a major health problem affecting children worldwide. Although incorrect feeding practices hold a prime position in the etiology, there are gaps in the literature pertaining to the physical properties of milk.

Aim: To assess the viscosity of human breast milk (HBM) versus infant milk formulae, with and without the addition of sweetening agents.

Materials and methods: All commercially available infant milk formulae (60 samples) and breast milk from 30 donor mothers were assessed for viscosity using Brookfield DV2T viscometer. The study period was from April 2019 to August 2019. Viscosity of infant milk formulae sweetened with sugar, honey, and brown sugar was further investigated and compared with that of HBM.

Statistical analysis: Inter-group and intra-group mean viscosity was compared using independent t-test and repeated-measures ANOVA.

Results: Viscosity of HBM ranged from 18.36 centipoise (cP) to 91.30 cP, the mean viscosity being 45.7 cP. Viscosity values varied for each formula group, the least being as low as 5.1 cP and the highest being 89.3 cP. The mean viscosities of each group were in the range of 33 to 49 cP.

Conclusions: HBM was found to have a tendency toward higher viscosity than most of the infant milk formulae. Also, varied viscosity values were obtained when commonly used sweetening agents were added to infant milk formulae. Greater viscosity of HBM might increase its adherence to enamel surface leading to prolonged demineralization and potentially altering the caries risk, needs to be investigated further.

Background: Pit and fissure sealing is an evidence-based preventive measure against dental caries, especially in primary teeth which possess high caries risk, and to give the required benefits of the sealant, a good adaptation, and sealing ability should be present.

Purpose: This study aimed to assess and compare the microleakage score of Ionoseal^® pit and fissure sealant, when used either alone or with prior surface treatment of erbium-doped yttrium aluminum garnet (Er: YAG) laser, acid etching, or their combination, in primary teeth.

Materials and methods: Forty healthy human molar teeth were randomly chosen and allocated into four study groups according to the surface pretreatment: group I, no surface pretreatment; Group II, 2W Er: YAG laser etching, Group III, combined laser etching and acid etching group, and Group IV, 37% phosphoric acid etching. After surface pretreatment procedures were conducted, the teeth were sealed with Ionoseal^®. Subsequent microleakage was assessed through dye penetration under a stereomicroscope. One sample from each group was randomly selected, and scanning electron microscopy (SEM) was carried out on the central slice of the three obtained slices of the samples.

Results: Chi-square test revealed a high statistically significant difference between groups (P = 0.00). Similarly, all pairwise comparisons revealed a statistically significant difference. Group I showed the greatest mean of microleakage score (1.5), followed by Group IV (1.4), Group II (0.7), and Group III which showed the least microleakage score (0.6). These findings were supported by the SEM examination results.

Conclusions: Using Ionoseal with prior surface treatment by combined 2 W Er: YAG laser etching and 37% phosphoric acid etching can result in the best sealing ability which would significantly enhance the long-term success of pit and fissure sealing in primary teeth.

Objectives: This study aimed to determine the mean oxygen saturation values (SpO₂) in primary teeth using pulse oximetry.

Materials and methods: This comprehensive literature search on pulse oximeter used for primary teeth in determining pulp vitality using MeSH terms in four electronic databases, including PubMed, Scopus, Cochrane Library, and Ovid^SP, from January 1990 to January 2022. Studies reported the sample size and the mean SpO₂ values (with standard deviations) for each tooth group were included. The quality assessment of all the included studies was done using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa Scale. The meta-analysis included studies reporting means and standard deviations of SpO₂ values. The I² statistics were used to determine the degree of heterogeneity among the studies.

Results: A total of 90 studies were identified, of which five met the eligibility criteria that were qualified for the systematic review, and among them, three were included in the meta-analysis. All five included studies were of low quality due to the high risk of bias related to the patient selection, index test, and uncertainties about outcome valuation. In the meta-analysis, the mean fixed-effect measure of oxygen saturation in the pulp of primary teeth was 88.45% (confidence interval: 83.97%-92.93%).

Conclusion: Though most of the available studies were of poor quality, the SpO₂ in the healthy pulp can be established (minimum saturation, 83.48%) in primary teeth. Reference values established might help clinicians to assess changes in pulp status.

Background: Molar Incisor Hypomineralization (MIH) affects about 14% of the population. MIH may lead to enamel breakdown, early tooth decay and is known to cause sensitivity, pain, discomfort, etc., Despite several studies reporting impacts of MIH on oral health-related quality of life (OHRQoL) in children; no systematic review has been reported till date.

Objectives: Our study aimed at assessing the impact of MIH on OHRQoL.

Search methods: Two researchers, Ashwin Muralidhar Jawdekar and Shamika Ramchandra Kamath, independently searched articles using appropriate keyword combinations in three search engines - PubMed, Cochrane Library, and Google Scholar and conflicts, if any were resolved by Swati Jagannath Kale. Studies either reported in English or complete translations available in English were selected.

Selection criteria: Observational studies on otherwise healthy 6-18-year-old children were considered. Interventional studies were included only to collect the baseline (observational) data.

Data collection and analysis: From 52 studies, a total of 13 studies could be included in the systematic review and 8 in meta-analysis. Total scores of OHRQoL measures reported in the child perceptions questionnaire (CPQ) 8-10, CPQ 11-14, and parental-caregiver perception questionnaire (P-CPQ) scales were used as variables.

Main results: Five studies (2112 subjects) showed an impact on OHRQoL (CPQ); the pooled risk ratio (RR) confidence interval (CI) were 24.70 (13.93-35.47), showing statistically significant value (P < 0.001). The Three studies (811 participants) showed an impact on OHRQoL (P-CPQ); the pooled RR (CI) was 16.992 (5.119, 28.865) showing statistically significant value (P < 0.001). Heterogeneity (I²) was high (99.6% and 99.2%); hence, random effect model was used. Sensitivity analysis of two studies (310 subjects) showed impact on OHRQoL (P-CPQ); the pooled RR (CI) was 22.124 (20.382, 23.866) showing statistically significant value (P < 0.001); the heterogeneity was low (I² = 0.0). The risk of bias across studies assessed using the appraisal tool for cross sectional studies tool was found to be moderate. The reporting bias assessed using the dispersion on the funnel plot was found to be minimal.

Authors' conclusions: Children with MIH are about 17-25 times more likely to have impacts on the OHRQoL compared to children with no MIH. Evidence is of low quality due to high heterogeneity. The risk of bias was moderate and publication bias was low.