International Journal of Clinical Pediatric Dentistry最新文献

Aim: To compare the efficacy of buccal infiltration (BI) and intraligamentary (IL) injection with 4% articaine in achieving anesthesia for pulp therapy in primary mandibular molars.

Materials and methods: A study was conducted in children aged between 4 and 8 years, whose primary mandibular molars were indicated for pulp therapy. Both injection procedures, IL and BI using articaine, were used in the same patient for bilateral pulp therapy of primary mandibular molars at an interval of 1 week appointments. Sound, Eye, Motor (SEM) scale, Facial Image Scale (FIS), and Visual Analog Scale (VAS) were used to assess pain at the time of injection and at the time of pulp therapy. Statistical analysis was done using the Chi-square test, independent t-test, and paired t-test.

Results: Both IL and BI techniques using 4% articaine serve as an alternative to the inferior alveolar nerve block (IANB) with lignocaine.

Conclusion: BI was less painful and more comfortable in patients at and during the time of pulp therapy when compared to IL injection.

How to cite this article: Saket A, Gupta S, Pandey P, et al. Comparative Evaluation of Efficacy of Buccal Infiltration and Intraligamentary Injection with 4% Articaine in Primary Molars: In Vivo Study. Int J Clin Pediatr Dent 2026;19(1):8-12.

Aims: To perform minimally invasive and preventive treatment in patients with Marfan syndrome (MFS) with hyperdontia in the upper jaw.

Background: Marfan syndrome is an autosomal dominant genetic disease of the connective tissue that is characterized by manifestations in cardiovascular, musculoskeletal, ophthalmological, and oral structures. The diagnosis of this disease is based on clinical and genetic criteria called the Ghent criteria. Within the oral manifestations, hyperdontia may occur, which corresponds to a numerical variation in the number of normal teeth; it can occur in a single or multiple ways, affecting both jaws unilaterally or bilaterally.

Case description: A 6-year-old male patient attended the Dental Care Center of the University of the Americas (CAO/UDLA) for evaluation. The reason for consultation was an anomaly in the shape of the upper central incisor. Clinical examination revealed tooth 21 in the shape of a nail, compatible with microdontia. The periapical radiographic examination determined the presence of supernumerary teeth, and the tomographic examination confirmed the diagnosis of hyperdontia in the definitive central incisors, altering the chronological eruption. Surgery and correction of the alteration are scheduled with the interdisciplinary team.

Conclusion: A successfully planned minimally invasive surgical treatment was performed. The initiation of preventive orthopedic treatment will provide the patient with an appropriate expansion of the upper jaw to provide adequate space for the eruption of their permanent anterosuperior teeth.

Clinical significance: Marfan syndrome brings important dental complications to consider and know.

How to cite this article: Valdiviezo JP, Hidalgo AC, Tates MR, et al. Marfan Syndrome-Comprehensive Dental/Surgical Management: Clinical Case Report. Int J Clin Pediatr Dent 2026;19(1):100-104.

Objective: To evaluate children's perspectives on pediatric dentists and dental environments using the write-and-draw technique.

Materials and methods: Children were divided into two groups based on prior dental experience. Anxiety levels were assessed using the Child Drawing: Hospital (CD:H) scale, and participants were asked to draw and write about their perceptions of dental visits.

Results: Children with prior dental experience showed lower anxiety levels. No significant gender differences in anxiety were observed within groups. Both genders in the exposed group exhibited lower anxiety than those in the nonexposed group. Children preferred play areas, colored clothing for dentists, and toy-shaped dental instruments. Even children without dental experience demonstrated basic oral health knowledge.

Conclusion: The write-and-draw technique effectively elucidates children's perspectives on dental experiences. Findings suggest tailoring anxiety management strategies based on previous dental exposure and creating child-friendly environments to improve pediatric dental experiences.

How to cite this article: Luqmana M, Kumar B, Pathivada L, et al. Evaluating Children's Attitudes toward Dentistry Using Write-and-draw Approach: A Cross-sectional Study. Int J Clin Pediatr Dent 2026;19(1):61-66.

Aims and background: This study compared the antimicrobial efficacy and cytotoxicity of traditional zinc oxide eugenol (ZOE) and a novel formulation of zinc oxide mixed with Achyranthes aspera leaf extract. A. aspera is known for its medicinal properties, and its potential as an alternative to eugenol in dental applications has been explored.

Objective: To compare and evaluate the antimicrobial efficacy of ZOE and zinc oxide with Achyranthus aspera leaf extract. To compare and evaluate the cytotoxicity of ZOE and zinc oxide with Achyranthes aspera leaf extract. To compare and evaluate the dentinal adaptability of ZOE and zinc oxide with Achyranthus aspera leaf extract.

Materials and methods: Antimicrobial efficacy against Enterococcus faecalis, Aggregatibacter actinomycetemcomitans, and Candida albicans was assessed using the agar diffusion method. Cytotoxicity was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The zones of inhibition were measured for antimicrobial analysis, and cell viability was recorded for cytotoxicity evaluation.

Results: The combination of zinc oxide and A. aspera formulation demonstrated significant antimicrobial activity, comparable to that of traditional ZOE. Also, cytotoxicity analysis revealed that the novel formulation exhibited lower toxicity to fibroblast cells than ZOE, indicating better biocompatibility.

Conclusion: Zinc oxide mixed with Achyranthes aspera leaf extract is a promising alternative to conventional ZOE, offering effective antimicrobial properties with reduced cytotoxicity. This suggests its potential use in dental applications where eugenol-induced toxicity is a concern.

Clinical significance: This study highlights the potential of A. aspera as a natural and biocompatible alternative to eugenol in dental materials. This novel formulation may enhance patient safety by reducing cytotoxic effects while maintaining antimicrobial efficacy, making it a viable option for endodontic and restorative applications.

How to cite this article: Abishek CB, Srinivasan D, Pragadesh G, et al. Evaluation of Antimicrobial Efficacy and Cytotoxicity of Zinc Oxide with Achyranthes aspera as Obturating Material in Primary Tooth: In Vitro Study. Int J Clin Pediatr Dent 2026;19(1):24-28.

Introduction: Bicuspidization is a surgical technique aimed at preserving mandibular molars with furcation involvement, a condition that compromises periodontal health and can lead to tooth loss. This procedure involves separating a molar into two functional units, facilitating improved access for oral hygiene and promoting long-term tooth retention. Iatrogenic furcation perforations, a complication of endodontic treatment, can further complicate these cases. This report presents a successful application of bicuspidization in a compromised mandibular molar.

Case description: A 14-year-old male presented with masticatory pain. Clinical examination revealed a pulpal floor perforation in a previously root canal-treated tooth #46. Radiographic evaluation showed furcation involvement. After unsuccessful initial management with Mineral Trioxide Aggregate (MTA), bicuspidization was performed. The procedure involved flap elevation, debridement, vertical sectioning of the tooth, and suture placement. Postoperative care included analgesics, oral hygiene instructions, and follow-up appointments. Crown lengthening and a single-unit cast metal crown were delivered at a later appointment. Clinical and radiographic evaluations at follow-up appointments (6, 9, and 18 months) demonstrated satisfactory healing and function.

Conclusion: Bicuspidization is a viable treatment option for managing mandibular molars with furcation involvement, particularly when aiming to preserve natural dentition. This case demonstrates that bicuspidization can effectively address furcation perforations, improve periodontal health, and provide a functional alternative to extraction.

Clinical significance: Bicuspidization preserves compromised molars with furcation involvement, offering an alternative to extraction by improving periodontal health, hygiene access, stability, and tooth prognosis.

How to cite this article: Aggarwal S, Zacharias L, Shetty R, et al. Bicuspidization-A Conservative Approach in Pediatric Dentistry: A Case Report. Int J Clin Pediatr Dent 2026;19(1):105-109.

Aim and background: The principal emotions of a child entering the dental operatory are usually fear and anxiety, which have an impact on their behavior during all future appointments. Over the past couple of decades, there has been a significant shift in professional and societal perspectives on handling child behavior. Hence, many dentists are interested in additional noninvasive alternatives to conventional behavior management techniques. Therefore, the goal of this study was to assess and relate the efficacy of three such minimally invasive, nonpharmacological behavior management methods in reducing dental anxiety by using certain physiological variables and an anxiety assessment scale (i.e., psychological variable), before and after a dental procedure.

Materials and methods: This single-blind, randomized clinical trial involved 88 subjects randomly allocated to four groups, who were treated under the influence of three different behavior management techniques (viz., audio distraction, aromatherapy, and clown therapy) and a conventional technique (control group). Anxiety levels were assessed using the Raghavendra Madhuri Sujata Pictorial Scale (RMS-PS), and measuring the changes in their hemodynamic variables and salivary biomarkers, prior to, and following treatment. The data were tabulated and statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 21.0 statistical software.

Results: All three behavior management techniques assessed in this study were effective in lowering anxiety levels among the subjects. More specifically, audio distraction outperformed the other two techniques, followed by the aromatherapy technique, which was found to be better than clown therapy and control groups.

Conclusion: While all three methods are able to lower dental fear and anxiety in children, audio-distraction is better among the three at achieving the same.

Clinical significance: Results of this study have the potential to guide pediatric dentists in selecting evidence-based, patient-friendly approaches to behavior guidance, thereby improving the overall quality of care, reducing appointment durations, and fostering a more positive dental experience for children.

How to cite this article: Dey MK, Dhinsa K, Yadav G, et al. A Comparative Assessment of Three Different Behavior Modification Techniques Using Physiological and Psychological Parameters: An In Vivo Study. Int J Clin Pediatr Dent 2026;19(1):73-84.

Aim and background: Indirect pulp capping (IPC) provides an approach to protect functional primary teeth up until their natural exfoliation occurs. The material used for capping must possess three essential characteristics, including biocompatibility, good sealing ability against bacteria, and support for pulp natural healing functions. The aim of this research investigation entails assessing the performance of mineral trioxide aggregate (MTA) putty and bioceramic putty as IPC materials within deciduous molars.

Design: The research involved 82 children from age 4 to 9 years. Teeth with carious lesions that needed IPC were divided into two different groups based on capping material, where group I contained MTA putty and group II held bioceramic putty. The evaluation of both clinical and radiological success was performed at each time point using Rajashekharan criteria on teeth that underwent IPC. The examination included checking for dentinal bridge formation. Statistical evaluation of all collected data used the McNemar Chi-squared test combined with the Pearson Chi-squared test and the independent t-test.

Results: The intergroup analysis was performed using the Pearson Chi-squared test. No failures occurred in either group based on radiological or clinical examinations at both 3 and 6 months of follow-up. At 9-month follow-up, the success rate was 100% in group I and 95.1% in group II. The difference was statistically nonsignificant. The proportion of patients who demonstrated increased dentinal bridge at the 9-month follow-up reached 97.6% in group I and amounted to 68.3% in group II, showing a statistically meaningful gap between the groups (p-value = 0.002).

Conclusion: MTA putty and bioceramic putty have proven their effectiveness for obtaining positive clinical and radiological results according to this investigation. The collected data demonstrate that bioceramic materials are effective in dentistry and provide essential information for deciding clinical pulp therapy approaches.

How to cite this article: Garg P, Sheoran N, Saraf BG, et al. Comparative Evaluation of Mineral Trioxide Aggregate and Bioceramic Putty for Indirect Pulp Capping in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2026;19(1):40-46.

Aim and background: In Spain, a new digital workflow protocol has been developed for patients with cleft lip and palate. This protocol involves several steps, including the creation of a double aligner tray for nasoalveolar molding (2A-NAM) and the utilization of digital intraoral scans for the movement design. The sequential process includes: intraoral scanning (IOS), virtual design (VD), digital impression (DI), 2A-NAM preparation, and analysis of anatomical changes. This process is repeated until the desired outcomes are achieved.

Case description: At just 7 days of age, records of the male child were obtained using an iTero® Element 5D intraoral laser scanner. Additionally, an extraoral record was taken to measure the distance from the commissure to the left nostril, which enables the reconstruction of the nasal stent of the tray. The resulting stereolithography (STL) files underwent digital planification using 3D NemoStudio. The degree of approximation, rotation, and inclination of major and minor segments varied for each (M) based on each individual record and the patient's specific condition. Finally, the Form 3+® 3D-printer was used to produce the VD using Formlabs® photopolymer resin. The technician then assembled the device using a Durasoft® PD splint (both hard and soft components), to which tension springs were added using wire and secured with resin. A total of five 2A-NAMs were required to achieve proper segment approximation prior to orthopedic surgery at 4.5 months of age.

Conclusion: By assessing the anatomical predictions provided by digital simulation, clinicians can make proper decisions regarding the approximation of the maxillary segments of the patient.

Clinical significance: The predictability of planned approximation movements and the absence of aligner injuries motivate the promotion of the protocol as a reliable method that facilitates pediatric dentistry and orthodontic treatment for any professional, ensuring patient safety.

How to cite this article: Rico-Lillo I, García-García VJ, Kasem K, et al. Doble Aligner Nasoalveolar Molding: A New Approach of Digital Protocol for Cleft Lip and Palate in Newborn Patients. Int J Clin Pediatr Dent 2026;19(1):110-119.

Background: Human dental pulp cells (HDPCs) are the primary cellular components of the pulp tissue and play a crucial role in its regenerative potential. In the context of vital pulp therapy (VPT), naturally derived herbal compounds have emerged as potential alternatives to conventional direct pulp capping agents due to their biocompatibility and bioactivity. Baicalein, a flavonoid derived from Scutellaria baicalensis, a traditional Chinese medicinal herb, has demonstrated anticancer, antiviral, and anti-inflammatory properties. However, its effects on odontogenic differentiation of dental pulp stem cells (DPSCs) remain unclear.

Aim: To evaluate the effect of baicalein on the odontogenic differentiation of DPSCs.

Materials and methods: Baicalein was prepared in varying concentrations from a commercially available source. DPSCs were isolated using the explant culture method and characterized through flow cytometry for mesenchymal stem cell (MSC) markers: CD73, CD90 (positive), and CD34, CD45, and HLA-DR (negative). Cytotoxicity was assessed using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. Odontogenic differentiation and mineralization were evaluated by measuring alkaline phosphatase (ALP) activity and mineral deposition using 2% Alizarin Red S staining.

Results: Mesenchymal stem cells from explant culture were free of hematopoietic lineage. MTT assay showed no cytotoxicity at 1-50 µg/mL. Compared to control, 10 and 15 µg/mL baicalein increased cell proliferation, though higher concentrations reduced it. At 10 µg baicalein, ALP activity (p < 0.05) and mineral matrix deposition significantly increased, as indicated by darker Alizarin Red S staining. Destaining confirmed higher calcium content in the 10 µg group compared to the control.

Conclusion: Baicalein promotes odontogenic differentiation and mineralization of DPSCs at optimal concentrations, highlighting its potential as a novel bioactive agent in direct pulp capping procedures.

How to cite this article: Patil S, Pawar M, Kharat A, et al. Effect of Baicalein on Odontogenic Differentiation of Dental Pulp Stem Cells: An In Vitro Study. Int J Clin Pediatr Dent 2026;19(1):92-99.

Background: The "BioFlx" crowns are a new generation of crowns. They have been marketed as flexible, long-lasting, self-adapting, and life-like preformed pediatric full-coverage restorations for primary teeth that offer the flexibility and snug fit of the preformed metal crowns, and the esthetics of preformed zirconia crowns. The clinical data in the literature for this crown are still nascent and evolving.

Aim: The present study evaluated the clinical performance of the BioFlx crown.

Materials and methods: Fifty BioFlx crowns were cemented in children who fulfilled the inclusion criteria. The crowns were evaluated immediately before cementation and at 6 months using the modified United States Public Health Service Ryge (USPHSR) scale.

Results: Descriptive statistics for each parameter in the study group were used for statistical purposes. The total number of crowns cemented, 50 (100%), compared to the number of dislodged crowns, 16 (32%), at 6 months in the "retention after cementation" parameter, were subjected to the Chi-square test. It revealed a p-value of 0.58, which was statistically insignificant.

Conclusion: The BioFlx crowns showed positive results concerning resistance to dislodgement before cementation, parental acceptance of esthetics, staining, gingival health, plaque retention, and occlusal wear. The results with respect to retention, though not statistically significant, require long-term clinical follow-up.

Clinical significance: This study addresses a significant gap in the clinical data regarding BioFlx crowns, a novel dental restoration material in pediatric dentistry. Marketed for their flexibility, durability, self-adaptability, and esthetic appeal, BioFlx crowns offer a comparative option to traditional preformed metal and zirconia crowns.

How to cite this article: Rao A, Mahabala KY, Tiwari S, et al. Clinical Evaluation of BioFlx Crowns for the Restoration of Primary Teeth. Int J Clin Pediatr Dent 2026;19(1):19-23.