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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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October-December 2018
Volume 36 | Issue 4
Page Nos. 327-416

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EDITORIAL  

Indian pediatric dentistry blueprint for 2020 p. 327
Sudhindra M Baliga
DOI:10.4103/JISPPD.JISPPD_277_18  PMID:30324919
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ORIGINAL ARTICLES - EPIDEMIOLOGY Top

Evaluation of the intensity of gingival melanin pigmentation at different age groups in the Indian population: An observational study p. 329
Palak Janiani, Pragathi R Bhat, Vijay A Trasad, Anirudh B Acharya, Srinath L Thakur
DOI:10.4103/JISPPD.JISPPD_192_17  PMID:30324920
Background: The brownish-black pigmentation of the gingiva has been reported in several countries. However, the available literature pertaining to the Asian population suggests that this pigmentation is more predominant in individuals with dark complexion. Although there is available literature on the intensity of gingival pigmentation with different age groups in Japanese and Israel population, no such literature pertaining to age and intensity of melanin pigmentation is available in the Indian population. Aim: This study aims to observe the intensity of melanin pigmentation in different age groups in the Indian population. Methods and Materials: Intensity of melanin pigmentation was observed by the gingival melanin pigmentation index as given by Ponnaiyan et al. in 250 individuals who were grouped under the age group of 0–5 years, 6–9 years, 10–12 years, 13–15 years, and 16–20 years. Each group comprised 25 individuals. Results and Conclusion: The results were subjected to statistical analysis so as to observe the intensity of melanin pigmentation at different age groups in the Indian population. It was concluded that with age, the intensity of gingival melanin pigmentation, as well as its distribution to the posterior gingiva was increased. As age increased, gingival pigmentation was more in the attached and interdental papilla, while in the younger age groups, it was confined either only to the interdental, marginal or attached gingival, or both depending on the skin color.
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Survey of knowledge of school children towards the prevalence, severity, management of maxillofacial injuries, and rescue skills in the event of a dog bite p. 334
Deepika Pai, Abhay Taranath Kamath, K Pratibha Panduranga, Ramchandra Kamath, Kalyana P Chakravarthy, Rashmi Nayak, K Chitra, Saurabh Kumar
DOI:10.4103/JISPPD.JISPPD_1110_17  PMID:30324921
Background: Maxillofacial injuries are reported commonly in children encountering animal/dog attack. The level of knowledge of children on such events can form a sound basis for the prevention of maxillofacial injuries resulting from dog bites/attacks. Aim: This study aims to assess the knowledge of children on maxillofacial injuries resulting from dog bites, their management, and rescue skills to be used during the event of a dog attack. Settings and Design: The study is a cross-sectional questionnaire survey. Material and Methods: Seven hundred children aged 7–12 years participated in the study. A questionnaire consisting of 21 questions assessed the common site and management of injury resulting from dog bites, the source of exposure, and the knowledge of children on rescue skills to be used in the event of dog attack. This was followed by an awareness program to educate the children on rescue skills and management of dog bite injuries. Statistical Analysis: Descriptive statistics were calculated for all the variables. Results: A significant percentage of dog bite injuries occurred on the face and hands in children. Boys were more common victims. Familiar dogs inflicted injuries to the children commonly than stray dogs. The children lacked knowledge on the management of dog bite injuries; however, they were aware of rabies and its prevention. The children were not well aware of rescue skills to be used in the event of a dog attack. Conclusion: Children are innocent and behavior of dogs are unpredictable hence they become victims of the dog attacks. Educating children on safe animal behavior can prove vital in reducing gruesome maxillofacial injuries resulting from dog attacks.
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School absenteeism, academic performance, and self-esteem as proxy measures of oral health status: A cross-sectional study p. 339
Thiruvenkadam Gopalan, Sharath Asokan, J Baby John, PR Geetha Priya
DOI:10.4103/JISPPD.JISPPD_217_18  PMID:30324922
Purpose: The purpose of the study was to assess the impact of school absenteeism, academic performances, and self-esteem of school-going children on their oral health status. Materials and Methods: The study sample included 2014 children aged 12–15 years from India. Rosenberg self-esteem scale was used to assess the self-esteem of the children. Data on school performance, homework completion, and absenteeism were obtained from the school authorities and parents. Clinical examination for each child was done to assess the Decayed, Missed, and Filled Teeth (DMFT) and Oral Hygiene Index-Simplified (OHI-S) scores. The data obtained were statistically analyzed using Pearson's Chi-square test, Mann–Whitney test, and Kruskal–Wallis test with the aid of SPSS software. Odds ratio was calculated with 95% confidence interval. P ≤0.05 was considered statistically significant. Results: Oral health had a significant association with school absenteeism and homework completion. School absenteeism was significantly associated with dental caries (P = 0.007) and poor oral hygiene (P = 0.001), whereas homework completion was significantly associated with dental caries alone (P = 0.002). There was no significant association between variables like self-esteem, first language, mathematics, and DMFT/OHI-S score. Conclusion: School records such as absenteeism data and homework completion can be used as proxy measures of the oral health status in children.
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ORIGINAL ARTICLES - LABORATORY RESEARCH Top

Antimicrobial efficacy of 980 nm diode laser on Enterococcus feacalis in conjunction with various irrigation regimes in infected root canals: An in vitro study p. 347
Aparna Singh Shaktawat, Kanika Gupta Verma, Virinder Goyal, Purshottam Jasuja, Suruchi Juneja Sukhija, Aditi Mathur
DOI:10.4103/JISPPD.JISPPD_128_17  PMID:30324923
Aim: The aim of the present study was to evaluate and compare the antimicrobial efficiency of different irrigating solutions against Enterococcus faecalis with or without the use of 980 nm diode laser in infected root canals. Materials and Methods: A total of 100 freshly extracted human single-rooted teeth were divided into three experimental groups (n = 30) and one control group (n = 10). Experimental group was subdivided into two subgroups A and B (n = 15), whereas control group was subdivided into positive and negative controls (n = 5). After access cavity preparation, the root canals were prepared using ProTaper rotary instruments. A volume of 5 ml of 5.25% sodium hypochlorite and 17% Ethylenediaminetetraacetic acid, 1.2 ml of 2% chlorhexidine gluconate, and 2 ml of neem solution was used for irrigation in Group I, II, and III, respectively. E. faecalis (ATCC 29212) was inoculated into each canal of experimental groups and incubated for 2 weeks under aerobic conditions at 37°C. In all the subgroups B, laser irradiation was performed, whereas, in subgroup A, no laser irradiation was done. In negative control, E. faecalis was not inoculated in samples, but in positive control, E. faecalis inoculation and incubation procedure was followed. With circumferential filing using #40 reamer, dentinal chips were collected using sterile paper points, vortexed in sterile saline, was then applied to UTI Hicrome agar culture plates and incubated at 37°C for 48 h. The cfu/ml for each plate was calculated using a bacterial colony counter. The data obtained were subjected to statistical analysis using SPSS software version 20.0. Results: The study showed that the least number of bacterial cfu/ml was observed in Group IB. The order of bacterial colony count (cfu/ml) was observed as Group IB <IA <IIB <IIA <IIIB <IIIA. Conclusion: The study concluded that the groups with laser irradiation along with irrigation protocols were more efficient as compared with irrigation protocol alone.
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Evaluation of enamel remineralizing potential of self-assembling peptide P11-4 on artificially induced enamel lesions in vitro p. 352
Vemulapalli Sindhura, KS Uloopi, C Vinay, Rayala Chandrasekhar
DOI:10.4103/JISPPD.JISPPD_255_18  PMID:30324924
Purpose: The purpose of this study was to evaluate the remineralizing efficacy of self-assembling peptide (SAP) P11-4 qualitatively and quantitatively using scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX), respectively. Methodology: Enamel samples (n = 24) were prepared by sectioning extracted premolars and subjected for demineralization to create artificial enamel lesions. The structural and elemental concentrations (calcium and phosphate weight %) were assessed to obtain baseline data using SEM and EDX spectroscopy, respectively. The samples were randomly allocated into two groups and were treated with SAP P11-4 (test group) and casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) (control group) followed by storage in artificial saliva to evaluate the remineralizing efficacy at 1-week, 1-month, and 3-month intervals. Results: Data were analyzed using the ANOVA and unpaired t-test. From the observed results, CPP-ACP showed a significant increase in Ca: P ratio (2.04 ± 0.2) with irregular surface calcific deposition at 1-week interval and this reduced with time (1.87 ± 0.11 at 3-month interval). Whereas P11-4 showed a significant increase in Ca: P ratio (1.95 ± 0.10) with uniform ion deposition suggestive of hydroxyapatite nucleation over a 3-month period. Conclusion: SAP P11-4 exhibited superior remineralization with uniform mineral deposition compared to CPP-ACP at 3-month interval.
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Evaluation of antimicrobial efficacy of Trachyspermum ammi (Ajwain) oil and chlorhexidine against oral bacteria: An in vitro study p. 357
Mahesh V Dadpe, Snehal V Dhore, Prasanna T Dahake, Yogesh J Kale, Shrikant B Kendre, Ayesha G Siddiqui
DOI:10.4103/JISPPD.JISPPD_65_18  PMID:30324925
Introduction: Plaque removal is of utmost importance for control of dental caries and other associated diseases of oral cavity. However, various natural agents have proven their efficacy over chemotherapeutic agents in terms of antibacterial activity against various microorganisms. The effect is mainly due to polyphenol as its major constituent. Aim: In this in vitro study, we aimed to determine the antibacterial efficacy of Trachyspermum ammi oil at different concentrations against five oral bacteria. Hypothesis: Herbal compound, T. ammi oil is effective in reducing five oral plaque-forming bacteria. Materials and Methods: We determined the antimicrobial activity of T. ammi oil (test material) against chlorhexidine (gold standard). Pure cultures of Streptococcus mutans MTCC No 497, Streptococcus oralis MTCC No. 2696, Lactobacillus acidophilus MTCC No. 10307, Lactobacillus fermentum MTCC No. 903, and Candida albicans MTCC No. 183 were obtained and grown in selective culture media. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of both materials were evaluated by serial dilution and disc diffusion method, respectively. Results: Our results revealed that T. ammi oil moderately inhibits bacterial growth with mean MIC of 250, 125, 250, 125, and 250 μg/ml, respectively. Mean MBC for T. ammi oil obtained was 18.60 ± 0.65, 11.60 ± 1.14, 14.10 ± 0.55, 11.50 ± 0.61, and 15.10 ± 0.74 mm. The MIC and MBC values were higher as compared to chlorhexidine gluconate and it was statistically significant. Conclusion: T. ammi (ajwain) can serve as a potential, natural, nontoxic, and economical therapeutic antiplaque agent.
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ORIGINAL ARTICLES - CLINICAL RESEARCH Top

Effects of distraction using virtual reality technology on pain perception and anxiety levels in children during pulp therapy of primary molars p. 364
Puppala Niharika, N Venugopal Reddy, P Srujana, K Srikanth, V Daneswari, K Sai Geetha
DOI:10.4103/JISPPD.JISPPD_1158_17  PMID:30324926
Objective: The aim of this study was to evaluate the influence of using virtual reality (VR) eyeglasses on severity of pain and anxiety during pulp therapy in pediatric patients considering childhood anxiety-related disorders as an important confounding factor in the dental setting. Materials and Methods: A total of 40 children aged between 4 and 8 years with no previous anxiety disorder were randomly divided into two groups. The study consisted of three consecutive treatment sessions. The two groups received pulp therapy with and without VR eyeglasses in a randomized single-blind-controlled crossover fashion. Then, at the end of each session, the patients' pain severity was assessed using Wong–Baker FACES Pain Rating Scale and state anxiety was measured by Faces version of the Modified Child Dental Anxiety Scale [MCDAS]. Changes in pulse oximeter and heart rate were recorded in every 10 min. The values obtained were tabulated and subjected to statistical analysis. Results: The study shows a significant decrease in pain perception (P < 0.001) and state anxiety scores (P < 0.001) with the use of VR eyeglasses during dental treatment. Conclusion: The results of this study provide an initial encouraging for the use of VR device during dental treatment by pediatric dentists, but additional empirical research is required.
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A comparative assessment of intranasal and oral dexmedetomidine for procedural sedation in pediatric dental patients p. 370
Vinod Patel, Neerja Singh, Anil Kumar Saksena, Subash Singh, SK Sonkar, S Mandeep Jolly
DOI:10.4103/JISPPD.JISPPD_40_18  PMID:30324927
Objectives: The objective of this study was to assess the safety and efficacy of intranasal and oral dexmedetomidine for procedural sedation in pediatric dental patients. Materials and Methods: Forty-four uncooperative American Society of Anesthesiologists Grade-I children, requiring dental treatment were randomly divided into four groups who received different doses of dexmedetomidine through intranasal and oral routes. The vital signs were monitored continuously during each visit. Results: In this study, significant (P < 0.05) differences were found in the onset of sedation, duration, and recovery time between intranasal and oral groups. All vital signs were within normal physiological limits with no significant adverse effects in either of the groups. Conclusion: Dexmedetomidine is a safe and effective agent for procedural sedation in pediatric dental patients with intranasal route having distinct advantages over oral route.
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A correlative analysis of dental age, chronological age, and body mass index and its impact on dental development in 6-13 year old children of Navi Mumbai, India p. 376
Rahul J Hegde, Vaishali Vadgaonkar, Shamika Kamath
DOI:10.4103/JISPPD.JISPPD_189_18  PMID:30324928
Purpose: Nutrition has a great impact on children's health. Of great concern are the underweight children because of the risk of illness and mortality in them. Being overweight can also have long-lasting adverse effect on development of the child. The purpose of this study was to determine body mass index (BMI) and dental development in normal and underweight children and to carry out a correlative analysis of calculated dental age, chronological age, and BMI in normal and underweight children of age group of 6–13 years of Navi Mumbai, India. Materials and Methods: The sample for the study consisted of 301 participants, that is, 171 boys and 130 girls who were divided into two groups, namely, normal and underweight. Results: When BMI was less than normal, calculated dental age was less and thus the dental development was retarded and vice versa. Conclusion: The following conclusions were drawn from the study: (1) a significant positive correlation was found between chronological age and dental age and (2) along with the chronological age and dental age, the calculated dental age difference must also be taken into consideration.
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Salivary lead concentration in dental caries among normal and children with cerebral palsy p. 381
Vidya B Vandal, Hina Noorani, PK Shivaprakash, Basavaraj N Walikar
DOI:10.4103/JISPPD.JISPPD_200_16  PMID:30324929
Introduction: Cerebral palsy (CP) is a neurological disability the exact cause of which is not known. Exposure to toxic elements, environmental pollutants, and various teratogens such as lead, either prenatal or postnatal, can be a risk factor for this neurologic disability. CP children have poor neuromuscular coordination, exposing them to increased risk of oral diseases such as drooling of saliva, periodontal diseases, dental caries, and malocclusion. There are less studies comparing lead concentration in CP children, as it can be one of the contributing factors to dental caries. Aims and Objectives: The present study was to estimate and compare the salivary lead level in normal and neurologically disabled children and to correlate salivary lead level with dental caries in both normal and neurologically disabled children. Materials and Methods: A study on 45 children reporting to CP rehabilitation center and 41 normal children taken from the Outpatient Department of the Pediatric and Preventive Dentistry. P.M.N.M. Dental College and Hospital, Bagalkot, Karnataka. All children were between the age group of 5–12 years. In all individuals, a thorough medical history and dental examination were done. The age, state of dentition, and the level of caries in all individuals were determined by the same examiner, and salivary lead concentrations were determined using atomic absorption spectrophotometer. All children were divided into four groups depending on the presence or absence of dental caries. Group 1 consisted of 20 normal children with dental caries, Group 2 consisted of 21 normal children without dental caries, Group 3 consisted of 25 CP children with dental caries, and Group 4 consisted of 20 CP children without dental caries. Results: Were recorded tabulated and statistically analyzed. CP children had high decayed, missing, and filled teeth/def scores, dental caries, and salivary lead concentration as compared to normal children. Statistically significant correlation was obtained between the dental caries and saliva lead concentration. The lead concentration was directly proportional to the carious status. Conclusion: CP children are more prone to dental caries and increased salivary lead concentration which could be a cause as well as the effect of CP.
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Salivary levels of Streptococcus mutans and Streptococcus sanguinis in early childhood caries: An in vivo study p. 386
Deepika Patidar, Suma Sogi, Varsha Singh, P Shinu, Ashish Loomba, Dinesh Chand Patidar
DOI:10.4103/JISPPD.JISPPD_204_18  PMID:30324930
Background: The oral microflora primarily involved in early childhood caries (ECC) is Streptococcus mutans while Streptococcus sanguinis is related to healthy caries-free mouth. The antagonism between the two at biological level is well recognized. Aim: This study aims to compare the pre- and posttreatment salivary levels of S. mutans and S. sanguinis in ECC. Methods: This cross-sectional study was performed on 40 eligible participants. Clinical examination was done, and decayed teeth were recorded. Pre- and Posttreatment saliva sample was taken, processed and bacterial counts were compared. Results: A statistically significant posttreatment reduction was found in S. mutans counts; however, a significant posttreatment elevation was seen in S. sanguinis counts (P < 0.001) using Wilcoxon signed-rank test. A significant weak positive correlation was found between S. mutans and decayed teeth in the mouth (r = 0.366 and P = 0.028) using Spearman's correlation. No significant gender association was found between pre- and posttreatment S. mutans and S. sanguinis counts (P = 0.908) and also between decayed teeth (P = 0.321) using Mann–Whitney U-test. Conclusion: Complete dental treatment procedure showed significant reduction and elevation in S. mutans and S. sanguinis counts, respectively. A positive association was observed between S. mutans and ECC while S. sanguinis were positively associated with posttreatment oral environment.
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Speech evaluation in children with missing anterior teeth and after prosthetic rehabilitation with fixed functional space maintainer p. 391
Garima Kalia, Sandeep Tandon, Nameksh Raj Bhupali, Ambika Rathore, Rinku Mathur, Khushboo Rathore
DOI:10.4103/JISPPD.JISPPD_221_18  PMID:30324931
Introduction: Speech and language development in children is a dynamic process. Development of vocal sound into meaningful speech was one of the major discoveries which have made the human beings to reach the pinnacle of the animal kingdom. The ability to speak is determined by the flow of air into the mouth which affects pronunciation of various words and phrases. Aim: This study aimed to evaluate speech changes before and after prosthetic rehabilitation with fixed functional space maintainer in children with missing maxillary anterior teeth. Materials and Methods: The study sample comprised of 25 children in the age range of 3–6 years having at least two maxillary anterior teeth indicated for extraction or had already got extracted. Speech therapist evaluated articulation of [v], [ph], [n], [d], [dh], [th], [t], [s.],[s], and [l] speech sounds of patients preoperatively (T0), postoperatively after the appliance insertion (T1), and postoperatively after 7 days (T2) using Weiss Comprehensive Articulation Test. The data obtained were analyzed using Chi-square and Mcnemar's test. Results: There was statistically significant (P < 0.05) correction in [v], [ph], [d], [dh], [th], [t], [s.], and [s] speech sounds immediately after prosthetic rehabilitation (T1). While, the assessment of speech sounds after 7 days of appliance insertion (T2) showed statistically nonsignificant differences. Conclusions: The results suggested that treatment of a patient with missing anterior teeth should not be restricted to esthetic and functional oral rehabilitation, but also comprehend with the speech, as premature loss of the primary maxillary incisor appears to have long-term effect on the speech development.
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Study of microbial diversity in saliva and plaque samples from caries-free and caries-affected children using denaturing gradient gel electrophoresis p. 396
GA Raviraj, Kishore G Bhat, Manohar S Kugaji, Vijay M Kumbar, Amruta Hooli
DOI:10.4103/JISPPD.JISPPD_206_18  PMID:30324932
Background: Recent investigations have shown the possible involvement of bacteria other than mutans group and Lactobacilli in the etiology of caries. Molecular methods have been used to study the microbial diversity in caries-active (CA) and caries-free (CF) children. Among them, denaturing gradient gel electrophoresis (DGGE) is more popular and has been used in the present study. Aims: The aim of the present study was to investigate the difference in bacterial diversity in saliva and plaque samples from CF and CA children using DGGE. Materials and Methods: The study involved saliva and plaque samples from 56 children of which 28 were CF, 20 with CA, and 8 with white spot lesions (WSP). DNA was extracted and subjected to polymerase chain reaction amplification with universal primers. It was then run in polyacrylamide gel electrophoresis with gradients of urea and formamide and stained with SYBR green. Multiple bands were produced in each sample lane and each band represents one organism. Statistical Analysis: A dendrogram was generated using Phoretix software and similarity index was calculated using a specific formula. Results: Samples in each group formed several clusters indicating a specific pattern of the bacterial profile. Similarity coefficient was calculated based on the number of bands, intensity, and location. The diversity was less in the saliva and plaque samples of CA group as compared to those of CF and WSP groups. Conclusions: DGGE can be used to study distinctive bacterial profiles in healthy and caries-affected sites. DGGE can be further developed as a pattern recognition tool with which to identify specific groups of bacteria. Saliva may be used to study bacterial diversity in dental caries.
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A 1-year appraisal of pit and fissure sealants following disinfection with and without chlorhexidine solution: An in vivo randomized trial p. 402
Vikram Pal Aggarwal, Anmol Mathur, Aditi Mathur
DOI:10.4103/JISPPD.JISPPD_165_18  
Objective: The objective of this study is to evaluate the effect of chlorhexidine on the outcome of pit and fissure sealant (PFS) in permanent molars. Methods: A double-blind randomized controlled trial using split-mouth design was conducted for a period of 1 year. The clinical trial registry was done in the Indian Council of Medical Research, and the clinical trial number obtained was CTRI/2016/08/007222. The age group of participants involved in the trial was 7–14 years. Maxillary or mandibular permanent molar which satisfies the criteria for application of PFS was included in the trial. Based on the eligibility criteria and considering the unknown observer/instrumentation errors, the sample size is 33 for each group. Simple randomization of treatment allocation was carried out using computer-generated random number for treatment assignment of the right molar tooth. The left molar received the alternative treatment. The outcomes of PFS were evaluated by a lone proficient assessor by means of the mouth mirrors and probes following the US public health service criteria. Results: A 6-month evaluation for the PFS with and without chlorhexidine showed 77.27% and 89.39% retention, respectively. PFS without chlorhexidine suffered a greater loss of surface texture and marginal discoloration in comparison to PFS with chlorhexidine at 3-, 6-, and 12-month intervals, but it was statistically insignificant. Conclusion: The present study showed improvement in outcome of PFS when an additional step of chlorhexidine is added although the results were statistically nonsignificant.
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SHORT COMMUNICATION Top

Does attachment profiles influence child's behavior in pediatric dental clinic? p. 407
S VS G Nirmala, Rupak Kumar Dasaraju, Nuvvula Sivakumar
DOI:10.4103/JISPPD.JISPPD_1169_17  
Although it was believed that attachment was due to the food provided by the parent figure, later it was proved that attachment is because the child considers parent figure as secure base. Hence, when a child feels distressed in dental operatory, the type of attachment pattern will determine the behavior of a child. This, in turn, could determine the weather parental presence is needed or not in dental operatory. Hence, attachment patterns could affect the quality of dental treatment delivered.
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CASE REPORT Top

Sequelae of delayed replantation of maxillary permanent incisors after avulsion: A case series with 24-month follow-up and clinical review p. 410
Shaik Hasanuddin, J Sharada Reddy
DOI:10.4103/JISPPD.JISPPD_187_18  PMID:30324935
Replantation of avulsed incisors in young children is a successful treatment modality. Almost all replanted teeth exhibit ankylosis followed by inflammatory or replacement resorption, as immediate replantation is practically rare. The purpose of the review is to report a series of cases of prolonged delay in replantation of avulsed incisors and discuss its sequelae, leading to different patterns of root resorption after a minimum follow-up period of 24 months. The present case series is a follow-up of five cases of delayed replantation (more than 24 h delay) without any root surface treatment. Extraoral endodontic therapy was performed before replantation. The avulsed teeth were stabilized using an acid-etch composite resin splint for 4 weeks. The patients were followed up at 3, 6, and 12 months interval and half-yearly thereafter, for examination of the replanted teeth clinically and radiographically. After 24-month follow-up, the replanted teeth were evaluated for gingival changes and clinical mobility. The radiographs were evaluated for external root resorption or inflammatory resorption, osseous root replacement, or replacement resorption. The case series concludes that avulsed teeth transported in dry as well as dessicated conditions and replanted after a delay of 24 h have a survival rate of more than 24 months, though there is no promising long-term prognosis. The sequelae in most of the cases are surface resorption followed by inflammatory resorption or resorption due to pulpal infection or replacement resorption.
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