International Journal of Clinical Pediatric Dentistry最新文献

Background: Craniosynostosis (CS) is defined as the premature fusion of cranial sutures and can be classified as nonsyndromic or syndromic and by which sutures are affected. It affects 1 in 2,000-2,500 children. The most common clinical feature in CS is an abnormal head shape. This is a consequence of the growth of the underlying brain and restriction of skull growth due to premature ossification of skull sutures. It may primarily occur due to genetic mutations or secondarily due to mechanical, environmental, and hormonal factors during pregnancy. The most frequently involved single suture is the sagittal suture, followed by the coronal, metopic, and lambdoid sutures, or multiple sutures.

Case description: An 8-year-old girl with second-degree consanguinity and several signs of CS is reported. A deoxyribonucleic acid (DNA) test report revealed an ERF gene mutation located on exon 4, concluding the diagnosis of craniosynostosis-4 with genetic heterogeneity. Intraoral examination revealed multiple unerupted teeth, dental caries, and deep pits and fissures.

Intervention: Adhesive restorations of carious teeth, pulp capping of 75, and fissure sealing of 46 were done. Extraction of 71 and root stumps of 54 were followed by band and loop space maintainer. In the recall visit after 6 months, 22, 24, and 32 were seen erupted into the oral cavity.

Clinical significance: Most genetically determined CS is characterized by autosomal dominant inheritance, but about half of cases are accounted for new mutations. Mutations in the ERF gene, coding for ETS2 repressor factor, a member of the ETS family of transcription factors, cause a recently recognized form of craniosynostosis (CRS4) with facial dysmorphism, increased intracranial pressure, Chiari-1 malformation, speech and language delay, and behavioral problems. The overall prevalence of ERF mutations in patients with syndromic CS is around 2%, whereas it is 0.7% in clinically nonsyndromic CS.

How to cite this article: Ranganathan R, Jampanapalli SR, Barathi D. Craniosynostosis-4 with Heterozygous Mutation in the ERF Gene: A Case Report. Int J Clin Pediatr Dent 2024;17(10):1163-1167.

Aim: To compare the microleakage of three bulk-fill composite resins with or without resin-modified glass ionomer cement (RMGIC) liner.

Materials and methods: A total of 30 maxillary human 1st premolar teeth were selected. Two box preparations were made on the mesial and distal sides. Teeth were randomly divided into three groups of 10 teeth each. RMGIC liner with 1 mm thick were applied to the mesial box. The specimens were divided into three groups according to the type of bulk-fill composites used and restoration of the cavities were done according to manufacturer instructions and light cured. Finishing and polishing were done and stored for 1 week in distilled water at 37°C. Thermocycling was then performed in a thermocycling unit. The specimens were then immersed in 0.5% methylene blue for 8 hours at 37°C. All the specimens were sectioned longitudinally in a mesiodistal direction and analyzed under 20× magnification in a stereomicroscope. The degree of dye penetration was scored.

Results: Subgroup M showed comparatively less microleakage compared to subgroup D in all the groups which was statistically significant. When microleakage between the study group on mesial and distal sides was compared, group smart dentin replacement (SDR)-M showed less microleakage compared to group F-M and this difference was statistically significant.

Conclusion: RMGIC is the recommended liner beneath the bulk-fill composites in class II cavities and SureFil SDR bulk-fill flowable can be the recommended composite resin for class II restorations.

Clinical significance: Bulk-fill composite is a time-saving material as it eliminates the incremental placement. RMGIC is always recommended beneath bulk-fill composites. SDR bulk-fill is the recommended composite restoration.

How to cite this article: Mundaragi VAC, Niranjan NT, Chandrashekhar KS, et al. Comparative Evaluation of Microleakage in Class II Composite Restorations Using Three Bulk-fill Composites with or without Resin-modified Glass Ionomer Cement Liner: A Stereomicroscopic Study. Int J Clin Pediatr Dent 2024;17(10):1146-1152.

Aims and background: This study aims to compare the fracture resistance force (FRF) and failure types of three-dimensional (3D)-printed stainless steel crowns (SSCs) and preformed SSCs in primary molars.

Materials and methods: Forty-eight over-retained and extracted mandibular second deciduous molars were divided into two groups: one receiving 3D-printed crowns and the other preformed crowns. Fracture resistance testing was performed using a universal mechanical testing machine, and failure types were analyzed post-testing.

Results: Fracture resistance testing revealed a significant difference between 3D-printed and preformed SSCs (p < 0.05), with 3D-printed crowns exhibiting a mean FRF of 3953.82 N compared to 742.94 N for preformed crowns. Additionally, Mann-Whitney U tests and Chi-squared tests were utilized to examine variations within and across the groups. Analysis of shear bond strength showed that 3D-printed crowns demonstrated superior adhesive performance compared to preformed crowns, with mean shear bond strength values of 3953.82 N and 742.94 N, respectively. Both groups A and B showed unrepairable failure modes.

Conclusion: The study concludes that 3D-printed SSCs offer distinct advantages over preformed options, including tailored fit, enhanced mechanical properties, and improved longevity. These findings underscore the potential of 3D printing technology to revolutionize pediatric dental restoration practices.

Clinical significance: Integrating 3D printing into pediatric dental practice holds promise for optimizing treatment outcomes and improving long-term oral health in children. The superior fracture resistance and adhesive performance of 3D-printed crowns suggest their potential to enhance restoration viability and reduce the need for subsequent interventions.

How to cite this article: Giridharan DL, Gopal S. Comparison of Fracture Resistance Force (Load-to-fractured Test) and Failure Type of 3D-printed Stainless Steel Crowns and Preformed Stainless Steel Crowns in Primary Molars: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(10):1129-1134.

Preserving deciduous teeth till their natural exfoliation is important to maintain arch length in different dentition periods. Premature loss of primary teeth may cause discrepancy in arch length due to drifting of teeth and supraeruption of the opposite teeth, thereby hindering the development of a harmonious, functionally and esthetically acceptable dentition. This article describes the fabrication and clinical application of a modified functional distal shoe appliance used due to pathological obliteration of the primary/deciduous mandibular second molar prior to the eruption of the permanent mandibular first molar. This modified functional intra-alveolar space maintainer appliance not only guides the first permanent molar eruption but also prevents ectopic eruption of the second premolar and supra-eruption of the second maxillary primary molar.

How to cite this article: Mohapatra A, Dutta S, Dutta B, et al. Operational Distal Shoe Appliance for Harmonious Occlusion: A Case Report. Int J Clin Pediatr Dent 2024;17(10):1172-1175.

Aim and background: To evaluate the in vivo and in vitro effects of three topical agents in reducing enamel demineralization around orthodontic brackets. Postorthodontic enamel demineralization persists to be undesirable and common complication.

Materials and methods: Twenty patients, who consented, were included into three experimental and a control group, following screening for inclusion, exclusion, and randomization. The experimental group was intervened with either GC Tooth Mousse Plus®, Clinpro® Tooth Cream, or Amflor® toothpaste. The baseline values were recorded using DIAGNOdent® following oral prophylaxis and brackets were bonded. The intervention group received the respective topical application of agents. Posttreatment values were recorded after 90 seconds of intervention and 20th day postintervention. Extraction of respective tooth was done on the 21st day to evaluate the microhardness using the Vickers hardness test.

Results: The results show the effectiveness of GC Tooth Mousse Plus® over Amflor® toothpaste followed by Clinpro® Tooth Cream for remineralization among patients undergoing orthodontic treatment and microhardness was highest for GC Tooth Mousse Plus®.

Conclusion: Topical agents can be used effectively as remineralizing agents in patients undergoing orthodontic treatment.

Clinical significance: Advanced diagnostic tools like the DIAGNOdent Pen® and remineralizing agents contribute to a comprehensive and proactive approach to dental care, particularly in populations with specific risk factors like children with high sucrose consumption.

How to cite this article: Sain S, Hegde SK, Bhat SS, et al. Remineralization of Enamel Using Topical Agents among Patients with Orthodontic Brackets: In Vivo and In Vitro Randomized Control Trial. Int J Clin Pediatr Dent 2024;17(10):1093-1098.

Aim and objectives: To evaluate the clinical performance (marginal discoloration, surface texture, and retention) of bioactive restorative material (ACTIVA) and resin-modified glass ionomer cement (RMGIC) in carious primary molar restorations at 6 and 12-month intervals.

Materials and methods: The split-mouth randomized controlled trial comprised 31 children aged 5-8 years having contralateral matched pair of carious primary molars with an International Caries Detection and Assessment System (ICDAS) II score 5. Sixty-two teeth were randomly allocated into two groups: group I-ACTIVA (n = 31) and group II-RMGIC (n = 31). After caries excavation, the teeth were restored with the respective materials and evaluated the marginal discoloration, surface texture, and retention after 6 and 12 months using modified USPHS (United States Public Health Service) criteria under the dental operating microscope.

Statistical analysis: Mann-Whitney "U" test was used for intragroup comparison and the Wilcoxon signed-rank test for intergroup comparison.

Results: A statistically significant difference was found in the surface texture of ACTIVA and RMGIC restorations at both 6-month (p = 0.002) and 12-month (p = 0.001) intervals, whereas the difference in the marginal discoloration and retention were not significant at both 6-month (p = 0.267 and 0.161, respectively) and 12-month intervals (p = 0.339 and 0.064, respectively).

Conclusion: The surface texture of ACTIVA is found to be superior to RMGIC, whereas marginal discoloration and retention are similar to RMGIC at both 6 and 12-month intervals.

Clinical significance: ACTIVA bioactive restorative material and RMGIC both enhance tooth remineralization with improved adhesion and fluoride release properties, making them valuable choices in various clinical scenarios.

How to cite this article: Bhavana K, Uloopi K, Vinay C, et al. A Randomized Controlled Trial Evaluating the Clinical Performance of Bioactive Restorative Material and Resin-modified Glass Ionomer Cement in Carious Primary Molar Restorations. Int J Clin Pediatr Dent 2024;17(10):1109-1113.

Objectives: Diabetes mellitus (DM) is among the four noncommunicable diseases. There are two types-type I and type II. The prevalence of type I DM in India is 0.26/1,000 population (1992). This study was carried out to assess dental caries status and gingival status. The study group was compared with the nondiabetic control group to find any association with metabolic control of the disease.

Methodology: A total sample size of 200 subjects was selected out of 100 patients referred to treat their poorly controlled type I diabetes mellitus at the tertiary hospital. Another 100 nondiabetic subjects were selected as controls. An oral clinical examination used a mouth mirror, dental explorer, visible light source, and cotton gauze. Decayed, missing, and filled teeth (DMFT), gingival index, plaque index, and calculus index were evaluated.

Results: Comparison of the gingival index between cases and control was found to be significant, where the p-value is <0.001. This points out that type I diabetic patients have more chance of gingival problems than others. The increased plaque index indicates the need to give more importance to oral health as it may lead to an increased calculus index in the future, leading to periodontal problems. It was found that glycosylated hemoglobin (HbA1c) is directly proportional to the gingival index.

Conclusion: Maintaining good oral health through regular check-ups with dental experts and motivating and educating type I diabetic patients as they are more prone to dental issues.

How to cite this article: Thankappan N, Chandran V, Venugopal M, et al. Assessment of Oral Health Status among Children with Type I Diabetes Mellitus: A Cross-sectional Study. Int J Clin Pediatr Dent 2024;17(10):1124-1128.

Odontogenic cysts can be treated in a number of ways, mostly aggressively by enucleation, less frequently conservatively. One such therapeutic approach is cyst decompression. It entails releasing the intraluminal pressure inside the cystic cavity, which shrinks the cyst and avoids the need for a more radical method of managing large cysts. This article presents the case study of an 8-year-old male child with an infected odontogenic cyst, treated with a unique decompression approach.

How to cite this article: Mistry LN, Deshpande SS, More SG. Management of Infected Dentigerous Cyst in an 8-year-old Patient Using Decompression Technique: A Case Report and Review of Literature. Int J Clin Pediatr Dent 2024;17(10):1176-1180.

Introduction: Identification of age is imperative for diversity of reasons including disputed birth records, legal issues, etc. Several growth assessment parameters like bone age, dental age, and the combination of both have been applied for different populations with variable outcomes. It is well documented that the chronological age does not necessarily correlate with the maturational status of a child. Hence, efforts were made to determine a child's developmental age by using dental and skeletal age. The knowledge of bone age and dental age is of great importance for pediatricians and pediatric dentists. It is essential for dentists to formulate treatment plans and it is a source of complementary information for pediatricians.

Aims: To assess the applicability of Cameriere's method for dental age assessment and its relationship with skeletal age (MP3) and chronological age in North Indian children.

Materials and methods: Children aged between 6 and 14 years were randomly selected. Chronological age was assessed by subtracting date of radiograph from the date of birth. The six modified MP3 stages given by Rajagopal and Kansal were used for skeletal age assessment. Dental age assessment was done based on Cameriere's method. Statistical analysis used: it was analyzed using Statistical Package for Social Sciences (SPSS) version 21.

Results: Among skeletal age subgroup of genders the calculated dental age based on Cameriere's method overestimated the chronological age significantly.

Conclusions: Overestimated dental age by Cameriere's method in North Indian children suggests a need for new regression equation for a better correlation with skeletal age and chronological age.

How to cite this article: Jamir T, Saha S, Dhinsa K, et al. Applicability of Cameriere's Method for Dental Age Assessment and Its Relationship with Skeletal Age (MP3) and Chronological Age in North Indian Children. Int J Clin Pediatr Dent 2024;17(10):1104-1108.

Aims and background: Combination of different noninvasive caries arresting approaches may improve the effectiveness and success rate of individual procedures for caries management. The purpose of this study was to evaluate clinical and radiographic success rate of a combination of 38% silver diamine fluoride (SDF) application and Hall technique (HT) for the management of dentinal caries in primary molars and compare it with conventional stainless steel crown (SSC) restoration.

Materials and methods: Children aged 4-8 years, having carious primary molars with the International Caries Detection and Assessment System (ICDAS) score of 5 or 6, were randomly assigned to treatment group A or B. Treatment group A (n = 25) received 38% SDF application and Hall crown, while group B (n = 25) received conventional SSC restoration. Follow-up was done at 1 month, 3, 6, 12, 24, and 30 months intervals.

Results: There was one case of major failure in group A (93.5% successful) while no case of major failure in group B (100% successful) and the difference was not statistically significant (p > 0.05). For minor failure (loss of SSC), the success rate was 91.3% in group B and 84.2% in group A, wherein the difference was not statistically significant (p > 0.05).

Conclusion: Conservative management of dentinal carious lesions with SDF and HT showed a similar success rate as compared to conventional operative procedures.

Clinical significance: This protocol can help reduce the clinical chair time and the need for deep sedation/general anesthesia in young children suffering from deep carious lesions with reversible pulpitis.

Trial registration number: CTRI/2020/07/026877, Clinical Trial Registry-India.

How to cite this article: Mittal M, Chopra R, Kumar A, et al. Combination of Silver Diamine Fluoride and Hall Technique for Caries Management in Primary Molars: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(10):1114-1120.