International Journal of Clinical Pediatric Dentistry最新文献

Purpose: This study aimed to evaluate and compare occlusal adaptation and bite force distribution following the placement of stainless steel crowns (SSCs) and BioFlx crowns in children aged 4-8 years using the T-scan system.

Materials and methods: A randomized controlled clinical trial was conducted on 50 children requiring pulpectomy and crown restoration in primary molars. The participants were randomly assigned to receive either SSCs (n = 25) or BioFlx crowns (n = 25). Occlusal contacts and bite force parameters were recorded at three intervals: baseline (precementation), immediately postcementation, and at 2 weeks postplacement using the T-scan system. Statistical analysis was carried out using Friedman's test, Mann-Whitney U test, Cochran's Q test, and McNemar's test. A p-value < 0.05 was considered statistically significant.

Results: Both crown types initially disturbed occlusal equilibrium and bite force distribution immediately after placement. At the 2-week follow-up, the BioFlx group demonstrated significantly better occlusal adaptation, with a quicker return to baseline bite force values and fewer persistent premature contacts compared to the SSC group (p < 0.05). Older children (>7 years) showed faster occlusal adaptation in both groups, especially in the BioFlx group.

Conclusion: BioFlx crowns provided superior short-term occlusal adaptation and faster normalization of bite force distribution when compared to SSCs. Their flexibility and biocompatibility may contribute to enhanced patient comfort and rapid occlusal integration. The T-scan system served as a reliable tool for objectively assessing occlusal changes in pediatric restorative procedures.

How to cite this article: Singh T, Devashish, Kannan A, et al. Bite Force Distribution and Occlusal Adjustment in Stainless Steel Crowns and BioFlx Crowns of Children Aged 4-8 Years. Int J Clin Pediatr Dent 2026;19(2):145-149.

Introduction: Children with autism spectrum disorder (ASD) exhibit heightened dental anxiety and uncooperative behavior due to sensory sensitivities and communication challenges. Pulp therapy (pulpotomy/pulpectomy) is a common, time-consuming procedure that is largely dependent on patient compliance.

Aim: This observational study was done to assess the effect of a sensory-adapted dental environment (SADE) on improving the outcomes of pulp therapy in children with autism aged 5-14 years, in comparison with conventional dental setting.

Methodology: A total of 60 ASD patients, requiring pulp therapy, were randomly allocated into two groups: SADE (n = 30) and conventional environment (n = 30). Outcome measures included cooperation scores, anxiety ratings, treatment completion rates, procedure time, caregiver satisfaction, and physiological stress [heart rate (HR)].

Results: Children in SADE showed significantly higher compliance and lower anxiety: mean cooperation scores (1-5 scale) were 4.6 ± 0.3 in SADE vs 3.2 ± 0.5 in controls (p < 0.001), and visual anxiety ratings (-10 scale) were 2.1 ± 1.0 vs 5.8 ± 1.2 (p < 0.001). Procedure completion was achieved in 93% of SADE cases vs 67% under conventional conditions (p = 0.01). HR increases during treatment were smaller in SADE (mean +5 bpm) than in controls (+15 bpm, p < 0.001). Caregiver satisfaction (Likert 1-5) averaged 4.7 in SADE vs 3.1 in controls (p < 0.001).

Conclusion: A multisensory-adapted environment markedly enhanced patient compliance and procedural efficiency in ASD children's pulp therapy, suggesting that SADE is a feasible nonpharmacologic strategy to mitigate anxiety and improve dental care outcomes.

How to cite this article: Panigrahi A, Mohapatra A. Enhancing Pulp Therapy Outcomes in Children with Autism: A Sensory-adapted Dental Environment Approach. Int J Clin Pediatr Dent 2026;19(2):195-199.

Aims and background: Silver diamine fluoride (SDF) is a minimally invasive and cost-effective agent widely used for caries arrest, particularly in pediatric dentistry. However, its primary drawback is the irreversible black discoloration it causes on the SDF-treated surfaces, limiting its acceptance in esthetically sensitive regions.The purpose of this systematic review was to examine and compare the effectiveness of different tooth-colored restorative materials in masking the discoloration on surfaces treated with SDF.

Materials and methods: A thorough literature search was performed using Google Scholar, PubMed Central (PMC), and Scopus databases up to March 2025. In vitro studies evaluating color masking using restorative materials such as glass ionomer cement (GIC), resin-modified GIC (RMGIC), composite resin, Cention N, giomer, and combinations with potassium iodide (KI) or opaquer systems over SDF-treated teeth were included. The primary outcomes assessed were ΔE (CIELAB), ΔL (brightness), and gray values. Risk of bias was evaluated using the Quality Assessment Tool for In Vitro Studies (QUIN Tool).

Results: A total of nine in vitro studies fulfilled the inclusion criteria. Composite resins consistently demonstrated superior esthetic outcomes, especially when placed after a delay or combined with opaquer systems (ΔE = 1.66-8.01). GIC showed poor masking ability, with ΔE values as high as 105. Among GIC variants, zirconia-reinforced GIC performed better (ΔE = 6.00), while RMGIC showed variable results. The use of KI yielded mixed outcomes, improving esthetics with composites but often worsening them with RMGIC and Zr-GIC. Long-term stability of composites was confirmed through aging and thermocycling protocols.

Conclusion: Composite resin, especially when combined with opaquer or used with delayed placement, appears to be the most effective material for masking SDF-induced discoloration. However, findings are based on in vitro studies, highlighting the need for well-designed in vivo research to validate clinical application.

Clinical significance: This study offers evidence-based insights into the most effective restorative material to mask SDF-induced discoloration without compromising the caries-arresting property of SDF, aiding clinicians in making well-informed decisions about the selection of restorative material and timing of restoration, ultimately improving patient acceptance of SDF treatment.

How to cite this article: Mathur A, Chaudhary Y, Shekhar S. Effectiveness of Tooth-colored Restorative Materials in Masking Discoloration Caused by Silver Diamine Fluoride: A Systematic Review of In Vitro Studies. Int J Clin Pediatr Dent 2026;19(2):262-270.

Background: In pediatric dental treatment, administration of local anesthesia (LA) is a fearful condition that leads to "escape alert" in children. This escaping treatment excuse, unfortunately, ends up worsening the overall oral health of the child. Hence, it is crucial to cultivate child-friendly methods to reduce pain during injection.

Aim: To assess which system, the Buzzy system or the conventional masked with camouflage syringe, aids in a greater reduction of pain perception in patients during LA procedures.

Method: A randomized controlled trial was conducted on 34 subjects aged between 5 and 12 years who required LA administration. Subjects were recruited by lottery method into group I-conventional masked with camouflage technique (control), group II-precooling along with vibration using the Buzzy system (experimental).

Results: In the present study, the pain score using the Buzzy system was statistically lower compared to the experimental group (p = 0.0001).

Conclusion: The Buzzy system is a compatible and economical method to diminish dental pain perception during LA administration.

How to cite this article: Dhembare-Patil AA, Jain M, Sogi HP S, et al. Comparative Evaluation of Buzzy System and Conventional Masked with Camouflage Syringe for Pain Perception in 5-12-year-old Children: A Split-mouth Study. Int J Clin Pediatr Dent 2026;19(2):164-170.

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.