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Introduction: The imbalance between remineralization and demineralization leads to the formation of secondary caries. Fluoride-releasing ability has been the characteristic property of glass ionomer cement (GIC), but it is uncertain if this property alone will be sufficient for the cessation of the growth of the organisms. Therefore, a restorative material with additional bacteriostatic properties needs to be introduced., Aim: To evaluate the microhardness and solubility of the conventional GIC after adding different combinations of antibiotic powders., Materials and Methods: In this study, the three groups were conventional GIC (group I), GIC + metronidazole + ciprofloxacin (group II), and GIC + metronidazole + amoxicillin/clavulanic acid (group III). The concentration of the double antibiotic combination was maintained at 1.5% w/w. The antibiotic powders were added to the GIC and evaluated for microhardness and solubility of the specimens., Results: The mean microhardness level of group II was the highest, which was statistically significant using analysis of variance (ANOVA) with a p -value of 0.022. The comparison of each group's solubility in different solutions was not statistically significant., Conclusion: Along with the conventional properties of GIC, an additional therapeutic gain can also be obtained by incorporating various combinations of antibiotics, thereby arresting the progression of caries at the site of infection itself., Clinical Significance: This new approach shall help in community health programs, where treatment of a large population needs to be done within a short span of time and arrest the progression of caries activity in deep caries., How to Cite This Article: Benson TL, Sogi S, Jain M, et al. Comparative Evaluation of Microhardness and Solubility of Different Combinations of Antibiotic Powders Added to Glass Ionomer Cement: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(6):619-624., Competing Interests: Source of support: Nil Conflict of interest: NoneConflict of interest: None, (Copyright © 2024; The Author(s).)

Objective: The study was conducted to analyze the pattern, etiology and management of maxillofacial trauma in children up to 16 years of age., Study Design: Records of the patients who sustained maxillofacial trauma from 2013 to 2018 were retrospectively evaluated for age, gender, etiology, pattern of injuries and their management. Children were divided into three groups-primary (0-5 yrs), mixed (6-11 yrs) and permanent dentition group (12-16 yrs). Maxillofacial trauma was observed as midface fracture, mandible fractures, soft tissue injuries and associated tooth fractures. SPSS software version 19.0 was used for the data analysis., Result: A total record of 99 children were evaluated. Gender-wise distribution was reported twice in male than females. Fall was observed as the major etiological factor (73.7%) with a significant p value of 0.012 using chi-square test. The highest frequency of maxillofacial trauma is noted in mixed dentition group (47.4%). Mandible fracture was most frequently observed followed by associated soft tissue injury. Conservative approach/closed reduction for management was executed for the majority of cases., Conclusion: Knowledge gained from the present study would help in assessing the effectiveness of present preventive modalities and facilitate elaboration of future preventive measures and new research works as well., (© The Association of Oral and Maxillofacial Surgeons of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Objective: To assess the presence of Enterococcus faecalis in root canals of deciduous molars with necrotic pulp by agar culture and polymerase chain reaction (PCR) assay., Materials and Methods: This is an experimental study, where a total of 120 endodontic samples were taken from deciduous molars with necrotic pulps. The presence of Enterococcus faecalis was assessed by culture, using Enterococcus confirmatory agar, and by PCR assay. Statistical analysis of the results was performed using McNemar's test., Results: The presence of Enterococcus faecalis was detected in 20 samples (16.67% of total) by microbial culture and in 45 samples (37.5% of total) by PCR assay, with a statistically significant difference between the two methods ( p < 0.001). Microbial culture and PCR both detect Enterococcus faecalis , with the latter detecting an additional 25 positive samples., Conclusion: In this study, PCR assay was significantly more sensitive than agar culture method in detecting the presence of Enterococcus faecalis in root canals of deciduous molars with necrotic pulp, that is, 37.5% of all samples., Clinical Significance: Importance of presence of Enterococcus faecalis in necrotic pulps of deciduous teeth, as it is primarily responsible for failure of endodontic treatment, thus helping clinicians to advocate the use of local drug delivery in primary teeth endodontics and also aids clinicians in choosing the most effective intracanal medication., How to Cite This Article: Nalawade TM, Bhat KG, Kale AD, et al. Evaluation of Presence of Enterococcus faecalis in Root Canals of Deciduous Molars with Necrotic Pulp by Agar Culture and Polymerase Chain Reaction. Int J Clin Pediatr Dent 2023;16(6):816-819., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Objective: To assess salivary nitric oxide (NO) levels in children with caries at baseline before treatment and compare salivary NO levels before treatment and after 15 and 30 days of the treatment., Study Design: The saliva sample was collected from a total of 31 children with caries aged between 6 and 12 years. NO levels were estimated in children with caries before and after treatment using Griess reaction. Decayed teeth in permanent dentition (DT) and and decayed teeth in primary dentition (dt) scores, pretreatment NO levels were recorded at the baseline. After completing the treatment, posttreatment NO levels were compared at 15 and 30 days using paired t -tests. Mann-Whitney U test was used for comparing NO levels with both genders. Further, the correlation of NO with age and dental caries was estimated using the Spearman correlation test., Results: A significant increase in salivary NO levels was found in children after treatment ( p < 0.001). No significant correlation was found between NO, age, gender, and DT and dt scores., Conclusion: Higher levels of NO were associated with low caries experience., Clinical Significance: The salivary NO in children is of higher diagnostic values as it can be used in caries risk assessment., How to Cite This Article: Jindal M, Sogi S, Shahi P, et al. Salivary Nitric Oxide Levels before and after Treating Caries in Children: A Comparative Study. Int J Clin Pediatr Dent 2023;16(S-2):S133-S137., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Introduction: Deep pits and fissures are more prone to caries development due to their complex morphological anatomy. Preventive measures, such as pit and fissure sealants, can help in the reduction of dental caries. Conventional sealants being hydrophobic in nature, require isolation. Sealants which are hydrophilic have been introduced as an alternative where isolation is difficult to achieve., Aim: To compare and evaluate the retention and marginal integrity of hydrophilic pit and fissure sealant (Embrace WetBond) with hydrophobic pit and fissure sealant (Clinpro) in permanent first molars., Materials and Methods: Sealants were applied randomly using the split-mouth design technique on 80 permanent first molars in children aged between 6 and 9 years and evaluation was done at 3, 6, 9, and 18 months., Results: The difference in retention rates between the groups was not significant using the Chi-squared test, though the WetBond group exhibited better results with 40% complete retention at the end of 18 months while in the Clinpro group, it was 37.50%. The marginal integrity in both the sealant groups was also found to be statistically insignificant. Caries incidence was found to be slightly higher in the Clinpro group., Conclusion: The clinical performance of Embrace WetBond was better when compared to Clinpro because of its moisture-tolerance capacity. Embrace Wetbond pit and fissure sealant can be the choice of material in cases where moisture control is a challenging issue., How to Cite This Article: Gyati O, Jain M, Sogi S, et al. Clinical Evaluation of Retention of Hydrophilic and Hydrophobic Pit and Fissure Sealants in Permanent First Molars: An 18 Months follow-up: Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(2):350-356., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Aim: To evaluate the oral health status of children with special healthcare needs (CSHCN) having either systemic illness or any disabilities., Materials and Methods: A retrospective analysis of oral health status was done from Jan 2013 to Dec 2018 on 58 CSHCN (both genders) up to 16 years of age. The oral health status of patients was assessed with the decayed, missing, and filled teeth (DMFT/dmft) indices and simplified oral hygiene index (OHI-S) by using the World Health Organization (WHO) 2013 oral health survey criteria., Results: Fair oral hygiene was dominantly present (62%) among all the subjects. Association between oral hygiene status and systemic illness/disability was done using the Chi-squared (χ 2 ) test and was found statistically nonsignificant. The overall mean DMFT/dmft found was 4.16. The highest mean DMFT/dmft score was recorded in nephrotic syndrome patients (16.0%), while the least score was seen among cleft anomalies (1.89%). Comparison between mean DMFT/dmft scores among various systemic illnesses/disabilities were done using Kruskal-Wallis one-way analysis of variance (Kruskal-Wallis ANOVA) test and found statistically significant ( p -value 0.048)., Conclusion: The majority of the CSHCN fall under fair oral hygiene status. A high caries prevalence and statistically significant value were demonstrated between mean DMFT/dmft scores of various systemic illnesses/disabilities., Clinical Significance: Present study aids in understanding the needs of the community, identifying high-risk groups, planning the required treatment and prevention strategies, and thus monitoring and improving the oral health status of children with special healthcare needs., How to Cite This Article: Patidar D, Sogi S, Patidar DC. Oral Health Status of Children with Special Healthcare Need: A Retrospective Analysis. Int J Clin Pediatr Dent 2022;15(4):433-437., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2022; The Author(s).)

Aim: To study the effect of combination of chlorhexidine and Fluoride on the growth and colonization of cariogenic bacteria ( Streptococcus mutans ) in children with mixed dentition., Materials and Methods: Sixty children of age 6-14 years with mixed dentition and S. mutans count > 1 × 10 5 CFU/mL of saliva were divided: group I-chlorhexidine varnish; group II-Fluoride varnish; group III-Combination of chlorhexidine and Fluoride varnish. chlorhexidine and Fluoride varnishes were applied to teeth once every week for four consecutive weeks in respective groups. Salivary S. mutans count was estimated and evaluated at baseline, 1, 3, and 6 months., Results: No significant difference was seen in group I and II at the end of 1, 3, and 6 months ( p > 0.001) but the reduction in S. mutans count was statistically more significant in group III after a period of 6 months ( p < 0.001). Maximum reduction in count was noted in group III at all intervals of varnish application., Conclusion: The concomitant use of chlorhexidine and fluoride varnish would prove to be more effective than individual components over a longer period of time and especially in high caries risk children., How to Cite This Article: More VP, Hugar SM, Sogi S, et al. Comparative Evaluation of the Efficacy of Chlorhexidine, Fluoride and the Combined Use of Chlorhexidine and Fluoride Varnishes on Salivary Streptococcus mutans Count in Children with Mixed Dentition: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(3):267-272., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2022; The Author(s).)

Aim: To evaluate and compare the effect of fixed and removable space maintainers or appliances on salivary factors ("salivary flow rate," pH, and buffering capacity of saliva) in children aged 5-12 years over a period of 3 months., Materials and Methods: Sixty children were selected for the study and equally alienated into two groups as group I for fixed appliances and group II for removable appliances). Unstimulated saliva was collected from children wearing fixed and removable space maintainers or appliances at baseline, 1, 2, and 3 months., Results: At the end of 3 months, there was a slight decrease in the buffering capacity and pH of saliva, which was not statistically significant in both the groups. An increase in unstimulated salivary flow rate was also seen in both the groups at the end of 3 months., Conclusion: Fixed and removable space maintainers or appliances act as opportunistic plaque retentive sites in children, necessitating appropriate oral hygiene maintenance and its reinforcement. Failure to adhere to a strict oral hygiene regimen can cause considerable enamel decalcification and plaque retention leading to alteration in oral microflora which has detrimental effects., Clinical Significance: This study paves way for provision of incorporating practice guideline information for both dentists and children undergoing long-term space maintainer or appliance therapy in children., How to Cite This Article: Kukreja P, Hugar SM, Hallikerimath S, et al. Evaluation of the Effect of Fixed and Removable Appliances on Salivary Parameters (Salivary Flow Rate pH and Buffering Capacity) in Children Aged 5-12: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(6):774-778., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; The Author(s).)

Aim: This retrospective study aimed to analyze dental traumatic injuries and their management in children up to 16 years of age., Materials and Methods: Records of the patients who sustained dental trauma from 2013 to 2018 were evaluated for age, gender, etiology, type of injuries, and their management. Children were divided into three groups-primary (0-5 years), mixed (6-11 years), and permanent dentition group (12-16 years). Dental trauma was assessed by Ellis and Davey's classification of tooth fracture along with other associated injuries., Results: Total records of 466 children with 750 injured teeth (665 permanent and 85 primary) were evaluated. Males were reported twice as females. Fall was noted as the major etiological factor (93.1%). The highest frequency of dental trauma was observed in the permanent dentition group (54.7%). Ellis class IV fracture was the most common dental injury and maxillary central incisor was the most frequently injured tooth. Soft tissue injury was noted as the most commonly associated injury. Most of the dental traumatic injuries in permanent teeth were treated by root canal treatment while the majority of primary dentitions were managed by observation and wound care., Conclusion: Ellis class IV fracture was noted as the most frequent type of dental injury and fall was a major etiological factor. The permanent dentition group of children was more affected and a male predominance was observed., Clinical Significance: The information gained from the present study would help in providing various preventive modalities to parents, caregivers, and teachers regarding these injuries in the future and also facilitate several new researches in this field., How to Cite This Article: Patidar D, Sogi S, Patidar DC, et al. Traumatic Dental Injuries in Pediatric Patients: A Retrospective Analysis. Int J Clin Pediatr Dent 2021;14(4):506-511., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

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., Competing Interests: There are no conflicts of interest

Aims: The aim of this study was to determine the relative antimicrobial effectiveness of these endodontic medicaments and various vehicles using an agar well diffusion assay., Materials and Methods: Double Antibiotic Paste(DAP), modified DAP, 2% Chlorhexidine gluconate and their combination with four vehicles namely Polyethylene glycol 400 (PEG), Propylene glycol (PG), combinations of PG with PEG and lastly Glycerine were tested using agar well diffusion assay. The minimum bactericidal concentration was noted against four standard strains of organisms ie Streptococcus mutans ATCC( American Type Culture Collection) 25175, Staphylococcus aureus ATCC 12598, Enterococcus faecalis ATCC 35550 and Eschericia coli ATCC 25922. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Issues of resistance, limited spectrum of activity and lack of antifungal properties, the hunt for the ideal intracanal medicament continues. In this regard, the vehicles used to form the pastes play a supportive role by forming the appropriate consistency for placement and may dramatically influence their chemical characteristics like their solubility and diffusion. Thus, inorder to use safer and equally effective intracanal medicaments, Chlorhexidine gluconate is being unveiled in this study., Results: The difference between the four vehicles when combined with the same endodontic medicament studied above is nonsignificant (NS) except against Porphyromonas gingivalis. Propylene glycol is significantly effective than Glycerine when used with DAP ie C+M medicament combination. (p = 0.029)., Conclusion: 2% chlorhexidine gluconate and modified DAP can definitely replace DAP and triple antibiotic paste as end-odontic medicaments with chlorhexidine having an added advantage of bactericidal action, substantivity, biocompatibility, low toxicity, and lesser chances of developing resistance., How to Cite This Article: Nalawade TM, Bhat KG, Sogi S. Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes. Int J Clin Pediatr Dent 2016;9(4):335-341., Competing Interests: Source of support: Nil Conflict of interest: None

Context: In endodontics, most of the commercial intra-canal medicaments have cytotoxic reactions and because of their inability to eliminate bacteria from dentinal tubules, recent medicine has turned its attention to the usage of biologic medication prepared from natural plants. The literature to testify the efficacy of natural alternatives in primary teeth is meagre and its effects as irrigating solutions need to be evaluated., Aim: To evaluate the antibacterial effectiveness of sodium hypochlorite, ethanolic extracts of Curcuma longa (turmeric) and Camellia sinensis (green tea) as irrigating solutions against the anaerobic bacteria isolated from the root canals of infected primary teeth., Materials and Methods: Thirty patients were selected based on the selected inclusion and exclusion criteria. Preoperative radiographs were taken. Rubber dam isolation and working length estimation were done, following which thirty samples were taken from the root canals of infected primary teeth using sterile absorbent paper points and transferred to tubes containing thioglycolate transport medium. The bacteria were then isolated using standard microbiological protocols and were subjected to antibiotic sensitivity testing using the three test irrigants., Statistical Analysis: SPSS 18 software using Chi-square test was used for statistical analysis., Results: The most commonly isolated bacteria included Porphyromonas sp., Bacteroides fragilis, Peptostreptococcus, and Staphylococcus aureus. Sodium hypochlorite and C. longa (turmeric) showed good antibacterial effect and were effective against most of the isolated bacteria. There was statistically significant difference in the antibacterial effect among the three tested groups (P < 0.001). The least effective was C. sinensis (green tea)., Conclusion: The infected primary teeth almost always present with a polymicrobial structure with a wide variety of anaerobic bacteria. The chemo-mechanical preparation plays an important role in eradicating the population of predominant micro-organisms in treating these teeth with promising effects with the use of newer test irrigants while avoiding the side effects of sodium hypochlorite.

Aim: The aim of the following study is to know the efficacy of remineralization of two pediatric dentifrices and one regular dentifrice on artificial carious lesions in primary teeth., Materials and Methods: A total of 21 teeth coated with nail varnish leaving a window of 1 mm were subjected to demineralization for 72 h. These 21 teeth were then sectioned into two equal parts with a diamond disc. The 42 sections obtained were then evaluated under the stereomicroscope and the demineralization values were noted. The 42 sections were divided into three groups: Group 1: Kidodent, Group 2: Cheeriogel, Group 3: Colgate Total and subjected to remineralization respectively for 7 days. The specimens were again evaluated under the stereomicroscope for the remineralisation values., Results: All the three dentifrices showed remineralization with artificial carious lesions. Colgate Total showed higher remineralization rates compared with the other two pediatric dentifrices. Kidodent showed a slightly higher remineralisation rate compared with Cheeriogel which was not significant., Conclusion/hypothesis: The pediatric dentifrices also showed remineralization with artificial carious lesions. Hence, we conclude that, this amount of remineralization was more or less, when compared to the regular dentifrice which showed higher remineralization rates, which could lead to adverse effects, like fluorosis if not used judiciously. On basis of which we hypothetize: Pediatric dentifrices have an appropriate fluoride content, as required by the children, and also does not minimize the cariostatic effects.