International Journal of Clinical Pediatric Dentistry最新文献

Background: Dental caries, primarily caused by Streptococcus mutans, is a prevalent oral health issue. Natural compounds such as clove and ginger exhibit antibacterial properties. The plant-derived compounds release phytochemicals, which aid in controlling the risk of the development of dental caries. This study aims to evaluate the efficacy of clove and ginger extracts against S. mutans in vitro, potentially offering new insights into alternative antimicrobial agents for caries prevention.

Objectives: To compare and assess the antimicrobial activity of the spice extract-clove (Syzygium aromaticum) and ginger (Zingiber officinale) against S. mutans.

Materials and methods: Approximately, 10 gm of ginger and clove powder was mixed with 10 mL of 70% ethanol. S. mutans [American Type Culture Collection (ATCC) 25175] were subcultured in brain heart infusion (BHI) broth and incubated at 37°C for 18-24 hours. The antimicrobial activity of ginger and clove extracts was evaluated using the microbroth dilution method in sterile 96-well microtiter plates.

Results: Growth of S. mutans was observed for two concentrations of clove (3.125 and 1.6%) and one concentration of ginger (1.6%). The median value for clove was 24 [Interquartile range (IQR): 20.25-29.25] and for ginger was 11.5 (IQR: 8.75-12.75). The comparison between ginger and clove at 1.6% concentration yielded a Z-value of -1.826 with a p-value of 0.068 (p > 0.05). While the lower median CFU count suggests ginger may have stronger antimicrobial activity, the difference was not statistically significant, indicating comparable efficacy of both extracts at this concentration.

Conclusion: Both ginger and clove extracts demonstrated antimicrobial activity against S. mutans. Ginger maintained complete growth inhibition up to 3.125% concentration, whereas clove showed bacterial growth at 3.125%. At an identical 1.6% concentration, ginger demonstrated a lower median CFU count (11.5, IQR: 8.75 - 12.75) compared to clove (24, IQR: 20.25 - 29.25), indicating stronger antimicrobial activity. However, this difference was not statistically significant (p = 0.068), suggesting comparable efficacy under the tested conditions. Both extracts show potential as natural antimicrobial agents for dental caries prevention.

How to cite this article: Rajkumar M, Ganesh A, Vignesh KC, et al. Comparative Evaluation of Antimicrobial Activity between Clove and Ginger Extracts against Streptococcus mutans: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(12):1489-1492.

Aim and background: The aim of the present study was to compare the efficacy of a caries control reagent [silver diamine fluoride (SDF)] and chemomechanical reagent (Papacarie gel) on smear layer removal under scanning electron microscopy (SEM) on root canal dentin of young permanent teeth.

Methodology: Therapeutically extracted young premolars (n = 30) were randomly divided into three groups of 10 teeth each. Group I, control group [5.25% NaOCl + 17% ethylenediaminetetraacetic acid (EDTA)], group II, Papacarie duo gel, and group III, 3.8% SDF solution. Root canals were prepared by rotary files, and an identical irrigation protocol was followed for the three groups. Teeth were bisected longitudinally and evaluated for smear layer removal under SEM. Images analyzed were scored using criteria given by Torabinejad. All the numerical scores were subjected to statistical analysis by the Chi-square test and Kruskal-Wallis test, and results were drawn.

Results: Scanning electron microscopy analysis revealed the presence of residual heavy smear layer on the entire root length in group III (100%) and minimal smear layer in group II (40%), which was statistically significant. On comparison at different root levels, a statistically significant difference was reported in the middle and apical thirds among all three groups (p ≤ 0.05).

Conclusion: Papacarie gel removed the smear layer as efficiently as the control group, besides being less detrimental to the immature dentin. Though 3.8% SDF inadequately removed the smear layer upon irrigation as compared to Papacarie and the control group, it effectively occluded the dentinal tubules. Both Papacarie and 3.8% SDF solution can be considered as adjunct root canal irrigants in young permanent teeth with wider dentinal tubules.

Clinical relevance: The smear layer acts as a substrate for bacteria and obstructs the canal walls. Its removal has been advocated, without damaging the dentinal microhardness of the root. In search of a biologically safe irrigation solution, Papacarie and SDF were considered, and statistically significant results were obtained.

How to cite this article: Mythreyi G, Sharada J, Shaik H, et al. Evaluation of the Efficacy of 3.8% Silver Diamine Fluoride and Papacarie as Root Canal Irrigants in Smear Layer Removal in Young Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(12):1413-1417.

Background: In primary teeth, pulpotomy is a well-established intervention for managing cariously exposed coronal pulp, with formocresol long considered the gold-standard medicament. Recent research focuses on wound-healing phenomena and the use of regenerative materials like chitosan owing to its functional versatility and unique characteristics.

Aim: To assess the clinical and radiographic outcomes of using chitosan as a pulpotomy agent in primary molars.

Materials and methods: Children aged 4-9 years, free from systemic illnesses and in need of pulpotomy, were selected. About 50 teeth were assigned to two groups: group I (chitosan) and group II (formocresol), and all treated teeth received stainless-steel crowns. Clinical and radiographic parameters were assessed at 1, 3, and 6 months posttreatment. The Chi-squared test was applied to compare the parameters and analyze the differences between the groups at the various time intervals.

Results: Group I (chitosan) demonstrated a clinical and radiographic success rate of 95.6%, while group II (formocresol) achieved 100%. The variation between the groups was not statistically significant.

Conclusion: The study indicated that chitosan (Axiostat®) can be considered a reliable pulpotomy agent in primary dentition and an effective substitute for formocresol.

How to cite this article: Krishna N, Rai K, Manju R, et al. Evaluation of Chitosan (Axiostat®) as a Pulpotomy Agent in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2025;18(S-1):S61-S65.

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.

Background: The incorporation of antibiotics into restorative materials has been shown to improve antibacterial effectiveness in previous studies. However, it remains uncertain whether such modifications could influence the mechanical properties of these materials.

Materials and methods: Metal molds (10 mm diameter × 6 mm thickness) were fabricated and divided into three groups: Group I-Cention-N (control), group II-Cention-N combined with metronidazole + ciprofloxacin, and group III-Cention-N combined with metronidazole + amoxicillin-clavulanate. The prepared specimens were immersed in neutral and acidic artificial saliva for 21 days. Microhardness and solubility were assessed at 24 hours, 72 hours, 7 days, and 21 days.

Results: In neutral saliva, all groups showed a gradual rise in microhardness values over 21 days. In acidic saliva, microhardness decreased for groups II and III, whereas group I exhibited a significant increase (p = 0.020). Solubility values were lowest in group III across both storage media.

Conclusion: The incorporation of antibiotic powders into Cention-N resulted in reduced solubility without adversely affecting its microhardness, which remained comparable to the unmodified material.

How to cite this article: Abhishek TS, Sogi HS, Jain M, et al. Comparative Evaluation of Microhardness and Solubility after Addition of Two Different Combinations of Double Antibiotic Powders Containing Metronidazole + Ciprofloxacin and Metronidazole + Amoxicillin Clavulanate to a Bulk-fill Alkasite Material, Cention-N: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(S-1):S45-S53.

Background: The cry is considered the basic reflex action the child tries to communicate. Applying behavior guidance techniques (BGT) suitably allows the dentist to lessen fear and anxiety.

Aim: The study aims to correlate the crying patterns with behavior and dental anxiety, and select appropriate nonpharmacological BGT for a specific type of cry.

Settings and design: The present study is designed to be a single-arm, behavioral interventional study.

Materials and methods: A total of 50 children aged 5-11 years were included, out of which crying was observed in 39 children. The cry was video-recorded during different treatment procedures commonly employed in pediatric dentistry and evaluated by two examiners to determine its type. Furthermore, the BGT was applied in a specific order, starting from tell, show, do (TSD) to physical restraints until the child displays a positive behavior; then, the appropriate technique was noted. Dental anxiety was noted preoperatively, during the treatment, and postoperatively. The data was subjected to statistical analysis.

Results: Among different types of cry, the frightened cry (FC) was the most common, followed by the compensatory (CC), obstinate (OC), pain (PC), and manipulative cry (MC). TSD was more effective in children, and the least was HOME (hand-over-mouth exercise). The association between the crying patterns, dental anxiety, behavior, and BGT is statistically significant (p < 0.001).

Conclusion: Based on the cry, precise BGT can be chosen for a particular treatment procedure. Hence, cry can be considered a potential communication tool in pediatric dentistry.

Clinical significance: Cry can be an effective means of communication in pediatric dentistry. Clinically, the study helps to choose a particular behavior guidance to alleviate dental fear and anxiety.

How to cite this article: Tharay N, Gurunathan D, Nirmala SVSG, et al. Assessment of the Relationship between Crying Patterns, Dental Anxiety, and Behavior Guidance Techniques: A Behavioral Interventional Study. Int J Clin Pediatr Dent 2025;18(S-1):S6-S10.

Aim and background: Chlorhexidine (CHX) is a gold-standard chemotherapeutic agent for preventing gingival and periodontal diseases. However, its drawbacks, such as metallic taste, burning sensation, and staining of teeth, make its acceptance questionable in children. To address this, the study aimed at the formulation of mouthrinses using herbal extracts of Alstonia scholaris and Calotropis procera plants, and evaluating and comparing its efficacy with CHX.

Methodology: The study was registered at CTRI (CTRI/2024/06/068874), which involved formulation of mouthrinses using the extracts, followed by a double-blinded clinical trial with 60 children aged 9-12 years, randomly assigned to three groups: A. scholaris, C. procera, and CHX. Parents were directed to dispense 10 mL of mouthrinse to their children two times a day for 14 days. The children were assessed at baseline and 14 days for plaque index, gingival index, salivary pH, and taste acceptability.

Results: The intragroup comparison showed a statistically significant reduction in mean plaque scores across all three groups over 14 days. Additionally, the C. procera group exhibited a significant increase in salivary pH over 14 days (p < 0.05). The intergroup comparison revealed no statistically significant differences in mean plaque and gingival scores (p < 0.05). However, the C. procera group showed an increase in salivary pH compared to the other two groups (p < 0.05). Furthermore, the taste acceptability of the C. procera group was significantly better than that of the other groups (p < 0.05).

Conclusion: The two herbal extracts were as effective as CHX in maintaining the oral health of children, with better taste acceptance, and can be considered as an alternative to CHX.

Clinical significance: Mouthrinses formulated with A. scholaris and C. procera extracts can be safely and effectively used for children.

How to cite this article: Valke PS, Shetty AJ, Naik SS, et al. Assessment of the Efficacy of Alstonia scholaris, Calotropis procera, and Chlorhexidine Mouthrinses on Oral Health of Children Aged 9-12 Years: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2025;18(S-1):S54-S60.