International Journal of Clinical Pediatric Dentistry最新文献

Background: Orofacial cleft is among the most common craniofacial malformations. It presents a complex and multifactorial etiology that involves genetic and environmental factors. One of the etiological factors is consanguinity (marriage between blood relatives). Multiple environmental risk factors, such as advanced maternal age, parity, maternal smoking, radiation, alcohol consumption, diabetes mellitus, and maternal use of drugs (i.e., anticonvulsants), folic acid deficiency, etc., have also been linked to the development of cleft lip and/or palate (CL/P). There is a dearth of literature reporting the occurrence of cleft due to consanguinity and other risk factors.

Aim: The aim of this study is to describe the orofacial cleft demographics and to determine the influence of parental consanguinity and other associated risk factors on the occurrence of orofacial clefts (OFC) at a tertiary healthcare hospital in Jammu Province.

Materials and methods: This was a hospital-based case-control study. In the present study, data collection was specifically done regarding demographic features, history of consanguinity, degree of consanguinity, and other associated maternal risk factors in both the cleft and control groups.

Result: This study elucidates a significant association between parental consanguinity, degree of consanguinity, and other associated risk factors (i.e., maternal age ≥30 years, birth order ≥3, maternal smoking, alcohol consumption, and lack of folic acid consumption) with the occurrence of OFC.

Conclusion: Prevention is better than cure. Awareness programs and appropriate counseling should be conducted to educate the community about the risk factors and the anticipated genetic consequences of consanguinity to prevent the development of cleft anomalies in such populations.

How to cite this article: Gupta A, Kaul B, Gulbar S, et al. Orofacial Cleft and Its Association with Consanguineous Marriage and Other Risk Factors: A Case-control Study from a Tertiary Care Hospital in Jammu Province. Int J Clin Pediatr Dent 2024;17(11):1258-1264.

Aim: The present case-control study was planned to assess the comparative efficacy of resin-modified calcium silicate, resin-modified glass ionomer, and Dycal as pulp capping agents in indirect pulp therapy for deeply carious young permanent molars.

Materials and methods: Thirty deeply carious young posterior teeth were treated by indirect pulp therapy. During the treatment, the cavity floor was lined with TheraCal or resin-modified glass ionomer cement (RMGIC) in the study group and with Dycal (control group) followed by GC IX and composite restoration. The teeth were reviewed and evaluated clinically and radiographically after 6 and 12 months.

Results: None of the study subjects experienced pain in any of the three study groups up to 12 months. Maturogenesis was seen in all 30 study teeth. Maximum% gain in dentin formation was seen in group I (TheraCal), that is, 16.100 ± 2.42, followed by group II (RMGIC), that is, 11.6000 ± 1.42, and group III (Dycal), that is, 9.6000 ± 0.96, and the difference between group I and group II and group I and group III was highly significant (p < 0.0001). Dentin formation was observed earlier at 6 months in 82.5% of cases with mesio-occlusal (MO) cavities as compared to 62.5% of cases with disto-occlusal (DO) extension.

Conclusion: TheraCal LC may be preferred as a pulp capping agent in the management of deeply carious young permanent molars for better healing in less time.

How to cite this article: Altaf G, Garg S, Saraf BG, et al. Clinical Effectiveness of Biomaterials in Indirect Pulp Therapy Treatment of Young Permanent Molars with Deep Carious Lesions: A Case-Control Study. Int J Clin Pediatr Dent 2024;17(11):1199-1205.

Context: Pulpectomy is recommended for primary teeth when both the coronal and radicular pulp tissues are irreversibly damaged. Biomechanical preparation of root canals is essential for the success of endodontic treatment. Achieving the optimal length during obturation while minimizing voids and ensuring a hermetic seal is crucial for the success of pulpectomy procedures.

Aims: The aim of this in vitro study is to compare the root canal obturation quality among Lentulo Spiral, Pastinject, and Dispo Van syringe in primary teeth using cone-beam computed tomography (CBCT) scanning.

Settings and design: The selected extracted primary teeth were from the age-group of 4-7 years. Teeth indicated for pulpectomy with at least two-thirds of the total root length present were included. The study was conducted over a duration of 6 months.

Methods and materials: The study examined 60 primary tooth root canals, divided into three groups. Endoflas was used for obturation with Lentulo Spiral, Pastinject, and Dispo Van syringe. Postoperative CBCT was used to assess the presence of voids.

Statistical analysis used: The values were analyzed for the success rate of obturation using an independent t-test with MedCalc for Windows.

Results: In this study, three different filling techniques were evaluated and compared based on the presence of voids in the canals. Pastinject exhibited superior performance with the fewest voids, followed by the Lentulo Spiral and Dispo Van syringe.

Conclusion: The findings indicated that the most effective technique for obturating primary teeth was the Pastinject method.

How to cite this article: Adhya S, Chakraborty S, Dey B, et al. Comparative Evaluation of Obturation Quality Using Three Different Obturation Techniques in Primary Teeth: A Cone-beam Computed Tomography Analysis: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1248-1251.

Aim and background: Glass ionomer cement (GIC) serves as a widely used restorative dental material, known for its direct bonding to tooth structures and fluoride-releasing properties. This study aims to investigate the enhancement of GIC through the incorporation of a green-mediated nanocomposite comprising chitosan, titanium, zirconium, and hydroxyapatite, with a focus on evaluating the wear resistance of the modified GIC.

Materials and methods: A one-pot synthesis technique was utilized to prepare a green-mediated nanocomposite incorporating chitosan, titanium, zirconium, and hydroxyapatite nanoparticles. Forty extracted teeth fulfilling the inclusion criteria were chosen for the study. Each tooth received a class I cavity preparation, and then they were divided into groups. Each group, comprising 10 teeth, received a restoration using green-mediated nanocomposite-modified GIC in varying concentrations: 3% for group I, 5% for group II, and 10% for group III. Additionally, there was a control group (group IV) consisting of conventional GIC without any modifications. To assess the wear resistance of the samples, they underwent a testing protocol, followed by placement in a chewing simulator for 30,000 cycles. Surface scans before and after chewing simulation were conducted, and deviations were superimposed using Geomagic software. The interim of root mean square (RMS), maximum deviation, and average deviation were analyzed to quantify the wear levels. Then the data obtained were subjected to statistical analysis, one-way analysis of variance (ANOVA), followed by Tukey's post hoc analysis to identify any significant differences among the groups.

Results: The least deviation of RMS (0.292 ± 0.063), maximum deviation (0.664 ± 0.076), and average deviation (0.263 ± 0.049) were observed in the 5% nanocomposite-based GIC group, followed by the 10 and 3% groups. The nanocomposite-modified GIC groups exhibited superior wear resistance compared to the conventional group. This outcome addressed the limitations of traditional GIC, signifying a substantial advancement in dental restorative solutions.

Conclusion: The incorporation of green-mediated chitosan, titanium, zirconium, and hydroxyapatite nanocomposite into GIC demonstrated a remarkable improvement in wear resistance. This study paves the way for future advancements in dental materials, representing a significant stride toward the creation of environmentally conscious and efficacious dental restorations.

How to cite this article: Sitaram SS, Paulraj J, Maiti S, et al. Enhancing Wear Resistance in Glass Ionomer Cement through Green-mediated Chitosan-, Titanium-, Zirconium-, and Hydroxyapatite-based Nanocomposites: An Analysis before and after Chewing Simulator Endurance. Int J Clin Pediatr Dent 2024;17(11):1229-1235.

Background: When it comes to reducing children's fear, anxiety, and discomfort during dental procedures, substantial local anesthetic delivery promotes adequate intervention. In the dental operatory, local anesthetic injections are the most anticipated or feared stimuli. The application of topical anesthetics, cryotherapy, and transcutaneous electrical nerve stimulation (TENS) to the oral mucosa prior to local anesthetic injections can alter pain perception in children.

Aim: To compare the efficacy of cryotherapy application, 2% benzocaine gel, and TENS therapy at reducing pain perception during local anesthesia (LA) administration in pediatric patients.

Materials and methods: In this randomized clinical trial, 75 pediatric patients between 4 and 8 years of age who needed LA for dental treatment were selected. They received cryotherapy (EXOCOOL) externally, 2% lignocaine topical gel (intraorally), or TENS therapy extraorally on the area of treatment. A pediatric dentist blinded to the study assessed Faces, Legs, Activity, Cry, and Consolability (FLACC) (subjective method), pulse rate, and SpO_2, and patients were instructed to use a visual analog scale (VAS) to rate their distress during injection and Venham's Picture Test for anxiety assessment. Statistical analyses were performed using the Wilcoxon and Mann-Whitney U tests.

Results: The EXOCOOL group had significantly reduced pain scores on the VAS scale (3.80) when compared with the topical anesthetic gel group (4.08). The TENS group had reduced pain scores on the FLACC scale as well (2.84) when compared with the topical anesthetic gel group (3.72), which was statistically significant (p = 0.003).

Conclusion: According to our study on pain and anxiety alleviation in children during LA administration, we found that TENS therapy demonstrated the highest effectiveness, surpassing both EXOCOOL and LA gel in providing relief.

How to cite this article: Goyal S, Patel M, Bhatt R, et al. Comparative Evaluation of Different Pain-alleviating Methods on Child's Dental Anxiety and Pain Perception during Local Anesthesia Administration: A Clinical Study. Int J Clin Pediatr Dent 2024;17(11):1265-1271.

Aim: The aim of this study was to evaluate and compare the apical microleakage of zinc oxide (ZOE) eugenol and Endoflas as obturating materials using different root canal irrigants in primary teeth.

Materials and methods: A total of 80 extracted primary anterior teeth were divided randomly into four groups with different irrigants and obturating materials used. Group I [ZOE + sodium hypochlorite (NaOCl)], group II [ZOE + NaOCI + ethylenediaminetetraacetic acid (EDTA)], group III (Endoflas FS + NaOCI), group IV (Endoflas FS + NaOCI + EDTA). Cleaning and shaping of the root canals were done using specified irrigants, followed by obturation with ZOE eugenol and Endoflas as per the respective groups. Specimens were then immersed in 2% methylene blue dye solution and stored for 24 hours. The specimens were split longitudinally into two halves and observed under a stereomicroscope. Apical microleakage was measured from the apex to the most coronal extent of dye penetration.

Results: The highest dye penetration was recorded for teeth filled with ZOE, group I (ZOE + NaOCl), with mean values of 1.924 ± 0.925. Endoflas group IV (Endoflas + NaOCI + EDTA) showed the lowest dye penetration with mean values of 0.901 ± 0.255. There was a statistically significant difference between the ZOE and Endoflas groups (p < 0.001). The result showed a statistically nonsignificant difference between the two Endoflas groups (p = 1.000). Minimum microleakage was found in group IV (Endoflas + NaOCI + EDTA).

Conclusion: Endoflas FS exhibits less apical microleakage than ZOE eugenol as an obturating material in primary teeth. Hence, Endoflas could be a potential alternative to ZOE eugenol with better sealing ability as an obturating material in primary teeth. Also, the addition of EDTA to irrigation protocol has shown a statistically nonsignificant improvement in microleakage reduction with both obturating materials.

How to cite this article: Kale YJ, Misal S, Dadpe M, et al. Comparative Evaluation of Microleakage of Zinc Oxide Eugenol and Endoflas as Obturating Materials Using Different Root Canal Irrigants in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1252-1257.

Aims and background: Failure of the endodontic treatment might be due to various reasons like zipping, apical blockade, ledging, debris extrusion, etc. Apical debris extrusion in primary teeth is of major concern as it does not have a proper well-developed apex, that is, mature apex. This study aims to compare and evaluate the apical debris extrusion in primary molars using three different pediatric rotary file system.

Materials and methods: Thirty freshly extracted teeth primary molars were divided into three experimental groups according to the used file systems as group I-NT Pedo Gold, group II-Pedo Flex, and group III-Kedo-S. Debris extruded during canal shaping were collected in preweighed vials. Each canal was irrigated with 6 mL of saline and 2 mL of sodium hypochlorite. The amount of debris extruded from each tooth was calculated by subtracting the preinstrumentation from the postinstrumentation measurement. Data were analyzed using analysis of variance (ANOVA) and post hoc Tukey tests with α = 0.05.

Results: Kedo-S showed statistically significant lesser apical debris extrusion than Pedo Flex and NT Pedo Gold (p-value < 0.001) while comparing Pedo Flex and NT Pedo Gold insignificant difference.

Conclusion: All three pediatric rotary file systems extruded debris apically; while Kedo-S can be safely used as a rotary file in pediatric dentistry with minimal apical debris extrusion.

Clinical significance: An ideal rotary instrument should not extrude debris apically, the lesser the extrusion greater the endodontic treatment success. Kedo-S can be securely used as a rotary file with less apical debris extrusion than the other two rotary systems.

How to cite this article: Manoharan M, Kowsalya S, Mathian VM, et al. Comparative Evaluation of Apical Debris Extrusion in Primary Molars Using Three Different Pediatric Rotary Systems: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(11):1224-1228.

Introduction: Utilizing 38% silver diamine fluoride (SDF) has been demonstrated in clinical trials to prevent and halt early childhood caries (ECC). Based on a research evaluation, it has been found that 38% SDF can effectively prevent new tooth decay and stop existing tooth decay in children's primary teeth.

Objective: This study aimed to assess the survival of teeth treated with repeated applications of 38% SDF in children with ECC and to compare the outcomes between single and multiple applications.

Materials and methods: A split-mouth, double-blind, active-control, parallel-arm randomized controlled trial was conducted following Consolidated Standards of Reporting Trials (CONSORT) guidelines. Children aged 4-5 years with bilateral ECC were recruited from a primary government school in Maharashtra, India. Treatment involved applying 38% SDF to carious lesions, with lesions randomized into two groups: single application and double application. Follow-ups were conducted at 6 and 12 months to assess lesion progression, depth, and survival.

Results: Eighty-four primary carious teeth from 42 female participants were included. Lesions were predominantly occlusal or proximal, with varying sizes and depths. After 12 months, 12 lesions failed in group I (single application) and 3 in group II (double application). The intergroup comparison of mean levels at 12 months showed a statistically significant difference (p = 0.01). Intragroup comparisons showed an increase in lesion depth and level from baseline to 6 months, with a subsequent rise from 6 to 12 months in group I. The mean survival rate of teeth after SDF application at the end of 12 months was around 94% for group II, while for group I it further decreased from 70 to 58%.

Conclusion: Repeated applications of 38% SDF showed improved survival rates of teeth in children with ECC compared to single applications. Double application of SDF demonstrated superior efficacy in maintaining tooth survival over 12 months.

How to cite this article: Kharat PB, Rajpurohit L, Mathur A, et al. Survival of Silver Diamine Fluoride Varnish Treated Teeth among Children with Single/Multiple Applications: A Split-mouth Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(11):1211-1218.

Background: Dental fear and anxiety have become a major obstacle for children to accept dental treatment. Dental anxiety ranks fifth among common fears.

Aim: The aim of this current systematic review is to assess the effect of thaumaturgical distraction in reducing anxiety in children undergoing dental procedures.

Materials and methods: This current systematic review was registered in Prospero (CRD42023411750) following PRISMA guidelines. Electronic searches were performed in the databases: PubMed, Scopus, Web of Science, and Google Scholar. The search was conducted from inception to March 1, 2024. A broader search strategy was used to prevent missing articles. The search was performed using broad terminology: ((thaumaturgy) OR (magic)) AND (dental). ResearchGate was also consulted, and cross-references were reviewed on this topic to extract all available literature. Only randomized controlled trials are included for data synthesis. Narrative and systematic literature reviews are excluded. Evaluation of the risk of bias is planned using the ROB2 criteria of the Cochrane Collaboration.

Results: A total of 798 titles were screened by title and abstract rigorously by three independent evaluators. After duplicate exclusion and removal of irrelevant titles, 11 articles were included for full-text analysis, of which 6 qualified for final data synthesis.

Conclusion: Within the limits of the available studies, significantly lower anxiety is exhibited in the children treated under the thaumaturgical distraction group as opposed to the control group.

How to cite this article: Lekhwani P, Tirupathi S, Afnan L. Thaumaturgical Distraction as a Modality for Reducing Dental Anxiety in Children: A Systematic Review. Int J Clin Pediatr Dent 2024;17(11):1296-1301.

Background: The best space maintainer in both primary and mixed dentition is the primary tooth itself. This is not only because of the clinical crown but also due to the presence of the roots and periodontium that guide the eruption of the permanent tooth. Although over the years many materials have been tried for obturation of pulpectomized primary teeth, no material has been found to fulfill all requirements. The aim of the present study was to evaluate the clinical and radiographic efficiency of zinc oxide-eugenol (ZOE), zinc oxide-ozonated oil, antioxidant mix, and probiotic mix in root canal treatment of primary molars.

Materials and methods: One hundred twenty primary molars of children aged 4-9 years presenting to the department were randomly assigned to one of four groups: obturated with ZOE, zinc oxide-ozonated oil, probiotic mix, or antioxidant mix. All the pulpectomies were carried out by a single operator. Follow-up was done at 3, 6, 9, and 12 months, and treatment success or failure was determined by the evaluation of clinical and radiographic findings.

Results: There was a statistically significant difference with respect to postoperative pain and swelling among the four groups at the end of the 12-month follow-up period (p < 0.05).

Conclusion: The study concludes that among the four different obturating materials, zinc oxide-ozonated oil has shown the most promising results in primary endodontically treated teeth, whereas antioxidant mix was comparable to ZOE with fewer disadvantages and side effects.

How to cite this article: Arora P, Mathur S, Arora P. Clinical and Radiographic Evaluation of Zinc Oxide-ozonated Oil, Zinc Oxide-eugenol, Antioxidant Mix, and Probiotic Mix as Obturating Materials in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(10):1153-1162.