International Journal of Clinical Pediatric Dentistry最新文献

Introduction: Esthetic dentistry plays an important role in providing several treatment options for tooth discoloration out of which the most common is tooth bleaching. Although it is less invasive and cost-effective but repeated bleaching could reduce the microhardness of enamel; this loss of microhardness after bleaching could be regained by incorporating topical fluoride agents.

Objective: To analyze and compare the effect of fluoride and additional fluoride application on the microhardness of the enamel prior to and postbleaching.

Materials and methods: Fifty sound extracted human premolars were divided into five groups and subjected to specific fluoride treatment pre- and postbleach period for 42 days. Microhardness of each specimen was recorded at baseline, 14th, 28th, and 42nd day.

Results: An intergroup comparison of each enamel specimen at different timelines was done by analysis of variance (ANOVA) test. Intragroup comparison at baseline was done using a post hoc test, and at 14th, 28th, and 42nd day was done by Bonferroni correction. The F-and p-value for baseline were 1.718 and 0.163, respectively, which were not significant. While F-value at 14th, 28th, and 42nd day was 33.036, 5.395, and 9.505, respectively, which shows all these timelines had a p-value <0.001 and the difference was statistically significant. A statistically significant increase was observed between specimens treated with combined fluoride therapy and only fluoridated toothpaste application at the end of 14th day, and no statistically significant difference was there at the end of 42nd day.

Conclusion: A significant increase in the microhardness of bleached enamel on fluoridated toothpaste application was observed. Further additional application of fluoride was not very effective when fluoridated toothpaste was used twice daily.

How to cite this article: Das S, Jain M, Sogi HPS, et al. Effect of Different Topical Fluorides on the Microhardness of Bleached Enamel: In Vitro Study. Int J Clin Pediatr Dent 2025;18(11):1365-1372.

Aim and background: Epidermal cysts, also known as epithelial inclusion cysts or epidermoid cysts, have epidermis as the cyst wall with keratin debris inside. Its incidence in the oral cavity is rare and constitutes only 0.01% of all the cystic lesions of the oral cavity.

Case description: A 13-year-old male presented with swelling on the left side of the tongue for 1 year. Patient had persistent discomfort in the area, but no complaints of any pain, difficulty in swallowing, or in speech. On examination, a well-circumscribed, round, nontender, cystic swelling of about 1 × 1 cm in size, with a smooth surface, was embedded in the left side of the anterior tongue. Ultrasound scan showed a cystic lesion with a possible diagnosis of epidermoid cyst. Surgical resection was performed under local anesthesia. On histopathology examination cyst showed fibromuscular content with keratin pearls on the basis of which the final diagnosis of epidermal cyst was made.

Conclusion: To date, very few cases of epidermal cyst of the tongue have been reported. These cysts, depending on the size and position, can lead to difficulty in swallowing, breathing, or speech. In certain cases, they can be asymptomatic, as seen in our patient, and recurrence is rare when removed in toto.

Clinical significance: Early identification and surgical excision of an epidermal cyst in the tongue are crucial to prevent potential complications such as secondary infection, enlargement, or interference with oral functions. Histopathological confirmation ensures accurate diagnosis and differentiates it from other cystic lesions, guiding appropriate management.

How to cite this article: Nayak PP, Nayak PP, Bhandary M, et al. Uncommon but Present-A Rare Presentation of Epidermal Cyst of the Tongue in a Pediatric Patient: A Case Report. Int J Clin Pediatr Dent 2025;18(11):1397-1399.

Objective: The study aimed to evaluate the effect of saliva on the compressive strength of three commonly used dental materials-mineral trioxide aggregate (MTA), Biod+, and Biodentine-used for root canal fillings.

Materials and methods: Thirty-six extracted primary molars were divided into two groups: a control group (group A) with no saliva exposure and an experimental group (group B) subjected to saliva exposure. Each group was further divided into three subgroups (n = 6), with specimens filled with MTA, Biod+, or Biodentine. After a standardized pulpotomy procedure, the materials were placed within the prepared cavities. The compressive strength of each material was tested using an Instron universal testing machine after a 4-hour setting period. Data were analyzed using one-way analysis of variance (ANOVA).

Results: Biod+ demonstrated the highest compressive strength among the three materials, both in the presence and absence of saliva. Biodentine exhibited the least variation in compressive strength following saliva exposure, indicating superior stability in an oral environment. MTA showed lower compressive strength compared to Biod+ and Biodentine. Statistical analysis confirmed a significant difference in compressive strength between the groups (p = 0.00532).

Conclusion: Biod+ exhibited the highest durability in terms of compressive strength, making it a promising material for endodontic applications requiring high mechanical resistance. Biodentine, on the other hand, demonstrated greater stability under salivary exposure, making it a reliable choice for clinical scenarios where moisture contamination is a concern. These findings provide valuable insights into the selection of optimal root canal filling materials based on specific clinical requirements.

How to cite this article: Bhatnagar S, Jeevanandan G. Effect of Saliva on Compressive Strength of Mineral Trioxide Aggregate, Biod+, and Biodentine: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(11):1345-1348.

Aims and background: Inpatient children may experience varying anxiety regarding intravenous (IV) cannulation. This study assessed preprocedural anxiety and procedural pain levels and determined their correlation.

Methods: We conducted an observational cross-sectional study involving 4-10-year-old children. Preprocedural anxiety was assessed by the Venham picture test (VPT) and Raghavendra, Madhuri, and Sujata pictorial scale (RMS-PS) while the revised faces pain scale (FPS-R) evaluated pain perception at the IV cannulation site. We analyzed the data via SPSS version 25.

Results: Out of 385 children, the majority (234, 60.8%) were aged 4-7 years, and 57.4% were boys. The 4-7-year-olds had significantly higher anxiety levels (p < 0.001), with no significant difference between the sexes. High to very anxiety was reported in 24.7%, while 13% had average anxiety (VPT), and 49% were somewhat happy (RMS-PS). Children who underwent first-time cannulation had higher median anxiety, and we found no significant difference in comparison to those with prior IV cannulation experience. Preprocedural anxiety significantly correlated with procedural pain (Spearman's rho: VPT vs FPS: 0.76; RMS vs FPS: 0.66, both p < 0.001), with a stronger correlation in children with no prior IV cannulation experience.

Conclusions: Younger children and those experiencing first-time IV cannulation reported higher anxiety, with a significant correlation to procedural pain.

Clinical significance: Self-report anxiety assessment tools usage can help pediatric teams identify and implement strategies to alleviate anxiety and create a comfortable atmosphere for inpatient children.

How to cite this article: Baliga S, SR R, Rao R, et al. Premedical Procedure Anxiety for Intravenous Cannulation in Hospitalized Children: A Facility-based Cross-sectional Study. Int J Clin Pediatr Dent 2025;18(11):1333-1338.

Purpose of the study: Pulpectomy has been a routine remedial endodontic procedure for treating a pulpally inflamed or infected deciduous tooth. The success of pulpectomy depends on thorough cleaning and shaping of the canals, complete debridement of the tissue remnants out of root canal spaces, and achieving a fluid-tight seal without any voids. Interestingly, the need for selection of a proper obturation technique collectively holds a major role in fulfilling various factors stated to be responsible for having a positive outcome. Hence, the purpose of the present research was to compare and assess the quality of obturation of various obturation techniques used in primary mandibular molars.

Materials and methods: A total of 128 root canals of 64 deciduous mandibular molar teeth were randomly allocated for obturation with zinc oxide eugenol (ZOE) paste using four primary teeth obturating techniques. The obturation quality was evaluated by scoring the extent of filling and the existence of voids. Intergroup comparison of the data was done using Fisher-Freeman-Halton exact test.

Results: The mean age of the study population was 7.58 ± 1.44 years (26 males and 22 females). The intergroup comparison of the obtained data subjected to statistical analysis using Fisher-Freeman-Halton exact test revealed statistically significant results with p-value of 0.04 and 0.03 when group III was compared with groups I and IV, respectively.

Conclusion: NaviTip double side port system proved to be efficient in attaining both optimally filled as well as a homogeneous obturation without voids in primary mandibular molar teeth.

How to cite this article: Subbaraj S, Chenchugopal M, Elangovan A, et al. In Vivo Comparative Evaluation of Four Different Obturation Techniques in Primary Teeth: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent 2025;18(11):1311-1317.

Aim: Dental anxiety is most prevalent during childhood and adolescence. It increases the decayed-missing-filled teeth index (DMFT), limits the provision of oral healthcare services, jeopardizes the dentist-patient relationship, decreases oral health quality of life, and negatively impacts psychosocial health. So the aim of the study is to assess salivary alpha amylase (SAA) levels when using audiovisual (AV) aids in children with varying dental anxiety.

Materials and methods: After obtaining the institutional ethical clearance, 60 children aged 4-12 years were considered for administration of local anesthesia for various dental procedures. They are divided into two groups of 30 each, based on the modified Venham picture test (MVPT). Heart rate (HR), blood pressure (BP), and SAA levels of these children were correlated with the effect of the AV distraction method.

Results: Paired t-test and Wilcoxon signed-rank test were performed to compare the mean pre- and postoperative HR, BP levels, and SAA levels within the two groups, respectively. Statistically significant reduction (p = 0.000*) in the physiological parameters was noticed after using AV aids as a behavior modification technique in both groups.

Conclusion: Audiovisual aids are a useful adjunct to reduce anxiety and discomfort associated with the dental procedures in a pediatric dental clinic.

How to cite this article: Pala K, Mukthineni S, Shaik N, et al. Evaluation of Salivary Alpha Amylase as a Noninvasive Biomarker in Dental Apprehension in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2025;18(11):1385-1389.

Background/objectives: Dental caries and periodontal diseases are considered the most common oral diseases that could be controlled by daily toothbrushing using a toothbrush. However, manual regular toothbrushing techniques may be performed incorrectly due to the inadequately developed motor skills of children. The new U-shaped toothbrush does not require as much control, and it is much easier to handle. Our objectives are to compare the effectiveness of plaque removal among three toothbrushes: Manual U-shaped toothbrush (U), battery-powered regular toothbrush (E), manual regular toothbrush (R), and the three above-mentioned to the control group (no brushing) (C).

Methods: This randomized controlled clinical trial was conducted at King Abdulaziz University Dental Hospital (KAUDH). A total of 56 participants (8-12-year-old) were randomly divided into the above-mentioned four groups. Two examiners conducted the study, where the first examiner was blinded to the type of toothbrush used, and was responsible for recording the full-mouth plaque score (FMPS) before and after brushing, while the second examiner was responsible for teaching children how to use the assigned toothbrush.

Results: For the FMPS means difference, a significant difference was found between the brushing groups (p < 0.001), post hoc testing showed statistically significant differences between (C) and (R) (p < 0.001), (C) and (E) (p < 0.001), (R) and (E) (p < 0.001), and (E) and (U) (p < 0.001), but not between (C) and (U) (p = 0.1229), or (R) and (U) (p = 0.1229).

Conclusion: The plaque removal efficiency was observed among (E), followed by (R), then (U) toothbrushes among children aged 8-12 years.

How to cite this article: Abdullah AM, Ainousa AM, Andijani BM, et al. Comparison of the Effectiveness of Three Different Types of Toothbrushes Among 8-12-year-old Children. Int J Clin Pediatr Dent 2025;18(11):1318-1321.

Background: Effective management of dental anxiety is essential for successful behavior guidance and ensuring a positive dental experience. Emotional responses such as stress and anxiety trigger ectodermal changes that increase the skin's electrical conductivity. This physiological response can be objectively measured using galvanic skin response (GSR).

Aim: Comparison of different music therapy techniques in alleviating anxiety in 6-10-year-old children during inferior alveolar nerve block (IANB) injection using GSR measuring ectodermal activity.

Materials and methods: Sixty children aged 6-10 years, requiring IANB, were divided into three groups: group A (white noise), group B (binaural beats), and group C [Gayatri mantra (GM)], with 20 participants each. Preoperative anxiety was assessed using the modified dental anxiety scale (MDAS), while postoperative using the visual analog scale (VAS). GSR, pulse rate (PR), and oxygen saturation (SpO₂) were recorded both pre- and postoperatively to evaluate the efficacy of each intervention.

Result: Preoperatively, no significant differences were observed in the anxiety scores among the three study groups (p > 0.0). In the postoperative phase, groups B and C exhibited significantly lower VAS scores compared to group A. Additionally, group C showed a notable reduction in GSR levels postoperatively when compared to both groups A and B. Significant reductions in mean GSR were observed from preoperative to postoperative measurements across all study groups. There were no notable differences in PR or SpO₂ among the three groups before and after surgery, with all comparisons yielding p-values > 0.05.

Conclusions: Managing dental procedures in anxious pediatric patients presents a significant challenge. Findings from this study suggest that music-based distraction techniques can effectively reduce anxiety and stress levels in children undergoing dental treatment.

How to cite this article: Arora P, Gupta S, Malik M, et al. Galvanic Skin Response as a Measure of Anxiety: A Comparative Evaluation of Gayatri Mantra Chanting and Conventional Music Therapy in 6-10-year-old Children during Inferior Alveolar Nerve Block. Int J Clin Pediatr Dent 2025;18(11):1358-1364.

Aim and background: The use of articaine is well documented in children aged 4 years and above. However, there is a paucity of data concerning its use in children younger than 4 years of age. This study observed the type and severity of adverse events (AEs) that could occur with the use of 4% articaine with 1:1,00,000 epinephrine for supraperiosteal injections in children below 4 years of age.

Materials and methods: About 30 children fulfilling the inclusion criteria, requiring supraperiosteal injections for procedures in posterior primary teeth, were observed postinjection of the drug. The procedures that followed the drug administration were classified as "simple" or "complex." The "type and severity" of the AEs observed were documented according to the methodology by Kalenderian. The World Health Organization-Uppsala Monitoring Centre (WHO-UMC) scale was utilized for the "causality" assessment of the drug. The "preventability" of the AEs was assessed using the modified Schumock and Thornton scale. AEs occurring in "<5 minutes," "until 60 minutes," and "up to 24 hours" were recorded. Descriptive statistics and cross-tabulations were done using Pearson's Chi-squared test, with significance set at p < 0.05.

Results: Three children (23.1%) reported pain in the observation time interval "until 60 minutes". These children had undergone procedures that were classified as "complex." The p-value was 0.037, which was statistically significant. The AE was categorized as "E1," which stands for "temporary mild harm to the patient" according to the Kalenderian methodology. The causality term chosen for the AE was "unlikely," and the AE was classified as "probably preventable."

Conclusion: The findings of this study, within the sample size studied, did not find any AE directly linked to 4% articaine hydrochloride with 1:1,00,000 epinephrine during supraperiosteal injections in children below 4 years of age.

Clinical significance: Articaine is not advocated for clinical use in children below 4 years of age. This study addresses the important clinical question of "whether articaine can be safely used in children under 4 years of age for supraperiosteal injections?"

How to cite this article: Ananthu H, Rao AP, Kamath A, et al. Adverse Events of 4% Articaine in Children below 4 Years of Age: An Observational Study. Int J Clin Pediatr Dent 2025;18(11):1322-1326.