Aims and background: Local anesthetics play a crucial role in pain management in pediatric dentistry, where anxiety and fear are common among young patients. This study aimed to compare the anesthetic efficacy of 2% lignocaine with a 20-gauge needle in an inferior alveolar nerve block (IANB) and 4% articaine with a 24-gauge needle in a buccal nerve block (BNB) during the extraction of dentoalveolar abscesses in children aged 5-11 years.
Materials and methods: A 12-month randomized controlled trial involving 100 healthy children was conducted following ethical standards. Patients were assigned to receive either lignocaine or articaine anesthesia. Pain assessments were conducted using the Wong-Baker Faces Pain Rating Scale (W-BFRS) and visual analog scale (VAS). Postoperative follow-ups were performed to evaluate pain, biting incidents, and numbness duration.
Results: The study demonstrated a strong positive correlation between W-BFRS and VAS ratings, indicating effective pain assessment. While both techniques showed efficacy, the BNB + local infiltration (LI) technique exhibited lower rates of reanesthesia and discomfort compared to IANB + LI. Follow-up assessments revealed shorter numbness duration and reduced biting incidents with the BNB + LI technique.
Conclusion: This study underscores the importance of considering patient comfort and experience when selecting anesthesia techniques in pediatric dentistry. Articaine emerges as a favorable option, offering improved pain management and patient satisfaction compared to lignocaine. Both the IANB + LI and BNB + LI techniques are viable options, with the choice influenced by adverse events and patient preferences. This research contributes valuable insights into optimizing pain management for pediatric dental procedures, particularly in cases of dentoalveolar abscesses.
How to cite this article: Sharma J, Sharma N, Gera D, et al. Comparative Evaluation of Clinical Anesthetic Efficacy of 4% Articaine with 24-Gauge Needle in Buccal Nerve Block Compared to 2% Lignocaine with 20-Gauge Needle in Inferior Alveolar Nerve Block in Children with Dentoalveolar Abscess. Int J Clin Pediatr Dent 2024;17(11):1236-1240.
Aim and background: Angioedema is a nonpruritic swelling that typically affects the skin, mucous membranes of the face, and perioral soft tissues. It can be life-threatening, but it is usually not and can be treated conservatively unless the airway is compromised. This paper seeks to illuminate a rare case of hereditary angioedema (HAE) onset following dental procedures in a 9-year-old Indian boy.
Case description: A 9-year-old male patient reported a chief complaint of spacing in the upper anterior region, which was diagnosed to be due to impacted supernumeraries. Two days after the oral surgical procedure, the child developed symptoms of periorbital edema with facial swelling. A second episode occurred a day after the delivery of the orthodontic appliance. This was also associated with facial swelling, respiratory distress, and gastrointestinal (GI) symptoms. A diagnosis of angioedema was confirmed and was treated appropriately.
Conclusion: Dental professionals must be aware of the possibility of triggering AE, a potentially fatal condition in patients. This case highlights the importance of comprehensive medical history intake and timely physician collaboration when confronting unexpected symptoms following a dental procedure.
Clinical significance: Awareness of rare conditions like HAE can aid dental professionals in early identification and appropriate management, preventing dangerous exacerbations and contributing to safer dental care.
How to cite this article: Barman KS, Ephraim R, Shivashankarappa PG, et al. Angioedema in a 9-year-old Child after Dental Treatment: A Rare Complication Explored through a Case Report. Int J Clin Pediatr Dent 2024;17(11):1285-1288.
Aims and background: The golden proportion is based on the premise that there is a link between natural beauty and mathematics. The study aimed to analyze the mesiodistal width of maxillary anterior teeth in primary and permanent dentition to determine whether a golden proportion exists among them.
Materials and methods: Sixty subjects were randomly selected in accordance with inclusion and exclusion criteria. Participants were divided into two groups, each comprising 30 children with primary dentition between 3 and 6 years old, and 30 children with permanent dentition between 12 and 13 years old. Intraoral photographs were taken using a smartphone (in-built sensor: Sony IMX890, focal length: 24 mm, aperture: f/1.8) and a cheek retractor, with the head upright and the occlusal plane parallel to the floor. The distance between the participant and the camera was fixed at 4 cm. The digital photographic images were transferred to a computer, and the perceived mesiodistal width was measured for anterior teeth using Adobe Photoshop CS (version 8) software.
Results: The ratio of lateral incisor to central incisor was not found to differ significantly between permanent and primary dentition (p-value > 0.05). However, the ratio of canine to lateral incisor was significantly greater in primary dentition compared to permanent dentition (p-value < 0.05).
Conclusion: The study revealed that the golden proportion was inconsistent in terms of relative tooth width in primary dentition.
Clinical significance: The golden proportion existing in permanent dentition serves as a guide for restoring severely mutilated anterior teeth, so it is important to assess whether the golden proportion exists in primary dentition.
How to cite this article: Pursnani RA, Saxena A, Parihar A, et al. Comparing the Existence of Golden Proportion Using Maxillary Anterior Teeth Dimensions in Primary and Permanent Dentition: A Cross-sectional Study. Int J Clin Pediatr Dent 2024;17(11):1206-1210.
Background: This case report examines the efficacy of intentional reimplantation (IR) in endodontics and explores the increased interest driven by recent advancements in regenerative techniques.
Case presentation: A 14-year-old male patient reported pain in the lower left back tooth (tooth #36). The radiographic assessment revealed a 4 mm × 4 mm periapical cyst. The patient chose an innovative approach, undergoing root canal therapy, atraumatic extraction, and immediate replantation using leukocyte and platelet-rich fibrin (L-PRF). A year later, radiographs confirmed cyst resolution with no new dental concerns.
Conclusion: IR with L-PRF and Biodentine™ was successful in the treatment of periapical cysts, offering a less invasive but effective alternative for complex endodontic cases.
How to cite this article: Saha S, Selvaraj M, Shetty YR, et al. Intentional Reimplantation Combining the Benefits of Leukocyte- and Platelet-rich Fibrin and Biodentine™ for the Treatment of a Large Periapical Cyst: A Case Report. Int J Clin Pediatr Dent 2024;17(11):1277-1280.
Aims and background: Myiasis is an infestation of live humans or animals with dipterous larvae that feed on the host's live or dead tissue. The incidence of oral myiasis is rare and even less common in children. Poor oral hygiene, neurological disabilities, bedridden or locomotor disabilities, low socioeconomic status, malnutrition, etc., are shown as important predisposing factors.
Case description: A 6-year-old female child reported a chief complaint of swelling, pain, and bleeding in the upper front teeth region for 1 day. Extraoral examination showed swelling of the right anterior region involving the upper lip and persistent mouth opening. Intraoral examination revealed ulceration on the anterior labial gingiva and crawling of maggots on the anterior labial aspect with seeming communication with the palatal aspect. Mechanical removal of maggots and debridement followed by antibiotic application and resorbable suture placement was done. Fourteen-day follow-up showed satisfactory healing.
Conclusion: Myiasis is a serious condition that requires public measures aimed at controlling flies, along with the implementation of basic sanitation and maintaining good oral and personal hygiene, for its eradication.
Clinical significance: Oral myiasis is a rare condition. The mean age of affected individuals at diagnosis is usually 41.9 ± 27.2 years. The age of the patient in this case report is 6 years with a comorbidity of cerebral palsy.
How to cite this article: Gudipati M, Jampanapalli SR. Oral Myiasis in a 6-year-old Child with Cerebral Palsy: A Case Report. Int J Clin Pediatr Dent 2024;17(11):1281-1284.
Aim and background: Although local anesthesia (LA) eliminates pain and instills a positive dental attitude, the physical appearance of its syringe is highly fear provoking and often intolerable. Therefore, the purpose of this study was to evaluate the pain and fear perception in camouflaged syringe (CS) and vibration-assisted syringe (VA) when compared with conventional syringe and with each other (VACS) during local anesthetic administration in pediatric patients aged between 6 and 12 years.
Materials and methods: Eighty-five subjects were randomly assigned into three groups: CS group (n = 7), VA group (n = 26), and VACS group (n = 27). Physiological and psychometric scale readings were noted before and after injection. The primary outcome was to assess the change in patients' fear and pain levels using CS and VA vs conventional injection techniques, using the above scales. The secondary outcome was to learn the preference for a particular injection technique by the subjects.
Results: Based on the changes seen in the physiological and psychometric scales, pain and fear control was better in CS in the CS group (p < 0.00 for heart rate, VAS, and SEM score), vibration-assisted syringe in the VA group (p < 0.00 for VAS and SEM score), and vibration-assisted syringe in the VACS group (p < 0.00 for VAS score). The majority preference was CS in the CS group (64%), vibration-assisted syringe in the VA group (60%), and CS in the VACS group (52%).
Conclusion: VA followed by CS is better than the conventional syringe in terms of reducing pain and fear perceived during LA administration. Children preferred CS over VA or the conventional syringe.
Clinical significance: Children's disruptive behavior due to dental fear and pain often results in difficulty in providing effective dental treatment, which is frequently caused by the syringe used in LA delivery. Thus, techniques used to minimize this fear and pain are essential to provide safe, efficient, and quality dental care to children.
Trial registration: The trial was registered with the Clinical Trial Registry of India (CTRI/2023/11/059505).
How to cite this article: Ahmad N, Jindal MK, Agrawal N, et al. Comparison of Conventional Syringe with Camouflaged Syringe and Vibration-assisted Syringe for Pain and Fear Perception during Local Anesthetic Administration in Children: A Split-mouth Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(11):1241-1247.
Aim and background: The applications of artificial intelligence (AI) are escalating in all frontiers, specifically healthcare. It constitutes the umbrella term for a number of technologies that enable machines to independently solve problems they have not been programmed to address. With its aid, patient management, diagnostics, treatment planning, and interventions can be significantly improved. The aim of this review is to analyze the current data to assess the applications of artificial intelligence in pediatric dentistry and determine their clinical effectiveness.
Materials and methods: A search of published studies in PubMed, Web of Science, Scopus, and Google Scholar databases was included till January 2024.
Results: This review consisted of 30 published studies in the English language. The use of AI has been employed in the detection of dental caries, dental plaque, behavioral science, interceptive orthodontics, predicting the dental age, and identification of teeth which can enhance patient care.
Conclusion: Artificial intelligence models can be used as an aid to the clinician as they are of significant help at individual and community levels in identifying an increased risk to dental diseases.
Clinical significance: Artificial intelligence can be used as an asset in preventive school health programs, dental education for students and parents, and to assist the clinician in the dental practice. Further advancements in technology will give rise to newer potential innovations and applications.
How to cite this article: Tanna DA, Bhandary S, Hegde SK. Tech Bytes-Harnessing Artificial Intelligence for Pediatric Oral Health: A Scoping Review. Int J Clin Pediatr Dent 2024;17(11):1289-1295.
Aim: The purpose of the study is to evaluate how well the Endovac system and conventional needle irrigation work to remove smear layers (SR) from primary teeth root canals.
Materials and methods: Fifty extracted human primary teeth were divided into two equal sections vertically, then positioned within an acrylic model that was secured with screws. Group A (Endovac), n = 25, and group B (traditional needle), n = 25. Next, a uniform irrigation technique was used in every tooth embedded in the study model. Sections were examined with a 100× magnification stereomicroscope and electron microscope. Statistical tests were used to analyze the data.
Results: Endovac removed the SR from the apical third of the root canal system more successfully than a traditional needle (<0.05).
Conclusion: Endovac has better performance than conventional needle irrigation in the removal of the SR in the deciduous teeth root canal system.
Clinical significance: (1) Removing the SR allows for more cleaning and disinfecting of root canal walls and better adaptation of root canal filling materials. (2) It is essential to remove the entire SR from the root dentin for successful endodontic treatment.
How to cite this article: Yadav P, Virdi MS, Saini C. Comparison of Debridement Efficacy of Two Irrigating Systems Endovac and Conventional Needle in Primary Tooth Root Canals: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1219-1223.
Aim: To compare the microleakage in class V cavities restored with Activa Bioactive Restorative, Activa Pronto, and nanohybrid composite.
Materials and methods: Standardized class V cavity preparations (mesiodistal: 3 mm; occlusocervical: 2 mm; axial depth: 1 mm) were made on the buccal surface of 60 extracted intact maxillary premolar teeth. The preparations were divided into three experimental groups (n = 20) depending on the restorative material used. Group I: Nanohybrid composite resin, group II: Activa Bioactive Restorative, and group III: Activa Pronto. Samples were polished and thermocycled at 5-55 °C with a dwell time of 60 seconds for 1,000 cycles.The apices were sealed with sticky wax and two coats of nail varnish applied 1 mm away from the restorative margins. Teeth samples were placed in 2% of methylene blue for 24 hours washed and processed for dye extraction method. Teeth samples were placed in a test tube containing 1 mL of concentrated nitric acid (65%wt) for 3 days. Test tubes were centrifuged at 14,000 rpm for 5 minutes, and 100 µL of the supernatant from each was transferred to a plate. The dye absorption was measured by an automated UV spectrophotometer at 550 nm using concentrated nitric acid as the blank.
Statistical analysis: One-way ANOVA test followed by Tukey's post hoc analysis was performed to compare the mean microleakage scores between the three groups.
Results: There was a statistically significant difference (p < 0.001) in mean microleakage scores between Activa Pronto (0.024 ± 0.002), Activa Bioactive Restoratives (0.045 ± 0.003), and nanohybrid composite resin materials (0.069 ± 0.003). The Activa Pronto group (0.024 ± 0.002) showed least microleakage values as compared to nanohybrid composite resin and Activa Bioactive Restorative group.
Conclusion: Activa Pronto and Activa Bioactive Restorative materials may be considered as replacement to the routinely used nanohybrid composites especially in class V cavities due to their bioactive properties and better esthetics.
Clinical significance: Based on the results of our study and that found in the literature, it is evident that newer bioactive restorative materials, Activa Pronto and Activa Bioactive Restoratives showed significantly less microleakage in class Vcavities when compared to conventionally used nanohybrid composite resins.
How to cite this article: V PT, Pai VS, B V, et al. Comparative Evaluation of Microleakage in Class V Cavities Restored with Newer Bioactive Restorative Materials: Activa Bioactive Restorative and Activa Pronto. Int J Clin Pediatr Dent 2024;17(11):1272-1276.
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