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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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   2014| October-December  | Volume 32 | Issue 4  
    Online since September 17, 2014

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Relevance of Piaget's cognitive principles among 4-7 years old children: A descriptive cross-sectional study
Sharath Asokan, Sharmila Surendran, Sureetha Asokan, Sivakumar Nuvvula
October-December 2014, 32(4):292-296
DOI:10.4103/0970-4388.140947  PMID:25231036
Background: According to Jean Piaget, children between 4 and 7 years of age are under the intuitive sub-stage of preoperational stage. Children possess specific characteristics based on their age. These characteristic cognitive principles have not been assessed in a dental setting. Research on the cognitive development of the child and its application to dental health care can enable pediatric dentists to better understand, approach and deliver improved quality of care to children. Purpose: The purpose of this study is to assess the prevalence of Piaget's cognitive principles among preoperational children. Materials and Methods: This cross-sectional study was conducted among 200 children, aged 4-7 years. Various characteristics, specific for this age group, such as egocentrism, concept of cardinal numbers based on centration, lack of conservation, and reversibility were assessed, using three tangible experiments and two interview questions. A comparison of the prevalence of each character was carried out among the children based on their age. Results: The prevalence of egocentrism based on the three mountain experiment was 65% and the personal interview showed a prevalence of 58%. Centration was appreciated in 83% of the study sample. The beaker experiment and the interview question revealed a lack of conservation in 89% and 59% of the children, respectively. There was a gradual and uniform reduction in the prevalence of the characters with an increase in age. Conclusion: All the three features assessed were observed in most of the children between 4 and 7 years of age as described by Piaget and most of his principles still appear valid today.
  16,924 587 -
Comparison of Endoflas and Zinc oxide Eugenol as root canal filling materials in primary dentition
Nivedita Rewal, Arun Singh Thakur, Vinod Sachdev, Nanika Mahajan
October-December 2014, 32(4):317-321
DOI:10.4103/0970-4388.140958  PMID:25231040
Background: Zinc oxide eugenol has long been the material of choice of pediatric dentists worldwide, although it fails to meet the ideal requirements of root canal filling material for primary teeth. Endoflas, a mixture of zinc oxide eugenol, calcium hydroxide, and iodoform, can be considered to be an effective root canal filling material in primary teeth as compared with zinc oxide eugenol. This study was carried out to compare zinc oxide eugenol with endoflas for pulpectomy in primary dentition. Aim: The objective of the study was to compare clinically and radiographically success rates of zinc oxide eugenol with endoflas for the root canal filling of primary teeth at 3, 6, and 9 months. Design: Fifty primary molars were included in the study with 26 teeth in Group I (Endoflas) and 24 in Group II (zinc oxide eugenol). A single visit pulpectomy was carried out. Results: The overall success rate of zinc oxide eugenol was 83% whereas 100% success was found in the case of endoflas. The obtained results were compiled and subjected to statistical analysis using the chi-square test. The difference in the success rate between the two was statistically significant (P < 0.05). Conclusion: Endoflas has shown to have better results than zinc oxide eugenol. It should therefore be the material of choice for root canal treatment in deciduous dentition.
  13,147 1,570 -
Molar-incisor hypomineralization: Prevalence, severity and clinical characteristics in 8- to 13-year-old children of Udaipur, India
Shubha Arehalli Bhaskar, Sapna Hegde
October-December 2014, 32(4):322-329
DOI:10.4103/0970-4388.140960  PMID:25231041
Background: The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH). Although the reported prevalence of MIH ranges from 2.4% to 40.2% worldwide, very little data is available from India. Objective: To assess the prevalence, clinical characteristics, distribution, severity and association with caries of MIH defects in children aged 8-13 years of Udaipur, Rajasthan. Study design: This cross-sectional descriptive study consisted of 1173 children aged 8-13 years selected by random sampling procedure. The European Academy of Pediatric Dentistry criteria were followed for MIH diagnosis. The presence of dental caries and treatment need for MIH-affected teeth were recorded as per the WHO criteria. Results: The prevalence of MIH in the children examined was 9.46%. Severity of the defects increased with the age of the children. Involvement of incisors increased when more First permanent molars (FPMs) were affected. An average of 3.65 teeth was involved per MIH-affected individual. Significantly larger numbers of mandibular FPMs and maxillary central incisors were diagnosed with MIH. The association of dental caries was significantly higher with MIH-affected FPMs. Primary molars and permanent canines and premolars were also showed MIH like lesions in some of the MIH-affected children. Conclusion: MIH was observed in about 10% of the children examined. MIH-affected FPMs appear to be more vulnerable to early caries and subsequent pulp involvement with need for extensive dental treatment.
  7,893 741 -
Comparison of instrumentation time and cleaning efficacy of manual instrumentation, rotary systems and reciprocating systems in primary teeth: An in vitro study
Farhin Katge, Devendra Patil, Manohar Poojari, Jitesh Pimpale, Abhinav Shitoot, Bhavesh Rusawat
October-December 2014, 32(4):311-316
DOI:10.4103/0970-4388.140957  PMID:25231039
Background: Paediatric Endodontics is an important clinical procedure commonly used to manage pulpally involved or non-vital teeth in children. One of the important steps in root canal preparation in deciduous teeth is the removal of organic debris. Aim: The aim of this study was to compare instrumentation time and cleaning efficacy of manual instrumentation, rotary systems and reciprocating systems in the preparation of primary molar root canals. Materials and Methods: India ink was injected into 120 root canals of maxillary and mandibular primary molars. The teeth were randomly divided into three experimental groups, Group one K-file (n = 30), group two ProTaper (n = 30), group three WaveOne (n = 30) and one control group (n = 30). The root canals were prepared using one of the three file system followed by clearing the teeth with different demineralizing solutions. The results were statistically evaluated using Kruskal-Wallis tests. Results: The file systems were compared at coronal, middle and apical level. In the coronal third, WaveOne showed more ink removal and the difference found was highly significant (P < 0.0001). In the middle third of the root canal, WaveOne performed better than ProTaper and K-file (P < 0.005). At the apical level, there was no statistical difference between the three systems. Conclusion: The reciprocating and the rotary systems showed better cleaning efficacy when compared to manual instrumentation especially, in coronal and middle one third.
  7,004 1,153 -
Early detection of congenital syphilis
Nagalakshmi Chowdhary, BS Kavya Rani, KS Mukunda, NK Kiran
October-December 2014, 32(4):333-337
DOI:10.4103/0970-4388.140969  PMID:25231043
Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson's teeth.
  7,465 414 -
Comparative evaluation of shear bond strength and microleakage of tricalcium silicate-based restorative material and radioopaque posterior glass ionomer restorative cement in primary and permanent teeth: An in vitro study
Vignesh Guptha Raju, Nilaya Reddy Venumbaka, Jayanthi Mungara, Poornima Vijayakumar, Sakthivel Rajendran, Arun Elangovan
October-December 2014, 32(4):304-310
DOI:10.4103/0970-4388.140952  PMID:25231038
Background: Restoration of carious primary molars is still a major concern while treating the young children that too in deep carious lesion which extends below the cemento-enamel junction (CEJ) where pulp protection and achieving adequate marginal seal are very important to prevent secondary caries. The needs were met with the development of new materials. One such of new bioactive material is tricalcium silicate-based restorative material (Biodentine), recommended for restoring deep lesions. Aim: To evaluate and compare shear bond strength and microleakage of tricalcium silicate-based restorative material (Biodentine) and glass ionomer cement (Fuji IX GP) in primary and permanent teeth. Materials and Methods: Occlusal surface of crowns were ground flat. PVC molds were stabilized over flat dentin surface and filled with tricalcium silicate-based restorative material (Biodentine)/glass ionomer cement (Fuji IX GP) according to group ascertained. Shear bond strength was evaluated using universal testing machine (INSTRON). Standardized Class II cavities were prepared on both primary and permanent teeth, and then restored with tricalcium silicate-based restorative material (Biodentine)/glass ionomer cement (Fuji IX GP) according to group ascertained, over which composite resin material was restored using an open sandwich technique. Microleakage was assessed using dye penetration. Microleakage was examined using a stereomicroscope. Results: Results showed that glass ionomer cement (Fuji IX GP) exhibited better shear bond strength than tricalcium silicate-based restorative material (Biodentine). Mean microleakage score for glass ionomer cement (Fuji IX GP) in permanent teeth was 1.52 and for primary teeth was 1.56. The mean microleakage for tricalcium silicate-based restorative material (Biodentine) in permanent teeth was 0.76 and for primary teeth was 0.60. Glass ionomer cement (Fuji IX GP) exhibited more microleakage than tricalcium silicate-based restorative material (Biodentine), which was statistically significant both in permanent (P = 0.02) and primary (P = 0.006) teeth. Conclusion: Shear bond strength of glass ionomer cement (Fuji IX GP) is greater than tricalcium silicate-based restorative material (Biodentine) in both primary and permanent teeth. Tricalcium silicate-based restorative material (Biodentine) exhibited less microleakage compared to glass ionomer cement (Fuji IX GP) in both primary and permanent molars.
  6,292 665 -
Simplified feeding appliance for an infant with cleft palate
Shaila Masih, Reena Annie Chacko, Abi M Thomas, Namita Singh, Rodny Thomas, Deena Abraham
October-December 2014, 32(4):338-341
DOI:10.4103/0970-4388.140970  PMID:25231044
A child born with cleft palate may experience difficulties while feeding. Early surgical treatment may need to be postponed until certain age and weight gain of the infant. The case presented here is of a 1-month-old neonate born with cleft palate, assisted with a new feeding appliance made with ethylene vinyl acetate using pressure molding technique to aid in proper feeding. The patient's weight and health significantly improved after the insertion of obturator. The advantages of this material included being lightweight, moldability, good palatal fit and decreased soft tissue injury.
  4,448 436 -
Obsessive compulsive disorder in dental setting
Preetika Chandna, Nikhil Srivastava, Vivek Kumar Adlakha
October-December 2014, 32(4):330-332
DOI:10.4103/0970-4388.140964  PMID:25231042
Globally, 20% of children and adolescents suffer from a disabling psychologic illness. Among these, Obsessive Compulsive Disorder (OCD) is listed by the World Health Organization (WHO) as one of the 10 most disabling conditions, with prevalence rates of OCD in children ranging between 1 to 3%. Pediatric dentists are in a unique position to diagnose psychological problems in children and adolescents due to their ongoing relationship with children and their parents that starts at a very early age. Timely diagnosis of psychological illness can result in early intervention as well as better patient management for the dentist too. The purpose of this case report is to highlight a case of OCD in an adolescent girl diagnosed in a dental setting.
  4,021 265 -
Clinical manifestations of oculodentodigital dysplasia
Gurusamy Kayalvizhi, Balaji Subramaniyan, Gurusamy Suganya
October-December 2014, 32(4):350-352
DOI:10.4103/0970-4388.140973  PMID:25231047
Oculodentodigital dysplasia (ODDD) is a multisystem congenital disorder characterized by abnormal facial development, deformed limbs and dentition. This report describes a rare incidence of ODDD-linked dermatological, cardiac, dental, and neurologic manifestations noted in an Indian child patient.
  4,038 183 -
Ectrodactyly-ectodermal dysplasia-cleft lip and palate syndrome
Reema Sharma Dhar, Amitava Bora
October-December 2014, 32(4):346-349
DOI:10.4103/0970-4388.140972  PMID:25231046
Ectrodactyly-ectodermal dysplasia-cleft (EEC) syndrome is an autosomal dominant disorder characterized by the triad of ectrodactyly-ectodermal dysplasia, and facial clefting along with some associated features. Presence of all the three major features in a single individual is extremely rare. We report a case of 4 year 11 months old child with EEC syndrome having ectodermal dysplasia-cleft lip and cleft palate and ectrodactyly with some associated features. Clinical features, diagnosis and role of a dentist in the multidisciplinary treatment approach have been elaborated in this case report.
  3,806 255 -
Vacuum formed splints: Novel method for managing oro-facial trauma
Shikha Choubey, Anand Shigli, Naveen Banda, Saket Vyawahare
October-December 2014, 32(4):353-356
DOI:10.4103/0970-4388.140975  PMID:25231048
Objective: Trauma to the oro-facial structures in children is different from trauma in adults. There are several points of differentiation between the two, the most important being growth. Aim: The purpose of this paper is to present the advantages of a vacuum-formed splint which was chosen as a practical and effective conservative treatment approach for the management of maxillofacial trauma. Case Report: A 9-year old boy reported to the department of pediatric and preventive dentistry with right mandibular parasymphyseal fracture. The trauma presented with the unique challenge to save and support the unerupted and developing tooth buds. Therefore, a vacuum-formed splint was fabricated and cemented in place for the next 4 weeks. Conclusion: The splinting method used for stabilization of the injured teeth is an important issue in trauma therapy to support the periodontal healing. Pediatric maxillofacial traumas require different clinical treatment strategies compared with fractures of the adult population.
  3,494 412 -
A study of occurrence of malocclusion in 12 and 15 year age group of children in rural and backward areas of haryana, india
Dhanashree Damle, Vinay Dua, Rajat Mangla, Mannu Khanna
October-December 2014, 32(4):273-278
DOI:10.4103/0970-4388.137622  PMID:25231033
Objectives: Objectives of the study were to determine the severity of malocclusion, orthodontic treatment needs and variation in malocclusion with respect to age and sex (gender) in 12 and 15 years age-group children in rural and backward areas of Haryana, India. Materials and Methods: A sample of 1322 school children (12 and 15 years of age) was selected randomly. Severity of malocclusion and orthodontic treatment needs were assessed according to dental aesthetic index (DAI) criteria (WHO). All the 10 components of DAI were assessed. Clinical examination was performed by single examiner. The data for each child was coded and analyzed by Statistical Package for Social Sciences (SPSS) version 13, Chi Square and Student t-tests. Results: 23.6% of the subjects had dental anomaly, ranging from mild to severe. Percentage of medium, high, and very high treatment needs in children was 15.1, 4.9, and 3.6% respectively. Conclusion: 76.4% children had little or no malocclusion and 23.6% children were in need of treatment which reveals that the infl uence of civilization has reached rural and backward areas.
  3,334 471 -
Association of physical properties and maintenance of sterility of primary teeth in human tooth bank
Nitika Bajaj, Navneet Grewal, Prashant Monga, Sukreet Grewal
October-December 2014, 32(4):279-285
DOI:10.4103/0970-4388.140939  PMID:25231034
Background: This study was carried out to evaluate the sterility and structural integrity of stored primary teeth in artificial saliva over a storage period of 12 weeks (3 months) in human tooth bank (HTB). Materials and Methods: A total of 80 freshly extracted teeth were taken and were categorized into four groups of 20 each. The samples were stored at 4°C for 12 weeks (3 months) in the refrigerator. During their storage time of 3 months, they were repetitively evaluated for their sterility, enamel hardness, calcium and phosphate solubility and color stability at regular intervals of 3 weeks. Observations and Results: That teeth stored in artificial saliva maintained their sterility throughout the storage time of 12 weeks, but changes in their physical and chemical properties occurred with an increase in storage time. Conclusion: Storage time not more than 9 weeks is recommended for deciduous teeth to be stored in artificial saliva in a HTB.
  3,080 446 -
Congenital parotid fistula
Shiggaon Natasha
October-December 2014, 32(4):357-361
DOI:10.4103/0970-4388.140976  PMID:25231049
Parotid fistula is a cause of great distress and embarrassment to the patient. Parotid fistula is most commonly a post-traumatic situation. Congenital parotid salivary fistulas are unusual entities that can arise from accessory parotid glands or even more infrequently, from normal parotid glands through an aberrant Stensen's duct. The treatment of fistulous tract is usually surgical and can be successfully excised after making a skin incision along the skin tension line around the fistula opening. This report describes a case of right accessory parotid gland fistula of a 4-year-old boy with discharge of pus from right cheek. Computed tomography (CT) fistulography and CT sialography demonstrated fistulous tract arising from accessory parotid gland. Both CT fistulography and CT sialography are very helpful in the diagnosis and surgical planning. In this case, superficial parotidectomy is the treatment of choice. A detailed history, clinical and functional examination, proper salivary gland investigations facilitates in correct diagnosis followed by immediate surgical intervention helps us to restore physical, psychological health of the child patient.
  3,144 199 -
Evaluation of canal transportation and centering ability of K 3 (0.02%) and K 3 (0.04%) with hand K files in primary teeth using spiral computed tomography
Haridoss Selvakumar, Vasanthakumari Anandhan, Eapen Thomas, Kavitha Swaminathan, Rajendran Vijayakumar
October-December 2014, 32(4):286-291
DOI:10.4103/0970-4388.140943  PMID:25231035
Background: One of the objectives of root canal preparation is to clean and shape the root canal system while maintaining the original configuration. Therefore, it is important to keep the instruments centered to provide a correct enlargement, without excessive weakening of the root structure. Aim: The aim of the study was to compare canal transportation and centering ability of K 3 (0.02% taper) and K 3 (0.04% taper) with stainless steel hand K files in primary teeth using a spiral computed tomography (SCT) scan. Materials and Methods: A total of 75 extracted mandibular primary second molars was collected. Canals were divided randomly into three groups of 25 teeth each. Group I: K 3 files (0.02% taper), Group II: K 3 (0.04% taper), and Group III: Stainless steel hand K files. Three regions from apical, mid-root, and coronal levels of the canal were recorded. All the teeth were scanned before and after instrumentation by using SCT. Results: K 3 (0.02% taper) showed less canal transportation and a better centering ratio than K 3 (0.04% taper) and stainless steel hand K files. Statistical Analysis: The mean values were compared between different study groups and the P-value was calculated by using Kruskal-Wallis one-way ANOVA. The Mann-Whitney U-test followed by the Bonferroni correction method was employed to identify the significant groups at the 5% level. Conclusion: K 3 (0.02% taper) shaped root canals without significant shaping errors when compared to K 3 (0.04% taper) and stainless steel hand K files in primary teeth.
  2,904 368 -
Type III B dens invaginatus: Diagnostic and clinical considerations using 128-slice computed tomography
Radhika Muppa, H Srinivas Nallanchakrava, Shanthan Mettu, Ravi Varma Dandu, Deepti Chaitanya Tadikonda
October-December 2014, 32(4):342-345
DOI:10.4103/0970-4388.140971  PMID:25231045
Endodontic therapy is successful only when thorough knowledge of root canal morphology is understood. Dens invaginatus is malformation of teeth resulting from invagination of tooth before biological mineralization occurs. It is clinically significant with an early pulpal involvement and chronic periapical lesion, which are often associated with this anomaly. The present case report describes a 13-year-old female patient who reported to our institution with complaint of pain and swelling in the right maxillary region. Intraoral examination revealed Ellis Type II fracture of right maxillary central incisor and normal appearing right maxillary lateral incisor. On radiographic examination right maxillary, lateral incisor roots are morphologically altered with an immature apex and a large periradicular lesion. Conventional radiographs help in the assessment of complex root morphology, but certain limitations pertaining to detail of complexity needs for the use of more advance imaging modalities. Complex anatomic variations can best be diagnosed with the use of computed tomography (CT). A combined endodontic and surgical treatment was performed followed by postobturation CT images which were reviewed as axial slices and in volume rendering multiplanar reconstruction. The scope of using spiral CT in the endodontic diagnosis and treatments is increasing as it provides better resolution than other methods.
  2,835 196 -
Cephalometric evaluation of adenoids, upper airway, maxilla, velum length, need ratio for determining velopharyngeal incompetency in subjects with unilateral cleft lip and palate
Avinash Gohilot, Tejashri Pradhan, Kanhoba Mahabaleshwar Keluskar
October-December 2014, 32(4):297-303
DOI:10.4103/0970-4388.140950  PMID:25231037
Objectives: Children with cleft lip and palate (CLP) are seen to have reduced airway size and large adenoids, which might lead to different characteristics in the upper airway and surrounding tissues from both morphological and functional perspectives. Decrease in adenoid size and increase in need ratio in cleft patients might lead to velopharyngeal incompetency (VPI) and development of nasality in adulthood. No studies have been conducted on the Indian population with variables contributing to VPI. So the aim was to evaluate the size and position of the adenoids, upper airway, maxilla, velum length and need ratio contributing to VPI in subjects with and without unilateral cleft lip and palate (UCLP) during juvenile and adolescent stages. Materials and Methods: Cephalograms of 120 subjects with 6-17 years were taken and various linear and angular measurements were measured and data was analyzed using the unpaired t test. Results: Adenoids were significantly larger and the upper airway smaller in the juvenile and adolescent cleft group than in the non-cleft group. In the adolescent cleft group, airway was larger than that in the adolescent non-cleft group. The maxilla was small and retropositioned in juvenile and adolescent subjects as compared to non cleft cases. Length of velum was smaller and need ratio was larger in both juvenile and adolescent groups as compared to the non-cleft group, suggestive of velopharyngeal incompetence. Conclusion: Decreased Adenoids, restricted airway, small, retruded maxilla, smaller velum length and larger need ratio larger were seen in the cleft group as compared to the non-cleft group, which was suggestive of VPI.
  2,679 239 -
Probiotic caries intervention…!!
ND Shashikiran
October-December 2014, 32(4):271-272
DOI:10.4103/0970-4388.140934  PMID:25231032
  2,256 392 -
A Tribute

October-December 2014, 32(4):362-362
  1,179 105 -
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