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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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   2012| April-June  | Volume 30 | Issue 2  
    Online since August 23, 2012

 
 
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REVIEW ARTICLES
Speech and language delay in children: A review and the role of a pediatric dentist
P Shetty
April-June 2012, 30(2):103-108
DOI:10.4103/0970-4388.99979  
Speech and language development is a useful indicator of a child's overall development and cognitive ability. Identification of children at a risk for developmental delay or related problems may lead to intervention and assistance at a young age, when the chances for improvement are the best. This rationale supports screening of preschool children for speech and language delay or primary language impairment or disorder, which needs to be integrated into routine developmental surveillance practices of clinicians caring for children.
  25,894 1,224 1
CASE REPORTS
Benign migratory glossitis with fissured tongue
M Goswami, A Verma, M Verma
April-June 2012, 30(2):173-175
DOI:10.4103/0970-4388.100008  
Symptomatic benign migratory glossitis (BMG) or "geographic tongue" is a rare occurrence in pediatric dentistry though asymptomatic BMG is comparatively common. BMG presents itself as an ulcer-like region on the dorsum of the tongue, which may recur at different sites on the tongue, creating a migratory appearance. Asymptomatic cases usually resolve on their own but symptomatic cases need treatment. Fissured tongue is a benign condition characterized by deep grooves on the dorsum of the tongue and, in many cases, is associated with geographic tongue. This article presents a case of symptomatic geographic tongue with fissured tongue with a history of asthma.
  20,720 743 3
New design space regainers: 'Lingual arch crossbow' and 'Double banded space regainer'
P Chalakka, AM Thomas, F Akkara, R Pavaskar
April-June 2012, 30(2):161-165
DOI:10.4103/0970-4388.100001  
This article highlights the use of two new design space regainers - the "lingual arch crossbow" and the "double-banded space regainer." The former may be used for distalizing a mesially migrated mandibular first premolar, if it erupts prior to the canine. The latter may be used in conventional cases of interdental space loss. They both contain assemblies that function through the action of NiTi open coil springs.
  13,140 1,783 -
REVIEW ARTICLES
Radix entomolaris and paramolaris in children: A review of the literature
NB Nagaveni, KV Umashankara
April-June 2012, 30(2):94-102
DOI:10.4103/0970-4388.99978  
Pediatric dentistry in the current scenario is not just about teeth and gums that are easily visible in children's mouth anymore. It is all about those structures that are hidden, difficult to identify, and often remain undiagnosed. Dentist can come across various anomalies pertaining to the crown structure during the clinical practice. Although supernumerary tooth is the most commonly seen anomaly, the presence of extra roots in molars is an interesting example of anatomic root variation. It is well known that both primary and permanent mandibular first molars usually have roots, one mesial, and the other distal root. Very rarely an additional third root (supernumerary root) is seen and when it is located distolingually to the main distal root is called "radix entomolaris (RE)" and when it is placed mesiobuccaly to the mesial root is called "radix paramolaris (RP)." The purpose of this article is to discuss the prevalence, morphology, classification, clinical diagnosis, and significance of supernumerary roots in contemporary clinical pediatric dentistry.
  9,914 974 1
ORIGINAL ARTICLES
Comparison of oral midazolam with oral tramadol, triclofos and zolpidem in the sedation of pediatric dental patients: An in vivo study
S Bhatnagar, UM Das, G Bhatnagar
April-June 2012, 30(2):109-114
DOI:10.4103/0970-4388.99980  
Objective: oral sedation is the simplest and most convenient sedation method for managing uncooperative child patients because it is easy to administer and there is no need for nasal hood or injection. Oral midazolam is the most commonly used preanesthetic medication for children. When given in amounts between 0.5 and 0.75 mg/kg of body weight, oral midazolam has been found to be an effective sedative agent for pediatric outpatients. Tramadol is a synthetic, centrally acting analgesic indicated for moderate to severe pain. Chloral hydrate is one of the sedatives most commonly used, has excellent absorption, fast induction, and exert minimal effects on respiration. zolpidem is the most commonly prescribed hypnotic due to its clinical efficacy, safety, and ability to be well tolerated with patients. Materials and Methods: 60 anxious and fearful children who reported to the department were treated under conscious sedation for the accomplishment of dental treatment. Patients were randomly assigned to four groups. Statistical analysis was done using Kruskal Wallis Test and decision criterion was to reject the null hypothesis if the P-value is less than 0.05. Results: it was observed that there is a statistically significant difference in median scores recorded for the level of sedation between the different groups (P < 0.001). Conclusion: this study concluded that midazolam is the best drug for producing conscious sedation followed by tramadol and triclofos. Zolpidem was not able to produce a sufficient level of sedation and it cannot be supported as a sedative agent at the present dosage.
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The prevalence of traumatic dental injuries to permanent anterior teeth and its relation with predisposing risk factors among 8-13 years school children of Vadodara city: An epidemiological study
MC Patel, SG Sujan
April-June 2012, 30(2):151-157
DOI:10.4103/0970-4388.99992  
Background and objective: dental trauma is an irreversible pathology that after occurrence is characterized by life-long debilitating effects. The objectives of this study were to measure the prevalence of anterior teeth fracture and their association with predisposing factors such as lip coverage, molar relationship, overjet, and variables such as age, sex, cause, and place of trauma. Materials and Methods: an epidemiological cross-sectional study was carried out among 3708 school children aged 8-13 years in the Vadodara city. All children completed a questionnaire related to history of trauma to their anterior teeth after which they were examined for lip competence, Angle's molar relationship amount of overjet and nature of trauma sustained. The results were statistically analyzed using the prevalence test, Chi-square test, and Mantel-Haenszel Common Odds Ratio. Results: the prevalence of traumatic injuries was 8.79% and the ratio of boys: girl's was 1.28:1. Inadequate lip coverage group sustained about five times more injuries than the adequate lip coverage group (P = 0.000, OR= 5.407). The maximum traumatic injuries were seen in children having Angle Class II Div 1 molar relationship and/or overjet greater than 5.5 mm and was statistically significant (P<0.05). Maximum number of injuries occurred at 9 years of age. The most predominant injuries were enamel fractures, the most common place for occurrence was home and fall against object, the most frequent cause. Conclusion: the prevalence of dental injuries in the Vadodara city is high and it has a great potential to be considered as an emerging public health problem.
  7,526 926 5
CASE REPORTS
Oral manifestations leading to the diagnosis of acute lymphoblastic leukemia in a young girl
BA Silva, CRB Siqueira, PHS Castro, SS Araújo, LER Volpato
April-June 2012, 30(2):166-168
DOI:10.4103/0970-4388.100003  
Background: oral complications may be leukemia's first presentation. Aim: to present a case of a young girl with a swelling on the face that led to the diagnosis of acute lymphoblastic leukemia is reported. Results: a 10-year old anemic girl was referred for evaluation and treatment of a swelling at the left-nasolabial region. Symptoms reported (tiredness, poor appetite, fever, lethargy, and musculoskeletal pain) and clinical findings (enlargement at the presternal region and brownish stain in the lumbar region) led to the suspicion of a hematopoietic malignancy. The diagnosis of lymphoblastic leukemia was attained after specific examination conducted by the pediatric oncologist and hematologist. Conclusion: dentists must be able to clearly recognize oral physiological characteristics, and, when identifying changes of normalcy, to fully investigate it requesting additional tests or referring the patient to specialized professionals.
  7,554 421 1
ORIGINAL ARTICLES
Comparison of mechanical and chemomechanical methods of caries removal in deciduous and permanent teeth: A SEM study
A Avinash, SD Grover, M Koul, MT Nayak, A Singhvi, RK Singh
April-June 2012, 30(2):115-121
DOI:10.4103/0970-4388.99982  
Background: Mechanical method of caries removal is associated with the removal of sound tooth structure, production of pain, heat, annoying sounds, and vibrations. Chemomechanical caries removal method is based on removal of only carious dentin leaving sound dentin intact. Aim: The aim of this study was to compare the efficacy of mechanical and chemomechanical methods of caries removal in deciduous and permanent teeth. Study Design: A total of 30 carious teeth including 15 deciduous and 15 permanent teeth having dentinal caries selected randomly and cut into two halves through center of the lesion, were subjected to caries removal by mechanical (Group A), and chemomechanical methods (Group B). Time taken for removal of caries was noted with stopwatch. Samples were prepared and seen under the scanning electron microscope for the presence of bacterial colonies. Data were analyzed using statistical package for social sciences (SPSS) Software. Results: No significant difference was found for the presence of bacterial colonies in both groups of deciduous and permanent teeth; however, time taken for caries removal by the chemomechanical method was twice than the mechanical method. Conclusion: despite the insignificant presence of bacterial colonies and twice time taken as compared to mechanical method, chemomechanical method was easy to introduce, was painless, did not form smear layer and conserved the sound tooth structure.
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The effectiveness of a musical toothbrush for dental plaque removal: A comparative study
M Ganesh, S Shah, D Parikh, P Choudhary, V Bhaskar
April-June 2012, 30(2):139-145
DOI:10.4103/0970-4388.99988  
Background and Objectives: the purpose of this study was to clinically evaluate and compare the efficacy of "Brush Buddies" musical tooth brush and Colgate Smile tooth brush in the reduction of established plaque and gingivitis. Materials and Methods: for this study, 120 healthy kids (73 boys and 47 Girls) were selected. The subjects were randomly assigned into two groups by a second examiner; one group used Colgate Smile brush and the other group used "Brush Buddies" musical tooth brush. Plaque index (Quigley and Hein), Modified Gingival Index (Lobene and Associates) and Gingival Bleeding Index (Ainamo and Bay) were assessed at baseline, 30th day, 60th day, and 90th day. Results: all the baseline indices appeared to be well balanced. At the end of the study, reduction in plaque index, modified gingival index and gingival bleeding index were statistically highly significant during each interval for both the toothbrushes. For "Brush Buddies" musical tooth brush, the reduction in all clinical parameters were statistically significant for 30 days and 60 days interval, while nonsignificant at 90 days interval. Interpretation and Conclusion: both the tooth brushes used in this study were clinically effective in removing plaque, improving gingival health. Musical tooth brush is more effective initially but as the time period increases both tooth brushes give almost similar results.
  5,865 547 -
Inter-relationship of intelligence-quotient and self-concept with dental caries amongst socially handicapped orphan children
PKS Virk, RL Jain, A Pathak, U Sharma, JS Rajput
April-June 2012, 30(2):127-132
DOI:10.4103/0970-4388.99986  
Context : India has been the focus of many health surveys among normal, physically, and mentally handicapped children. However, the data, concerning oral health conditions of socially handicapped children living in orphanages, are scanty. Aims: To study the effect of parental inadequacy, environmental deprivation, and emotional disturbances on dental caries through intelligence quotient (IQ) and self-concept in orphan children and also to co-relate dental caries with different levels of IQ and self-concept. Settings and Design: The study was carried out amongst socially handicapped children living in orphanages. Patients and Methods: 100 children in the age group of 10-14 years from orphanages were selected. Malin's Intelligence Scale for Indian Children (MISIC) was used to assess the intelligence quotient; self-concept questionnaire to assess self-concept of the child and recording of dental caries status of children was done as per WHO Index (1997). StatisticaL Analysis Used : To assess the relationship of dental caries with IQ, student's unpaired t-test was used and; to find the relationship between self-concept and dental caries, Karl-Pearson's coefficient of co-relation was applied. Results: the children in orphanages had a lower IQ and high caries experience but had an above average self-concept. There was also no co-relation between dental caries and self-concept. Conclusions: Orphan children, being socially handicapped, are at an increased risk for dental caries due to a lower IQ level, parental deprivation, and institutionalization. Moreover, lack of co-relation between dental caries and self-concept could be explained by the fact that dental caries is a lifelong process whereas different dimensions of self-concept are in a state of constant flux.
  6,034 373 1
Effect of casein phosphopeptide - amorphous calcium phosphate containing chewing gum on salivary concentration of calcium and phosphorus: An in-vivo study
BP Santhosh, P Jethmalani, KK Shashibhushan, VV Subba Reddy
April-June 2012, 30(2):146-150
DOI:10.4103/0970-4388.99990  
Aim: Caries clinical trials of sugar-free chewing gum have shown that the gum is noncariogenic and in fact has anticariogenic effect through the stimulation of saliva. Sugar-free gums, therefore, may be an excellent delivery vehicle for safe and effective additive, capable of promoting enamel remineralization. Casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) nanocomplexes incorporated into sugar-free chewing gum have shown to remineralize enamel subsurface lesions in situ. So this study was conducted to evaluate the effect of CPP-ACP containing sugar-free chewing gum on salivary concentration of calcium and phosphorous. Materials and Methods : Unstimulated saliva from each 24 selected subjects was collected. Then each subject was given two pellets of chewing gum containing CPP-ACP and asked to chew for a period of 20 min, after which saliva samples were collected from each individual. Once all the samples were collected they were assessed for calcium and phosphorous concentration using affiliated reagent kits and photometer. Statistical Analysis Used: Data obtained were analyzed using student's paired t test. Results: Significant difference was found in the calcium and phosphorus concentration of saliva before and after chewing CPP-ACP containing chewing gum. Conclusions: Chewing of CPP-ACP containing chewing gum showed a significant increase in the salivary concentration of calcium for a prolonged period of time hence it may help in the remineralization of tooth surfaces.
  5,473 582 2
CASE REPORTS
Mandibular mass in pediatric patient: A diagnostic dilemma
PA Ranadive, MD Deshpande, SN Ingole, C Ankush
April-June 2012, 30(2):179-182
DOI:10.4103/0970-4388.100013  
A case of aggressive Juvenile ossifying fibroma in a child has been discussed. The unique appearance of this particular lesion demonstrates a close relationship between aggressive ossifying fibroma and well-differentiated osteogenic sarcoma. The age of the patient and the location of the tumor in the case presented made it mandatory to utilize multiple diagnostic parameters and adjunctive diagnostic help to resolve the dilemma posed by this tumor. Differentiation of ossifying fibroma from other benign and malignant neoplasms as well as fibrous dysplasia is important in correct management of the lesion.
  5,089 303 -
Dynamic 3 T MRI of temporomandibular joint in diagnosing a stuck disk
J Sureka, DV Reddy, AK Karthik
April-June 2012, 30(2):158-160
DOI:10.4103/0970-4388.99994  
Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of internal derangement of the temporomandibular joint (TMJ). Dynamic MRI including the open and close mouth views in sagittal plane determine the exact position of articular disk and thus help to evaluate the joint for internal derangement. We also highlight the role of dynamic MRI of TMJ in diagnosis of stuck disk in a 17-year-old male who presented with symptoms of pain and difficulty in opening the mouth.
  5,012 302 1
ORIGINAL ARTICLES
An estimation of fluoride release from various dental restorative materials at different pH: In vitro study
RN Bahadure, RK Pandey, R Kumar, K Gopal, RK Singh
April-June 2012, 30(2):122-126
DOI:10.4103/0970-4388.99983  
Background: In the mid of 1980s, the cariostatic effect of fluoride ions on enamel caries had been demonstrated in many studies. The use of fluoride releasing dental restorative materials has seen increasing from many years for the specific purpose of leaching of fluoride into the surrounding tissues to inhibit secondary dental caries as well as prevention of caries in the newly erupted tooth. In the dental caries, acidic environment causes the demineralization of tooth structure and also affect the restorative margins of dental restoration. Aim: various restorative materials show different behavior in different pH conditions of oral cavity. Thus, the aim of this study was to evaluate the fluoride release of the various restorative materials at different pH. Design: In this in vitro study, 30 samples of each dental restorative material were prepared and grouped into five with six samples in each group as per the pH of the solution 4.3, 4.6, 5.0, 5.5, and 6.2. All the samples were subjected to alternate cycling of the demineralizing solution (6 h) and remineralizing solution (18 h) for 15 days. Results: the fluoride release was measured by using fluoride ion specific electrode and digital ion analyzer. The result showed that the fluoride release rate was significantly higher in first day and reduced after third day to nearly constant level. At pH 4.3, the fluoride release was highest and lowest at pH 6.2. Conclusion: the Amalgomer CR showed the highest fluoride release among all the experimental dental restorative materials.
  4,657 518 -
CASE REPORTS
Enamel renal syndrome: A rare case report
SV Kala Vani, M Varsha, Y Uday Sankar
April-June 2012, 30(2):169-172
DOI:10.4103/0970-4388.100006  
Enamel renal syndrome is a very rare disorder associating amelogenesis imperfecta with nephrocalcinosis. It is known by various synonyms such as amelogenesis imperfecta nephrocalcinosis syndrome, MacGibbon syndrome, Lubinsky syndrome, and Lubinsky-MacGibbon syndrome. It is characterized by enamel agenesis and medullary nephrocalcinosis. This paper describes enamel renal syndrome in a female patient born in a consanguineous family.
  4,455 404 1
ORIGINAL ARTICLES
Self etching adhesive on intact enamel
GM Devarasa, VV Subba Reddy, NL Chaitra
April-June 2012, 30(2):133-138
DOI:10.4103/0970-4388.99987  
Background and Objective: to analyze the poor performance of self-etch adhesives on intact enamel. Materials and Methods: labial surfaces of 20 caries free permanent upper central and lateral incisors were cleaned, sectioned of their roots. All specimens were mounted on acrylic block and divided randomly into two groups. In one group the application of self-etch adhesive was carried as per manufacturer's instructions, composite cylinders were built, whereas in the other group, 37% phosphoric acid was applied before the application of self-etching adhesives. Then the resin tags were analyzed using the scanning electron microscope. Results: showed that when phosphoric acid was used, there was significant increase in the depth of penetration of resin tags. Conclusion: the results indicate that out of both treatment groups, pre-etching the intact enamel with 37% phosphoric acid resulted in the formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond, which might have resulted in attaining higher bond strength of the Clearfil SE bond to intact enamel.
  3,379 293 -
CASE REPORTS
Presurgical management of a child with missing lower lip using a new design of fixed lower tongue crib
S Safeena, M Najmuddin, K Reddy
April-June 2012, 30(2):183-185
DOI:10.4103/0970-4388.100019  
Missing of any perioral structure can result in imbalance of muscular forces leading to loss of structure and function along with esthetics especially in a growing individual and can result in permanent damage. Rehabilitation of such children is a challenge and requires an integrated multidisciplinary approach not only to correct the defect, but also to ensure normal development with minimal handicap. Here is a case report of a 10-year-old child with missing lower lip due to childhood infection and its presurgical management using a new design of fixed lower tongue crib used to limit tongue pressure, improve tongue position, and facilitate lower incisor retraction. A new clinical experience for lower lip missing cases in children are added, as these cases are rare.
  3,291 265 -
Regional odontodysplasia: A case of progressive tooth development
R Ganguly, A Ramesh
April-June 2012, 30(2):176-178
DOI:10.4103/0970-4388.100010  
Regional odontodysplasia (RO) is considered a relatively rare dental anomaly despite increasing numbers of case reports in recent years. It usually presents as a localized anomaly in tooth development affecting a few adjacent teeth in a single maxillary or mandibular quadrant. The purpose of this paper is to describe an uncommon case of regional odotodysplasia involving noncontiguous mandibular teeth, crossing the midline in a male patient, and showing progressive normalization of tooth anatomy over a period of 6 years. Typically, teeth affected with RO become pulpally involved early on and are either extracted or endodontically treated. Such reports of automatic normalization over time in RO is supportive of a more conservative treatment approach.
  3,217 254 -
EDITORIAL
Greetings from Davangere, Karnataka, India
VV Subba Reddy
April-June 2012, 30(2):93-93
DOI:10.4103/0970-4388.99977  
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