A Comparative Evaluation of Salivary Changes and Oral Indices in Pediatric Patients Having Chronic Kidney Disease and Juvenile Diabetes with Healthy Controls

Background and Aim: Chronic Kidney disease is a common condition seen in Juvenile diabetes with 90% of renal impairment patients displaying a wide spectrum of oral manifestations in the hard and soft tissues including changes of the salivary composition and flow rate. There is an increase in the serum cystatin-C, urea and creatinine levels in these patients, which is reflected in the saliva. This study was conducted to assess the changes in salivary levels of cystatin-C, urea, and creatinine as well as oral – Decayed, Missing and Filled Teeth Index (DMFT) and gingival indices in pediatric patients suffering from chronic renal disease and juvenile diabetes and compare them with healthy individuals.Methods: Fifteen patients with juvenile diabetes suffering from chronic renal disease and 15 healthy controls aged 2-18 years were included in the study. Their saliva was analyzed for creatinine, cystatin-C and urea levels using an auto-analyzer and correlated with their existing serum levels. DMFT, gingival index, gingival bleeding and gingival enlargement indices were also assessed. Results: Increased levels of salivary cystatin C, urea (p value <0.001) and creatinine (p value =0.001) were seen in the cases. The deft value was significantly lower (p value <0.001) while the gingival index, gingival bleeding index, and gingival enlargement index were significantly higher in the subjects with renal impairment.  Conclusion: Chronic Kidney disease results in many metabolic changes in the body, necessitating frequent biochemical blood analysis. Saliva, being a non-invasive, simple and rapid adjunctive tool, can be used for diagnosing and staging the disease and to check the progression of the condition.Keywords: Chronic Kidney Disease; Renal Dysfunction; Saliva; Cystatin-C; Diagnosis

Evaluation Of Knowledge, Attitude And Practice In Parents Regarding Paediatric Oral Health Care

Objective:  To assess the knowledge, attitude, and practise in parents regarding paediatric oral health care.       Design:  A cross sectional questionnaire survey of 500 parents visiting dental clinics for the first time at the Department of Paediatric and Preventive Dentistry for dental treatment of their child.  Outcome measures:  Responses were obtained for dental knowledge, attitudes and practise. Relating to the eruption and shedding of deciduous and permanent teeth, preventive aids in pedodontics, diseased conditions such as dental decay, gums swelling and crowding, frequency of consumption of refined food by their children and oral health practise.      Results:  Parents have approximately similar percentage of positive knowledge i.e.38.4% and 38.8% towards preventive oral health and oral disease respectively. In addition the positive attitude was also found to be 77.5% and 77.8% towards preventive oral health and oral disease respectively. Whereas only 11.41% showed a positive attitude towards practising the preventive oral health, in contrast with oral disease showing 35.6% parents positive practise. Conclusions:  Parents had positive attitude on the need to conserve natural teeth for their children, but they lacked adequate knowledge regarding preventive oral health and oral disease. And also very low utilization of dental services in spite of positive attitude towards dental treatments

Comparison of clinical performance of newer chemo-mechanical caries removal system and conventional cavity preparation technique in children

Objective: The study was aimed to compare the clinical performance of newer chemo-mechanical caries removal system and conventional cavity preparation technique in children. Study Design: Forty primary molars or first permanent molars of twenty children between the age groups of seven to ten years were selected randomly and divided into two groups of twenty teeth each: Group I was treated by the mechanical method and Group II with Brix 3000 gel method. The efficacy, time taken, and the pain threshold were evaluated during the caries removal by Ericson D et al. scale, stopwatch and modified visual analog scale, respectively. The preferred choice of treatment was assessed using a questionnaire. Results: The comparison between the time taken by the two methods showed a significant difference (P < 0.05). The caries removal efficacy indicated a significant difference as well ( P < 0.05). The pain rating results indicated a notable difference in the mean Visual Analogue Scale score (P = 0.001). The comparison between the two choices of treatment indicated a significant difference at p≤0.05. Conclusion: It was concluded that airotor was efficient in caries removal and while Brix 300 had lower pain rating and better patient acceptance

Comparative evaluation of impact strength of natural tooth and two different fragment reattachment technique: An in-vitro study

Background: The reattached fragments are prone to re-fracture if another traumatic episode occurs or under non-physiological use of the restored teeth. There is a scarcity of literature regarding the management of uncomplicated crown fracture reattachment following a further fracture Therefore, concerns have been directed towards the strength of reattachment of the fractured teeth. Hence the aim of the in-vitro study was to evaluate & compare the impact strength of reattached fragments with composite resin & polyethylene fiber impregnated in composite resin with that of the natural tooth. Methodology: Total samples of 42 teeth were collected and indicated for extraction. They were cleaned ultrasonically and later stored in a 0.9% saline solution. The samples were divided into three groups of 14 samples each. The fracture was induced by disk, only Ellis class II fractured teeth were included in the study. Group 1 (control group) sound tooth: Directly checked for impact strength. Group 2: Reattachment of the fractured fragment using composite resin. Group 3: Reattachment using polyethylene fiber impregnated in composite resin with minimal preparation. All samples were thermocycled between 5°C - 55°C for 500 cycles with 30 seconds dwell time and tested in an ‘impact testing machine’.&nbsp

Golden triangle of minimal intervention dentistry in paediatric dentistry

The Minimal Intervention Dentistry (MID) approach provides a more all-inclusive approach towards caries management, comprising of prevention, control, and treatment of caries. The various minimally invasive techniques employed in the MID are the preferred treatment modalities to treat dental caries in children. They are being increasingly employed by dentists with an aim to increase co-operation of children, with an added advantage of giving them a positive dental experience. The behavior modification of young children for an effective Paediatric Dental Care revolves around the Paediatric Dentistry Treatment Triangle, corners of which are formed primarily by the child, parent and dentist.  To that end, we have tried to look at certain aspects of the MID from the perspective of a paediatric dentist and thereby proposed a modification of the ‘Golden Triangle of MID’ in relation to its application in paediatric dentistry

Comparative evaluation of remineralising and adsorption properties of regular cow milk and A2 milk using human enamel discs and hydroxyapatite discs: An in-vitro SEM study

Depending on the frequency and type of intake, milk can affect caries formation by virtue of its demineralisation- remineralisation properties. The effect of A2 milk on human dentition is still unexplored. Hence,the aim of the present study was to evaluate and compare the remineralising and adsorption properties of regular cow milk and A2 milk using Human Enamel discs and Hydroxyapatite(HA) discs in an in-vitro model. Materials and methods: To evaluate the remineralising properties of milk, 24 human enamel discs and 24 Hydroxyapatite(HA) discs were divided equally into two different milk groups. Subsurface carious lesions were created and they were subjected to remineralisation-demineralisation cycles using twenty-one-day pH-cycling model. Baseline, post-demineralisation and post-remineralisation differences between the groups were studied by microhardness test (Vicker’s Indenter) and surface roughness test (profilometer). Ca:P ratio of the subtrates was analysed using Scanned Electron Microscopy Energy Dispersive X-Ray (SEM-DEX) analysis of five HA discs, out of which two were  treated with the different milk types and the remaining  three with different controls. Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE) based analysis, followed by densitometric evaluation was performed to examine the adsorption of caseins from the two milk types on HA discs.&nbsp

A Case of Full Mouth Rehabilitation of a 5-year-old Child with Severe Early Childhood Caries

An important health problem worldwide that adversely impacts infants and children’s oral health is early childhood caries. Early loss of primary teeth due to trauma or caries can result in decreased masticatory function, reduced esthetics, incorrect pronunciation of sounds, and the development of aberrant oral habits. Every child has a fundamental right to live happily and healthily; therefore, it should be addressed and managed to prevent further complications. This case report gives insight into the dental rehabilitation of the patient with mutilated primary dentition

Artificial intelligence in pediatric dentistry – A systematic review

Background: Artificial intelligence (AI) refers to the development of computer systems capable of performing tasks that normally require human intelligence. AI and its subsets, machine learning and deep learning, have been incorporated into several aspects of dentistry including pediatric dentistry. However, there is a lack of documentation and analysis of the current applications of AI in pediatric dentistry. Aim: The aim of this systematic review was to evaluate the effectiveness of AI as a diagnostic tool in pediatric dentistry. Materials and Methods: The literature for this paper was identified by performing a thorough search in electronic databases such as PubMed, Google Scholar, and Cochrane Library from the years 2011 to 2021. The following keywords and Boolean operators were used: AI AND pediatric dentistry, artificial neural networks AND pediatric dentistry, convolutional neural networks AND pediatric dentistry, and machine learning AND pediatric dentistry. After applying appropriate inclusion and exclusion criteria, 13 articles were selected, fully read, and systematically analyzed as per a specific research question. Results: Among the 13 selected articles, it was found that AI is a useful tool for dental diagnosis/classification, cephalometric landmark identification, identification of early childhood caries patterns, chronological age assessment in children, assessment of facial attractiveness in cleft patients, dental plaque detection, and oral health education. Conclusion: The selected articles indicate that AI is an effective diagnostic tool and has the potential for assisting several aspects of pediatric dentistry. However, further studies are required to assess the clinical effectiveness of these AI models