Background:A major objective in the management of deep carious lesions involving proximal surfaces of primary molars is to control marginal leakage. This could occur due to dimensional changes or failure in the adaptation of pulp capping materials to the prepared cavity. Evaluation of microleakage is important for assessing the success of newer pulp capping materials. Introduction:Biodentine exhibits good sealing ability but possesses longer setting times and handling difficulties, which might delay the placement of the final restoration. The sealing ability of newer dual-cure calcium silicate-based material in TheraCal PT in class II cavities of primary molars is not known. Hence, the current study aimed to evaluate and compare the microleakage of Biodentine and TheraCal PT in primary molars. Materials and methods:Extracted, noncarious primary molars (n = 28) were collected, and standardized class II cavities were prepared and restored with Biodentine (group I) and TheraCal PT (group II). Following this type, IX glass ionomer cement (GIC) was placed and polished. Microleakage was assessed using the dye penetration method, and data obtained through stereomicroscopic analysis were statistically analyzed. Results:The mean microleakage score observed in group I was 2.0 ± 1.3 MPa, and in group II was 1.0 ± 1.1 MPa. Comparable sealing ability was observed between both groups (p = 0.061). Conclusion:TheraCal PT could be used as a suitable alternative to Biodentine for use in vital pulp therapeutic procedures in children to reduce the treatment time and improve sealing ability. How to cite this article:Anusha B, Shivashankarappa PG, Mohandoss S, et al. In Vitro Evaluation of Sealing Ability of Biodentine and TheraCal PT in Primary Molars. Int J Clin Pediatr Dent 2024;17(2):158-161.

Introduction: The conventional approach to root canal preparation in primary molars involves hand instrumentation. However, the disadvantage of longer instrumentation time poses a challenge for dentists treating paediatric patients. As a solution, rotary file systems have been introduced to reduce chairside time and improve patient cooperation. Among the various rotary file systems available, the "Kedo S Square" rotary files are exclusive single files made of Nickel-titanium (NiTi), offering increased flexibility and variable taper to adapt to the curved canals of deciduous molars. Aim: To assess and compare the instrumentation time and obturation quality of rotary “Kedo S Square” files with manual K files in deciduous molars. Materials and Methods: This randomised clinical trial was conducted from July 2022 to February 2023 included 40 primary molars from four to six-year-old children requiring root canal therapy. The teeth were evenly allocated to two groups: Group 1 underwent instrumentation using “Kedo S Square” files, while Group 2 underwent instrumentation using manual K files. The instrumentation time was recorded, and post-treatment radiographs were taken to evaluate the quality of obturation by a single-blinded investigator. Statistical analysis included the Independent t-test, Levene’s Test for Equality of Variances, Chisquare test, and Fisher’s-exact test. Results: The use of Kedo S Square files resulted in significantly less instrumentation time (p<0.001) with a mean time of 3.91±1.462 minutes. There was no statistically significant difference in obturation quality between the two groups, with a p-value of 0.427. Conclusion: Kedo S “Square” files demonstrated comparable obturation quality with shorter instrumentation time compared to manual K files in root canals of primary molars.

Introduction: Orphan children are usually abandoned by their parents and these children are more vulnerable to oral health problems due to lack of knowledge and psychological support. These children do not receive adequate preventive health care and often suffer from oral health diseases. Oral Health Education (OHE) is the paramount of health promotion and prevention of oral health disease and also it throws some light on unattended oral health problems. Aim: To assess the knowledge, attitude and oral hygiene practices among 10 to 15 year-old orphanage children and to compare the effectiveness of OHE using video (child model) vs conventional method (Dentist) on knowledge, attitude and oral hygiene practices. Materials and Methods: This prospective interventional study was conducted among 120 orphanage children of 10-15 years in Puducherry, India. OHE using dentist and child model OHE video intervention was given to group I and group II, respectively. Knowledge, attitude and practice scores of both the groups was assessed at pre-test, post-test and 15 days follow-up using a prevalidated questionnaire. The data thus collected were statistically evaluated using repeated measures of Analysis of Variance (ANOVA), independent t-test, percentage. Results: When compared with baseline, a significant increase in knowledge, attitude and practice scores were seen in posttest and follow-up of child model video group when compared to conventional dentist led OHE group (p≤0.001). The results of this study indicate that knowledge, attitude and practice regarding oral health were improved in OHE using child model video group. Conclusion: From the results of this study it was found that incorporation of video in imparting OHE using child model can be an effective tool in improving oral health knowledge and it is evident that these children will be more confident, comfortable receiving instructions from children of their age group.

Paediatric Dentistry has witnessed significant changes in the materials used in pulp therapy in recent years. Bioceramic materials have been considered as the dawn of a new era in dentistry. The introduction of these materials into pulp therapy as mineralising materials has brought about enormous productive changes. Bioaggregate (BA) is a newly introduced nanoparticle-sized bioceramic material produced as an alternative to Mineral Trioxide Aggregate (MTA), aiming to overcome the disadvantages of the material. Invitro studies and a few clinical studies have demonstrated its biocompatibility and other properties, establishing it as an alternative to MTA and expanding its clinical applications. The aim of the present narrative review is to provide insight into the properties of BA, considering its scope in Paediatric dentistry.

of America, developed UltraSeal XT hydro, a novel acrylate-based, moisture-tolerant, self-adhesive/light-cured, and hydrophilic, PFS. 7This effectively bonds to moist enamel hence preventing moisture-related failure, and presents a discrete advantage in children as moisture control is a significant problem.

Maxillary midline diastema is a self-correcting anomaly which in few conditions may get retained in adolescence stage due to various aetiological factors and correction of which is usually done at permanent dentition stage. The persistence of midline diastema can be predicted in mixed dentition period and necessary management could be provided at the mixed dentition period. This case report is on a novel technique using ‘M’ spring to correct the midline diastema in mixed dentition period.

The eruption of teeth in newborns is a rare disorder of the oral cavity and are called 'natal teeth' when they are present at birth or 'neonatal teeth' when they erupt within the first month of life. In most of these cases, they are prematurely erupted deciduous teeth or supernumerary teeth. Supportive management should be given, to facilitate child's feeding and to prevent further complications, such as aspiration as the tooth could be mobile. This study describes a series of cases that were reported to our department, involving teeth located in the mandibular anterior region either at birth or within a few days after birth. The choice of treatment for each child was based on individual assessment of the case, considering options such as monitoring and extraction along with their associated complications.

Abstract Background It has been observed that children with special healthcare needs exhibit higher dental anxiety levels because of various barriers. In the literature, there is no anxiety assessment scale for speech and hearing-impaired children. A new concept of pictorial representation of common emotions observed during dental treatment was used to design an innovative scale, thereby helping to improve communication and in bringing out positive behavior among the children. This study aimed to assess and validate the efficacy of an anxiety rating scale for speech and hearing-impaired children. Materials and methods A total of 36–12-year-old children with speech and hearing impairments from a special school were selected for this study. The pretreatment anxiety score among the children was assessed using the pictorial anxiety rating scale. Results The anxiety rating scale was well accepted by speech and hearing-impaired children. It was well-supported by expert opinions and equal distribution of anxiety scores. Conclusion The pictorial scale is a valid anxiety assessment scale for measuring dental anxiety among speech and hearing-impaired children. It can be used independently to assess dental anxiety in clinical settings and epidemiological studies as well. How to cite this article Shivashankarappa PG, Kaur J, Adimoulame S. Anxiety Rating Scale for Speech and Hearing-impaired Children. Int J Clin Pediatr Dent 2022;15(6):704-706.

ABSTRACT Introduction/background The preventive benefits of pit and fissure sealants rely on their retention and sealing ability. The drawback of the conventional pit and fissure sealant is its poor retention due to the presence of moisture. Among the numerous pit and fissure sealants available, newer hydrophilic sealants are ideal for children. This study evaluates and compares the sealing ability of hydrophilic sealant Embrace WetBond with conventionally used glass ionomer sealant under a stereomicroscope. Materials and methods A total of 48 extracted human premolars were randomly divided into two groups (N = 24) and sealed with Embrace WetBond and GC Fuji VII as per manufacturers’ instructions. Following thermocycling, the sectioned samples were evaluated for sealant penetration, unfilled space, and total length of fissure under a stereomicroscope at magnifications 2.5×, 4×, and 5×. The values were measured in microns and in various fissure types using the ”ImageJ app” to measure the sealant penetrability and sealing ability. The data recorded were statistically evaluated. Results The penetrability of moisture-tolerant sealant was better (87.8 ± 10.7) compared to that of glass ionomer sealant (73.8 ± 15.5) (p = 0.002). Among the samples, U-type fissure patterns displayed greater penetrability (94.2 ± 6.2), whereas IK-type fissures revealed the lowest degree of penetrability (67.5 ± 7.3). Conclusion Embrace WetBond is better than glass ionomer sealant with respect to penetrability and sealing ability under stereomicroscope hence recommended as a better sealant for pediatric clinical practice. How to cite this article Priscilla S, Shivashankarappa PG, Mohandoss S, et al. Comparative Evaluation of Sealing Ability of Moisture-tolerant Sealant and Glass Ionomer Sealant Using Stereomicroscope: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S67–S71.

The pulpectomy procedure includes the complete removal of the pulpal tissue, debridement, and preparation of the canal space, followed by obturation. The standard method of cleaning and shaping the canals in primary teeth uses hand files, which can lead to iatrogenic errors. Kedo S files are exclusive pediatric rotary file systems of which the Kedo S Square file system (IV generation) have various advantages. The study aims to evaluate and compare the cleaning efficacy of Kedo S Square files and manual K files in root canals of primary teeth: An In-vitro comparative study was conducted, which included 56 root canals from 25 primary molars. 2-3ml of India ink dye was injected into canals and were randomly divided into two groups in which instrumentation was done using Kedo S Square files and Manual K files, respectively. The teeth were subjected to decalcification and dehydration and observed under a stereomicroscope for traces of Indian ink in the canals. Results were recorded and statistically analyzed using the Chi-Square test. Kedo S Square files had statistically better cleaning efficacy compared to the K file in the coronal(P=0.001), middle(P=0.000), and apical third(P=0.001) of the root canal. The cleaning efficacy of both Kedo S Square and K files varied in different thirds of the canals, but it was not statistically significant. Pediatric rotary Kedo S Square files were effective compared to Manual K Files concerning cleaning efficacy.

Introduction: Fear of the unknown causes anxiety in paediatric patients. The use of tell-show-do, along with audiovisual distraction, promotes positive behaviour and reduces anxiety. The use of a Dental Operating Microscope (DOM) as a visual distraction aid provides better cooperation in paediatric patients. Aim: To evaluate the effects of a DOM on anxiety, behaviour, and treatment time during a restorative procedure in paediatric dental patients. Materials and Methods: The present study was a parallel-arm, randomised clinical trial conducted at IGIDS, Puducherry, India, in 2022, over a period of four months. Healthy five to sevenyear-old children on their first dental visit were selected (n=90) and divided into two groups using simple randomisation. Group A: Restoration of teeth without a DOM, and group B: Restoration of teeth using a DOM. Anxiety and behaviour were measured as soon as the child entered the operatory (T1), after tell-show-do for the procedure (T2), after cavity preparation (T3), and after completion of the restoration (T4). Caries removal efficacy and treatment duration were also assessed. The data obtained were statistically analysed using the Chi-square test and independent sample t-test (p<0.05). Results: Out of the 90 children who participated in the study, 47 (52%) were girls, and 43 (47%) were boys. There was a decrease in anxiety and improved patient behaviour during cavity preparation (T3) and after completion of restoration (T4) in group B (p<0.001). The operator also reported higher visual (71.10%) and tactile (95.60%) scores in caries removal, with a shorter treatment duration in groups where DOM was used (p<0.001). Conclusion: The use of DOM reduced anxiety levels and improved the compliance of children during dental procedures. Operator ergonomics and the quality of treatment could be enhanced by recommending DOM in regular paediatric dental practice.

Context:The smear layer produced during the instrumentation of the root canal contains both organic and inorganic components, and it is recommended to be removed as it has a mixture of bacteria and their byproducts. Irrigants like sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), endodontic irrigant, citric acid, etc., possess the ability to remove the smear layer. Considering the antimicrobial effect, antiinflammatory, cavity disinfectant, nontoxicity, better taste, and aroma of herbal products, a novel approach has been introduced in the field of endodontics.Aims:To assess the efficacy of passion fruit juice in removing the smear layer and its erosive potential in root canals after instrumentation by scanning electron microscopy.Materials and methods:About 35 single-rooted premolars were divided into five groups-30% passion fruit extract (PFE), 17% EDTA, 17% EDTA + 5.25% NaOCl, 30% PFE + 17% EDTA, and saline. Following irrigation with the above irrigants, each tooth was split into two halves and examined and scored for smear layer removal (modified Torabinejad's criteria) using a scanning electron microscope.Statistical analysis:Overall comparison of the irrigant's action on removing the smear layer and their erosive potential was done using the Kruskal-Wallis test, and intergroup comparison of the irrigant action was done using the Mann-Whitney U test. All the statistical analyses were set with a significance level of p < 0.05.Results:A total of 30% PFE produced less erosion and statistically significant smear layer removal in the coronal and middle third of the root. When combined with 17% EDTA, it effectively removed the smear layer in all three-thirds of the root. Around 30% PFE + 17% EDTA is less erosive when compared to 17% EDTA + 5.25% NaOCl.Conclusion:This study revealed that 30% PFE and 30% PFE + 17% EDTA are promising irrigants as root canal disinfectants in endodontics.How to cite this article:Venkatachalamoorthi V, Shivashankarappa PG, Adimoulame S, et al. Effect of Passion Fruit Juice in Removal of Smear Layer in Root Canal of Ex Vivo Human Teeth: A Scanning Electron Microscopic Study. Int J Clin Pediatr Dent 2023;16(S-2):S190-S194.

Aim: TheraCal PT is a newer dual-cured resin-modified calcium silicate material with comparable biological properties to Biodentine. However, its bond strength to the dentin substrate is not known, especially for its use in primary teeth. Hence, the current study aimed to evaluate and compare the shear bond strength of two pulp capping materials, Biodentine and TheraCal PT in primary molars. Materials and Methods: In this experimental study, 28 non-carious human primary molars, which were nearing exfoliation, retained, or for orthodontic purposes, were extracted and collected. Using simple random sampling, they were randomly allocated into two groups with n = 14 in each group. Following occlusal flattening, cylindrical plastic tubes were stabilized and filled with TheraCal PT in group A and Biodentine in group B. All samples were incubated, subjected to universal testing machine, and analyzed under stereomicroscope for assessing the modes of failure. The statistical methods used were Independent t test, frequency, percentage (%), and Chi-square for intergroup comparison. The level of significance was kept at 0.05. Results: Significant differences in modes of failure were observed between TheraCal PT and Biodentine groups with P = 0.041. The modes of failure observed were mostly adhesive in group A compared with group B. The mean values of shear bond strength observed for groups A and B were 5.1 +/- 3.5 and 3.1 +/- 1.2 MPa, respectively. Conclusion: The shear bond strength observed for TheraCal PT was found to be comparable to that of Biodentine in primary molars.

Aim: This narrative review aims to provide an insight into a resin-modified newer calcium silicate-based material called TheraCal LC, its uses, and scope in Pediatric Dentistry. Materials and Methods: Literature search was conducted through various databases such as PubMed, Hinari, Cochrane, and Google Scholar by three independent reviewers using both MeSH terms and free terms. The articles published in English relevant to Pediatric Dentistry were selected, whereas unpublished articles in other languages and studies done in permanent teeth in children above 15 years were excluded. From the search results obtained, n = 258 articles were relevant. The reference list of all the articles included were hand-searched; full text evaluation was done and duplicates were removed. Results: A total of 26 published articles encompassing animal in-vitro and clinical studies using TheraCal LC in primary and young permanent teeth were included. TheraCal LC exhibits shorter setting time, superior mechanical properties, esthetic, weakly radiopaque, and lower biocompatibility. This makes it suitable for its use as a good pulp capping material in deep dentinal carious lesions in primary and young permanent teeth as a protective liner/base. However, few animal studies showed that TheraCal LC is not suitable for pulpotomy and furcation perforation repair, and limited human studies were available. Conclusion: TheraCal LC is found to be a promising alternative as a pulp-capping material to other calcium silicate-based materials in the management of deep carious lesions for pediatric dental practice. However, more clinical studies with long-term follow-up are necessary for its use as a pulpotomy material.

Even in the 21st century, dental caries are considered a global burden, severely upsetting the health and quality of life of those affected. Apart from the fluoride use and regular oral hygiene, one of the most important prophylactic approaches against caries occurrence is the sealing of pits and fissures. Pit and fissure sealants are a core part of the preventive program in pediatric dentistry and should be considered as a key component of minimally invasive dentistry due to their broad patient benefit. The primary sealant efficacy measure is retention. If the sealant remains bonded to the tooth and offers a good seal, then it is right to expect the occurrence of caries to be diminished. Traditional pit and fissure sealants are hydrophobic. These materials are based on bisphenol A-glycidyl methacrylate (bis-GMA) and other monomers requiring a dry field which is hard to achieve in an oral environment, especially for children. This review highlights the literature on the effectiveness of moisture tolerant pit and fissure sealant, which are the hydrophilic pit and fissure sealant, and a general overview of the pit and fissure sealant materials used for sealing occlusal surfaces, its classification as well as indications and possible side effects. How to cite this article: Priscilla S, GS P, Mohandoss S. Moisture Tolerant Pit and Fissure Sealant: A Literature Review. Int J Clin Pediatr Dent 2022;15(2):233-239.

Background:In primary teeth, working length determination is complicated due to its continuous alteration in dimension, shape, and root apex position. Accurate working length determination is essential to achieve the optimal cleaning and disinfection of the canal. Despite the use of conventional radiographic method, newer methods are available to increase the accuracy of WL determination. This study aims to compare electronic apex locator (EAL) with radiographic method of WL determination and to evaluate its accuracy using cone-beam computed tomography (CBCT).Materials and methods:Sixty root canals from 34 extracted primary teeth were included. Occlusal surfaces were flattened and access opening done for all the samples. Teeth were subjected to working length determination by conventional radiograph and EAL. Samples were then mounted on a U-shaped wax and subjected to CBCT. Results were recorded and statistically analyzed using ANOVA and ICC for quantitative data.Result:The mean measurement of radiographic, EAL and CBCT methods are 11.708, 11.200, and 10.895, respectively. Mean measurements demonstrated significant difference (p < 0.05) between three methods. ICC demonstrated high correlation between EAL and CBCT with Cronbach's α value of 0.962 and moderate correlation were observed between radiographic method and CBCT (0.706) and EAL and radiographic method (0.763). EAL demonstrated 87% accuracy whereas radiographic method demonstrated 63% accuracy to the actual length as evaluated by CBCT.Conclusion:EAL is more accurate than conventional radiographic method as evaluated by CBCT.How to cite this article:Shibin J, GS P, M S, et al. Evaluation of the Working Length Determination Accuracy by Cone-beam Computed Tomography in Primary Teeth. Int J Clin Pediatr Dent 2022;15(S-1):S92-S96.

Aim and objective:To assess the effectiveness of visual distraction with and without virtual reality glasses in reducing dental anxiety among children with hearing and speech disabilities undergoing dental treatment.Materials and methods:Twenty-four children with hearing and speech disabilities aged 6-12 years were selected and were randomly divided into three groups (N = 8). Children in group A received no distraction, group B received visual distraction using virtual reality (VR) glasses and group C received visual distraction without VR glasses during dental treatment. The anxiety levels were measured using PJS- Pictorial Scale and physiological parameters - before, during, and after a dental procedure. Then intragroup and intergroup comparison was done.Results:Intragroup comparison showed that "During" and "Post" treatment anxiety scores were significantly (p < 0.05) lower than that of "baseline" in group B. Intergroup comparison of anxiety scores in the three groups, at all three intervals, showed a statistically significant difference in the "during treatment" anxiety score (p = 0.049) with least score in group B.Conclusion:Visual distraction using VR glasses can be recommended as an effective distraction technique in reducing dental anxiety among children with speech and hearing disabilities.How to cite this article:Kaur J, Shivashankarappa PG, A S, et al. Effectiveness of Visual Distraction with and without Virtual Reality Glasses in Reducing Dental Anxiety among Children with Hearing and Speech Disability: A Pilot Study. Int J Clin Pediatr Dent 2021;14(S-2):S162-S166.

Background/aim:Dental trauma draws attention in special children due to its risks and consequences. The aim of this study was to estimate the prevalence, etiology, and risk factors of traumatic dental injuries in children with special healthcare needs of Puducherry.Materials and methods:A cross-sectional survey among 121 special children aged 4-18 years was carried out in Puducherry. The children were examined for the presence of traumatic dental injuries (TDI) and associated risk factors for the occurrence of trauma and classified according to the WHO epidemiological field survey classification.Results:Prevalence of TDI was 40.5%. The majority of them were restricted to enamel fractures and the most commonly affected were permanent maxillary central incisors. The most common cause of injury was ˝falling over˝ and home was the frequent place of injury to occur. The risk factors associated with TDI were mesoprosopic facial form, convex facial profile, increased overjet, Angles Class II molar relationship, posterior facial divergence, and incompetent lips which were statistically significant.Conclusion:The study concludes the prevalence of TDI is more prevalent in CSHCN, thereby it is necessary to create awareness, health education, and periodic screening for efficient treatment.How to cite this article:Martin AG, GS Prathima, Sanguida A, et al. Prevalence, Etiology, and Risk Factors of Traumatic Dental Injuries in Children with Special Needs of Puducherry. Int J Clin Pediatr Dent 2022;15(1):104-108.

Context: Probiotics are defined as live microorganisms which when delivered in adequate amounts provides health benefit in the host. Dietary supplements like lozenge seem to be the easy and acceptable vehicle for ingestion of probiotics in young children. Aim: To assess the efficacy of probiotics in plaque reduction and gingival health among 6-12 years school children before and after short term daily intake of Probiotic lozenge. Settings and Design: This Comparative study was conducted among 60 children in the age group 6–12 years. Thirty children in experimental group; who were given lozenge containing probiotic bacteria twice daily, one in the morning and another in the evening after brushing for one month. The placebo lozenge group also followed the same protocol. Statistical Analysis Used: SPSS version 21. Results: The Probiotic lozenge group was found to have statistically significant reduction in plaque scores when compared to that of the placebo group with P < 0.001 and there was also a significant improvement in gingival health. Conclusion: An effective reduction in plaque accumulation and gingival inflammation was found with the use of probiotic lozenges and hence proved the therapeutic value of the same.

Dental caries detection at an early stage by applying dermatoglyphics and assessing the salivary pH levels can facilitate the initiation of preventive measures at a younger age. However, there are little data available to substantiate the utility of dermatoglyphics and salivary pH in studying the genetic basis of dental caries.Therefore,the present study was aimed to assess the correlation between dermatoglyphic patterns and salivary pH in children with and without Early Childhood Caries (ECC).This cross-sectional study was carried out in 156 children of randomly selected schools in Puducherry in the age group of 3-5 years. Children with decayed, extracted and filled (defs) score of = 5 for group 1 (children with ECC) and defs score of 0 for group 2 (children without ECC) were considered for the study. Their fingerprint patterns and salivary pH were recorded and analysed using Chi-square test and Spearman correlation tests.In children without ECC group, loop frequency 10 and 7 was the most observed category whereas in subjects with ECC group, whorl frequency 7 and 8 was the most observed category. Significant proportion of whorls was seen more in both males and females in ECC group(p<0.0001). The mean salivary pH of subjects with ECC was 6.35±0.38 which was statistically significant (p<0.0001). Dermatoglyphic pattern and salivary pH can be used as predictive tool for diagnosis of ECC as there exists a definite variation in dermatoglyphic patterns and salivary pH in children with ECC and caries-free group. There are various methods to diagnose ECC but so far, there is no method to predict ECC using a dermatoglyphic pattern, salivary pH and ECC that may further facilitate initiation of preventive measures to avoid the progression of ECC at a younger age.