Aim and background: In pediatric dentistry, successful dental care involves both the proper execution of the procedure and the development of a positive approach to dental visits. Recent advances in conservative dentistry have introduced self-limiting methods for caries removal, designed to reduce pain and discomfort while enhancing patient comfort. The present in vivo study aimed to compare the efficiency of caries removal, the time required, and pain perception associated with ceramic burs, polymer smart burs, and conventional tungsten carbide burs in primary molars.
Methods: A total of 90 primary molars from 30 children (21 boys and 9 girls) aged between 5 and 9 years (mean age 6.77 ± 1.36) were included. Caries excavation was carried out using tungsten carbide burs (group I), polymer burs (group II), and ceramic burs (group III). The parameters assessed were the efficacy of caries removal, time required for excavation, and pain perception, and comparisons were made among the three groups.
Results: Polymer burs required significantly more time for caries excavation than both tungsten carbide and ceramic burs. Caries removal efficacy was highest with tungsten carbide burs, followed by ceramic burs, while polymer burs showed the lowest efficacy, with statistically significant differences between groups. Pain perception was lower with ceramic and polymer burs compared to tungsten carbide burs.
Conclusion: Ceramic burs are more efficient than polymer burs in minimally invasive caries excavation.
Clinical significance: Minimally invasive dentistry in pediatric patients is clinically significant as it focuses on early prevention, preserves tooth structure, minimizes discomfort and trauma, and supports long-term oral health through less invasive, more child-friendly techniques. This study provides evidence that the ceramic bur is an effective minimal invasive tool for caries excavation.
How to cite this article: Krishnaveni L, Dash JK, Baliarsingh RR, et al. Comparative Evaluation of Caries Removal Efficacy of Ceramic Bur, Polymer Smart Bur, and Conventional Tungsten Carbide Bur in Primary Molars: A Clinical Study. Int J Clin Pediatr Dent 2025;18(10):1222-1227.
Aims and background: Early dental caries are caused by subsurface demineralization of enamel and manifests 0.0015 as noncavitated, white lesions. Remineralization is a process that replaces lost mineral ions in demineralized enamel. Saliva naturally aids in remineralization. However, this process is slow and can be hampered under cariogenic conditions. Fluoride has been a significant caries-preventive agent, promoting remineralization, and preventing demineralization. However, interest in non-fluoridated treatments has increased due to concerns about dental fluorosis. Proanthocyanidins (PACs), which are extracted from grape seeds, have remineralization potential owing to their capacity to chelate calcium and phosphate ions.
Materials and methods: This study examined the remineralization effectiveness of a fluoride varnish and a PAC biovarnish on artificially induced dental caries in vitro. Grape seeds were used to extract PACs to create a biovarnish. Three groups of 60 primary molar teeth each-control (no treatment), fluoride varnish, and PAC varnish-were used. The sample tooth was immersed in a demineralizing solution for 4 days to produce artificial caries lesions. Remineralization treatments were administered twice a day for 7 days after demineralization. Changes in surface topography and enamel hardness were evaluated by scanning electron microscopy (SEM) and Vickers enamel microhardness testing (VEMH).
Results: One-way ANOVA (analysis of variance) revealed significant differences (p = 0.00) after remineralization, with the PAC varnish group showing the highest (VEMH) values. SEM analysis showed effective remineralization with PAC varnish, presenting a surface similar to sound enamel.
Conclusion: The novel PAC biovarnish demonstrated superior remineralization efficacy compared with fluoride varnish, suggesting it as a promising alternative for fluoridated caries prevention treatments.
Clinical significance: The study demonstrates that PAC biovarnish is a highly effective alternative to fluoride varnish for enamel remineralization, potentially reducing the risk of dental fluorosis. This offers a promising nonfluoridated option for caries prevention and management.
How to cite this article: Baskar R, Srinivasan D, Eagappan AR S, et al. Comparative Evaluation of Remineralization Efficacy of a Novel Proanthocyanidin Biovarnish with Fluoride Varnish on Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(10):1187-1193.
Introduction: Composite resins are one of the favored choices of dental restoration due to their esthetic appearance, adhesion, and tooth structure preservation. However, they have certain drawbacks, such as lower wear resistance, polymerization shrinkage, and microcracks at the margins. Silver nanoparticles (AgNPs) release cationic silver with oxidative potential, contributing to improved mechanical and enhanced antibacterial properties of dental materials.
Aim: To determine whether AgNPs-incorporated in Omnichroma decrease the microleakage and increase the microhardness.
Materials and methods: A class V cavity was prepared on 40 premolar extracted teeth, which were randomly segregated into four groups: Group I-Omnichroma composite resin for microleakage evaluation; group II-AgNPs-incorporated Omnichroma composite resin were assessed for dye penetration by Michal Staininec and Mark Holtz scoring using a stereomicroscope; group III-Omnichroma composite resin for microhardness evaluation; group IV-AgNPs-incorporated Omnichroma composite resin were evaluated for microhardness values using a Vickers microhardness tester.
Results: All the data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. Student's t-test was applied for the variables. There was a statistically significant difference in the microleakage scores between groups I and II (p = 0.005). The microhardness values were also improved, although there was no statistically significant difference between groups III and IV. (p = 0.08).
Conclusion: Incorporation of 0.3 wt% of AgNPs into the Omnichroma composite resin statistically decreased the microleakage and improved the microhardness. The distinct characteristics of AgNPs can be employed to enhance the properties of dental materials.
How to cite this article: Mendon MS, Jain M, Sogi S, et al. An In Vitro Comparative Evaluation of Microleakage and Microhardness of Omnichroma and Silver Nanoparticles-incorporated Omnichroma. Int J Clin Pediatr Dent 2025;18(10):1181-1186.
Oral ulcers are a common problem across most age-groups, having limited treatment modalities such as gels, solutions, and creams. Mucoadhesive patches containing chemical agents have been studied. However, there is scanty literature on the incorporation of a natural agent into the drug delivery system for the treatment of oral ulcers. Amla (Phyllanthus emblica), a medicinal plant well known for its healing properties, shows immense potential for the treatment of oral ulcers. The aim of this study is to develop and characterize a mucoadhesive patch containing Amla bark and fruit extracts and assess its physicochemical properties and wound healing efficacy. The phytochemical analysis revealed the presence of phytocompounds having antioxidant, anti-inflammatory, antiulcerogenic, and various other medicinal properties. The mucoadhesive patches were formulated using the solvent casting method. The patches were then subjected to in vitro tests such as folding endurance, swelling index (SI), mucoadhesive strength, tensile strength, moisture absorption (MA), Fourier-transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM), and revealed optimal results. Assessment of the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay of the extracts revealed that 25 µg/mL was the maximum safest therapeutic dose for human oral fibroblasts. A wound healing assay revealed that in a 12-hour period, the ethanolic extracts of P. emblica bark and fruit at 10 µg/mL concentration demonstrated an enhanced wound closure rate with values of 50.12% and 67.44%, respectively. Both extracts exhibited 100% wound healing after 24 hours. This study supports the ethnopharmacological relevance of P. emblica in oral ulcer treatment, highlighting its potential as a wound healing agent. The findings justify further development and clinical evaluation of P. emblica mucoadhesive patches for the treatment of oral ulcers.
How to cite this article: Jairam LS, Deveswaran R, Khan FA, et al. Development and Characterization of an Oral Mucoadhesive Patch Containing Amla (Phyllanthus emblica) Bark and Fruit Extracts to Promote Healing of Oral Ulcers: An In Vitro Study. Int J Clin Pediatr Dent 2025;18(10):1234-1242.
Aim: This study aimed to evaluate the caries risk in children with early childhood caries (ECC) and late childhood caries (LCC) using the American Dental Association's Caries Risk Assessment Form (ADA-CRAF) and compared contributing risk factors for cavitated and noncavitated lesions between the groups.
Materials and methods: A cross-sectional study performed between January 2022 and December 2023 included 218 children aged 1-6 years, divided into ECC (<3 years, n = 109) and LCC (3-6 years, n = 109) groups, based on recently proposed caries classification terminology. Caries risk was assessed using ADA-CRAF, with clinical examinations categorizing lesions as cavitated or noncavitated. Data were analyzed using the Chi-square test, with statistical significance set at p < 0.05.
Results: Among participants, 78% were in the high caries risk category. The LCC group showed a higher prevalence of cavitated (78.9%) and noncavitated lesions (63.3%) compared to the ECC group (50.5% and 38.5%, respectively). Significant risk factors included visible plaque, fluoride exposure, and the consumption of frequent sugary beverages. Notably, children without cavitated or noncavitated lesions could still be classified as high risk, highlighting the importance of preventive measures.
Conclusion: The study revealed a high prevalence of dental caries (n = 147; 67%) among children under 6 years, based on assessments using the ADA-CRAF. The analysis of risk factors, such as visible plaque and the consumption of sugary foods, shows that these factors contribute significantly to a high caries risk in both the ECC and LCC groups.
How to cite this article: Vignesh KC, Veeravagoo L, Gandikota KA, et al. Caries Risk Assessment in Children with Early Childhood Caries and Late Childhood Caries. Int J Clin Pediatr Dent 2025;18(10):1267-1271.
Aim and background: A child's first impression of the dental clinic impacts their willingness to cooperate during treatment, and factors like the dentist's gender, attire, and clinic colors strongly influence a child's comfort. Colors in particular play a crucial role in shaping emotions and reducing fear. This study aims to evaluate children's knowledge of a pediatric dentist and their preferences regarding the dentist's gender, attire, and the dental clinic environment.
Materials and methods: A cross-sectional study was conducted among 186 schoolchildren aged 6-12 years. Children were provided with images of male and female dentists and a clinical setting along with 10 colors and were asked to color them based on their preferences. Data were analyzed using SPSS 20.0.
Results: A statistically significant knowledge gap (p < 0.001) was observed between younger and older children regarding the knowledge of pediatric dentists, where older children were more aware. Sixty-four percent of children stated that a dentist's attire influenced their anxiety, while 74% believed clinic environment colors affected their comfort levels. Most children preferred a dentist of their own gender. Blue was the most favored color for dentist's attire among both genders. For the clinic environment, boys preferred blue, whereas girls opted for pink. Brown was the most chosen color for dental chairs.
Conclusion: The results of our current study conclude inadequate knowledge about pediatric dentists in children. The dental clinic environment and the dentist's attire affect the child's anxiety level.
Clinical significance: Pediatric dentists must recognize that clinic ambiance and attire significantly influence child behavior. Understanding these preferences enables pediatric dentists to create child-friendly, psychologically supportive environments that enhance the overall dental experience.
How to cite this article: Alahari SV, Cheruku SR, Swathi SS, et al. Pediatric Dentistry through a Child's Lens-The Role of Dentist's Gender, Attire, and Clinic Ambiance in Gen Alpha's Experience: A Cross-sectional Study. Int J Clin Pediatr Dent 2025;18(10):1260-1266.
Aim and background: The aim is to evaluate the longevity of the Hall Technique (HT) compared to orthodontic bands (BOCIV) for treating carious lesions in the deciduous molars of children with disabilities.
Materials and methods: A total of 58 children with cognitive impairments, diagnosed with mild to moderate learning disabilities, aged 4-10 years, presenting with carious lesions classified as scores 5/6 in deciduous molars, were included. The sample consisted of 100 teeth, divided into two groups: HT, n = 50; and BOCIV, n = 50. Clinical and radiographic follow-ups were conducted at 6 and 12 months. Kaplan-Meier survival curves and log-rank tests were used to compare the two groups. Cox regression analysis was performed to assess the influence of other variables.
Results: After 12 months, 72 teeth were reevaluated. A total of 100 teeth were reevaluated at least once during the study and included in the survival analysis. HT showed superior performance (88% survival) compared to the BOCIV (66% survival). Regarding marginal adaptation, BOCIV showed a higher frequency of subgingival extension, whereas the HT group exhibited better proximal contact preservation.
Conclusion: Orthodontic bands cemented with conventional glass ionomer (BOCIV) may be considered an alternative treatment for extensive carious lesions in deciduous molars; however, HT demonstrated superior survival, marginal adaptation, and proximal contact retention.
Clinical significance: This study highlights a treatment option for these carious lesions in deciduous molars for children with disabilities. The study was registered in the Brazilian Registry of Clinical Trials (REBEC) under the number RBR-825qxqw.
How to cite this article: Pedroza ACBB, Gimenez T, Resende CS, et al. Hall Technique Compared to Orthodontic Band Cementation in Carious Injuries in Deciduous Teeth of Children with Disabilities: Randomized Clinical Trial. Int J Clin Pediatr Dent 2025;18(10):1272-1277.
Aim: To evaluate the structural characterization and biocompatibility of novel glass ionomer cement (GIC) enhanced with a nanocomposite of chitosan, titanium, zirconium, and hydroxyapatite.
Materials and methods: The experimental GIC was formulated by incorporating chitosan, titanium, zirconium, and hydroxyapatite nanoparticles into the conventional GIC matrix. The modified GIC was analyzed using scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) to assess the integration of the nanocomposite and its effects on the microstructure. Fibroblast cell viability was evaluated on GIC composite disks compared to conventional GIC. Fluorescence microscopy was performed to assess cell viability and morphology. SEM was used to evaluate fibroblast attachment and morphology on the experimental GIC surfaces. The obtained data were statistically analyzed using one-way analysis of variance (ANOVA) to determine significant differences between groups.
Results: X-ray diffraction confirmed the successful incorporation of the nanocomposite components, with evidence of phase stability and homogeneous distribution. FTIR identified strong chemical interactions between the nanocomposite and GIC matrix. SEM revealed reduced porosity and uniform dispersion of nanoparticles, contributing to enhanced structural integrity. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay demonstrated high fibroblast cell viability, comparable to control samples, with no significant cytotoxic effects. Live/dead staining showed a higher proportion of viable cells on the modified GIC, indicating improved biocompatibility. SEM analysis of cell adhesion revealed better attachment and spreading of fibroblasts on the nanocomposite-enhanced GIC.
Conclusion: The integration of a chitosan-titanium-zirconium-hydroxyapatite nanocomposite into GIC enhances its mechanical properties, biocompatibility, and bioactivity. This multifunctional material addresses the limitations of conventional GIC and offers potential as a next-generation material.
How to cite this article: Muthukumaran V, Paulraj J, Maiti S, et al. Evaluation of Structural Characterization and Biocompatibility of Glass Ionomer Cement Enhanced with Nanocomposites of Chitosan, Titanium, Zirconium, and Hydroxyapatite: Assessment of Cell Viability and Adhesion through Gingival Fibroblast Cell Line. Int J Clin Pediatr Dent 2025;18(10):1249-1254.
Objective: This study evaluated the outcomes of treating anterior crossbite in early mixed dentition patients using the Myobrace appliance.
Materials and methods: A retrospective study was conducted on 30 Vietnamese children aged 6-10 years with anterior crossbite from 2020 to 2022. Oral habits, including tonguethrusting, lingual frenum interference, and tongue posture, were evaluated pre- and post-therapy. Clinical, radiographic, and soft tissue outcomes were assessed to monitor craniofacial, dental, and esthetic changes before and after treatment.
Results: The mean age was 8.1 years (SD = 0.94), with 60% female participants. The average treatment time was 14.5 months (SD = 1.31). Tonguethrusting decreased from 23.3 to 3.3%, lingual frenum interference resolved completely (43.3 to 0%), and low tongue posture declined from 33.4 to 6.6%. Overjet improved from -2.5 (SD = 1.90) to 1.6 mm (SD = 1.14), and overbite reduced from 2.2 (SD =0.92) to 0.8 mm (SD =1.14). Maxillary and mandibular incisor angulations showed significant improvements: U1 to SN increased from 100.4° (SD = 7.14) to 109.5° (SD = 7.18), and IMPA decreased from 89.8° (SD = 8.77) to 87.0° (SD = 7.97). Most patients adhered to the recommended wear and exercise regimens, though 40% experienced appliance detachment in the first 2 weeks.
Conclusion: The Myobrace system effectively corrected anterior crossbite, improved oral habits, and enhanced dental alignment in early mixed dentition, promoting functional and esthetic improvements.
How to cite this article: Pham TT, Tran BC, Pham TTH. Effectiveness of Myobrace Therapy in Correcting Anterior Crossbite in Early Mixed Dentition: A Retrospective Study. Int J Clin Pediatr Dent 2025;18(10):1243-1248.
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