The Role of Three-Dimensional Imaging (CBCT) in Enhancing Diagnostic Accuracy in Endodontics: A Randomized Controlled Trial

Background

In the field of endodontics, accurate diagnosis is pivotal for successful treatment outcomes. This randomized controlled trial (RCT) explores the potential of cone-beam computed tomography (CBCT) as a tool to enhance diagnostic accuracy in endodontic procedures.

Materials and Methods

An RCT was conducted with a sample of 120 patients presenting with endodontic issues. The patients were divided into two groups: Group A received traditional two-dimensional radiography, while group B underwent CBCT scans. The diagnostic accuracy was assessed by comparing the radiographic findings with the clinical evaluation by experienced endodontists.

Results

The results indicated a significant improvement in diagnostic accuracy in the CBCT group (group B) with an arbitrary value of 88% accuracy, compared with the traditional radiography group (group A) with only 65% accuracy. The CBCT group showed a clearer visualization of root canal anatomy, periapical lesions, and the presence of additional canals, contributing to the enhanced diagnostic capability.

Conclusion

This RCT demonstrates that CBCT significantly enhances diagnostic accuracy in endodontics compared with traditional two-dimensional radiography. The improved visualization of root canal anatomy and periapical regions allows for more precise treatment planning, ultimately leading to better treatment outcomes.

Presurgical Orthopedic Nasoalveolar Molding in Cleft Lip and Cleft Palate: Case Report

Aim and objective

The present clinical report describes management of complete unilateral cleft lip and palate with presurgical nasoalveolar molding (NAM) therapy for infants.

Background

Orofacial clefts have a negative impact on the health and social integration of individuals affected. Patients undergo numerous procedures until they reach adolescence. The ultimate focus of surgical intervention is to improve the esthetic appearance of the lip and nose by improving the lip scar, nasal tip projection, and symmetry of the nasolabial complex.

Case description

This paper discusses a situation in which the parents of a three days old baby with the chief complaint of regurgitation of milk while feeding. On examination, baby had complete left-sided cleft lip and cleft palate (CL+CP).

Conclusion

Before surgery, nasoalveolar molding has been shown to be a useful adjunctive therapy for reducing hard and soft tissue cleft deformity.

Clinical significance

Passive preoperative intervention of the lip and alveolar segments helps to reduce tissue tension and is thought to improve surgical outcomes by minimizing wound healing disturbances and scarring.

How to cite this article

Shaik N, Eggula A, Pudi S, et al. Presurgical Orthopedic Nasoalveolar Molding in Cleft Lip and Cleft Palate: Case Report. Int J Clin Pediatr Dent 2023;16(4):659-662.

Assessing the Pediatricians' Role in Improving Young Children's Oral Health in Telangana State: A Cross-sectional Study

Background

Primary precautionary approaches for oral health is an essential tool concerning public health, as dental caries is one of the eminently prevailing chronic diseases among children across the globe. As pediatricians and pediatric healthcare professionals are more likely to encounter children when compared to general dentists, it is crucial for them to be acquainted with possible risk factors and diseases occurring in early childhood. Therefore, it is highly advocated to take necessary steps at an initial stage to help promote pragmatic results during childhood and succeeding adulthood phases.

Objectives

The pediatrician's attitude toward dental health and his dental screening, counseling, and referral practices.

Material and methods

This was a cross-sectional study in the Hyderabad district, following area sampling on a sample of 200 child healthcare professionals, as calculated based on a pilot study. A definitive and validated questionnaire was used for the collection of data, and pediatric health professionals were approached in their workplaces.

Results

About 44.5% of pediatricians usually check teeth during routine tongue and throat examinations. Around 59.5% of them suspect cavities when the child looks undernourished. A total of >80% of them voted that oral health cannot be neglected, as it is an integral part of a child's general health and dental screening, and referral at regular intervals of time is their responsibility. Only 8.5% advised fluoridated toothpaste, whereas only 62.5% counseled parents on the dental ill effects of nighttime bottle-feeding and digit sucking.

Conclusion

Although all the pediatricians had appropriate attitudes toward oral health, they were not put into action by many.

Dental public health significance

Pediatricians play a vital role as potential partners in the oral health promotion of children and their families. A pediatric primary care provider's regular screening, counseling, and referral would help his/her patients in getting the right treatment done at the right time.

How to cite this article

Reddy SM, Shaik N, Pudi S, et al. Assessing the Pediatricians' Role in Improving Young Children's Oral Health in Telangana State: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(5):591-595.

Sports Cult in Hyderabad: Role of a Pedodontist in Protecting Winning Smile

Aim and objective

To assess dental trauma, level of knowledge of participants about the preventive measures, and management of traumatic dental injuries during sports in children aged 6–15 years in private sports academies in Hyderabad.

Materials and methods

A cross-sectional study was carried out among 317 children aged 6–15 years and 25 coaches by a structured questionnaire to assess the prevalence of dental trauma during sports followed by an awareness program on prevention. Data obtained were analyzed.

Results

Twenty-two percent (76) of children reported an incidence of dental injuries. Thirty-five percent (111) of children were aware that reimplantation was possible. Forty-three percent (139) of children knew that mouthguards can prevent orofacial injuries, but none are using them. Seventy-six percent (19) coaches would refer the child to a general physician in cases of reported trauma.

Conclusion

In our study, most of the children and coaches lack awareness about sports-related dental injuries, their prevention, and initial management. None of the children were using mouthguards. Pediatric dentists should conduct programs at schools/sports academies to spread knowledge and awareness about sports-related dental injuries. Further studies are required in this aspect with a larger sample size.

How to cite this article

Pranitha V, Mounika PBN, Dwijendra SK, et al. Sports Cult in Hyderabad: Role of a Pedodontist in Protecting Winning Smile. Int J Clin Pediatr Dent 2021;14(5):652–656.

Oral health status and treatment needs of children with special health care needs in rural and urban areas of Hyderabad - A cross sectional study

Aim:

The aim of the cross-sectional study was to ascertain the oral health status and treatment needs of special health care need children of age group 3–16 years in rural and urban areas of Hyderabad, Telangana, India.

Materials and Method:

To assess and compare the caries status, oral health status, oral hygiene measures, diet and treatment needs in rural and urban population. The data collected was processed and analyzed using the SPSS statistical software program.

Results:

Among 1000 subjects in rural and urban population highly significant difference was observed for Oral hygiene aids (P < 0.003) and for DMFT (P < 0.008) and no significant difference for dmft (P > 0.26). OHIs status showed no difference in primary and permanent in both rural and urban population (P > 1). Filled and missed were in DMFT, dmft was very low even though there were carious tooth in study population. Most of the children in rural and urban population required varied treatment needs like oral prophylaxis, restoration, pulp therapy, crowns and extractions.

Conclusion:

High prevalence of dental caries and the need for restorative care was noted in these children emphasizing the necessity of change of attitude towards oral health and improved oral care by repeated counselling of parents by primary health care physicians.

Reversal of Compromised Bond Strength of Bleached Enamel Using Cranberry Extract as an Antioxidant: an In Vitro Study

Background and Objectives: Bleaching reduces the bond strength of enamel, if adhesive restorations are carried out immediately. Reversal of compromised bond strength of bleached enamel by application of antioxidant agents has been reported in the literature. The aim of the study is to assess the neutralizing effect of 6% cranberry (CB) solution on the bond strength of bleached enamel compared with that of 10% sodium ascorbate (SA) solution.

Materials and Methods: Enamel surfaces of 64 extracted human premolar teeth were randomly divided into four groups based on the antioxidant used. Further subgrouping was done in Groups II, III, and IV dividing each group into subgroup A and subgroup B of eight teeth each based on whether the bonding was performed immediately or after a delay of 14 days postbleaching respectively. Shear bond strength (SBS) of the specimens was measured using a Universal testing machine. The data were then tabulated and statistically analyzed using one-way ANOVA (analysis of variance) and Tukey’s post-hoc parametric tests. A p-value of <0.05 was considered statistically significant.

Results: The SBS measurements were compared among the four groups including the subgroups. The SBS was highest in the SA delayed bonding group and lowest in the bleached immediate bonding group.

Conclusion: A 10% SA solution has proven superior to 6% CB solution in the reversal of compromised bond strength following bleaching.

P577Early experience with the first pacemakers to directly connect with smart devices for remote monitoring

Background

Remote monitoring is associated with improved patient outcomes; however, adoption and adherence to remote monitoring via home-based consoles remains suboptimal. BlueSync technology in new generation pacemaker and CRT-P models enables the implanted device to communicate directly with patient-owned, Bluetooth-equipped smartphones/tablets and an app (MyCareLink Heart). The app can automatically retrieve information from the cardiac device and transmit the data to the remote network, eliminating the need for traditional remote monitoring consoles.

Objectives

To characterize the communication process between implanted pacemakers and smart device remote monitoring apps by assessing the success of prescheduled remote transmissions in the first month of follow-up. Additionally, to assess the feedback of both patients and clinicians about the process of device pairing.

Methods

Enrollment in the BlueSync Field Evaluation began in April 2018 and was completed November 2018. Follow-up is ongoing. Prior to enrollment in the evaluation, patients completed the device pairing process with the app using their own compatible smartphone or tablet. Patient and clinician questionnaires were completed at the time of the device pairing process. After enrollment, successful completion of scheduled transmissions occurring in the first month were analyzed.

Results

Preliminary data includes 241 enrolled patients with mean age of 64.7±15.5 yrs (min 20, max 90 yrs), who completed device pairing between their implanted device and their smart device app. Of enrolled patients, 79% felt that the device paring was easy to do, 85% were satisfied with the amount of time it took to complete it, and 93% felt that they would be comfortable using the app. Clinicians reported that 67% of the device pairings took less than 20 minutes and 78% felt patients would be able to use the app independently. At the time of analysis 174 patients had at least one scheduled transmission within the first month, and collectively had a total of 322 scheduled transmissions. Out of these, 309 (96%, 95% CI: 93%-98%) were successfully completed.

MyCareLink Heart App

Conclusions

Initial experience with the world's first app based remote monitoring system for Bluetooth enabled pacemakers demonstrated success to scheduled transmissions in the first month across a wide range of patient ages. Patients and clinicians reported high satisfaction with this novel technology.

Acknowledgement/Funding

Medtronic PLC

Fluoride ingestion and thyroid function in children resident of naturally fluoridated areas - An observational study

Background

Literature shows association between systemic fluorides with water fluoride level above 3ppm and endocrine disorders especially related to thyroid. Aim & Objectives: To estimate serum T3, T4, TSH, Fluoride levels among children with normal nutritional status and optimal iodine intake, residing in three different ranges of drinking water fluoride levels below 3ppm.

Material and Methods

Present double blinded observational trial comprised of 293 children aged between 9-13 years consuming naturally fluoridated water of 3 different ranges: Group I: 0.01 - 0.6ppm, Group II: 0.7-1.2ppm and Group III: 1.3-1.8ppm. For each child demographic data, BMI and Clinical Fluorosis Index were recorded along with serum T3, T4, TSH, Fluoride levels. Data was analyzed using Chi Square, Kruskal Wallis test and Repeated measures of ANOVA with SPSS 23.

Results

For serum TSH levels 40% of children of group I had deranged levels followed by group III (20%) and Group II (16%). For serum T4 levels 24% of children of both groups I and III had deranged levels followed by group II (20%). Inter group correlation of drinking water fluoride levels to number of deranged serum T3, T4, and TSH of the children showed non-significant association.

Conclusions

According to the present study results long term intake of fluoridated drinking water (0.02 -1.4 ppm) did not showed effect on the thyroid function in the children with normal nutritional status and optimal iodine intake.

Key words:Iodine, nutrition, serum fluoride, systemic fluoride, thyroid function test.

Fluoride and Thyroid Function in Children Resident of Naturally Fluoridated Areas Consuming Different Levels of Fluoride in Drinking Water: An Observational Study

Background:

Literature shows association between systemic fluorides and endocrine disorders especially related to thyroid, with lack of clarity.

Aims and Objectives:

The aim and objective of this study was to estimate serum triiodothyronine (T3), thyroxin, thyroid-stimulating hormone (TSH), fluoride, calcium, phosphate, and alkaline phosphatase levels among children with normal nutritional status and optimal iodine intake residing in three different ranges of drinking water fluoride levels.

Materials and Methods:

The present double-blinded, observational trial comprised of 293 children aged between 9 and 13 years consuming naturally fluoridated water of three different ranges: Group I: 0.01–0.6 parts per million (ppm), Group II: 0.7–1.2 ppm, and Group III: 1.3–1.8 ppm. For each child's demographic data, body mass index and Clinical Fluorosis Index were recorded along with serum T3, T4, TSH, fluoride, calcium, phosphate, and serum alkaline phosphatase levels. Data were analyzed using Chi–square test, Kruskal–Wallis test, and repeated measures ANOVA with SPSS 23.

Results:

For serum TSH levels, 40% of children in Group I had deranged levels followed by Group III (20%) and Group II (16%). For serum T4 levels, 24% of children of both Groups I and III had deranged levels followed by Group II (20%). Intergroup correlation of drinking water fluoride levels to the number of deranged serum T3, T4, and TSH of the children showed nonsignificant association. Serum T3, calcium, phosphate, and alkaline phosphatase levels in all children showed values falling within normal range.

Conclusion:

According to the present study results, long-term intake of fluoridated drinking water (0.02–1.4 ppm) did not show effect on the thyroid function in children with normal nutritional status and optimal iodine intake.

Effectiveness of Plaque Control with Novel Pediatric Oral Hygiene Need Station (Modified Oral Irrigation Device) as Compared with Manual Brushing and Flossing: Randomized Controlled Pilot Trial

Background:

Establishing good hygiene habits are valuable for present and future oral health. Below 6 years, tooth brushing should be performed by parents, as increasing dexterity and cognition may permit supervised brushing until the child is capable of independent brushing.

Aim and Objectives:

The aim of the present study was to evaluate the effectiveness of modified oral irrigation device in children in terms of plaque control and to compare the effectiveness of plaque control with manual brushing with the modified oral irrigation device in children.

Materials and Methods:

A randomized clinical trial was performed on 12 subjects who were allocated to the two study groups. After obtaining the consent, the control group was instructed tooth brushing with regular pediatric commercially available toothbrush and the intervention group with modified oral irrigation device. Plaque scores in both groups were assessed pre- and post-brushing using modified navy plaque index.

Results:

The data were subjected to Descriptive statistics and Paired t-test using SPSS version 22. Intragroup comparison of mean difference of plaque score in control group and intervention group pre- and post-brushing was statistically significant. Intergroup comparison of manual brushing group with modified oral irrigation group shows P < 0.05 was statistically significant.

Conclusion:

Within the limitation of the present study, it has been found novel pediatric oral hygiene need Station is more effective than manual brushing since it combined the effect of brushing, flossing (water floss), and rinsing in children simultaneously and at the same time did not demand any special motor skill.