Suprabha Bs

Evaluation of pit-and-fissure sealants placed with four different bonding protocols: a randomized clinical trial

BACKGROUND Application of adhesive after acid etching may increase the retention of pit-and-fissure sealants and improve clinical effectiveness. AIMS To clinically evaluate the retention, marginal discoloration and caries incidence of pit-and-fissure sealants applied using four bonding protocols: conventional acid etching, etch-and-rinse adhesive, multimode universal adhesive and self-etch adhesive used after acid etching. DESIGN In this split-mouth design study, the four adhesive protocols were randomly assigned to the four erupted, non-carious first permanent molars and involved 52 patients between 6 and 10 years of age. The sealants were evaluated at 3-, 6- and 12-month intervals. Statistical analysis was carried out using Friedman test and Kruskal-Wallis test. RESULTS At 12 months, the retention rate was maximum in etch-and-rinse and universal adhesive groups (77.1%) followed by self-etch adhesive (58.3%) and conventional acid etching group (45.8%). Dental caries was observed only in one tooth, and marginal discoloration was found to be the highest in conventional group and least in etch-and-rinse group. CONCLUSIONS Use of adhesives during pit-and-fissure sealant application does not significantly enhance sealant retention nor decrease marginal discoloration. Etch-and-rinse adhesive is advantageous only at short term.

Pulp regeneration using nanohydroxyapatite as scaffold in an immature central incisor: A 10-month follow-up

Tissue engineering has emerged as the fastest new concept in endodontics especially in immature teeth. In the present case report, pulp regeneration technique was done on a nonvital immature central incisor using nanohydroxyapatite. The case was followed-up to 10 months, and the final result was a completely resolved resorption of both the root and adjacent bone and also with thickening of dentinal wall. Capping the blood clot with mineral trioxide aggregate have been recognized as the protocol for successful regeneration. However, the main concern is that the clot may tend to disintegrate thus weakening the scaffold. Nanohydroxyapatite helped to support the clot and thus prevented it from collapse. Nanohydroxyapatite also underwent almost complete dissolution by the end of 10 months. Clinical Relevance To Interdisciplinary Dentistry Pulp regeneration is one of the latest techniques that have provided excellent success in an immature nonvital tooth. One of the reasons for failure of this technique is the disintegration and collapse of the clot that is formed. Scaffolds are used to support the clot and in the present technique, nanohydroxyapatite is used. Nanohydroxyapatite also underwent almost complete dissolution by the end of 10 months.

Knowledge, attitude, and behavior of nurses toward delivery of Primary Oral Health Care in Dakshina Kannada, India

Majority of young children in many countries do not visit dental clinics for examinations before the age of three though they frequently visit primary health care providers for routine medical check-ups. Nurses are easily accessible and are in frequent contact with waiting mothers and children for routine check-ups and this provides an opportunity to integrate oral health promotion and care into health care. The purpose of this study was thus to study the knowledge, attitude and behaviour towards oral health care among nurses. Methods: The study was a cross-sectional questionnaire survey. Total of 170 medical nurses working in the Institutional Hospital and who provided care for paediatric patients and pregnant mothers participated in the study. Statistical Analysis: Chi-Square test was used to analyse the data using SPSS version 17.0 with a significance value of P < 0.05. Results: All the nurses were aware that good oral health is important for overall health of the child. About 70% of the respondents had poor knowledge regarding dental caries. Good response was obtained regarding importance of oral hygiene maintenance for both the child and mother for prevention of caries. Majority of the nurses showed positive attitudes toward preventive OHC and the role of medical nurses. Routinely the nurses do not refer pregnant mothers and children for dental check up nor do they counsel them regarding oral hygiene and its importance. Conclusion: Appropriate training and encouragement for promotion of oral health and to provide suitable care for the prevention of dental diseases should be included in the curriculum of nurses training.

Comparative evaluation of Nano-hydroxyapatite and casein Phosphopeptide-amorphous calcium phosphate on the remineralization potential of early enamel lesions: An in vitro study

Background: Benefits of remineralizing agents in a wide variety of formulations have been proved beneficial in caries management. Casein phosphopeptide-amorphous calcium phosphate (CPP–ACP) nanocomplex has been recommended and used as remineralizing agent. Nano-hydroxyapatite (n-HAp) is one of the most biocompatible and bioactive material having wide range of application in dentistry, but does it excel better compared to CPP-ACP. Aims: To evaluate and compare the remineralizing efficiency of the paste containing hydroxyapatite and casein phosphopeptide-amorphous calcium phosphate. Settings and Design: The study was an in vitro single blinded study with lottery method of randomization approved by the Institutional Ethics Committee. Materials and methods: 30 non carious premolar teeth. The teeth were demineralized and divided into 2 groups and subjected to remineralization. The samples were analysed for surface hardness and mineral content. Statistical Analysis: Student t’ test and repeated measures of ANOVA was applied. Results: Average hardness in Nano-hydroxyapatite group increased to 340 ± 31.70 SD and 426 ± 50.62 SD for 15 and 30 days respectively and that of (CPP–ACP), 355.83 ± 38.55 SD and 372.67 ± 53.63 SD. The change in the hardness values was not statistically significant with P value of 0.39 (P > 0.05). Calcium and Phosphorous levels increased in both the groups but was not significant. Conclusion: Both the agents used are effective in causing remineralization of enamel. Nano-hydroxyapatite is more effective as compared to Casein phosphopeptide-amorphous calcium phosphate, in increasing the Calcium and Phosphorus content of enamel, and this effect is more evident over a longer treatment period. Key Message: Remineralizing agents are a boon for caries management. With the advent of many formulations it is difficult to clinically select the agent. This study compares the remineralizing potential of Casein phosphopeptide-amorphous calcium phosphate nanocomplex and Nano-hydroxyapatite and found that both are effective as remineralizing agents.

Evaluation of conventional, protaper hand and protaper rotary instrumentation system for apical extrusion of debris, irrigants and bacteria- An in vitro randomized trial

Background Endodontic instrumentation carries the risk of over extrusion of debris and bacteria. The technique used and the type of instrumentation influences this risk. Aim The purpose of this study was to evaluate and compare the K-file, ProTaper hand and ProTaper rotary instrumentation systems for the amount of apically extruded debris, irrigant solution and intracanal bacteria. Design Experimental single blinded randomized type of in vitro study with sample of 30 single rooted teeth. Endodontic access cavities were prepared and the root canals were filled with the suspension of E. faecalis. Myers and Montogomery Model was used to collect apically extruded debris and irrigant. Canals were prepared using K files, Hand protapers and Protaper rotary files. Statistical analysis Non Parametric test like Kruskal-Wallis and Mann-Whitney U test were applied to determine the significant differences among the group. Results Tests revealed statistically significant difference between the amount of debris and number of bacteria extruded by the ProTaper hand and the K-files. No statistically significant difference was observed between the amounts of irrigant extruded by the ProTaper hand and the K-file system. Statistically significant differences were observed between the amounts of bacteria and irrigant extruded by the ProTaper rotary and the Protaper hand. No statistically significant difference was observed between the amounts of debris extruded by the ProTaper hand and the K-file system. Conclusions Amount of apical extrusion of irrigant solution, bacteria and debris are significantly greater with K File instruments and least with Protaper rotary instruments. Key words:Protaper, rotary, periapical extrusion.

Pulpal response to ferric sulfate and diode laser when used as pulpotomy agent: An in vivo study

INTRODUCTION Ferric sulfate and Laser has been used for conventional pulpotomy therapy. Clinical and radiographic evaluation of pulpotomies using these have been done in numerous studies but there exists few studies analysing the histologic response of pulp to laser and ferric sulfate. AIM The aim of the study was to evaluate and compare histological changes seen in the pulp following ferric sulfate and laser pulpotomy and compare these effects. MATERIALS AND METHODS This was a single blind in vivo study, consisting of 24 primary teeth. The teeth were randomly divided into two groups based on the material to be used and subgrouped based on the time period (30 and 45 days) of evaluation. The teeth were extracted after the study period and tissue processing done and subjected to Haematoxylin and Eosin staining procedure. The tissues were evaluated for dentin bridge formation, quality of dentin formation in the bridges, location of dentin bridges, tissue reaction to the material, inflammatory cell response and necrosis. The statistical analysis was done using SPSS 20.0 software. Intragroup comparisons of the observed values were analysed using Chi-square test. RESULTS Statistical analysis revealed non-significant difference between the two materials to produce reparative dentin and also the quality of dentin bridges formed in both the groups during both the observational periods. Majority of the samples in both ferric sulfate and laser group exhibited dentin bridge at the interface of the exposed pulp, bridging or attempting to bridge the site exposed to the pulpotomy material. The ability of the materials to evoke a foreign body and inflammatory cell responses in the pulpal tissue was not significant. All the samples of both the groups showed signs of necrosis with two samples of laser group showing severe necrosis in 45 days period. The difference between the groups in 30 days group was statistically significant. CONCLUSION Laser and ferric sulfate are found to be able to initiate dentin bridge at the interface between the pulp and the material but the quality of bridge formed was better in laser group. Laser group showed more macrophage infiltration, inflammatory cell infiltration and areas of necrosis compared to ferric sulfate group though not statistically significant.

Association of level of education and utilization of restorative dental care among rural women in India: Cross-sectional study

Background: The utilization of restorative dental care is very scarce in rural India. Association between level of education and health of a person has been well-documented in many countries and time periods with a range of potential factors shaping the connection between both. Objectives: This cross-sectional survey was conducted to evaluate an association between the level of education (educational qualification) and utilization of restorative dental care among rural women associated with self-help groups. Materials and Methods: A semi-structured questionnaire was administrated to 660 rural women associated with self-help group by trained research assistants. The 604 completed questionnaires were received and reviewed. The education levels were divided into three groups: Group 1 - illiterates (17.2%), Group 2 - school educated (69.4%), and Group 3 - college educated (13.4%). Chi-square test was applied to evaluate the utilization of dental services by rural women, and logistic regression was applied to evaluate the influence of their educational qualifications on utilization. Results: A total of 604 properly filled questionnaires out of 660 (91.51% response rate) were included in the analysis. Only 56.9% of the sampled rural women indicated that they have visited dentists earlier. The maximum number of individuals who have never visited the dentist belonged to illiterate group (55.7%), and the association was statistically significant (0.004) when compared with educated individuals. Conclusion: The results of this study concluded that the level of education has a significant influence on the utilization of dental care.

Oral Health Issues in Women: An Overview

Oral health is a vital component to a woman’s overall well- being. Oral health conditions and diseases are not gender specifi c but can aff ect women diff erently. The physiological cycle in women’s life have a strong eff ect on the oral tissues. Especially pregnancy is a critical time to address oral health issues, since it has an infl uence on the child’s health. Women also face a lot social barriers which prevent them from seeking oral health care. This review article discusses the various gender related conditions that have to be taken into consideration during diagnosis and treatment of oral conditions.

Accuracy of apex locator for root canal length determination of deciduous molars compared to conventional radiograph

Background: To assess whether apex locators are accurate in determining the root canal length in resorbing roots of deciduous tooth compared to the conventional radiographic method. Materials and Methods: Samples for the study included 30 primary maxillary and mandibular molar root canals in children of age group 5 to 12 years. Root canal lengths were determined with Conventional radiographs, Apex locator and direct measurements using stereomicroscope. Results: When the measurements from radiograph and apex locator were compared with direct measurements, they were non-significant with P value of 0.342 and 0.266 respectively and F value of 0.396 and 0.303, respectively. Conclusions: Apex locator and conventional radiograph both are proven to be accurate in working length determination in primary molars. Apex locators can thus be used in resorbing root canals of deciduous molars obtaining good results with no radiation hazard and processing difficulties. Clinical Relevance to Interdisciplinary Dentistry Working length determination is one of the crucial steps for the final outcome of the endodontic procedure Apex locators work well in fully formed roots, but is it the same in cases of resorbing roots especially as seen in deciduous teeth The answer to the same question may be relevant in roots with external root resorption or in an immature root

A comparative study of shear bond strength of two adhesive liners to nanocomposite

Aim: To compare the shear bond strength of resin-modified glass ionomer and nano-filled flowable composite liners to nanocomposite restorative material. Materials and Methods: In this in vitro study, 24 specimens were prepared in acrylic blocks for the study with 12 in each group. Group I consisted of resin-modified glass ionomer liner (GC Fuji II LC Improved) bonded to a cylinder of nanocomposite (Z350 Universal Restorative) whereas in Group II flowable composite liner (Filtek Z350 Flowable Restorative) was bonded to a cylinder of nanocomposite (Z350 Universal Restorative). Shear bond strength was determined using Instron Universal testing machine. Students independent sample t test was used for analysis. Results: The mean shear bond strength value of Group I was greater than Group II and the difference was statistically significant (P = 0.001). Conclusion: Resin-modified glass ionomer appears to be a more compatible liner under nanocomposite restoration than flowable composite as it exhibited significantly higher shear bond strength. Clinical Relevance to Interdisciplinary Dentistry Resin-modified glass ionomer and flowable composites have been used as liners under resin composite restorations in both primary and permanent teeth to compensate for their polymerization shrinkage. Adequate bonding of liners to composites is as important as bonding to dentin for the success of this technique. Bonding of resin-modified glass ionomer liner to nanocomposite restorative material is better than flowable composite liner and hence should be preferred over flowable composite as a liner.