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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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   Table of Contents - Current issue
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April-June 2020
Volume 38 | Issue 2
Page Nos. 97-207

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EDITORIAL  

COVID-19 – “The game changer” of the real world p. 97
Sudhindra Baliga
DOI:10.4103/JISPPD.JISPPD_265_20  PMID:32611851
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ORIGINAL ARTICLES - EPIDEMIOLOGY Top

Association between early childhood caries and feeding practices among 3–5-year-old children of Indore, India Highly accessed article p. 98
Khushboo Barjatya, Ullal Anand Nayak, Ankur Vatsal
DOI:10.4103/JISPPD.JISPPD_60_20  PMID:32611852
Background: The impact of early childhood caries (ECC) seen in infants and young children to the society is enormous. Most studies on ECC have been focused on specific ethnic and lower socioeconomic communities, however fewer studies are conducted in India as compared to other developed countries. Aims: The study investigates the association between selected feeding practices and the presence of early ECC among 3–5 year-old children of Indore city. Methodology: A cross-sectional sample consisted of 640 preschool children of different socioeconomic status (SES). A self-administered questionnaire was used to obtain information about demographic backgrounds and feeding history of the child. The caries experience of children was recorded. Statistical Analysis: The data were evaluated using Chi-square and multivariate logistic regression. Results: The prevalence of ECC was found to be 64%. ECC was found to be significantly associated with age, SES, breastfeeding for more than 1 year, bottle feeding, bottle content used other than water, feeding at night, and cup drinking after 1 year. Conclusion: The present study indicates that ECC and feeding habits have a significant relationship. The content of the bottle feed and feeding practices at night are the strongest factors among all feeding habits associated with ECC
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A survey of training in leadership abilities and professional expectations among heads of pediatric dentistry departments in dental institutions of India p. 104
Gauri Kalra, Vijay Prakash Mathur
DOI:10.4103/JISPPD.JISPPD_172_20  PMID:32611853
Purpose: A web-based questionnaire survey was undertaken among the heads of pediatric dentistry departments to find out trainings received, participation in administrative responsibilities, expectations, stress related to the position, and overall satisfaction levels in dental institutes of India. Methodology: An online survey was sent to 188 heads of the pediatric dentistry after formulating and piloting the questionnaire. A descriptive analysis was performed using SPSS version 18.0. Results: Fifty-seven males and 43 females, making a total of 100 responses were received, making 53.2% response rate. The main issues came out to be lack of adequate training about the leadership role of heads and inadequate participation in major administrative activities related to department. The stress was primarily due to extensive paperwork, meetings, and effect on interpersonal relationships. Conclusion: It could be concluded that the respondents were not having a free hand in handling respective departments and there had been lack of formal trainings about leadership abilities and other soft skills before being appointed as head of the department.
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Parent's attitude toward use of internet for child's oral health and treatment p. 110
Gyanendra Kumar, Aditi Garg, Mridula Goswami, Ferah Rehman, Ravita Bidhan
DOI:10.4103/JISPPD.JISPPD_86_20  PMID:32611854
Background: Widespread use of internet in the modern era has allowed increased access to seek medical and dental education by self-education. However, limited evidence is reported regarding the use of internet to gather oral health information by patients reporting to dental hospital in a centrally located institute of New Delhi, India. Aim: The aim of the present cross-sectional study was to evaluate the parental attitude toward the use of internet related to child's oral health and treatment. Design: The data was collected from 500 patients from the Outpatient Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi. A self-administered questionnaire with open ended questions assessing parental attitude toward the use of internet for oral health information was designed, and patients willing to participate were included. Materials and Methods: The present cross-sectional study was conducted among 500 parents selected randomly from the Out Patient Department. The participants were given the questionnaire which assessed their attitude towards use of internet related to child's oral health and treatment. The data was collected and statistical analysis was performed. Results: 86% reported to have high school education, 7% to have middle school education, 3% to be diploma holders, 2% to be graduates and postgraduates, and only 2% as professionals. 56.1% of the participants use internet to gather information on oral health, whereas only 41.9% reported that they have access to internet but do not use to search information related to oral health and disease. 26.1% of the participants often search information on internet before consulting a doctor, and 29.3% discuss treatment plan after searching from internet with their doctor. Conclusion: Since the use of internet by younger adults seeking information on oral health seems to be more prevalent among educated people, less prevalence is reported in this study. Majority of the participants were aware regarding the harmful effects of such information and also reported that treatment or medication searched on internet made their problem worse than before.
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YouTube™ as a source of information on oral habits p. 115
Huseyin Simsek, Suleyman Kutalmış Buyuk, Ebru Çetinkaya
DOI:10.4103/JISPPD.JISPPD_357_19  PMID:32611855
Background: The aim of this study was to evaluate the content of oral habit videos on YouTube™. Materials and Methods: The four keywords “Oral Habits,” “Thumb Sucking,” “Tongue Thrust”, and “Finger Sucking” relevant terms oral habits were searched on YouTube™. The videos sorted by view count were screened and evaluated. The following exclusion criteria were defined as; non-English videos, unrelated to a topic, poor audio-video quality, and duplication. A hundred videos were analyzed for general video characteristics (number of views, likes, dislikes, number of comments, and uploaded date) the purpose of the video, information content, audio-visual quality, and viewers' interaction index. Results: The top hundred videos have been viewed an average of 26,870.83 times. Most videos were uploaded by dentists (n = 29; 29.0%). Most of the videos (44.0%) were classified as having moderate general information content and 38.0% were rated as good, and 18.0% were rated as poor. Videos generally involved information about oral habits (82.0%), followed by personal experience (12.0%). The viewers' interaction index of all evaluated YouTube™ videos was 0.59. Good content videos had a significantly higher interaction index than the other groups (P = 0.011). Conclusions: YouTube™ videos about the oral habits are generally inadequate and patients must be recommended to view them with caution. High quality and more informative videos about oral habits in dentistry should be uploaded to YouTube™ by professionals.
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Phlebotomy for obtaining platelet-rich fibrin autograft in children for pediatric dental procedures: Parental views, understanding, and acceptance p. 119
Kapil Gandhi, Priyanka Goswami, Ritika Malhotra
DOI:10.4103/JISPPD.JISPPD_4_20  PMID:32611856
Background: The negative perception of parents toward invasive dental procedures has always created a barrier in delivering successful treatment to pediatric patients. Surprisingly, little is known about the perspective of parents and the impact of demographic and psychological factors guiding their decision. Aim: To evaluate the acceptability of phlebotomy for obtaining platelet-rich fibrin (PRF) to be used in pediatric endodontic procedures among parents of children. Design: A cross-sectional study design was used for the survey. The design involved interviewing the parents of children aged 3 to 14 years, who fulfilled the inclusion criteria and were indicated for regenerative pulp therapy using PRF. Materials and Method: The sample included one hundred and fifty shortlisted parents who were made to answer questionnaires on sociodemographic data and psychological variables. A single pediatric dentist educated the parents individually on the procedure, risks, and benefits of PRF, following which parental consent and views were recorded in the developed performa. Results: Consent of 63.3% was recorded at the end of the study. Parenting pattern and parental dental anxiety were found to have significant correlation with the treatment acceptance. Conclusion: It is the responsibility of the pediatric dentist to communicate the treatment strategies in a manner that is acceptable to the parents for which a thorough knowledge about parental factors is necessary. This study helps in identifying such factors and highlights the importance of demonstration aids in parental education and motivation.
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Pattern of antibiotic prophylaxis practice for dental procedures in children with congenital heart disease p. 126
Jama’iah Mohd Sharif, Raja Zarina Raja Shahardin, Ganasalingam Sockalingam
DOI:10.4103/JISPPD.JISPPD_235_18  PMID:32611857
Background: Various antibiotic prophylaxis guidelines have been published such as the American Heart Association 2007, British Society for Antimicrobial Chemotherapy 2006, National Institute for Health and Clinical Excellence 2008, European Society of Cardiology 2015, and in Malaysia, the National Antibiotic Guideline 2014 and Clinical Practice Guidelines for the Prevention, Diagnosis and Management of Infective Endocarditis 2017. The aim of the study is to determine the pattern of antibiotic prophylaxis practice for dental procedure in children with congenital heart disease (CHD) at the Department of Paediatric Dentistry, Kuala Lumpur Hospital. Materials and Methods: A comparative cross-sectional study of dental records from 2010 to 2015 was done by collecting data on the source and reason of referral, types of heart condition, dental procedure, and antibiotic given. Results: There were 210 patients; 69.5% had acyanotic CHD, 21.9% cyanotic CHD, 6.7% repaired CHD with residual defects, and 1.9% with previous infective endocarditis. Slightly more than 58% were referred from government doctors (pediatric cardiologist and National Heart Institute). The common cause for referral was dental assessment (47.6%). Antibiotics were prescribed to 23.3% (49/210) patients, of which, 34.7% was given ampicillin or amoxicillin/clavulanic acid. About 96% of cyanotic heart cases undergoing invasive dental procedures were prescribed antibiotic prophylaxis. Almost 31% were prescribed with antibiotic prophylaxis even though it was not indicated. Conclusion: This study shows that there is variability in prescribing antibiotic prophylaxis, and it is important for dental clinicians to standardize the practice of giving antibiotic prophylaxis.
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ORIGINAL ARTICLES - LABORATORY RESEARCH Top

Comparative evaluation of calcium release of the apical plugs formed by mineral trioxide aggregate, Biodentine, and EndoSequence root repair material with and without 2% triple antibiotic powder: An in vitro study p. 132
Pooja Nitin Mapara, ND Shashikiran, Sachin Gugawad, Namrata Gaonkar, Savita Hadakar, Swapnil Taur, Dhanshri Khade
DOI:10.4103/JISPPD.JISPPD_74_20  PMID:32611858
Background: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. Aim: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. Methods: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. Results: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. Conclusion: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.
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Effect of three silver diamine fluoride application protocols on the microtensile bond strength of resin-modified glass ionomer cement to carious dentin in primary teeth p. 138
Savil Ramachandra Uchil, Baranya Shrikrishna Suprabha, Ethel Suman, Ramya Shenoy, Srikant Natarajan, Arathi Rao
DOI:10.4103/JISPPD.JISPPD_159_20  PMID:32611859
Background: Use of silver diamine fluoride (SDF) after selective caries excavation can arrest the further progress of the carious lesion. Application of potassium iodide (KI) can reduce the staining due to SDF.Aim:The aim of the study was to evaluate the effect of the application of SDF, with and without acid etching and KI on the bond strength of resin-modified glass ionomer cement (RMGIC) to the carious dentin of primary teeth. Materials and Methods:In thisin vitro study, caries was induced on the occlusal surface by inoculating Streptococcus mutans strain in 36 extracted primary molars. The teeth were divided into four groups (n = 9), and the following treatments were done to the carious dentin prior to final restoration with RMGIC: Group I: 10% polyacrylic acid conditioner, Group II: 38% SDF, Group III: 37% phosphoric acid etchant followed by 38% SDF, and Group IV: 37% phosphoric acid etchant followed by 38% SDF and 10% potassium iodide solution. The microtensile bond strength was measured using universal testing machine. Failure modes were recorded using a scanning electron microscope. Results: There was no significant difference in microtensile bond strengths between the groups (P = 0.665), with the highest value seen in Group III. Conclusions: Application of SDF with or without acid etching and KI does not affect the bond strength of RMGIC to carious dentin of primary teeth.
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In vitro evaluation of antimicrobial effect of Myristica fragrans on common endodontic pathogens p. 145
Jyothsna Vittoba Setty, Ila Srinivasan, Roopashree Teeka Sathiesh, Mamata Kale, Vidyullatha Vittoba Shetty, Salgundi Venkatesh
DOI:10.4103/JISPPD.JISPPD_214_20  PMID:32611860
Background: Complete elimination of microorganisms from the root canals is the important key for the successful endodontic treatment. Constant emergence of resistant strains and adverse effects of synthetic drugs has led to the search of effective herbal alternatives. Nutmeg (Myristica fragrans) is one such spice used for its various medicinal activities. Aims: To evaluate the antimicrobial effect of M. fragrans on common endodontic pathogens of primary tooth. Materials and Methods: Essential oil of nutmeg was extracted by hydrodistillation method, and its phytoconstituents were determined by thin-layer chromatography (TLC), high-performance TLC, and gas chromatography–mass spectrometry analysis. Minimum inhibitory concentration of essential oil against standard strains of common endodontic pathogens (Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Streptococcus mutans, Candida albicans, Lactobacillus casei, Actinomyces viscosus, Prevotella intermedia, and Porphyromonas gingivalis) was determined by serial tube dilution method. Results: Essential oil of M. fragrans was effective against all tested endodontic microorganisms. Discussion: The active components of essential oil of nutmeg such as myristicin, myristic acid, trimyristin, elemicin, and safrole have good antimicrobial activity and are effective against endodontic microorganisms. Conclusion: M. fragrans can be used as an effective medicament in the treatment of endodontic infections.
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ORIGINAL ARTICLES - CLINICAL RESEARCH Top

Evaluation of antifungal activity of six children's toothpaste on Candida albicans isolated from early childhood caries patients p. 152
TP Chandhru, VR Anusha, Faizal C Peedikayil, MB Gufran Ahmed, Soni Kottayi, Dhanesh Narasimhan
DOI:10.4103/JISPPD.JISPPD_3_20  PMID:32611861
Background: Early childhood caries (ECC) is an aggressive, destructive form of dental caries that affects the children younger than 6 years of age. Candida is known to increase the adherence of Streptococcus mutans to the oral biofilm and produce acids that cause tooth demineralization. Aim of the Study: To evaluate the efficacy of six commercially available children's toothpaste on clinical isolates of Candida albicans obtained from ECC patients. Materials and Methods: The study population comprised 60 children aged 3–6 years having ECC. Samples were divided into six groups comprising ten children in each group. Samples were collected using sterile cotton swabs, inoculated on Sabouraud dextrose agar, and incubated at 37°C for 24 h. Species identification was done by germ tube test and growth on corn meal agar. After the confirmed growth of C. albicans, the six commercially available children's toothpaste namely Organic Children's Coconut Oil Toothpaste®, Aloe Dent Children's Toothpaste®, Patanjali Dant Kanti Junior Toothpaste®, Colgate Kids Toothpaste®, Pediflor Kids Toothpaste®, and Crest Pro-Health Stages Kids Toothpaste® and distilled water as control group were subjected for antifungal activity of C. albicans. Agar plates were incubated at 37°C for 48 h, and the diameter of the zones of inhibition was measured and recorded. Data were tabulated and statistical analysis was done using Statistical Package for the Social Science (16.0) version. Results: Pediflor kids toothpaste® showed maximum antifungal activity and Aloe Dent children's toothpaste® showed minimum antifungal activity. Conclusion: All brands of children's toothpaste show antifungal activity against Candida albicans.
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A clinical evaluation of two electronic apex locators and conventional radiography in working length determination in primary molar and its influence on children's behavioral responses p. 158
Krithi Nellamakkada, Sandya S Patil, Madhu Kakanur, Ravi S Kumar, Rachna Thakur
DOI:10.4103/JISPPD.JISPPD_28_20  PMID:32611862
Background: Accurate root canal length determination, simplicity of the procedure, and patient's cooperation are important determinants in the success of endodontic treatment in primary teeth. Aim: The aim of the study was to clinically compare the accuracy of Propex Pixi and Formatron D10 apex locators with conventional radiography in determining working length in mandibular primary second molars with and without varying degrees of physiological root resorption. Design: A nonrandomized clinical trial was conducted in 115 mandibular primary second molars indicated for pulpectomy in 90 pediatric dental patients. A single calibrated examiner determined the working length by conventional radiographic method and electronic apex locator (EAL) methods in a total of 376 canals. Behavior of the children during execution of each method in each tooth was recorded using the Frankl's behavior rating scale. The data obtained were tabulated and subjected to statistical analysis. Results: Significant correlation (intraclass correlation = 0.80 and 0.81, P < 0.001) could be detected between working length measurements obtained using Propex Pixi and Formatron D10 and measurements obtained using conventional radiography. Higher percentage of negative behaviors (negative and definitely negative) was observed during the conventional radiographic method (68.6%) as opposed to the Propex Pixi (16.5%) and Formatron D10 (20.8%) methods. Conclusions: Both the apex locators were as accurate as conventional radiography in determining working length in primary teeth; Formatron D10 being more accurate than Propex Pixi. The EALs were far better accepted by children than conventional radiography.
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Comparison of antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of primary teeth p. 164
Suchi Agarwal, Parimala Tyagi, Ashwini Deshpande, Saurabh Yadav, Vipul Jain, Kuldeep Singh Rana
DOI:10.4103/JISPPD.JISPPD_119_20  PMID:32611863
Aim:Sodium hypochlorite, though considered an ideal root canal irrigant, cannot be used at required concentrations in children, due to its undesirable effects. Hence, it is imperative to search for an ideal root canal irrigant to avoid these undesirable effects which we hope to achieve with this study. The antimicrobial efficacy of aqueous ozone, green tea, and normal saline as irrigants in pulpectomy procedures of the primary teeth has been compared. Materials and Methods: Sixty patients between 4 and 8 years of age with a single-rooted deciduous tooth indicated for pulpectomy were included. The infected teeth were randomly allocated to one of the three treatment groups based on the irrigating agents used, namely normal saline, green tea extract, or ozonated water. Specimens for anaerobic culture were collected three times from the teeth: before irrigation, after initial irrigation, and on the 3rd day after final irrigation. Results and Conclusion: Mean colony forming unit (CFU) count after both initial and final irrigation with ozonated water was significantly lower when compared with green tea and normal saline. Further, it was observed that the mean CFU count with green tea was significantly lower than the counts obtained with normal saline on the 3rd day after final irrigation. Hence, both ozonated water and green tea could be considered a good alternative to conventional root canal irrigants in the primary teeth. Larger sample sizes with a larger variety of irrigants are recommended.
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In vivo evaluation of zinc oxide-propolis mixture as root canal filling material in the primary molars: A 24-month follow-up randomized controlled trial p. 171
Kakarla Sri RojaRamya, C Vinay, KS Uloopi, Rayala Chandrasekhar
DOI:10.4103/JISPPD.JISPPD_127_20  PMID:32611864
Background: Pulpectomy is a routine practice in children with pulpal and periapical infections, the success of which depends on the elimination of bacteria from the root canals. Propolis, a natural product with proven antibacterial and anti-inflammatory properties when mixed with zinc oxide powder as root canal filling material, it could provide good success in endodontic therapy of primary teeth. Aim: The aim was to evaluate and compare the clinical effectiveness of zinc oxide-propolis mixture with zinc oxide eugenol (ZOE) as root canal filling material in nonvital primary molars. Settings and Design: This was a 2-arm, parallel group randomized controlled trial with blinded outcome assessment. Materials and Methods: Forty primary molars from children aged 4–8 years requiring pulpectomy treatment were randomly allocated into two groups according to the obturating material used: zinc oxide-propolis mixture (test group) and ZOE (control group). All the pulpectomy treated teeth were finally restored with stainless steel crowns, and the children were recalled at 6, 12, and 24 months for postoperative clinical and radiographic evaluation. Statistical Analysis: Chi-square test was used to analyze the data. Results: The overall success rate of pulpectomy with zinc oxide-propolis mixture and ZOE was found to be 95% and 70%, respectively, and the difference was statistically significant (P = 0.037). Zinc oxide-propolis mixture has shown a success rate of 100% at 6 months and 95% at 12 and 24 months follow-up, whereas ZOE has shown 80% success rate at 6 and 12 months, and it declined to 70% at 24-month follow-up. Conclusion: Zinc oxide-propolis mixture demonstrated good clinical and radiographic success at the end of 24 months, and hence, it can be considered as an alternate root canal filling material in the primary teeth.
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Comparative evaluation of a novel herbal anesthetic gel and 2% lignocaine gel as an intraoral topical anesthetic agent in children: Bilateral split-mouth, single-blind, crossover in vivo study p. 177
Vedangi Arvind Mohite, Sudhindra Baliga, Nilima Thosar, Nilesh Rathi, Pramod Khobragade, Rashi Srivastava
DOI:10.4103/JISPPD.JISPPD_226_20  PMID:32611865
Background: Topical anesthetics have an intrinsic part to reduce pricking pain sensation due to needle stick before injection in children. Aim: The present study aimed to determine the effectiveness of a novel herbal anesthetic gel used as a topical anesthetic before an inferior alveolar nerve block. SettingsandDesign: This was a bilateral split-mouth, single blind, crossoverin vivo study. Methods: Atotal number of 30 children were selected for this study design. After the application of the topical anesthesia, a 26-gauge needle was inserted in the mucobuccal fold and local anesthetic solution was deposited. Assessment of pain perception was done before the procedure and at the time of needle penetration using hemodynamic parameters such as blood pressure and heart rate. The objective and subjective pain assessment was recoded through sound eye motor scale and Faces Pain Scale-Revised (FPS-R). StatisticalAnalysis: As the data followed a normal distribution, parametric tests were used to analyze these data. The independent sample t-test and paired sample t-test were used to check the mean differences. Results: The data showed no statistically significant differences in the objective and subjective pain assessment values of the novel herbal anesthetic gel compared to the 2% lignocaine gel. However, the intragroup comparisons of the before and during treatment results showed statistically significant results (P < 0.05). Conclusion: The novel herbal anesthetic gel was effective and safe in reducing the pain from needle insertion. Thus, setting up scientific evidence for the therapeutic usage of herbal products can, therefore, assist to develop a more efficient and alternative topical anesthetic.
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A comparative evaluation of pain perception following topical application of benzocaine gel, clove-papaya based anesthetic gel and precooling of the injection site before intraoral injections in children p. 184
A Anantharaj, Jiline Mary Sabu, Sudhir Ramakrishna, Ramya Bangalore Jagdeesh, P Praveen, Prathibha Rani Shankarappa
DOI:10.4103/JISPPD.JISPPD_153_18  PMID:32611866
Background and Aim of the Study: The topical anesthetic property of clove remains unexplored even though it has been widely used in dentistry since ages. Hence, the aim of the study was to compare the topical anesthetic efficiency of precooling with ice, clove–papaya based topical gel and benzocaine gel in pediatric patients. Methodology: Sixty healthy children aged 9–10 years who required local anesthetic injections for dental procedures were selected and divided into three groups with 20 patients each. In the first visit, written consent and intraoral screening of the patients were performed. In the second visit, the topical anesthetic agents were applied in the respective groups for 1 min and later local anesthetic injections were administered. Pain perception was evaluated using Sound, Eye, Motor Scale (SEM scale) and Wong Baker Faces Pain Rating Scale (WBFPRS), tabulated, and statistically analyzed. AResults: The test results demonstrated that benzocaine group has the highest mean WBFPRS score followed by clove–papaya group and then ice cone group. The ice group showed the least mean SEM scale score, followed by the benzocaine group and then clove–papaya group. However, the mean WBFPRS score and the mean SEM scale score did not show any statistically significant difference. Interpretation and Conclusion: All the three topical anesthetic agents provided similar surface anesthesia in children. The newly introduced clove–papaya based topical anesthetic gel showed encouraging results, hence can be used as a potent topical anesthetic agent.
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CASE REPORTS Top

Oral submucous fibrosis in children and adolescents: Analysis of 36 cases p. 190
Chandramani Bhagwan More, Naman R Rao, Rahul Hegde, Rahi M Brahmbhatt, Ashish Shrestha, Gyanendra Kumar
DOI:10.4103/JISPPD.JISPPD_173_20  PMID:32611867
Oral submucous fibrosis (OSMF) is a chronic debilitating irreversible oral potentially malignant disorder affecting any part of the oral cavity. It is usually seen in adults but rarely noticed in children and adolescents. Since the paucity of the cases, there exists a gap of knowledge in the causative habits, root reasons of habit initiation, age of habit initiation, and the common clinical representation of this disorder. The current article aims to bridge this gap by presenting unusual 36 cases of children and adolescents reported at the tertiary care hospital of Vadodara, Gujarat, India, with specific areca nut chewing habit and distinct features of OSMF. Furthermore, the present case series is the first of its kind in the scientific literature with a high number of OSMF cases in children and adolescents.
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Hemifacial microsomia managed by distraction osteogenesis: A clinicoradiological report p. 200
Shikha Dogra, Vignesh Guptha Raju, Vimanyu Kataria
DOI:10.4103/JISPPD.JISPPD_291_19  PMID:32611868
Hemifacial microsomia (HFM) is a congenital malformation in which there is hypoplasia of hard and soft tissues on one side of the face. It is considered the second most common congenital syndrome of the head-and-neck region. The hypoplasia manifests in all the structures derived from the first and second branchial arches and therefore, growth and development of these structures is affected in this condition. The present case is a variant of HFM in a 5-year-old Indian male child, which has been diagnosed based on clinical and radiological findings and managed successfully by surgical technique known as distraction osteogenesis.
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McGovern nipple: An alternative for nose breathing in newborn with CHARGE syndrome, having bilateral choanal atresia p. 204
Sanjay Kumar, Mansi Jain, Suma Sogi, Avaneet Thukral
DOI:10.4103/JISPPD.JISPPD_320_19  PMID:32611869
CHARGE syndrome caused by the mutation of CHD7 genes is associated with many congenital anomalies. Individuals are diagnosed based on major and minor characteristic features and confirmed by genetic testing. Major criteria characterized by 4C's: Coloboma, Cranial nerve abnormalities, Choanal atresia, and typical CHARGE ear are seen. In this article, a case of a newborn suffering from CHARGE syndrome having stressful breathing is reported. A McGovern nipple was fabricated and secured in the oral cavity to maintain the oral airway till further surgical interventions were done.
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