Arun Elangovan

Exploring the relation between body mass index, diet, and dental caries among 6-12-year-old children

BACKGROUND AND AIM Childhood overweight and obesity are becoming a major public health concern all over the world. Change in lifestyles and economic growth have led to sedentary lifestyle and altered dietary patterns. There are conflicting reports in the literature regarding the association between body mass index (BMI) and dental caries from various parts of the world. The aim of the present study was to determine if there is an association between BMI-for-age and dental caries in children and to find out the role of diet with respect to BMI-for-age and dental caries. MATERIALS AND METHODS Demographics and anthropometric measurements were obtained for 600 children and BMI-for-age was calculated. Clinical examination for dental caries was carried out following WHO criteria. A diet recording sheet was prepared and children/parents were asked to record the dietary intake for 3 days. Data obtained were statistically analyzed using Chi-square, analysis of variance (ANOVA), and multiple linear regression. RESULTS After excluding improperly filled diet recording sheets, 510 children were included in the study. Caries prevalence was more in obese children than in other BMI groups. Caries scores increased as BMI-for-age increased, though this was not statistically significant. Consumption of fatty foods and snacks was more with obese children compared to other groups. A correlation was found between caries and snacks. CONCLUSION Dental caries scores showed no relationship between BMI-for-age in children. Both snacks and fatty food items were consumed more by obese children, which seeks attention.

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.

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.

Comparative evaluation of fluoride release and recharge of pre-reacted glass ionomer composite and nano-ionomeric glass ionomer with daily fluoride exposure: An in vitro study

AIM This in vitro study was designed to investigate the effects of daily fluoride exposures on fluoride release and recharge by prereacted glass ionomer (PRG) composite and nano-ionomeric glass ionomer. MATERIALS AND METHODS Seventy-two specimens (36 of each material) were prepared and by placing the restorative materials into Teflon mold. Each specimen was subjected to one of three daily treatments (n = 12): (1) No fluoride treatment (control); (2) application of a fluoride dentifrice (1,000 ppm) once daily; and (3) the same regimen as (2), plus immersion in a 0.05% sodium fluoride (NaF) mouth rinse (225 ppm) immediately following the dentifrice application. Specimens were suspended in a storage vial containing 10 ml demineralizing solution for 6 h and transferred to a new test tube containing 10 ml remineralizing solution for 18 h. Fluoride treatments of the specimens were completed every day prior to their immersion in the demineralizing solution. Media solutions were buffered with equal volumes of total ionic strength adjustment buffer (TISAB) II; fluoride levels were measured using a digital ion analyzer and fluoride electrode throughout the 21 day duration of the experiment. RESULTS Nano-ionomeric glass ionomer showed a better amount of fluoride release than PRG composite irrespective of the fluoride treatment supplementation (P < 0.01). Additional fluoride supplementation improved fluoride release and recharge ability for both the materials when compared to their respective control groups. The fluoride recharge for both materials did not show any sustained pattern of release. CONCLUSION Nano-ionomeric glass ionomer demonstrated a greater ability to release and recharge compared with that of PRG composite.

Prevalence of dentofacial abnormalities in children and adolescents with β-thalassaemia major

BACKGROUND β-thalassaemia major is a hereditary hemolytic anemia and the patients often experience growth retardation, protrusive maxilla, and depressed nasal bride leading to various degrees of malocclusion. AIM The purpose of this investigation is to find the prevalence of dentofacial abnormalities in β-thalassaemia major patients. SUBJECTS AND METHODS Seventy-two patients between 6 and 18 years of age diagnosed with β-thalassaemia major were examined for extraoral abnormalities, malocclusion, oral hygiene, and dental caries. Data obtained were tabulated and statistically analyzed using Chi-square and paired t-test. RESULTS Thirty-nine (54.2%) were males and 33 (45.8%) were females. Prominent extraoral abnormalities were found in 41 (56.9%) of the individuals. Study population predominantly had class I occlusion (59.7%) followed by class II occlusion (23.6%) and no class III occlusion. Mean oral hygiene index-simplified score was 2.43 ± 1.24, mean decayed missing filled teeth (DMFT) score was 7.10 ± 3.92, and deft was 5.68 ± 3.12. CONCLUSION Despite starting regular blood transfusion at an early age, β-thalassaemia major patients showed marked facial abnormalities. When compared with individuals with no systemic disease, oral hygiene status was similar, but the caries experience was higher in β-thalassaemia major patients. Therefore, emphasis to educate these patients in the prevention and control of dental caries and maintenance of good oral hygiene should be considered.

Comparative evaluation of the antimicrobial efficacy of four chewing sticks commonly used in South India: An in vitro study

BACKGROUND AND AIM The use of chewing sticks has been well documented since ancient times in India. Chewing sticks are a good alternative to the toothbrush for maintaining oral hygiene. The present study was designed and conducted to compare and evaluate the antimicrobial effects of the aqueous extracts of neem, miswak, mango, and banyan chewing sticks against two bacterial species considered the most important in the initiation and progression of dental caries, namely Streptococcus mutans and Lactobacillus acidophilus, respectively. MATERIALS AND METHODS Twigs of the above mentioned chewing sticks were sun dried and powdered, and sterile aqueous solutions of 10%, 25% and 50% concentrations were prepared. Culture plates for S mutans and L acidophilus were prepared and the growth was transferred to nutrient agar and Mueller-Hinton agar; antimicrobial activity of the extracts was tested after 72 h, using the disc diffusion method. Normal saline was used as control. RESULTS The antimicrobial activity of neem, miswak, and mango extracts increased as their concentrations increased. Both banyan extract and saline showed no antimicrobial activity against the organisms tested. CONCLUSION AND RECOMMENDATIONS Based on the zones of inhibition, aqueous extracts of neem showed the most antimicrobial activity against S mutans, while miswak extracts showed superior antimicrobial activity against L acidophilus. We recommend further phytochemical and pharmacological studies to discover newer nonsynthetic tooth pastes and mouthwashes.

Comparative Evaluation of Endovac and Conventional Irrigating Syringe on Apical Extrusion in Primary Molars. An in vitro Study

OBJECTIVES The present study was undertaken to evaluate and compare the apical extrusion of irrigant and depth of irrigant penetration into dentine using the EndoVac irrigating system and manual irrigation system in primary molar teeth. STUDY DESIGN Twenty five extracted primary molars satisfying the inclusion and exclusion criteria were divided into two groups with 29 roots in each group with an equal distribution of apical foramen area. The teeth were mounted in pre-weighed glass bottles and the canals were irrigated with 5.25% sodium hypochlorite solution mixed with acid fuchsin using either of irrigating systems according to the group ascertained. The amount of irrigant extruded was recorded. The roots were sectioned at two mm, four mm and six mm from the apex and examined under a stereomicroscope for depth of irrigant penetration. RESULTS Apical extrusion of the irrigant solution was significantly less with the EndoVac system (1.18±1.04) when compared with the manual irrigation system (2.3±1.55) (P=0.002)*. Results showed that greater irrigant penetration was achieved using the EndoVac irrigation system compared to the manual irrigation system (P= 0.000)*. With both the irrigation systems, the depth of irrigant penetration was better in the six mm sections followed by the four mm sections and two mm sections (P=0.000)*. CONCLUSION The EndoVac irrigation system demonstrated better efficacy compared to manual irrigation system with less apical extrusion and better depth of irrigant penetration into dentine.

Comparative Evaluation of the Efficacy of EndoVac and Conventional Irrigating Systems in Primary Molars – An in Vitro Study

OBJECTIVE The present study was undertaken to evaluate and compare the apical extrusion of irrigant and depth of irrigant penetration into the dentinal tubules using the EndoVac irrigating system and the manual irrigation system in primary molar teeth. STUDY DESIGN Twenty five extracted primary molars satisfying the inclusion and exclusion criteria were divided into two groups of 29 roots in each group with an equal distribution of apical foramen area. The teeth were mounted in pre-weighed glass bottles and the canals were irrigated with both the irrigating systems using 5.25% sodium hypochlorite solution mixed with acid fuchsin which enables the irrigating solution to penetrate efficiently into the dentinal tubules. The amount of irrigant extruded was recorded. The roots were sectioned at 2mm, 4mm and 6mm from the apex and examine the depth of irrigant penetration into the dentinal tubules under a stereomicroscope. RESULTS Apical extrusion of the irrigant was significantly less with the EndoVac system (1.18±1.04gms) when compared to manual irrigation system (2.3±1.55gms) (P<0.05). EndoVac irrigation system showed greater depth of irrigant penetration into the dentinal tubules (49.90±17.52mm, 32.17±12.20mm and 15.70±8.91mm) compared to the manual irrigation system (30.48±16.27mm, 14.74±9.67mm and 5.59±7.09mm) at 6mm, 4mm and 2mm respectively (P<0.05). Results showed that the depth of irrigant penetration into the dentinal tubules with both the irrigating systems was found to be significantly greater in the six mm sections compared to the four mm and two mm sections (P<0.05). CONCLUSION The EndoVac irrigation system showed significantly greater efficacy compared to the manual irrigation system in primary molars with less amount of irrigant extrusion and better depth of irrigant penetration into the dentinal tubules.

In vivo evaluation of 4% articaine and 2% lignocaine intraligamentary injection administered with single tooth anesthesia-wand

Background: The available literature confirms the effectiveness of intraligamentary injections equal to nerve blocks and articaine equal to lignocaine with better depth of penetration for single tooth pulpectomy procedures with less postoperative soft tissue trauma. An advancement in the field of local anesthesia delivery is the Single Tooth Anesthesia-Wand (STA-Wand) which is relatively pain-free and offers comfort to the child. Aims: This study aims to evaluate and compare the anesthetic effectiveness and postoperative complications of 4% articaine and 2% lignocaine intraligamentary injection administered as single tooth anesthesia using a computer-controlled local anesthetic delivery system, the STA-Wand. Settings and Design: Using a randomized, split-mouth, cross-over study design, twenty children aged 4–10 years who required bilateral mandibular pulpectomies were administered intraligamentary injections with 4% articaine and 2% lidocaine in two appointments using STA-Wand. Pain, anxiety, and cooperation levels were scored by an operator and an observer at four phases of treatment using Wong-Baker Faces Pain Rating Scale and Two-6 point Co-operation Anxiety Rating Scale. Results were tabulated and analyzed. Statistical Analysis: Mann–Whitney U-test, paired t-test, and Students t-test. Results: Both the local anesthetic agents were equally effective with no significant difference (P > 0.05) throughout rest of the treatment procedure compared to injection phase in minimizing pain, anxiety, and gaining the cooperation levels of children whereas during injection phase, 4% articaine showed superior effectiveness in minimizing pain compared to 2% lignocaine (P = 0.054). Conclusion: Both the local anesthetic agents delivered using STA-Wand is clinically acceptable, effective, and safe for usage in children.

Shade selection of primary maxillary anterior teeth in children using Vitapan classical shade guide

Aim: The purpose of this study was to determine the closest matching shade for primary maxillary anterior teeth from the most widely used Vitapan classical shade guide available for permanent teeth. Materials and Methods: A total of 313 children aged between 3 and 5 years were evaluated. Vitapan classical shade guide was used to determine the shade of six primary maxillary anterior teeth. Scores obtained were noted down in a scoring sheet and values were tabulated. Data collected were tabulated and statistically analyzed using Pearson Chi-square test. Results: A1 was found to be the closest matching shade for primary maxillary anterior teeth. D3 was found to be the least prevalent shade for primary maxillary anterior teeth. There was no statistical significant difference in the shades among teeth of same quadrant (p > 0.05) and also between teeth of right and left quadrants (p > 0.05), respectively. Conclusion: A1 shade of Vitapan classical shade guide is the most prevalent shade for primary maxillary anterior teeth and can be satisfactorily reproduced to all primary maxillary anterior teeth in general.

Efficacy of three-tone disclosing agent as an adjunct in caries risk assessment

Background: Today, most approaches to caries viewed that catastrophic change in normal plaque biofilm is responsible for the disease. The behavior and composition of the biofilm are a reflection of the oral environment; the caries is a reflection of adverse changes occurring in that environment. Thus, it is important to identify the pathogenicity of the plaque biofilm so as to predict the caries risk. The recently developed three-tone plaque disclosing agent was used to test its ability in identifying the pathogenicity of plaque. Aim: To assess the efficacy of three-tone plaque disclosing agent in identifying the plaque pathogenicity and correlate with the clinical caries status and microbiological findings. Materials and Methods: Sixty children of 6-13 years age group of both sexes were clinically examined for caries and plaque scores, and then disclosing agent was applied; the color stained plaque samples were collected and cultured for microbiological assessment, and the data were analyzed based on the caries status of the children. Results: There was a significant difference between the pathological plaque of caries active and caries free group (P < 0.05). The pathological plaque scores and the total colony counts, Streptococcus counts and mutans streptococci counts increased with the increase in caries. Conclusion: Three-tone plaque disclosing agent was effective in identifying pathological plaque and can be used as one of the chairside adjuvants in caries risk assessment.