Background: Chlorhexidine gluconate is a widely used antimicrobial agent. Adding chlorhexidine and quaternary ammonium compounds to filling materials, such as composite resins, acrylic resins, and glass ionomer cements increases the antibacterial property of restorative materials. This study includes antibacterial property of glass ionomer restorative cements with chlorhexidine gluconate. Aim: The primary objective of our study was to compare the antimicrobial properties of two commercially available glass ionomer cements with and without chlorhexidine gluconate on strains of mutans streptococci. Materials and methods: Two glass ionomers (Fuji II Conventional and Fuji IX) were used. Chlorhexidine gluconate was mixed with glass ionomer cements, and antimicrobial properties against mutans streptococci were assessed by agar diffusion. The tested bacterial strain was inhibited and the antimicrobial properties decreased with time. Results: The highest amount of antimicrobial activity with mean inhibitory zone was found in Fuji II with chlorhexidine gluconate followed by Fuji IX with chlorhexidine gluconate, Fuji II without chlorhexidine gluconate, and Fuji IX without chlorhexidine gluconate. Conclusion: The results of the study confirmed that the addition of 5% chlorhexidine gluconate to Fuji II and Fuji IX glass ionomer cements resulted in a restorative material that had increased antimicrobial properties over the conventional glass ionomer cements alone for Streptococcus mutans. How to cite this article: Yadiki JV, Jampanapalli SR, Konda S, Inguva HC, Chimata VK. Comparative Evaluation of the Antimicrobial Properties of Glass Ionomer Cements with and without Chlorhexidine Gluconate. Int J Clin Pediatr Dent 2016;9(2):99-103.

Aim: To evaluate the prevalence of various gingival biotypes and to corroborate gingival thickness and gingival biotypes across tooth type, site, and gender. Materials and methods: A cross-sectional study was conducted across systemically healthy subjects. A systematic clinical evaluation for gingival biotypes and gingival thicknesses was recorded by modified Iwanson's gauge, to the nearest 0.1 mm, probing the gingival sulcus at the midfacial aspect of maxillary and mandibular central incisors and first molars. All measurements were made across a total of 920 sites in 115 subjects (69 female and 46 male) based on gingival transparency and were statistically analyzed. Results: A significant agreement on the reproducibility of the measurements was noted. The median overall gingival thickness was recorded at 0.75 mm with interquantile difference of 0.39 mm. The thin biotype variant showed across the ranges of 0.3 to 0.6 mm of gingival thicknesses and thick biotype variant across the ranges of 1.0 to 1.2 mm, with more prevalence in anterior and posterior site respectively. Moreover, for gingival thickness of 0.7 mm, the probe visibility showed tendency toward both thin/thick biotype variant in both anterior and posterior segments. The disposition of male participants toward thick biotype and female participants toward the thin biotype variant has been noted. Conclusion: Within the limitations of the current study, our data support the traditional hypothesis of two main gingival biotypes as distinguishable by gingival transparency. In addition, we provide evidence of existence of intermediate biotypes with respect to gingival thickness. These findings can be utilized as objective guidelines for determination of biotype and can be implicated in many dental operative procedures. How to cite this article: Rathee M, Rao PL, Bhoria M. Prevalence of Gingival Biotypes among Young Dentate North Indian Population: A Biometric Approach. Int J Clin Pediatr Dent 2016;9(2):104-108.

Aim: The aim of this study was to compare the survival of composite resin restorations retained by glass fiber posts or reversed-orientated (upside-down) metal posts in severely decayed primary anterior teeth after 6, 12, and 18 months. Materials and methods: A total of forty-four 3- to 5-year-old children with bilateral severely decayed primary maxillary canines were included. Patients were treated under general anesthesia. After pulpectomy, an intracanal post was seated in the primary maxillary canine on each side: either a glass fiber post or a metallic post in reversed orientation and teeth restored with light-cured composite. Survival rate of each technique was evaluated at predetermined follow-ups and data were analyzed with McNemar's test (α = 0.05). Results: The difference in survival of restorations retained by two types of posts was not statistically significant in clinical and radiographical evaluations after 6, 12, and 18 months. The survival rate of reversed-orientated metal and glass fiber posts after 18 months was 81.1 and 67.6% respectively (p = 0.14). Conclusion: Reversed-orientated metal post did not show lower clinical survival compared with glass fiber posts in 18-month follow-up. Hence, reversed-orientated metal post can be considered as a potential method to obtain retention for composite restorations in severely decayed primary anterior teeth. How to cite this article: Vafaei A, Ranjkesh B, Løvschall H, Erfanparast L, Jafarabadi MA, Oskouei SG, Isidor F. Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts. Int J Clin Pediatr Dent 2016;9(2):109-113.

Background: Streptococcus mutans (ATCC25175) has a profound effect on the incidence of dental decay in the human population. Many studies have been performed to assess the antimicrobial activity of different cements. However, little or no information is available about the antibacterial properties of Type II glass ionomer cement (GIC), Type IX GIC, and AMALGOMER™ ceramic reinforcement (CR). Aim: To comparatively evaluate the antibacterial activity of Type II GIC, Type IX GIC, and AMALGOMER™ CR by modified direct contact test. Materials and methods: The total sample size was 72 which was divided into four study groups. Six wells were coated by each: Type II GIC, Type IX GIC, AMALGOMER™ CR, and control group (only S. mutans). Statistical analysis was done using analysis of variance and the intergroup comparison was done using post hoc Tukey test. Results: AMALGOMER™ CR was found to have a better antibacterial effect as compared with Type II and IX GIC. Conclusion: AMALGOMER™ CR can serve as a valuable cement in pediatric dentistry due to its anticariogenic property. How to cite this article: Hugar SM, Assudani HG, Patil V, Kukreja P, Uppin C, Thakkar P. Comparative Evaluation of the Antibacterial Efficacy of Type II Glass Ionomer Cement, Type IX Glass Ionomer Cement, and AMALGOMER™ Ceramic Reinforcement by Modified “Direct Contact Test”: An in vitro Study. Int J Clin Pediatr Dent 2016;9(2):114-117.

Aims: The aim of this study was to evaluate the effectiveness of two different varieties of electronic apex locators and radiovisiography (RVG) for working length determination in primary teeth. Materials and methods: A total of 30 primary teeth indicated for pulpectomy in children aged 3 to 8 years were randomly selected and subjected to working length determination using two varieties of electronic apex locators and RVG separately. The data were then subjected to statistical analysis. Results: A very strong correlation between electronic measurement methods and RVG length was observed. Conclusion: Radiovisiography and apex locators are equally effective in determining working length in primary teeth. How to cite this article: Abdullah A, Singh N, Rathore MS, Tandon S, Rajkumar B. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo. Int J Clin Pediatr Dent 2016;9(2):118-123.

Objectives: The aim of this study was to compare the cleaning efficacy and instrumentation time between manual Hedstrom files (H-files) and rotary Mtwo files in primary molar root canals. Materials and methods: A total of 90 primary root canals were selected using standardized radiographs. The canals were injected with India ink with 30 gauge insulin syringe and divided into three groups. Group I—30 root canals instrumented with H-files, group II—30 root canals instrumented with Mtwo files, and group III—control group in which no canal instrumentation was done. The teeth were cleared in various solutions and then observed under a stereomicroscope. Results: No significant difference was seen in cleaning efficacy between H-files and Mtwo files in coronal, middle, and apical thirds of the root canal. The instrumentation time recorded for H-files (3.41 ± 0.38 minutes) was significantly less than that of Mtwo files (4.81 ± 0.52). Conclusion: Although there was no significant difference in cleaning capacity, further studies should be carried out using the single file systems. How to cite this article: Katge F, Chimata VK, Poojari M, Shetty S, Rusawat B. Comparison of cleaning Efficacy and Instrumentation Time between Rotary and Manual Instrumentation Techniques in Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2016;9(2):124-127.

Aim: The aim of the study is to determine how rural children view children with visible incisor fracture. Materials and methods: Class 7 (aged 11–12 years) and class 10 (aged 14–15 years) schoolchildren (the participants) were invited to make a social judgment about the color photograph of two children (the subjects). Participants were randomly allocated either (i) pictures of children without incisor fracture or (ii) pictures of the same children whose photographs had been digitally modified to visible incisor fracture. Using a child-centered questionnaire, participants rated subjects using a four-point Likert scale for three negative and six positive attributes. Total attribute scores were tested for significant differences, according to whether the subject had visible incisor fracture or not, using multivariate analysis of variance (p < 0.05). Results: Both class 7 and 10 children rated subjects with visible incisor fracture more negatively than the subjects without incisor fracture. Female participants of class 10 have rated the male subject with incisor fracture significantly negatively (p < 0.01) than male subject without incisor fracture. How to cite this article: Venkatesan R, Naveen M, Teja R, Paulindraraj S, Vallabhaneni SK, Arumugam SB. Psychosocial Effects of Fractured Anterior Teeth among Rural Children. Int J Clin Pediatr Dent 2016;9(2):128-130.

Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138.

Lesch–Nyhan syndrome (LNS), a rare inborn error of metabolism, is characterized by self-injurious behavior, which results in partial or total destruction of oral and perioral tissues and/or fingers. Persistent self-injurious behavior (biting the fingers, hands, lips, and cheeks; banging the head or limbs) is a hallmark of the disease. Prevention of self-mutilation raises significant difficulties. A case of a 10-month-old boy with aggressive behavior and severe lower lip injuries is presented. How to cite this article: Jathar P, Panse AM, Jathar M, Gawali PN. Lesch–Nyhan Syndrome: Disorder of Self-mutilating Behavior. Int J Clin Pediatr Dent 2016;9(2):139-142.

In a child with cleft lip and/or palate, nutrition is the first priority as for any other child. These children have specific physical limitations. To fulfill their nutritional requirement, these children need modifications in order to thrive and grow. Failure to adjust to these needs could place the children into a potential life-threatening situation. One of the immediate problems to be addressed in a newborn with cleft lip/palate is difficulty in feeding. Nasal regurgitation and choking are common because of inability of the palate to separate the nasal and oral cavities. The case presented here discusses the management of feeding problem in the infant with cleft lip/palate. How to cite this article: Goswami M, Jangra B, Bhushan U. Management of feeding Problem in a Patient with Cleft Lip/Palate. Int J Clin Pediatr Dent 2016;9(2):143-145.

One of the most challenging tasks for a pediatric dentist is the management of deleterious oral habits which adversely affect the dentofacial complex. However, if these habits can be intercepted and diagnosed well in time, they can save the patient from the psychological impact of undergoing long treatment therapies. One such rare deleterious oral habit is cheek biting that affects the buccal mucosa. Presented here is a case report which describes the interception of this deleterious habit in a 15-year-old female child who was a bilateral cheek biter with the help of an innovative intraoral appliance: The cheek plumper. How to cite this article: Rana V, Srivastava N, Kaushik N, Panthri P. Cheek Plumper: An Innovative Anti-cheek Biting Appliance. Int J Clin Pediatr Dent 2016;9(2):146-148.

A case report of a 6-year-old male child who reported with recurrent oral and skin ulcerations since childhood and was diagnosed as lipoid proteinosis manifesting with generalized thickening, hardening, and scarring of the skin and hoarseness of voice; is presented here. How to cite this article: Mittal HC, Yadav S, Malik S, Singh G. Lipoid Proteinosis. Int J Clin Pediatr Dent 2016;9(2):149-151.

Dilaceration of the permanent tooth usually is a consequence of traumatic injuries to the primary teeth. Although it may appear anywhere in the long axis of the tooth, i.e., crown, cementoenamel junction, or root, most often the root is involved. However, crown dilaceration is a rare condition representing 3% of the total injuries. Maxillary incisors are more susceptible to such injury and affected tooth may either erupt buccally or lingually or remain impacted. Hitherto, the treatment options also differ as per the clinical scenario. This article proposes a novel technique of restoring esthetic function of the affected permanent maxillary lateral incisor with crown-root dilaceration while preserving the vitality of tooth. How to cite this article: Achary RC, Ravi GR. A Novel approach of Esthetic Management and preserving Vitality of Dilacerated Permanent Maxillary Lateral Incisor. Int J Clin Pediatr Dent 2016;9(2):152-155.

Cysticercosis is a condition in which a human acts as the intermediate host of the pork tapeworm Taenia solium. Although cysticercosis is a common disease in some regions of the world and can occur in any body site, oral lesions are rare. In this report, we document the case of oral cysticercosis in a 10-year-old boy who sought treatment for an asymptomatic nodule on the dorsal surface of the tongue. A detailed history, thorough clinical examination, morphological appearance and the histopathologic findings of the excised cyst formed the basis for the diagnosis of the lesion. How to cite this article: Goenka P, Sarawgi A, Asopa K, Gumber P, Dutta S. Oral Cysticercosis in a Pediatric Patient: A Rare Case Report with Review. Int J Clin Pediatr Dent 2016;9(2):156-161.

Introduction: This cross-sectional retrospective study was designed to assess the relationships among breastfeeding duration, nonnutritive sucking habits, convex facial profile, nonspaced dentition, and distoclusion in the deciduous dentition. Materials and methods: A sample of 415 children (228 males, 187 females) aged 4 to 6 years from a mixed Indian population was clinically examined by two orthodontists. Information about breastfeeding duration and nonnutritive sucking habits was obtained by written questionnaire which was answered by the parents. Results: Chi-square test did not indicate any significant association among breastfeeding duration, convex facial profile, and distoclusion. Statistically significant association was observed between breastfeeding duration and nonspaced dentition and also between breastfeeding duration and nonnutritive sucking habits. Nonnutritive sucking habits had a statistically significant association with distoclusion and convex facial profile (odds ratio 7.04 and 4.03 respectively). Nonnutritive sucking habits did not have a statistically significant association with nonspaced dentition. Conclusion: The children breastfed ≤ 6 months had almost twofold increased probability for developing sucking habits and nonspaced dentition, respectively, than the children who had breastfeeding ≥ 6 months duration. It can also be hypothesized that nonnutritive sucking habits may act as a dominant variable in the relationship between breastfeeding duration and occurrence of convex facial profile and distoclusion in deciduous dentition. How to cite this article: Agarwal SS, Sharma M, Nehra K, Jayan B, Poonia A, Bhattal H. Validation of Association between Breastfeeding Duration, Facial Profile, Occlusion, and Spacing: A Cross-sectional Study. Int J Clin Pediatr Dent 2016;9(2):162-166.

Aims: To determine the prevalence of molar incisor hypomineralization (MIH) in Indian children and to analyze the possible etiological factors. Materials and methods: First permanent molars and all permanent incisors were examined in 1,369 children aged 8 to 12 years. Examinations were performed by two calibrated observers. The subjects were evaluated using judgment criteria proposed by Weerheijm et al in 2003. The parents accompanying children were given a questionnaire regarding pre- and postnatal history of the children. Results: A total of 191 children were diagnosed with MIH with a prevalence of 13.9%. Chi-square/Fisher exact test was used to compare the dichotomous variables. The relative risk with its 95% confidence interval was calculated to find the risk of clinical infections, such as chicken pox, jaundice, renal disorders, cardiac disorders, and affected molars with sex and type of delivery. Pre- and postnatal history of infection in a child was significantly correlated with the prevalence of MIH. Conclusion: The prevalence of MIH was 13.9% in the age group of 8 to 12 years. Prenatal and postnatal infections play an important role in hypomineralization of molars and incisors. How to cite this article: Mishra A, Pandey RK. Molar Incisor Hypomineralization: An Epidemiological Study with Prevalence and Etiological Factors in Indian Pediatric Population. Int J Clin Pediatr Dent 2016;9(2):167-171.

Aims: The aim of this study was to assess the knowledge, attitude, and behavior of school children towards oral health. Settings and design: Descriptive study. Materials and methods: School children (n=700) aged between 10 to 14 years in a Davangere school were recruited into this study. The subjects completed a questionnaire that aimed to evaluate young school children's behavior, knowledge, and perception of their oral health and dental treatment. Statistical analysis: The results were statistically analysed and percentage was calculated. Results and conclusion: The participant oral hygiene habits (such as tooth brushing) were found to be irregular, and parent role in the oral hygiene habits of their children was limited. The study population showed higher awareness of caries than periodontal conditions. The children in this study also recognized the importance of oral health. The results of this study indicate that Comprehensive oral health educational programs for both children and their parents are required to achieve this goal. How to cite this article: Vishwanathaiah S. Knowledge, Attitudes, and Oral Health Practices of School Children in Davangere. Int J Clin Pediatr Dent 2016;9(2):172-176.

Aims: The aim of this study was to evaluate the knowledge and awareness among parents and general dental practitioners regarding rehabilitation with full coverage restoration in children following pulp therapy. Materials and methods: A multiple choice questionnaire was given to 1,000 parents and 400 general practitioners in this multicentric trial. The questionnaire assessed their beliefs, knowledge regarding care of primary teeth, assessment of treating children, and knowledge regarding importance of primary teeth. All the questionnaires were then compiled and statistically analyzed using Statistical Package for Social Sciences (SPSS) software. Results and discussion: 53% parents did not know the importance of primary teeth and 73% parents also thought that no treatment is possible for pulpally involved primary teeth. 20% parents believed that root canal treatment can be possible for children and only 10% knew about full coverage restorations. 40% of the general dentists felt that the best treatment in the case of primary necrotic teeth is extraction and only 13% knew about stainless steel crowns. 62% of general dental practitioners pointed out patients’ noninterest in providing crowns whereas 68% parents reported non-information by dentists. Conclusion: Both parents and general dental practitioners have incomplete and inadequate knowledge regarding full coverage restorations, and we need to improve the knowledge and dental awareness of the parents and the general dental practitioners. How to cite this article: Moda A, Saroj G, Sharma S, Gupta B. Knowledge and Awareness among Parents and General Dental Practitioners regarding Rehabilitation with Full Coverage Restoration in Children: A Multi-centric Trial. Int J Clin Pediatr Dent 2016;9(2):177-180.