Aim: This study was undertaken to evaluate the percentage of gutta-percha-filled area (PGFA) using microscopic analysis of the cross-sections in the apical third of root canals when filled either with Thermafil technique, Warm Vertical Condensation technique and Cold Lateral Condensation technique without using sealers. Materials and methods: Sixty single rooted extracted permanent teeth were collected. After crown amputation, the teeth were randomly divided into three experimental groups of 20 specimens each. Group I—thermafil obturation technique, group II—warm vertical condensation obturation technique and group III—cold lateral condensation obturation technique. Obturation was performed by specific techniques without using sealers. After obturation, the teeth were cross-sectioned horizontally at 2 to 3 mm from apex with the help of double sided diamond disk. Sections were digitally photographed and measured under Stereomicroscope at magnification of 50×.   Using a KS 100 imaging system the area of canals and the gutta-percha was recorded, also the percentage of gutta-percha filled area (PGFA) was calculated. The observations thus obtained were subjected to statistical analysis using ANOVA and student ‘t’ test. Results: Maximum group difference was observed between groups I and III (3.558 ± 0.138) while minimum difference was observed between groups I and II (1.223 ± 0.137). Thus, all the between group differences were statistically significant. Conclusion: This study supports the belief that the Thermafil Obturation technique produces significantly higher percentage of gutta-percha filled area (PGFA) than the warm vertical condensation technique or cold lateral condensation technique.

Objective: To do a comparative study of microleakage of glass ionomer cement (GIC) and chitosan modified glass ionomer cement and evaluate which exhibited lesser microleakage. Materials and methods: Sixty freshly extracted sound primary molar teeth were obtained. Two groups of samples were created for the study which comprised of group I (glass ionomer cement—GIC) and group II (Chitosan modified glass ionomer cement). Class V cavities were prepared on the buccal surfaces. All the tooth surfaces except the restoration and a 1 mm zone adjacent to its margins were covered with two coats of varnish. The specimens were then immersed in 2% basic fuschin dye solution for 24 hours. The teeth were sectioned into two halves buccolingually in an occlusoapical direction. Sections were viewed under stereomicroscope and the degree of microleakage was evaluated using specific scoring criteria. For comparative evaluation of microleakage scores between glass ionomer cement and chitosan modified cement, a nonparametric Mann-Whitney statistical analysis was done. Results: Statistical analysis showed no significant differences between groups I and II with the p-value at >0.05. Conclusion: Chitosan modified GIC holds great promise for general dentistry as a future restorative material with microleakage properties similar to or better than GIC. How to cite this article: Abraham D, Thomas AM, Chopra S, Koshy S. A Comparative Evaluation of Microleakage of Glass Ionomer Cement and Chitosan-modified Glass Ionomer Cement: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):6-10.

Background: Many chemomechanical caries removal (CMCR) agents have been introduced and marketed since 1970s, with each new one being better and effective than the previously introduced. Papacarie and Carisolv are new systems in the feld of CMCR techniques. These are reportedly minimally invasive methods of removing carious dentin while preserving sound dentin. Aim: To compare the Efficiency (time taken for caries removal) and effectiveness (Knoop hardness number of the remaining dentin) of caries removal by three minimally invasive methods, i.e. hand excavation and chemomechanical caries removal using Carisolv and Papacarie. Materials and methods: Thirty recently extracted human permanent molars with occlusal carious lesions were divided randomly in three equal groups and bisected through the middle of the lesion mesiodistally and excavated by two methods on each tooth. Results: Statistically significant difference was present among three methods with respect to time and knoop hardness values (KHN) of the remaining dentin. Conclusion: The Efficiency of Hand method is better compared to CMCR techniques and effectiveness of CMCR techniques is better than Hand method in terms of dentin preservation so the chances of maintaining vitality of the pulp will be enhanced. How to cite this article: Boob AR, Manjula M, Reddy ER, Srilaxmi N, Rani T. Evaluation of the Efficiency and Effectiveness of Three Minimally Invasive Methods of Caries Removal: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):11-18.

Objective: Objectives of our studies were to predict dental fear in a child patient depending on salivary alpha amylase (sAA) level before and after dental treatment and to evaluate correlation of later with behavior of child patient during dental treatment. Materials and methods: Seventy-seven children between age of 5 and 12 years were divided in three groups. Group 1 consisted of 25 school children who did not undergo any dental treatment. Groups 2 and 3 underwent dental treatment without and with local anesthesia respectively. Groups 2 and 3 were administered child fear survey schedule-dental subscale (CFSS-DS) questionnaire before treatment. Salivary samples were collected for sAA estimation in groups 2 and 3 children before and after completion of dental treatment and behavior during treatment was noted using Frankel behavior rating scale. Group 1 acted as control in which salivary sample was collected in absence of dental stress. Results: When groups 2 and 3 were combined, pretreatment sAA level had a statistically significant (p = 0.0094) correlation with CFSS-DS scores. Conclusion: Alpha amylase can be used as a screening tool to predict level of dental fear in a child patient. How to cite this article: Noorani H, Joshi HV, Shivaprakash PK. Salivary Alpha Amylase as a Noninvasive Biomarker for Dental Fear and Its Correlation with Behavior of Children during Dental Treatment. Int J Clin Pediatr Dent 2014;7(1):19-23.

Objectives: The study is to evaluate changes in microhardness of enamel after exposure to acidic center filled chewing gum on primary and permanent teeth. Methods: Thirty primary and 30 permanent molar extracted teeth were painted with acid resistant varnish except a small window over buccal surface. Teeth were divided into four groups according to type of teeth and type of chewing gum (Center fresh and Bubbaloo) (D₁, P₁, D₂ and P₂); each tooth was exposed to whole chewing gum mashed with 5 ml of artificial saliva for five minutes at room temperature twice a day for 5 days. After the exposure, teeth were stored in deionized water and submitted for microhardness tests. Results: Paired t-test and independent sample t-test were used for statistical analysis. A significant reduction in microhardness was found between exposed and unexposed areas in all groups. There was no statistically significant difference in reduction of microhardness to chewing gums, and between primary and permanent enamel. Conclusion: There is a definite reduction in microhardness in all groups exposed to chewing gums. Both the chewing gums are equally erosive; both permanent and primary teeth were affected. How to cite this article: Mudumba VL, Muppa R, Srinivas NCH, Kumar DM. Evaluation and Comparison of Changes in Microhardness of Primary and Permanent Enamel on Exposure to Acidic Center-filled Chewing Gum: An in vitro Study. Int J Clin Pediatr Dent 2014;7(1):24-29.

Ergonomics is much broader than preventing work-related musculoskeletal disorders. The successful application of ergonomics assures high productivity, avoidance of illnesses and injuries, and increased satisfaction among workers. Unsuccessful application, on the other hand, can lead to work-related musculoskeletal disorders (MSDs). This article sets forth broad important background information on ergonomics so that the dental practitioner can have a general awareness of ergonomic risk factors as well as some basis for understanding the ongoing dialogue about ergonomics, its diagnosis, treatment, and regulation. This article provides alternatives to be considered by the practitioner in light of the practitioner's own circumstances, experiences and goals. A practitioner wishing to improve his or her work environment, for whatever reason, may wish to follow an incremental approach to such efforts, as is briefly discussed here. How to cite this article: Gupta A, Bhat M, Mohammed T, Bansal N, Gupta G. Ergonomics in Dentistry. Int J Clin Pediatr Dent 2014;7(1):30-34.

Successful root canal treatment depends on the thorough management of the canal anatomy. The use of periapical radiographs is essential to identify and monitor the canal's morphological variations. The C-shaped single canaled mandibular 2nd molar probably requires a different regimen of treatment from the two rooted, three canaled version, as it is rare. Because of the importance of its true diagnosis and treatment, a comprehensive review of published information and investigations about it in addition to approaches for its treatment is necessary. In this article, a detailed review and three case reports with different C-shaped canal confgurations have been described which were successfully negotiated, prepared and obturated. How to cite this article: Raisingani D, Gupta S, Mital P, Khullar P. Anatomic and Diagnostic Challenges of C-Shaped Root Canal System. Int J Clin Pediatr Dent 2014;7(1):35-39.

Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the developing dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42.

Epidermal nevi are hamartomas that are characterized by hyperplasia of the epidermis and adnexal structures, and may be associated with serious disfiguration. Germline mutations in the FGFR3 gene have found to be the etiology of epidermal nevus. Patients often seek treatment from dermatologic surgeons but even an alert dentist can help to diagnose the lesion from its clinical appearance. Various treatment modalities are available and it is the clinician's choice to choose depending upon the patient's condition. How to cite this article: Arora B, Khinda VIS, Bajaj N, Brar GS. Congenital Epidermal Nevus. Int J Clin Pediatr Dent 2014;7(1): 43-46.

‘Copper beaten’ skull refers to the prominent convolutional markings seen in multiple bones of the skull. Underlying cause is thought to be related to increased intracranial pressure resulting from such processes as craniosynostosis, obstructive hydrocephalus and/or intracranial masses. However, the copper beaten appearance of the skull has poor sensitivity in detecting increased intracranial pressure as such an appearance can also be seen in normal patients. In this article, we have reported a case of a 5 years old child with classical features of beaten silver skull. How to cite this article: Desai V, Priyadarshini SR, Sharma R. Copper Beaten Skull! Can It be a Usual Appearance? Int J Clin Pediatr Dent 2014;7(1):47-49.

Odontomas are a common type of odontogenic tumor, usually asymptomatic and mostly detected on routine radiographic examination. An 11-years-old male child with the chief complaint of mobility of deciduous dentition in the upper front region was diagnosed with an odontome with an impacted central incisor, missing lateral incisor and retained deciduous incisors following radiographic analysis. Histopathology revealed a compound odontoma following a conservative enucleation. Odontomas associated with primary dentition, impacted teeth and erupting into oral cavity have been described, but the association with a missing lateral incisor makes this an interesting case report. How to cite this article: Nammalwar RB, Moses J. A Rare Association of Compound Odontome with Missing Lateral Incisor. Int J Clin Pediatr Dent 2014;7(1):50-53.

Dentigerous Cyst/developmental cyst of benign odontogenic origin are ones that surround the crown of impacted, embedded, unerupted or developing teeth. Dentigerous cyst is second most common cyst of the oral cavity after radicular cyst. They are usually solitary in occurrence and mostly associated with the mandibular third molars. Dentigerous cysts involving impacted second premolars are rarely reported in the literatures. We present a rare case of dentigerous cyst in a 12-year-old female patient associated with an impacted mandibular second premolar. How to cite this article: Mishra R, Tripathi AM, Rathore M. Dentigerous Cyst associated with Horizontally Impacted Mandibular Second Premolar. Int J Clin Pediatr Dent 2014;7(1): 54-57.

Failure of eruption of primary teeth can be considered rare, especially in maxillary anterior teeth. The problem can be either mechanical obstruction of eruption or a failure of the eruption mechanism. This case report presents failure of eruption of the maxillary right deciduous central incisor in a 4-year-old girl. The unerupted primary tooth was removed surgically. The histological finding revealed fibroma with reactive giant cells. Periodic follow-up visits were advised to monitor the developing dentition and to ensure enough space for the permanent incisor. How to cite this article: Shakra KA. Management of Unerupted Maxillary Deciduous Central Incisor: A Case Report. Int J Clin Pediatr Dent 2014;7(1):58-60.

Metallic foreign bodies are rarely found in the maxillary sinus, and usually they have a dental origin. Two main surgical approaches are currently used for the removal of foreign bodies in the maxillary sinus: the bone flap and the endoscopic sinus techniques. However, the treatment is not only surgical removal. We are reporting one case of foreign body like a hand sewing needle entered into the maxillary sinus through an unusual route—carious deciduous molar tooth. It was diagnosed by three-dimensional images from cone-beam computed tomography (CBCT) and removed by a simple procedure, with magnetic iron, thereby avoiding the risk of damage to a large portion of the alveolar bone near the maxillary sinus. How to cite this article: Shao L, Qin X, Ma Y. Removal of Maxillary Sinus Metallic Foreign Body Like a Hand Sewing Needle by Magnetic Iron. Int J Clin Pediatr Dent 2014;7(1):61-64.

Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. The Efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case of trauma in permanent right central maxillary incisors with tooth fragments embedded in the lower lip. Thorough clinical examination followed by soft tissue radiographs confirmed the presence of a fractured incisal fragment, which was surgically retrieved under local anesthesia. Direct composite restoration was placed. After finishing and polishing, an esthetic and natural-looking restoration was achieved; this completely satisfied the functional and esthetic expectation of the patient and dental team. How to cite this article: Avinash A, Dubey A, Singh RK, Prasad S. Surgical Removal of Coronal Fragment of Tooth Embedded in Lower Lip and Esthetic Management of Fractured Crown Segment. Int J Clin Pediatr Dent 2014;7(1):65-68.

Apert's syndrome (acrocephalosyndactyly) is a rare congenital disorder characterized by craniosynostosis, midfacial malformation and symmetrical syndactyly of hands and feet. Craniofacial deformities include cone-shaped calvarium, flat forehead, proptosis, hypertelorism and short nose with a bulbous tip. Intraoral findings include high arched palate with pseudocleft, maxillary transverse and sagittal hypoplasia with concomitant dental crowding, skeletal and dental anterior open bite and several retained primary teeth. We report one such case of 14-year-old boy having all the classical features of Apert's syndrome with particular emphasis on brief review of genetic features. How to cite this article: Kumar GR, Jyothsna M, Ahmed SB, Lakshmi KRS. Apert's Syndrome. Int J Clin Pediatr Dent 2014;7(1):69-72.