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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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   2009| January-March  | Volume 27 | Issue 1  
    Online since May 2, 2009

 
 
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ORIGINAL ARTICLES
Comparison of oral midazolam with a combination of oral midazolam and nitrous oxide-oxygen inhalation in the effectiveness of dental sedation for young children
AM Al-Zahrani, AH Wyne, SA Sheta
January-March 2009, 27(1):9-16
DOI:10.4103/0970-4388.50810  PMID:19414968
Aim: To compare the effectiveness of 0.6 mg/kg oral midazolam sedation alone and a combination of 0.6 mg/kg oral midazolam plus nitrous oxide-oxygen inhalation sedation, in controlling the behavior of uncooperative children during dental treatment. Study Design: The study had a crossover design where the same patient received two different sedation regimens, that is, oral midazolam 0.6 mg/kg and oral midazolam 0.6 mg/kg with nitrous oxide-oxygen inhalation during two dental treatment visits. Materials and Methods: Thirty children (17 males and 13 females) were randomly selected for the study, with a mean age of 55.07 (± 9.29) months, ranging from 48 - 72 months. A scoring system suggested by Houpt et al. (1985) was utilized for assessment of the children's behavior. Results : There was no significant (p > 0.05) difference in the overall behavior assessment between the two sedation regimens, that is, oral midazolam alone and oral midazolam plus nitrous oxide-oxygen. However, the combination of midazolam and nitrous oxide-oxygen showed significantly (p < 0.05) superior results as compared to midazolam alone, in terms of controlling movement and crying during local anesthesia administration and restorative procedures. Conclusion: Compared to oral midazolam alone, a combination of oral midazolam and nitrous oxide inhalation sedation appears to provide more comfort to pediatric dental patients and operators during critical stages of dental treatment.
  15 13,301 1,280
CASE REPORTS
Save-a-tooth: Conservative surgical management of dentigerous cyst
P Shivaprakash, T Rizwanulla, DK Baweja, HH Noorani
January-March 2009, 27(1):52-57
DOI:10.4103/0970-4388.50820  PMID:19414976
Dentigerous cysts are the most common bony lesions of the jaws in children. It is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars; the other teeth that are commonly affected are, in order of frequency, the maxillary canines, the maxillary third molars, and rarely the central incisors. Radiographically, the cyst appears as ovoid well-demarcated unilocular radiolucency with a sclerotic border. Careful evaluation of the history and the clinical and radiographical findings help clinicians to currently diagnose the condition, identify the etiological factors, and administer the appropriate treatment.
  9 11,119 1,001
REVIEW ARTICLE
The genomics of oral cancer and wound healing
YB Aswini
January-March 2009, 27(1):2-5
DOI:10.4103/0970-4388.50808  PMID:19414966
Oral cancer is the most common malignancy in India, where it is epidemiologically linked to the chewing of betel quid and other carcinogens. But various point mutations were detectable in the p53 and p15 genes. Hence, this review was conducted with the aim to find out genetic risks as well as markers for oral cancers and wound healing. Tobacco-related cancers are associated with polymorphisms of the CYP1A1 and GSTM1 genes in terms of genotype frequencies and cigarette smoking dose. Expression of E6/E7 were also found in tumors, most of which were derived from the oropharynx. Presence of homozygous arginine at codon 72 renders p53 about seven times more susceptible to E6-mediated proteolytic degradation. Erythropoietin, vascular permeability factor (VPF, also known as vascular endothelial growth factor or VEGF), and PDGF has been implicated as one of the principal mitogens involved in cutaneous wound healing. Activation of NF-kB is associated with enhanced cell survival. Human papilloma virus status is a significantly favorable prognostic factor in tonsilar cancer and may be used as a marker in order to optimize the treatment of patients with this type of cancer.
  6 7,993 1,251
CASE REPORTS
Acute immune thrombocytopenic purpura triggered by insect bite
R Namdev, SR Dutta, H Singh
January-March 2009, 27(1):58-61
DOI:10.4103/0970-4388.50821  PMID:19414977
Idiopathic Thrombocytopenic Purpura (ITP) is a blood disorder characterized by an abnormal decrease in the number of platelets in the blood. Acute thrombocytopenic purpura is most commonly seen in young children, with a sudden onset, following a viral illness, vaccination or an insect bite. The report is a rare case of ITP, which was triggered by a honey-bee bite and caused continuous intermittent bleeding from the gingival sulcular region of the maxillary left permanent first molar, and ecchymotic spots on the forehead, scalp, and lower limbs. A complete hemogram revealed severe thrombocytopenia with platelet count as low as 15,000/mm3. The patient was immediately hospitalized and administered platelet replacement and medication. With this report, the authors, as dentists, emphasize the significance of recognition, early diagnosis, and referral of such patients with bleeding disorders to specialized centers, for prompt treatment.
  5 13,107 547
Unicystic plexiform ameloblastoma: An insight for pediatric dentists
C Yavagal, R Anegundi, S Shetty
January-March 2009, 27(1):70-74
DOI:10.4103/0970-4388.50824  PMID:19414980
Ameloblastomas have been categorized broadly into three biologic variants: cystic (unicystic), solid, and peripheral. The term plexiform unicystic ameloblastoma refers to a pattern of epithelial proliferation that has been described in cystic lesions of the jaws. Although the histology suggests that cystic ameloblastomas follow a biologically low-grade course, recent evidence suggests that they may often behave clinically as biologically aggressive tumors. This is supported by the high incidence of cortical perforation, tooth resorption, lesion size, bony destruction, and a high rate of recurrence after simple enucleation. This article tries to provide an insight for pediatric dentists regarding this biologically distinct entity. A literature review on the topic has been added along with a case report highlighting the state-of-the-art approach and management of such ameloblastomas, in pediatric patients.
  5 7,063 910
ORIGINAL ARTICLES
Comparative evaluation of shear bond strength of two self-etching adhesives (sixth and seventh generation) on dentin of primary and permanent teeth: An in vitro study
SM Yaseen, VV Subba Reddy
January-March 2009, 27(1):33-38
DOI:10.4103/0970-4388.50814  PMID:19414972
Aim: The present study was undertaken to compare and evaluate shear bond strength of two self-etching adhesives (sixth and seventh generation) on dentin of primary and permanent teeth. Materials and Methods: Flat dentin surface of 64 human anterior teeth (32 primary and 32 permanent) divided into four groups of 16 each. Groups A and C were treated with Contax (sixth generation), while groups B and D were treated with Clearfil S3 (seventh generation). A teflon mold was used to build the composite (Filtek Z-350) cylinders on the dentinal surface of all the specimens. Shear bond strength was tested for all the specimens with an Instron Universal Testing Machine. Data were statistically analyzed using one-way ANOVA for multiple group comparison, followed by student's unpaired 't' test for group-wise comparison. Results: There was no statistically significant difference in shear bond strength among the study groups except that primary teeth bonded with Contax exhibited significantly lesser shear bond strength than permanent teeth bonded with Clearfil S3. Conclusion: This study revealed that Clearfil S3 could be of greater advantage in pediatric dentistry than Contax because of its fewer steps and better shear bond strength in dentin of both primary and permanent teeth.
  5 8,820 997
Dermatoglyphic interpretation of dental caries and its correlation to salivary bacteria interactions: An in vivo study
A Sharma, R Somani
January-March 2009, 27(1):17-21
DOI:10.4103/0970-4388.50811  PMID:19414969
Background: Dental caries is defined as an infectious disease of microbial origin which is related to every specialty of dentistry in one or the other way. Genetic susceptibility to dental caries is dependent on certain factors, which if evaluated, can help in estimating disease situation prematurely. The present study was done to estimate dermatoglyphic dependence of dental caries and its relation with salivary bacteria levels, primarily Streptococcus mutans. Aims: To determine if there is any significant correlation between salivary bacteria interactions, dermatoglyphics, and dental caries. Settings and Design: In the present study, 90 subjects were evaluated for dermatoglyphics in conjunction with bacteria levels. Methods and Materials: Dermatoglyphic interpretation was done using stamp-pad method and S. mutans levels were estimated by microbial culture of salivary samples collected. Statistical Analysis : Z-test (standard normal variate, proportion) was used to analyze dermatoglyphic patterns and bacteria levels. Results and Conclusions: 1. Subject group had a decreased frequency of loops, whereas control group had an increased frequency of loops on all palmar digits. 2. Subject group had high S. mutans growth, whereas control group had low S. mutans growth. Subject group had positive correlation with loops and S. mutans growth likened to control group that had negative correlation with both.
  5 8,891 1,304
CASE REPORTS
Peripheral ossifying fibroma
UM Das, U Azher
January-March 2009, 27(1):49-51
DOI:10.4103/0970-4388.50818  PMID:19414975
The peripheral ossifying fibroma (POF) is a reac­tive gingival overgrowth occurring frequently in the anterior maxilla in teenagers and young adults. The pediatric patient with a POF has special manage­ment considerations compared to the adult, as it requires early recognition and treatment by the dentist. It requires proper treatment protocol with close postoperative follow-up. The present report describes a case of POF in a girl, which was surgically excised from the palatal mucosa in the maxillary incisor area. Some features of the differential diagnosis and therapy when it occurs are discussed.
  4 8,494 1,080
Intraosseous neurofibroma of maxilla in a child
P Sharma, A Narwal, AS Rana, S Kumar
January-March 2009, 27(1):62-64
DOI:10.4103/0970-4388.50822  PMID:19414978
Central tumors of neurogenic origin are among the most rare primary jaw tumors in children. Intraosseous neurofibromas of the jaws occur more often as solitary lesions rather than as part of a generalized neurofibromatosis. We are presenting a case of solitary intraosseous neurofibroma of the maxilla in a five-month-old infant, which is probably the youngest such case published in literature so far.
  4 5,884 476
ORIGINAL ARTICLES
Oral health status of 6- and 12-year-old school going children in Bangalore city: An epidemiological study
UM Das, JP Beena, U Azher
January-March 2009, 27(1):6-8
DOI:10.4103/0970-4388.50809  PMID:19414967
Background: Oral health is an essential component of health throughout life. However, millions of individuals suffer from dental caries and periodontal disease, resulting in unnecessary pain, difficulty in chewing, swallowing and speaking, and increased medical costs; hence, the present study was conducted to evaluate the oral health status of school children which would help us in planning and implementing necessary preventive measures. Aims and Objectives: 1. To assess the prevalence of dental caries among school children, using the Dentition Status and Treatment Needs Index. 2. To assess the prevalence of malocclusion among the study population, using the WHO criteria. 3. To assess the prevalence of dental calculus among the study population using the criteria of Community Periodontal Index of Treatment Needs. Materials and Methods: The study was conducted at a school in Bangalore city. The study population comprised of school children of two age groups - 6 and 12 years. A total of 430 subjects of both the sexes were surveyed, out of which 229 were in 6-year age group and 201 in 12-year age group. Results: No significant difference was observed between the age groups - 6 and 12 years - with respect to the proportion of dental caries (P > 0.05). Highly significant difference was noticed between the two age groups with respect to calculus (P < 0.01) and malocclusion (P < 0.05).
  4 8,559 1,328
The state of infant oral healthcare knowledge and awareness: Disparity among parents and healthcare professionals
PK Shivaprakash, I Elango, DK Baweja, HH Noorani
January-March 2009, 27(1):39-43
DOI:10.4103/0970-4388.50816  PMID:19414973
Provision of infant oral health (IOH) care is a challenging issue in the rural areas of our country due to lack of pedodontists and other dental workforces. To overcome these barriers it is essential to call the medical and other healthcare professionals to provide IOH care in joint collaboration with dental professionals. However, it is unclear to what extent these medical professionals are really aware of preventive strategies and to what extent they impart them. Thus, the present study was designed to begin from the grass-root levels, that is, assessing the baseline knowledge and awareness regarding IOH care among students (dental/medical) and parents (urban/rural). Variation of opinions with inconsistencies were obtained from both medical and/dental students and as well as from both the parental groups. This study calls for further research to evaluate the role of various factors involved in IOH care and to effectively educate all healthcare providers in this area.
  3 7,512 858
Children's behavior pattern and behavior management techniques used in a structured postgraduate dental program
A Sharath, P Rekka, MS Muthu, V Rathna Prabhu, N Sivakumar
January-March 2009, 27(1):22-26
DOI:10.4103/0970-4388.50812  PMID:19414970
Background : Anxiety and fear remain the primary emotion of a child entering a dental office. Successful pediatric dentistry depends not only on the dentist's technical skills, but also on his ability to acquire and maintain a child's cooperation. Methods: A retrospective study was done using the case records of 247 children, to evaluate their behavior patterns, based on the Wright's modification of Frankl's behavior rating scale. Various behavior management techniques like the tell-show-do, reinforcements, voice control, and hand over mouth exercise used in the postgraduate section of the Department of Pediatric Dentistry, Meenakshi Ammal Dental College, Chennai, India, were also evaluated in this study. Results: Behavior of the children improved on the subsequent visits. Tell-show-do was the most common behavior management technique used and more aversive management techniques were rarely used in managing children in the dental office. Conclusion: Proper assessment of children's behavior helps the dentist to plan appointments and render effective and efficient dental treatment. Appropriate use of management techniques can improve the child's behavior in subsequent dental visits.
  3 25,011 1,979
Comparative evaluation of fluoride release from PRG-composites and compomer on application of topical fluoride: An in-vitro study
KS Dhull, B Nandlal
January-March 2009, 27(1):27-32
DOI:10.4103/0970-4388.50813  PMID:19414971
Aims and Objective: To determine the fluoride release from Giomer and Compomer, using different topical fluoride regimes, and to compare the amount of fluoride release from giomer with that of compomer. Materials and Method: Forty-eight specimens of each giomer and compomer were divided into four treatment groups, namely, control group, fluoridated dentifrice (500 ppm) once daily group, fluoridated dentifrice (500 ppm) twice daily group, fluoridated dentifrice (500 ppm) once daily + fluoridated mouthwash (225 ppm) group. Each specimen was suspended in demineralizing solution for six hours and remineralizing solution for 18 hours. Fluoride release was measured in both the demineralizing solution and remineralizing solution daily for seven days. Total daily fluoride release for each specimen was calculated by adding the amount released in the demineralizing solution to that released in remineralizing solution. Results and Conclusion: The fluoride release (ppm) was found to be more in Giomer when compared to Compomer. The fluoride released from Giomer and Compomer was significantly greater in the acidic demineralizing solution than in the neutral remineralizing solution. It was found that increasing fluoride exposure significantly increased fluoride release from the giomer and compomer. It was found that the fluoride release from the subgroups of giomer and compomer was in the following order: fluoridated dentifrice twice daily > fluoridated dentifrice once daily + fluoridated mouthwash > fluoridated dentifrice once daily > control group. It was found that the giomer showed a greater fluoride uptake than the compomer.
  3 9,469 798
An analysis of concentration of sucrose, endogenous pH, and alteration in the plaque pH on consumption of commonly used liquid pediatric medicines
S Sunitha, GM Prashanth, Shanmukhappa , GN Chandu, VV Subba Reddy
January-March 2009, 27(1):44-48
DOI:10.4103/0970-4388.50817  PMID:19414974
Background: Many parents are often unaware of the hidden, added sugars in many foods and drinks including pediatric liquid medicines; thus, hidden sugar in the form of pediatric medications has not been focused upon as cariogenic agents. Objective: (i) assess concentration of sucrose in six pediatric drugs, (ii) determine endogenous pH of these drugs, and (iii) estimate drop in the plaque pH in the oral cavity in first 30 minutes after consumption of the drugs. Materials and Methods: Ten adult volunteers with mean age of 22 years were double blinded for the study. Concentration of sucrose was assessed by volumetric method at Department of Chemical Branch of Engineering. Endogenous pH and drop in the plaque pH after consumption of the drugs were assessed using digital pH meter. Statistical analysis: SPSS software was used to assess the pH level at different time intervals and expressed as mean ± SD. Changes in pH were assessed by one-way ANOVA followed by Wilcoxons signed rank test. P-value was set at 0.05. Result: There were varying amounts of fermentable sucrose detected in the drugs; all the drugs were acidic. There is a significant drop of plaque pH after consumption of the drug. Conclusion: These sweeteners along with their low endogenic pH form a high cariogenic formulation. Thus, nonsucrose (noncariogenic) or sugar-free medications are needed to be prescribed along with proper oral hygiene care to the children under medication.
  2 7,443 758
CASE REPORTS
Orthodontic management of faciolingual horizontally impacted maxillary central incisor
HS Chawla, A Kapur
January-March 2009, 27(1):65-69
DOI:10.4103/0970-4388.50823  PMID:19414979
This paper describes the successful alignment of a horizontally impacted maxillary central incisor positioned high in the vestibule, in a 15-year-old girl, by purely orthodontic means. A unique and innovative technique for traction was employed so as to cause minimal injury to the neighboring soft tissue. The article is a step forward in establishing the predictability of orthodontic alignment in management of such cases, which may become the method of choice over extractions or surgical repositionings.
  1 6,974 767
EDITORIAL
Seasons greeting from Davangere, Karnataka, India
VV Subba Reddy
January-March 2009, 27(1):1-1
DOI:10.4103/0970-4388.50807  
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