Purpose: The most common chronic disease of childhood is early childhood caries which is five times more prevalent than asthma and seven times higher than that of allergic rhinitis. Most children do not receive dental care until they are three years old, yet by the time more than thirty percent of children from lower socioeconomic groups already have caries. To determine the prevalence and severity of early childhood caries among pre-school children, to describe the child characteristics associated with the development of early childhood caries and to find the association of early childhood caries and maternal risk factors. Materials and Methods: This descriptive study was carried out among children attending the immunization clinic of Sree Avittam Thirunal Hospital, Medical College, Trivandrum and children attending the randomly selected Anganwadies and Day care centres in Trivandrum, the capital of Kerala, wherein there are migrants from all over the State. A total of 350 children aged 12-36 months and their mothers were studied. The mother was first interviewed by a structured questionnaire; then the child's and mothers clinical examination was carried out covering caries experience and oral hygiene status. Results: Among 350 children studied the prevalence of dental caries in this study population was found to be 50.6 %( 177). Statistically significant associations were found between the severity of decay and the child's age(P<0.001), female gender(P<0.05),low socioeconomic status (P<0.05), feeding frequency (P<0.05), type of feeding(P<0.01), fell asleep with nipple in mouth (P<0.05), duration of breast feeding(P<0.001), consumption of cariogenic type of snacks(P<0.01), age of commencement of tooth brushing(P<0.05), brushing frequency(P<0.05), oral hygiene status of child(P<0.001), DMFS scores of mothers (P<0.001), and oral hygiene status of mother (P<0.001).

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Aim : The present study was conducted to determine and compare the shear bond strengths of Conventional glass ionomer; Resin-modified glass ionomer; Polyacid-modified composite and Composite Resin, and to assess and determine the mode of failure (adhesive, cohesive, mixed). Materials and Methods : Occlusal dentin of 40 extracted human teeth were randomly divided into four groups of ten teeth, each based on the restorative materials tested as follows: Group I: Conventional Glass Ionomer Cement (Control); Group II: Resin-modified Glass Ionomer Cement; Group III: Polyacid-modified Composite Resin; Group IV: Hybrid Composite Resin. The bonded materials were subjected to shear bond strength (SBS) testing in a Instron Universal Testing Machine (UTM) at a crosshead speed of 0.5 mm/min. The bond failure location was examined by the use of a stereomicroscope at 10× magnification. The mean SBS of Groups I-IV obtained was 3.81, 9.71, 11.96 and 18.16 MPa, respectively. Comparison of mean shear bond strengths of all groups was done by one way ANOVA test and comparison of means in between groups by the Student's t test. Conclusion : It is concluded that the compomer restorative materials show higher shear bond strength than conventional glass-ionomer and resin-modified glass-ionomer, but less than composite resin.

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Aims and Objectives : To compare the marginal sealing ability of ormocer with a hybrid composite using an ormocer based bonding agent and a conventional fifth generation bonding agent. Materials and Methods : Fifty four human premolars were randomly distributed into four test groups of 12 teeth each and two control groups of 3 teeth each. Class I occlusal preparation of 1.5 mm depth were made in each tooth. These were restored using the adhesive and restorative material according to the group. The restorations were finished using a standard composite finishing and polishing kit. Thermocycling between 5 ^o C and 55 ^o C was carried out. Having blocked the root apex and the entire tooth surface except 1 mm around the restoration margin, the teeth were immersed in 2% methylene blue for 48 hours, after which the dye penetration through the margins of each sample was studied under a stereomicroscope. Results and Discussion : Group IV (Admira with Admira Bond) showed the minimum marginal leakage with a mean of 0.200 mm. Four samples in this group showed no microleakage at all and a maximum of 0.400 mm was seen in one sample. Group II (Spectrum TPH with Admira Bond) showed the maximum leakage with a mean of 0.433 mm. One sample showed as much as 1.00 mm of microleakage. Admira when used with Admira Bond showed lesser microleakage than Spectrum TPH used with Prime & Bond NT, the difference being statistically insignificant.

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Aim : The paper aims to present a study conducted in Dera Bassi, Mohali, India. The purpose of the study was to ascertain the prevalence of traumatic dental injuries (TDI) in children of age group 7-12 years in private schools in Gulabgarh village. Material & Method : Age & sex distribution, etiological factors, risk factors and cause of injury were the parameters taken into consideration. The data collected was processed and analyzed using the SPSS statistical software program. Results : The overall prevalence of dental trauma was 14.5%, amongst the 880 subjects examined, out of which, 63.2% males and 36.4% females were found to be affected. The maxillary central incisor was found to be most commonly affected tooth (43.8%). The most common cause of injury reported was fall during playing (37.5%). Conclusion : Enamel fracture was most prevalent (50%). No risk factor was significantly higher than others; however children with Angle's class II div 1 malocclusion exhibited greater risk factor for traumatic injuries.

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Objective : To evaluate and compare the retention, marginal discoloration, surface texture and anatomical form of pit and fissure sealants. Materials and Methods : Thirty children between the ages of 6 and 10 years, who were attending the school health program regularly, had participated in the study. A split-mouth design was used in which the two fissure sealants (Helioseal-F and Glass ionomer Fuji VII) were randomly placed in 60 matched contralateral pairs of permanent molar teeth. Sealants were rated by a single trained and calibrated examiner using mouth mirrors and probes following the US Public Health Service criteria. The sealants were evaluated at 3 months, 6 months and 1 year intervals. Results : The data obtained for retention, marginal discoloration, surface texture and anatomical form of pit and fissure sealants were tabulated and compared statistically using the Chi-square test of significance. Conclusion : The Helioseal-F sealant was better than the Glass ionomer Fuji VII sealant with respect to retention, anatomical form and surface texture. Both the materials showed similar results with respect to marginal discoloration.

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Context: Polymerization shrinkage in composite resins is responsible for microleakage. Methacrylate-based composite resins have linear reactive groups resulting in high polymerization shrinkage. A recently introduced composite resin Filtek P90 is based on siloxanes and oxiranes which polymerize by cationic "ring opening" polymerization resulting in reduced polymerization shrinkage. Objectives: Aim of this study was to compare microleakage in class II cavities restored with a nanoceramic restorative (Ceram X) and a silorane composite (Filtek P90). Materials and Methods: Standardized class II box type cavities were prepared on mesial (Groups Ia and IIa) and distal (Groups Ib and IIb) surfaces of twenty extracted permanent molar teeth with gingival floor ending 1 mm coronal and apical to the cementoenamel junction, respectively. The teeth in Group Ia and Ib were restored with Ceram X and Group IIa and IIb with Filtek P90. The specimens were thermocycled and microleakage evaluated. Statistical Analysis Used: The data were statistically analyzed using Wilcoxon Signed-Rank test at the 0.05 level of significance. Results: Mean microleakage score of group la and lb was 1 ± 2.260 and 2.8 ± 1.229, respectively. And that of group Ila and llb was 0.2 ± .869 and 0.3 ± .588, respectively. When groups I and II were compared, results were statistically significant (P<0.05). Conclusion: It was concluded that silorane-based composite may be a better substitute for methacrylate-based composites.

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Ameloblastic fibroma and related lesions constitute a group of lesions, which range in biologic behaviour from true neoplasms to hamartomas. This group of lesions is also sometimes referred to as mixed odontogenic tumors and usually includes ameloblastic fibroma, ameloblastic fibrodentinoma and ameloblastic fibro-odontoma. Despite numerous efforts however, there is still considerable confusion concerning the nature and interrelationship of these mixed odontogenic tumors and related lesions. The malignant counterpart of these lesions namely aameloblastic fibrosarcoma, ameloblastic dentinosarcoma and ameloblastic odontosarcoma respectively are said to arise secondarily in their benign counterpart or de novo. Recurrence of the benign lesion raises the risk towards malignant transformation therefore a radical surgery should be planned inspite of enucleation or curettage. Here we present a case of an aggressive ameloblastic fibrodentinoma which was radically excised in the light of clinical and histological presentation followed by reconstruction of mandible.

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The cemento-ossifying fibroma is classified as a fibro-osseous lesion of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. A case of cemento-ossifying fibroma involving the left mandible is described in a 35 year old female patient. The clinical, radiographic and histological features as well as surgical findings are presented. The cemento-ossifying fibroma is a central neoplasm of bone as well as the periodontium which has caused considerable controversy because of the confusion regarding terminology and the criteria for its diagnosis.

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Aim: To evaluate and compare the pH and antibacterial property of Ca(OH) ₂ combined with iodine potassium iodide (IKI) or chlorhexidine (CHX) on E. faecalis and to assess and compare their effect on fracture resistance of root dentin. Materials and Methods: CHX (0.5%) The following test materials were used: Group I Calcium hydroxide + saline, Group II Calcium hydroxide + CHX (0.5%) and Group III Calcium hydroxide + IKI (2%). For antibacterial activity, 60 root dentin blocks (20 in each group) were infected by E. faecalis followed by placement of medicaments. At the end of 24 h and 7 days, 10 samples from each group were randomly chosen and assessed for antibacterial activity. For evaluation of root strength, 30 teeth were used and stored in sterile saline after placement of medicament. At the end of 30 days, samples were subjected to fracture resistance testing on the Universal Strength Testing Machine. Hounsfield strength testing machine, UK pH of the various calcium hydroxide combinations was determined with a digital pH meter. Statistical analysis : Kruskal Wallis test, Mann Whitney U test, and one-way ANOVA test for intergroup comparison and Wilcoxon's signed rank test and student's paired t test for intragroup comparison. Results : Group III showed significantly greater antibacterial activity against E. faecalis, followed by group II and control group. There was no statistically significant change in the pH and root strength values among all the groups. Conclusion : The present study revealed that IKI or CHX in combination with Ca(OH)2 is an effective medicament against E. faecalis.

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Early Childhood Caries (ECC) is a devastating form of dental decay having a multi - factorial origin. This study was undertaken to determine the prevalence of ECC in Bangalore city, South India, and also to study its associated risk factors. Random sample of 1500 children, aged between 8 - 48 months, was selected from play homes and nursing homes of various parts of the city. Dental caries was recorded according to World Health Organization criteria. Information regarding risk factors for caries was obtained through a structured questionnaire given to mothers or caretakers. The data was subjected to statistical analysis. The prevalence of ECC was 27.5% and the mean decayed, extracted and filled tooth index was 0.854. There was a strong association of ECC with the risk factors studied.

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Introduction : The premature loss of primary teeth may reduce arch length required for the succeeding tooth and, hence, predisposes crowding, rotation and impaction of the permanent teeth. There are only limited studies carried out about the prevalence of early loss of primary teeth. Aim : The present study was performed to evaluate the prevalence of early loss of primary teeth in school children in Chidambaram town in Tamilnadu, India. Settings and Design : A total of 1121 school children (561 boys and 560 girls) between 5 and 10 years of age were selected for the study. Materials and Methods : An experienced examiner performed all clinical examinations under natural light. Data including age and missing tooth was collected. Statistical Analysis Used : Microsoft Excel/2000 (Microsoft Office XP) data spreadsheet was used and later exported to the Statistical Package for Social Science (SPSS) for Windows (version 10.0). Descriptive statistics was applied and, from the results, chi-square tests were applied at a level of significance of 5% (P < 0.05). Results and Conclusions: The results showed that 16.5% of the sample had early loss of primary teeth, but no differences were observed between genders (P > 0.05). The greatest prevalence was found among the 8-year olds (5.08%), and the most commonly missing teeth were the right lower primary first molars (16.82%). It can be concluded that the prevalence of early loss was high and that the lower primary molars were the most commonly missing teeth in the present study

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Obstructive sleep apnea syndrome (OSAS) is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty.

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Melanotic neuroectodermal tumor of infancy is a very rare benign but locally aggressive neoplasm of neural crest origin with a high recurrence rate. It usually affects infants of less than 1 year of age. Most commonly, the lesion affects the maxilla followed by skull, mandible, brain and other extracranial sites. We report an 11-month-old female baby with a similar tumor involving the anterior region of maxilla along with a brief review of the literature and differential diagnosis. A wide surgical excision was performed by an intraoral approach. A 2-year follow-up of the patient showed no recurrence.

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Lymphangioma is a benign hamartomatous hyperplasia of lymphatic vessels. Majority of them are superficial, but a few may extend deeply into the connective tissue. Intraoral lymphangiomas occur more frequently on the dorsum of tongue, followed by palate, buccal mucosa, gingiva, and lips. Surgical excision is the treatment of choice. The prognosis is good for most patients, although large tumors of neck/tongue may result in airway obstruction and death. This case report series discusses the clinical features, histopathology, and treatment of lymphangioma.

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Objective: Verrucous lesions of the oral cavity can be of varied histopathology. The present study evaluates the clinico-pathological features of verrucous lesions of the oral cavity and analyzes the treatment outcomes. Materials and Methods: This is a retrospective study of 15 consecutive patients who presented with verrucous lesions of the oral cavity, during the 5-year period from January 2006 to December 2010. Demographic, clinico-pathological features, treatment details, and outcomes were analyzed. Results: Fifteen patients with verrucous lesions of the oral cavity were treated with surgery as the primary modality. The mean age was 62.8 years (range 35-85 years). Wide excision of the primary lesion with adequate mucosal and soft-tissue margins was carried out. Free-flap reconstruction was done in eight patients. All patients remain loco-regionally controlled with good functional speech and swallowing outcome. Conclusions: Verrucous lesions of the oral cavity are a distinct clinical entity with varied histopathology. A surgical excision with wide margins and appropriate reconstruction is necessary to optimize the disease and functional outcome.

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Epidermal nevi are hamartomatous lesions that are typically present at birth, but can occur anytime during childhood and may rarely appear in adulthood. An estimated one-third of individuals with epidermal nevi have involvement of other organ systems; hence, this condition is considered to be an epidermal nevus syndrome. There are four distinct epidermal nevus syndromes recognizable by the different types of associated epithelial nevi: linear sebaceous nevi, linear nevus comedonicus, linear epidermal nevus, and inflammatory linear verrucous epidermal nevus (ILVEN). Each type may be regarded as a part of a syndrome with other systemic manifestations. We report a rare case of ILVEN syndrome in a 23-year-old female patient with a wide spectrum of mucosal, cutaneous, and skeletal abnormalities, demonstrating the polymorphic presentation of this condition.

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Objective : To provide information on the state of occlusion and the spaces available after complete eruption of the primary dentition and to compare the characteristic features of the primary dentition in Chennai and Hyderabad, two of the metropolitan cities in South India. Materials and Methods : Children in the age range between 3 and 5 years were selected from different schools of both Chennai and Hyderabad, with a complete set of primary dentition. Study casts were obtained and assessment of spacing in the primary dentition and the primary molar relationship were recorded in centric occlusion. The data obtained was subjected to statistical analysis. Results : The mean values and standard deviations for the primary molar relationship and spacing in primary dentition are given in the tables. Conclusion : Bilateral flush terminal plane relationship of the second primary molars and spaced dentition was most frequent in primary dentition of the children in both Chennai and Hyderabad groups. Significant differences were not found among both groups and genders.

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Hypophosphatasia is a congenital disease characterized by deficiency of serum and tissue non-specific alkaline phosphatase activity. The disease occurs due to mutations in the liver/bone/kidney alkaline phosphatase gene. Six clinical forms of hypophosphatasia are recognized. Systemic symptoms of the disease are respiratory complications, premature craniosynostosis, widespread demineralization and rachitic changes in the metaphases, stress fractures, chondrocalcinosis and osteoarthropathy. Characteristic dental symptoms include premature loss of deciduous teeth, premature exfoliation of fully rooted permanent teeth, severe dental caries and alveolar bone loss. This clinical report describes the prosthetic rehabilitation of a sixteen year old female patient with hypophosphatasia with partial anodontia and no occlusion. Patient was managed clinically by saving her remaining teeth, fabricating a maxillary overdenture and mandibular cast partial denture. This not only helped her functionally in biting and chewing food and achieving a good occlusion, but also restored her confidence and self image by improving the aesthetics.

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Epidermolysis Bullosa (EB) is a form of severe skin adhesion defect due to the disruption of the dermal- epidermal junction. It is classified into simplex and dystrophic forms depending on the level at which the junction is compromised. Repeated ulcerations and bullae formation in the mouth lead to scarring that brings about various changes in the oral cavity. These include loss of sulcular depth, ankyloglossia, limited mouth opening and other dentoalveolar changes. At present while there is no cure for EB, the therapeutic approaches are essentially aimed at controlling the infections and maintaining an acceptable quality of life. Dental management should aim at maintaining a functional dentition that would help in mastication and favour nutrition. Oral manifestations and dental management in a child diagnosed with dystrophic EB since birth are presented here.

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Excessive occlusal wear can result in pulpal injury, occlusal disharmony, impaired function and aesthetic deformity. Loss of anterior guidance can result from severe wear of anterior teeth, which protects the posterior teeth during excursive movement. The collapse of posterior teeth also results in the loss of normal occlusal plane and the reduction of the vertical dimension. This clinical report describes the use of the Hobo twin-stage procedure for rehabilitation of a patient with severe tooth wear, resulting in reduced vertical dimension of occlusion.

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Aim : The aim of the present study was to estimate and compare the microleakage of a pit and fissure sealant after etching and Er:YAG laser treatment. Materials and Methods : Twenty non-carious premolars extracted for orthodontic reasons were equally divided into two groups. Samples in Group- I were treated with 37% phosphoric acid. Samples in Group II were irradiated with Er: YAG laser at 400 mJ at 4 Hz. Sealant was placed and light cured. Then, the samples were subjected to thermocycling. The samples were then immersed in 1% methylene blue. The samples were sectioned and examined under stereomicroscope at ×10 magnification. Results : Acid etched samples showed significantly less microleakage when compared to laser etching and it was statistically significant (P<0.01).

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The correction of skeletal Class III malocclusion with severe mandibular prognathism in an adult individual requires surgical and Othodontic combination therapy. The inter disciplinary approach is the treatment of choice in most of the skeletal malocclusions. A case report of an adult individual with Class III malocclusion, having mandibular excess in sagittal and vertical plane and treated with orthodontics,, bilateral sagittal split osteotomy and Le - Forte I osteotomy for the correction of skeletal, dental and soft tissue discrepancies is herewith presented. The surgical-orthodontic combination therapy has resulted in near-normal skeletal, dental and soft tissue relationship, with marked improvement in the facial esthetics in turn, has helped the patient to improve the self-confidence level.

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The peripheral giant cell granuloma (PGCG) is a reactive exophytic lesion of the gingiva and alveolar ridge that usually occurs as a result of local irritating factors such as plaque, calculus, chronic infections, chronic irritation, tooth extraction, improperly finished fillings, unstable dental prosthesis, and impacted food which originates from the periosteum or periodontal ligament. This article presents management of an unusual PGCG located on the partially edentulous mandible.

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Uremic stomatitis is a rare mucosal disorder associated with renal disorders. Here, we report a case of a 42-year-old male patient suffering from diabetes, angina pectoris, with white curdly pseudomembrane over the dorsal surface of the tongue, which was diffuse. The etiology, clinical features, and treatment are discussed.

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Ectopic canine teeth develop displaced from their normal position. Any permanent tooth can be ectopic, and the cause may be both genetic and environmental. Orthodontic treatment is justified because ectopic canine teeth can migrate in the jaw bone and may damage the adjacent teeth roots and bone. Orthodontic treatment is also justifiable for aesthetic reasons. Diagnosis and treatment of ectopically erupting permanent maxillary canines requires timely management by the orthodontist. Internal or external root resorption of teeth adjacent to the ectopic canine is the most common sequel. Malocclusion with severe crowding is difficult to treat without extraction. Non-extraction treatment of ectopic canines can compromise the patient's profile. This article represents two cases of extraction treatment approach for buccally displaced or ectopic canine in a patient with severe crowding in the mandibular arch.

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Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA). Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

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Mucopolysaccharidosis type I (MPS I H, Hurler syndrome) is a rare autosomal recessive inborn deficiency in the metabolism of glycosaminoglycans (GAGs) heparan sulfate and dermatan sulfate, resulting from deficiency of Alpha-L-iduronidase enzyme. This condition is characterized by accumulation of incompletely degraded glycosaminoglycans into various organs of body, which leads to impairment of organs and body functions. Such children appear nearly normal at birth; however, if left untreated, show a progressive mental and physical deterioration leading to death due to cardiorespiratory failure before the second decade of life. Pedodontists have a role for early diagnosis, rendering corrective and preventive treatment to the developing dentition, and referring the patient to the concerned specialities. An interesting case of a seven year old boy with a combination of skeletal, neurological, ophthalmologic, oro-dental and radiological findings of this diverse and devastating clinical entity with MPS I-(Hurler syndrome) has been presented here in this case report.

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An impacted or missing permanent tooth can add significant complications to an otherwise straightforward case. When multiple impacted teeth are present, the case complexity increases further. Developing a treatment sequence, determining appropriate anchorage, and planning and executing sound biomechanics can be a challenge. The following case report illustrates a patient with three retained primary teeth and three impacted permanent canines. After careful treatment planning and extraction of multiple primary teeth;, followed by attempted guided eruption of impacted teeth, the patient finished with a significantly improved functional and aesthetic result.

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