Objective: To evaluate the effectiveness of audiovisual (AV) aid in assessing the parental attitude for their child's oral health. Materials and methods: A study (cross-sectional) was conducted in 50 parents of the children between age group of 0 and 14 years. A PowerPoint presentation was given to parents in two batches, and its effectiveness was assessed by comparing results of questionnaire before and after presentation. Data were collected through a questionnaire. Statistical analysis: All data were compiled using MS Office Excel Sheet, and analysis was performed using the Statistical Package for Social Sciences software for descriptive analysis, and the level of statistical significance used in this study was chosen at p value < 0.005. Results: The results proved that selected sample had lack of knowledge regarding primary teeth and its importance, oral health care of the child from birth, ideal time of first dental visit, and preventive treatments before awareness program. But there was significant difference in attitude of parents regarding their child's oral health care after presentation. Conclusion: Within the limitation of the study, the high prevalence dental caries in children showed that change of parental behavior and attitude is much more important rather than focusing on increasing knowledge only. Hence, AV aids can be effective tools for increasing awareness.

Context: Dental caries is the most common oral disease in preschool children. It is considered to be due to multifactorial etiology, affecting primary molars with various caries patterns. Aim: The aim of the study was to determine prevalence and patterns of dental caries in primary molars of preschool children. Prevalence and patterns of dental caries were correlated with age and gender. Settings and design: The study design adopted was analytical observational study. Materials and methods: Caries examination was done using plain mouth mirror, probe, and tweezers with cotton pellets under standardized environment. Children's age was measured in years, and the age in years and months were merged with nearest round off number. Statistical analysis used: Obtained data were subjected to statistical analysis using SPSS software. Test for significance was done with the help of Chi-square test. Results: In Maxilla, max. rt 2nd molars (p value = 0.036), max rt 1st molars (p value = 0.035), max lt 1st primary molars (0.095), and max lt 2nd primary molars (p value = 0.005) showed significantly different caries patterns at different ages of preschool children, while no significant differences were observed in caries patterns in male and female gender. In mandible, man. lt 2nd primary molars (p value = 0.005), and man. rt 2nd primary molars (p value = 0.004) showed significantly different caries patterns in different ages of preschool children, while Mand. Lt 1st primary molars (p value = 0.389) and Mand. Rt 1st primary molars (p value = 0.272) showed nonsignificant differences in caries patterns with different ages of preschool children. A nonsignificant difference in caries patterns was noted in male and female gender. Conclusion: Mandibular primary molars were more vulnerable for caries development when compared to maxillary primary molars in preschool children. The number of caries patterns present in mandibular and maxillary primary molars, were as follows: Mn. Rt 1st PM > Mn. 1st Lt PM & max lt 1st PM > max lt 2nd PM and max rt 1st PM > Mn. Rt 2nd PM > Mn. Lt 2nd PM > max rt 2nd PM.

Background: Fluoride varnish with therapeutic tricalcium phosphate formulas such as Clinpro™ varnish has shown greater tendency in treating white spot lesions (WSLs) by inhibiting the progression of initial enamel lesions through the mineral exchange. The self-assembling peptide SAP₁₁-4 (Curodont Repair, CDR) works on a different scale in treating WSLs by mimicking the enamel matrix and aiming to guided enamel regeneration. Aim: To quantitatively and qualitatively compare the effectiveness of the SAP₁₁-4 vs tricalcium posphate fluoride (TCPF) in remineralization of WSLs in young permanent teeth. Materials and methods: Nine healthy patients were enrolled in this study. The trial was performed on 40 young permanent teeth in the initial demineralization stage. Teeth were randomly assigned to receive either TCPF (group I) or SAP₁₁-4 (group II). Lesions were assessed at pretreatment, 3, and 6 months posttreatment quantitatively per laser fluorescence DIAGNOdent pen and qualitatively through the International Caries Detection and Assessment System (ICDAS) II. Results: The result of the current study revealed a significant quantitative and qualitative increase in remineralization of WSLs in both groups and over time intervals. However, the WSL recovery was significantly better in the self-assembling peptide group, reflecting an excellent remineralization potential of the WSLs by the SAP₁₁-4 compared to TCPF varnish. Conclusion: Both TCPF and SAP₁₁-4 were effective in treating WSLs. However, the success of guided enamel regeneration by the SAP₁₁-4 through the biomineralization has proven superiority of this material compared to TCPF. Clinical significance: Early detection of WSLs and minimal intervention through remineralizing agents can limit unnecessary tissue loss, further caries progression, and consequently prevent further harm to the patients.

Background: The antimicrobial activity of restorative materials has a major role in preventing recurrent caries. Aim: To assess the antimicrobial activity of triphala and propolis-modified glass ionomer cement (GIC) against Streptococcus mutans and Lactobacillus. Materials and methods: The samples were prepared using cylindrical molds (6 mm in diameter and 2 mm in thickness). A total of 30 samples were prepared containing 10 samples in each group. Group I, 10 samples of glass ionomer with aqueous extract of triphala were prepared; group II, 10 samples of glass ionomer with 50% of ethanolic extract of propolis (EEP); and group III as control consisting of 10 samples of glass ionomer. The samples were placed in to agar plates containing inoculum of S. mutans and Lactobacillus and incubated at 37°C for 48 hours and using a digital caliper, zones of inhibition formed around specimens were measured. Results: Data obtained were analyzed using nonparametric Kruskal-Wallis test followed by pairwise comparison was done using Dunn-Bonferroni test. Group I and group II showed highest antimicrobial efficacy against S. mutans and Lactobacillus with no statistical significant difference, i.e., (p value > 0.05) but in both groups I and II, there was a statistical significant difference when comparing with group III i.e., (p < 0.05). Conclusion: Thus, triphala and propolis-modified GIC provided higher antibacterial effect with increased level of inhibition against the S. mutans and Lactobacillus; hence, it can be used as a choice of restorative material to treat dental caries. Further studies are required to determine the physical and mechanical characteristics of the material.

Aim and objectives: To compare coronal tooth discoloration obtained by different endodontic materials—MTA Plus, Bio MTA+, Biodentine. Materials and methods: Pulps in 30 caries-free mandibular and maxillary intact human premolars and molars scheduled for extraction for periodontally compromised reasons were mechanically exposed and allocated to each of the three groups, MTA Plus, Biodentine and Bio MTA+. After the pulpotomy procedure, the base of resin-modified GIC was given and the teeth were filled with composite resin. After extraction, the teeth were stored in artificial saliva and spectrophotometer analysis done eventually at 1, 7, 30, and 60 days later. Images of all teeth were recorded at each interval using a digital camera and the ΔE values for all specimen at interval were recorded and compared. Results: Majority of the specimens showed discoloration after placement of MTA Plus, Biodentine, and Bio MTA+. The statistical analysis showed significant differences between the MTA Plus, Bio MTA+, and Biodentine experimental groups during the observation period. Conclusion: Under the states of this study, compared to Bio MTA+ and MTA Plus, Biodentine created significantly less discoloration. Clinical significance: Mineral trioxide aggregate materials lead to higher amount of discoloration on the tooth surface than Biodentine. Hence, Biodentine should be the material of choice for use in esthetic area to avoid chances of tooth discoloration.

Aim and objectives: The aim of the study was retrospective comparative evaluation of past 3 years’ pediatric oral lesions diagnosed from the Department of Dentistry, UPUMS, Saifai, Etawah, and classification and identification of pediatric oral lesions on the basis of demographic features and histopathological features. Materials and methods: The present retrospective comparative evaluation was done with the help of the last 3 years’ histopathological reports obtained from the Department of Dentistry, U.P. University of Medical Sciences, Saifai, Etawah. Pediatric patients of age 0–17 years divided in three groups included in the study. Results: In our department, out of total 450 histopathological reports, 56 reports were of pediatric cases in which males were 38 and females were 18. Pediatric patients were further divided into three categories: primary dentition period (0–5 years), mixed dentition period (6–12 years), and permanent dentition period (13–17 years). Conclusion: This retrospective study is an effort for classifying and identifying pediatric oral lesions on the basis of demographic features and histopathological features. The majority of the oral lesions detected were benign in nature.

Introduction: Good oral health during pregnancy and infancy is important for the overall health and well-being of mother and child, respectively. Aim: To assess the knowledge and attitude of expectant mothers regarding the effect of their oral health and its influence on infant oral health. Materials and methods: A cross-sectional study was conducted among expectant mothers. They were randomly selected from those reporting to the Department of Gynecology in Government and Private Hospitals in Durg, Chhattisgarh. A total of 124 closed-ended, self-administered questionnaire were filled by participants, which had 21 items addressing the knowledge and attitude of expectant mothers regarding their oral health and oral hygiene practices; the transmission of bacteria from mother to child; cariogenic food consumption; effect of periodontal disease on infant's teeth and safe trimester for dental treatment. Data were tabulated and subjected to statistical analysis. Results: Significant differences were found in expectant mothers’ knowledge and attitude based on their age (p = 0.02, 0.07), education level (p = 0.001, 0.95), trimester (p = 0.83, 0.43), and number of pregnancies (p = 0.05, 0.10), respectively. Conclusion: The knowledge related to the oral health of pregnant women during pregnancy was found to be low and needs to be improved. Clinical significance: Execution of educational programs along with other healthcare professionals to motivate expectant mothers.

Background and objectives: Fragment reattachment procedure provides conservative treatment option when an intact fractured fragment is available. Rewetting of fractured fragment before reattaching has shown better bond strength of attached fragment. Therefore, fracture resistance of reattached fractured fragment with hydration and without hydration was evaluated and compared. Materials and methods: Ellis class II fracture was induced in selected and coded 60 extracted maxillary central incisors using a custom-made-wise and assigned into group I and group II (without hydration and with hydration) and both the groups were further divided into two groups (1 week and 3 months). In group I, fractured fragments were reattached after bench-drying for 24 hours. In group II, fractured fragments were reattached after hydrating for 1 hour following bench-drying for 24 hours. Composite (Filtek Z350 XT, Universal Restorative, 3M ESPE) was used to reattach the fractured fragments. Reattached fractured fragments were stored in artificial saliva for 1 week and 3 months and subjected to fracture resistance test using Universal Testing Machine. The data obtained were tabulated and statistically analyzed. Results: Fracture resistance in hydration samples was higher than without hydration at the end of 1 week and 3 months statistically. Fracture resistance of fractured fragment at the end of 3 months was higher in both with hydration and without hydration but was not significant with hydration. Conclusion: Hydration of fractured fragment before reattachment procedure has shown better fracture resistance and improved further after storing in artificial saliva for 3 months.

Aim: To assess the effects of different bleaching procedures on the mineral component and surface topography of the enamel using scanning electron microscope (SEM) and energy-dispersive X-ray spectrometry (EDX). Materials and methods: Forty samples of approximately 3 × 3 mm size from the coronal portion of 20 extracted human anterior teeth were obtained. The samples were divided into two control groups and three experimental groups. In group I or positive control (n = 5), no bleaching or phosphoric acid treatment to the enamel surface was done. Group II samples or negative controls (n = 5) were treated with 37% phosphoric acid. In group III (n = 10), the tooth was treated with 35% hydrogen peroxide (HP) without any activation. Group IV (n = 10) was treated with 37.5% HP with LED light activation and group V (n = 10) was treated with 45% HP with diode laser activation. The calcium (Ca) and phosphorus (P) levels of each sample were measured using an EDX system prior to bleaching treatments. All the samples were again subjected to the EDX analysis after the bleaching treatment and two samples (after EDX analysis) from each group were subjected to the SEM analysis. Result: No significant difference was seen in phosphorus levels before and after the bleaching. However, significant increase in calcium levels was observed after bleaching activated with LASER and LED light. The SEM observations revealed maximum surface alterations on the enamel after chemically activated bleaching. Conclusion: The LASER-activated bleaching agent seems to be more surface-friendly and less time-consuming as compared to other bleaching systems.

Context: Several efforts were made in order to alter the compositions of acidic food items concerning their properties to be able to reduce their erosivity potential. The addition of combinations of calcium and phosphate salts to these food products has grabbed great interest. Aim: In vitro evaluation of the effect of the addition of 0.2% w/v casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) to four commonly available beverages (of which two were carbonated) on enamel erosion. Materials and methods: Sound-extracted human third molar teeth were taken, and enamel sections (n = 270) were made and polished. Acid-resistant nail varnish was painted to create an exposed enamel window of 1 mm², followed by testing of the four soft drinks and distilled deionized water (DDW). Every drink was evaluated with and without the addition of 0.2% w/v CPP–ACP. The enamel specimens were kept in 50 mL solution at 37°C for 30 minutes, rinsed, and then varnish was removed. All samples were then profiled using white-light profilometer, and erosive depths were recorded. Statistical analysis: One-way analysis of variance test and post hoc Tukey test. Results: Enamel erosion was created by all the soft drinks tested, but the addition of 0.2% w/v CPP–ACP has remarkably reduced (p value < 0.05) erosive depths in all test solutions compared to solutions without CPP–ACP. The erosive depths for solutions with DDW did not vary much from those with 0.2% CPP–ACP. Conclusion: Addition of 0.2% w/v CPP–ACP to the soft drinks has remarkably reduced their erosivity potential.

Aim: To know the association of sense of coherence (SOC), caries experience, and socioeconomic status (SES) in 11–16-year-old schoolchildren. Materials and methods: This cross-sectional study included a total of 595 schoolchildren aged 11–16 years, and informed consent was obtained. Demographic and socioeconomic data were collected through pro forma filled by the parents. Sense of coherence of children was recorded with SOC-13 item questionnaire given in both English and local language (Telugu). Caries experience was recorded with DMFT index by carrying out the intra-oral examination of children. Results: In a total of 595 schoolchildren, 35% children have weak SOC, 34.9% have moderate SOC, and 29.9% have strong SOC. Caries experience was inversely associated with SOC (p value = 0.006) on analysis by ANOVA. On multivariate regression analysis, it was observed that for every one-unit increase in SOC, caries experience decreased by 0.11 unit. However, there was statistically no significant (p value = 0.09) relation between childhood SES and SOC. Age (p value = 0.08) and gender (p value = 0.19) are not associated with SOC. Conclusion: Sense of coherence influences the caries experience irrespective of socioeconomic status, age, and gender of the child. Clinical significance: Children having stronger SOC have increased likelihood to seek out preventive dental services, which helps in maintaining good oral health. SOC is structured mainly by the experiences during the early years of life. Therefore, SOC can be strengthened by interventions in the early life through school dental health programs.

Aim: The orthodontic treatment planning relies on correct diagnosis of skeletal discrepancy, which demands accurate and precise cephalometric parameters. This study proposed an angle, which is based on unvarying cephalometric points and gives a true sagittal skeletal maxillomandibular relationship. Materials and methods: The present study was conducted on 279 individuals (13–30 years), which were divided into three groups (class I, II, and III skeletal malocclusion) depending on beta, wits, and ANB (A point, Nasion, B point) angles. Tau angle was measured, which lied at the junction of lines connecting the points T to G and G to M. ANOVA and the Dunnett T3 post hoc test were used to discern difference between three skeletal patterns. The gender difference in each skeletal pattern was found using the unpaired Student's t-test. Receiver-operating characteristic (ROC) curves determined the Tau angle's sensitivity and specificity to differentiate among skeletal patterns. Results: The Tau angle between 28° and 34° suggests a skeletal class I malocclusion; values below 28° show a class III skeletal pattern and above 34° suggest skeletal class II pattern. Conclusion: Tau angle gives a true sagittal skeletal relationship, which depends on stable landmarks and is unaffected by rotation of jaws in vertical dimension due to growth or orthodontic therapy. Clinical significance: Tau angle provides a demarcation among three skeletal malocclusions, which can be an important tool for treatment planning in pediatric patients having both anteroposterior and vertical dentofacial discrepancies.

Background: Developmental defects of enamel especially enamel hypomineralization are prevalent among children. Hypomineralized second primary molars (HSPM) present a serious clinical dilemma for the current practitioners. It represents as a potential predictive factor for molar incisal hypomineralization (MIH). The reported prevalence of HSPMs in India however still remains uncertain. Methodology: A total of 649 children aged 6–10 years were randomly selected from various schools in Delhi NCR. The teeth were indexed for developmental defects of enamel using modified European Academy of Paediatric Dentistry judgment criteria given by Ghanim et al. Results: A total of 83 HSPMs were observed in 33 of the 649 subjects examined, with a prevalence of 5%. Molars affected had prevalence of 62.88%, with two deciduous molars being most commonly affected. Of the defects present, creamy white opacities were most common followed by yellowish brown opacities. Posteruptive breakdowns (PEB) were more commonly associated with yellowish brown opacities. Conclusion: The prevalence of HSPMs in Delhi, NCR was 5%. Creamy white opacities were the most common lesion present.

This study was conducted to assess or evaluate the influence of parental employment on the child's oral and dental health. Aims and objectives: This study aims to assess the repercussions of working parents in Jammu belonging to nuclear and joint families on the oral and dental health of children aged 2–14. Materials and methods: A cross-sectional study was conducted in which a total of 1,848 children were examined from March 01, 2012, to February 28, 2014, who came to seek treatment in the Department of Pediatric and Preventive Dentistry, Indira Gandhi Govt. Dental College and Hospital, Jammu, along with the accompanying parents. Assessment was based on the following parameters: dental caries, eruption status of teeth, and orthodontic status. Results: Age-wise distribution of the patients was done in four groups, 2–5 years (33%), 5–8 years (30%), 8–11 years (21%), and 11–14 years (16%), and were examined as per the above-mentioned criteria. The results were compiled and statistically analyzed using Chi-square test. Children of working parents exhibited more incidence of dental caries which was statistically analyzed (p value = 0.111) and was found insignificant and when analyzed as per the retained deciduous teeth and orthodontic anomalies (p value <0.05) was found to be highly significant. Also, children belonging to the nuclear families whether employed or unemployed were found to be more affected by the above-mentioned dental diseases. Conclusion: It was seen that the children whose both parents were working had more incidence of dental caries, over-retained deciduous teeth, and were possessing habits that lead to orthodontic anomalies.

Background: Dental profession is labeled as a high-risk profession, due to which dental care professionals are under tremendous pressure during the outbreak of COVID-19 pandemic. The aim of this study was to assess the psychological impact of the COVID-19 pandemic on dental interns in Riyadh, Saudi Arabia. Materials and methods: A cross-sectional study was conducted among dental interns from different universities in Riyadh, Saudi Arabia. The data were collected using a validated Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Descriptive statistics were presented using frequencies (n) and percentages (%). Chi-square and Fisher exact tests were used to assess the association between sociodemographic data (age, gender, nationality, marital status, and history of physical and mental illness) and levels of depression, anxiety, and stress. A p < 0.05 was considered as statistically significant. Results: A total of 160 dental interns were invited to participate in this survey; out of which 110 participants responded yielding a response rate of 78%. The mean age of the study participants was 25.1 years. About 65% of the participants were female. Only 14.5% of the subjects reported having a past history of physical or mental illness. Depression, anxiety, and stress were identified in 11.9%, 7.3%, and 0.9% of the dental interns, respectively. Demographic characteristics did not appear to influence depression, anxiety, or stress levels (p > 0.05). Conclusion: The outbreak of COVID-19 pandemic has affected the mental health of dental interns. The presence of depression, anxiety, and stress among dental interns highlights the need for special intervention and support programs to promote mental health and well-being among dental interns.

Aim: This present longitudinal, quantitative, and analytical pilot study evaluated the impact of daily indirectly supervised toothbrushing on water consumption. Materials and methods: The study was carried out in a social center that provided care to children aged 5–14 years in Campinas in the state of São Paulo. Calibrated hydrometers were installed on taps used by the children, and the daily volume of water used was measured for 25 school days (T0). An educational program was then implemented (T1), where supervised toothbrushing was explained, encouraged, and put into action. The next phase (T2) incorporated a recreational approach to the rational use of water, and the consumption was measured for another 25 school days. After six months (T3) without further educational interventions by the researchers, water consumption was measured for the same period of 25 school days. The data were analyzed based on the mixed models methodology for measures repeated over time. Results: The water consumption did not change significantly (p > 0.05) between the different phases of the study (T0 = 0.43 ± 0.19, T1 = 0.38 ± 0.17, T2 = 0.39 ± 0.15, T1 = 0.48 ± 0.21 dm³/day/child). Conclusion: The introduction of toothbrushing into the routine of the children, in the context of recreational and sustainable health education, did not have a detrimental impact on water consumption. Clinical significance: Among the many recommendations for the introduction and implementation of supervised toothbrushing programs in school environments, there is no mention of the measures taken during such procedures aimed at economizing water, the rational use of which should be a daily practice irrespective of the water conditions of the surrounding region. The findings of this study contribute to the enhancement of educational and pedagogical activities in schools.

Aim: The aim of the study was to clinically and radiographically evaluate the efficacy of formocresol, Allium sativum oil, and Aloe barbadensis gel as pulpotomy medicaments in primary molars. Materials and methods: Eighty-two primary molars indicated for pulpotomy were included in the study. The molars included were divided into three groups by simple random sampling, and treatment was done with formocresol as control, comparing it with Aloe barbadensis gel and Allium sativum oil. Results: The teeth were then followed up for 6 and 12 months clinically and radiographically. Chi-square test was used to compare the clinical and radiographic results between the groups. McNemar test was used to compare the clinical and radiographic results at 6 and 12 months. The results revealed that there was no significant difference between the groups when comparing the experimental groups to the control. Conclusion: The study shows that Aloe barbadensis gel and Allium sativum oil may be used as an alternative to formocresol as pulpotomy medicaments.

Aim: Pulpectomy in the primary tooth has unique challenges due to morphological variations in root pattern and physiological root resorption. The electronic apex locator (EAL) is one of the recent methods to determine the estimation of working length without much radiation exposure to the patient as well as the operator. The present study was undertaken for evaluating and comparing the efficacy of EAL, conventional radiography, digital radiography, and actual visual method for the estimation of in the root canal working length (RCL) in extracted primary teeth. Materials and methods: Ninety extracted, single-rooted primary teeth were selected. Working length estimation was done with an EAL, conventional, and digital radiographic method, and compared it with an actual visual method. Results: Accuracy of EAL was observed to be 99.7% followed by digital radiograph (98.1%) and conventional radiograph (96.1%). Both EAL and digital radiographic methods showed a high correlation as compared to conventional. The comparative efficacy of an EAL with a visual method was found to be statistically non-significant (p > 0.005). Conclusion: Root canal working length determined through the electronic method was found to be an accurate and effective tool in single-rooted primary teeth and can be indicated for clinical implementation in endodontic treatment of primary teeth.

Objective: To compare the efficacy of two intravenous combinations of drugs ketamine–propofol (KP) vs ketamine–dexmedetomidine (KD) for sedation in children undergoing dental treatment. Study design: Thirty patients were selected, evaluated according to the predetermined criteria and divided in equal numbers of 15 amongst 2 groups KP and KD. Materials and methods: Informed consent was taken, nil per oral (NPO) guidelines were followed and the study drug was administered. Dental procedure was performed. Heart rate (HR), blood pressure (BP) and oxygen saturation (SPO₂) were monitored continuously throughout the procedure. The modified Ramsay sedation (MRS) score was recorded along with Houpt sedation score. Recovery status was accessed by modified Aldrete's recovery scale. Statistical analysis: Student t test was used for comparing HR, BP and SPO₂. Chi-square test was used to compare MRS, Houpt sedation score and modified Aldrete's recovery scale amongst the two groups KP and KD. Results: The sedation achieved with both the groups was adequate. Both the drugs produce adequate hemodynamic stability. Conclusion: Ketamine–dexmedetomidine has a better efficacy over the other group, ketamine–propofol.

Introduction: An accurate impression is one of the prime factors for success of any restoration, more so in field of fixed prosthodontics. The critical aspect is to reproduce fine surface details along with ease of use. Knowledge of impression materials and the techniques to which each is best suited is essential in achieving consistent results. Objective of the study: The purpose of this study is to evaluate the accuracy of various putty-wash techniques in a laboratory model that simulated the clinical practice. Materials and methods: A metal master model, containing three full crowns fixed partial denture (FPD) abutment preparations, was fabricated. A perforated custom tray was fabricated that can be placed in the same position on the master model for each impression. For each technique, 10 impressions of the master model were made and poured using a die stone. The measurements were made of the models using a measuroscope and the accuracy of the impressions was recorded. Results: The statistical comparison between groups I, II, III, and IV casts measurements by using the Mann–Whitney test showed highly significant statistical difference between the various groups from each other (p < 0.001) Conclusion: The accuracy of the working casts obtained from group III impression (two-step using 1 mm coping) was the best, whereas it was least with group II impression (two-step using polyethylene spacer).

Introduction: Among the various plants studied, cinnamon has emerged as a potential herbal antimicrobial agent. Besides the medicinal plants, recently probiotics have also been recognized to affect cinnamon bark oil Streptococcus mutans (S. mutans) and other harmful oral and gut microflora. Aim and objective: This placebo-controlled study aims to compare the antimicrobial potential of cinnamon bark oil incorporated and probiotic blend [Lactobacillus plantarum (TSP-Lp1), and Lactobacillus rhamnosus (TSP-Lrh1)] incorporated mucoadhesive patch against salivary S. mutans in caries active 7–10-year-old children. Design: It was a double-blinded placebo-controlled study with n = 60. They were randomly allotted into three groups—Group I: Cinnamon patch, group II: probiotic patch, and group III: control patch (placebo) with n = 20 in each group. Materials and methods: The study was carried out in three phases. In the first phase, the minimal inhibitory concentration (MIC) of cinnamon bark oil was determined against S. mutans followed by the formulation of cinnamon and probiotic patches. After a washout period of 2 weeks and a collection of baseline saliva samples, these patches were tested on the subjects from respective groups for 14 days with twice a day placement protocol. On the 15th day, saliva samples were collected and cultured, CFU/mL of the saliva of S. mutans for each subject was recorded and compared with baseline samples. Feedback in the form of a questionnaire was obtained from the patients. Statistical analysis: Descriptive statistics, paired t-test for intragroup comparison, unpaired t-test for intergroup comparison, analysis of variance (ANOVA) for intergroup comparison, and post hoc Scheffe's. Results: The results showed that both cinnamon patch and probiotic patch were comparable to each other in terms of their anti-S. mutans activity. The intragroup comparison of the CFU/mL count showed a highly significant reduction from baseline to post-intervention for both the groups (p = 0.001). Conclusion: Both cinnamon and probiotic blend have a strong antimicrobial property owing to their ability to cause significant reduction in salivary S. mutans and both the patches showed good patient acceptance.

Aim and objective: The purpose of this systematic review is to analyze the suitability of the zirconia crowns for restoration of damaged primary teeth in children. Background: This systematic review has been conducted in line with the preferred reporting items for systematic reviews (which is also called as PRISMA) guidelines. A search for the relevant articles of zirconia crowns in deciduous teeth has been made in electronic database of PubMed and a study design (meta-analysis), i.e., PICOS framework. The words used in the search are “zirconia crowns” and “primary molars,” “zirconia crowns” and “primary incisors,” “zirconia crowns” and “children,” “zirconia crowns” and “primary teeth.” Review results: The database search showed 44 studies of which 20 articles were excluded as they were irrelevant, duplicates, and data were not available. In the present systematic review, the remaining 24 articles were included. Conclusion: Zirconia crowns have been proved with better results than other crowns in terms of gingival and periodontal health, esthetics, and crown fractures. However, the quantity of tooth preparation and the wear of antagonist tooth are reported to be more in case of zirconia crowns. Future randomized control studies should be carried out in primary teeth due to less number of randomized studies on this topic. Clinical significance: Zirconia crowns are now widely used in dentistry and there is an increase in the number of studies, so a systematic review evaluating and comparing results is warranted.

Background: Combined use of povidone iodine (PI) along with topical fluorides (TF) has been suggested as a promising strategy to reduce dental caries incidence and cariogenic bacterial load. However, the available literature presents mixed evidence regarding its effectiveness as compared to TF application alone. Aim and objective: ‘TF + PI’ vs TF alone in the prevention of dental caries among 1–12-year-old children assessed through caries increment and mean S. mutans and Lactobacillus counts. Materials and methods: Five databases (Cochrane Central Register of Controlled Trials, EBSCOhost, PubMed/Medline, Scopus, and Web of Science) were searched for relevant literature. Out of 72 studies that were screened, 7 eligible studies were included out of which 4 studies were subjected to meta-analysis. The generic inverse variance test was used to assess the primary outcome reported as mean ± SD/ events occurred (caries incidence), whereas for mean post-intervention S. mutans colony count, inverse variance function was used. The Cochrane's Collaboration tool and Modified Downs and Black scoring criteria were used to evaluate the quality of the included articles. Heterogeneity across the studies was assessed using the I² statistic. Statistical significance was set at p < 0.05. Results: Overall, for primary and permanent dentition combined, the dental caries incidence was found to be significantly lower in the ‘TF + PI’ combined therapy group as compared to TF alone [SMD −0.4 (−0.78 to −0.03), p = 0.04]. The two groups showed no significant difference with respect to post-intervention S. mutans count [SMD −0.1 (−0.57 to +0.37), p = 0.69]. No study was found that compared post-intervention Lactobacillus count between the two groups. Conclusion: Based on the pooled analysis from the limited literature available, there is a very low quality of evidence that ‘TF + PI’ combined therapy is more effective in the prevention of new caries lesions among 1–12-year-old children as compared to TF use alone. Future clinical trials with robust methodologies are recommended to generate conclusive evidence. Clinical significance: PI application might exert an added benefit with TF in preventing the occurrence of new carious lesions among 1–12-year-old children.

Introduction: Moyamoya disease (MMD) is a rare neurovascular disorder that is characterized by chronic progressive stenosis at the apices and bilateral occlusion of the intracranial internal carotid arteries. The occlusion is gradual in manner; multiple anastomoses are formed between the internal and external carotid arteries. The incidence of MMD has increased in Asian countries with a decline in Europe and United States. Case description: The case report describes the specific clinical features and dental treatment in a 12-year-old male presenting with MMD with right-side hemiplegia. The patient presented with broken tooth in the upper front tooth region due to trauma. The dental treatment plan focused on providing restorative as well as preventive care to the patient. Clinical significance: The patients with MMD have an increased risk of stroke development, which may be aggravated by pain or anxiety. It is necessary to avoid cerebral ischemic attacks caused by fluctuating BP and respiration. It becomes imperative to maintain normocapnia, normotension, and pain control during the procedure in order to prevent postoperative ischemic complications. Dental professionals must attain a complete knowledge of this disease and perform the dental treatment in pain and stress-free manner.

Aim and objective: To report a case with Floating–Harbor syndrome (FHS), emphasizing the general features and dental abnormalities and the treatment procedures and its outcome. Background: FHS is an extremely rare genetic disorder, characterized by a triad: short stature, speech delay, and characteristic facies like triangular shape, bulbous nose, wide columella, deep-set eyes, long eyelashes, thin lips, short philtrum, and broad mouth. Approximately 50 cases have been described in the medical literature till date. Diagnosis is often delayed because the characteristic features of this syndrome are nonfamiliar. Case description: A male child aged 5 years was referred to the dental OPD with the chief complaint of decayed upper and lower front and back teeth. On examination, the patient was found to have FHS along with the dental caries. Conclusion: FHS is a rare genetic dysmorphic/mental retardation syndrome affecting both sexes but more among the female sex. There is no known cure for the disease and the treatment is symptomatic and supportive. Clinical significance: An early diagnosis of FHS is important, as it enables with adequate information. These multiple malformations identification by an early diagnosis is crucial, as it requires a multidisciplinary approach in the initial evaluation, treatment, and follow-up.

VPS45-associated severe congenital neutropenia type V (VPS45-associated SCN5) is an autosomal recessive disorder caused by defective endosomal intracellular protein trafficking due to mutations in VPS45 underlies a reduced absolute neutrophil count >500 cells/mm³ and impaired neutrophil function. VPS45-associated SCN5 is a very rare condition with only 19 patients previously reported in the literature. Patients suffering from this disorder having profound neutropenia in the first months of life, fever, pneumonitis, skin infections, oral ulcerations, and gingivitis. This paper reports the first two cases of VPS45-associated SCN5 in Saudi Arabia and describes the treatment approaches for periodontal disease as a manifestation of that disorder since the existing dental literature is lacking sufficient information on the management of those kinds of patients. The present two cases reflect the importance of early diagnosis of periodontal disease as a possible indicator of underlying systemic disease.