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Introduction and AimPerforming endodontic treatment in an immature permanent tooth that has experienced trauma or carious exposure can pose challenges. The root canals in these teeth are typically open and fragile, making instrumentation and obturation difficult. Traditional apexification, which involves placing calcium hydroxide paste in the root canal for a specified period to induce the formation of a calcified barrier, has been a long-standing approach. While it is a widely used method, leaving the paste in the root for extended periods can weaken it due to the paste’s hygroscopic properties and the proteolytic activities of calcium hydroxide. As a result, researchers have been exploring alternative treatments that allow for the full development of immature teeth. Revascularization has emerged as one such alternative, with a variety of treatment protocols documented in scientific literature. Description of the CaseThis case report, for the first time, describes the use of NeoPutty MTA® and triple antibiotics paste for revascularization in a young female child on a carious, exposed lateral incisor with opex apex with success. ConclusionThe revascularization process attempted on the infected tooth met with success and closure of apex was noticed in a short period of time.

Background: Traumatic dental injuries in children present unique challenges, requiring evidence‐based and individualized approaches. Accidental falls are a common cause, resulting in a spectrum of clinical presentations. Managing tooth injuries in mixed dentition adds complexity to treatment decisions. Methods: This case report details the conservative management of an 8‐year‐old with a fractured permanent lateral incisor following a fall. The child's physical status was assessed, ruling out abuse and associated neurological issues. A novel pediatric full crown fabricated from a hybrid glass material was chosen for its minimally invasive preparation and aesthetic properties. Results: Procedural details, including crown sizing, contouring, and bonding, are outlined. One‐year follow‐up revealed no discoloration, pain, or adverse effects. The hybrid glass material demonstrated longevity in bonding, maintaining both function and esthetics. The discussion encompasses the choice of crown materials and the advantages of hybrid glass material. Conclusion: The case highlights successful conservative restoration in mixed dentition using a pediatric full crown with a hybrid glass material. This approach achieved functional and aesthetic improvements, preserved tooth vitality, and ensured patient satisfaction. [ABSTRACT FROM AUTHOR]

Aim. The current review aims to explore postoperative neurological complications in third molar extractive surgery. Materials and Methods. The PRISMA protocols were followed when conducting this review. We found a total of 2,250 articles that matched our topic using the Boolean keywords, mandibular nerve complications AND oral surgery, from PubMed (1,083), Scopus (435), and Web of Science (732), with the filters of English language articles, time range January 1, 2003, to September 30, 2023, and human studies. After 762 duplicates were eliminated, there remained 1,488 articles. Eleven final articles were deemed of the highest relevance to our topic by eliminating articles in animals, non‐English language, reviews, meta‐analysis, and off‐topic. A potential risk in the third molar extraction was temporary loss of sensibility often caused by mild compression or irritation of the mandibular nerve. This typically resolves within weeks or months, but in severe cases, recovery might take longer. Permanent loss of sensation can occur, indicating significant nerve damage and lasting effects on touch, temperature, or pain perception. Conclusions. Various treatments exist for nerve damage, including low‐level laser therapy, pain management medications, or physical therapy. While these therapies may improve neurosensory impairment, patients often report a decline in their quality of life. [ABSTRACT FROM AUTHOR]

Background: Audiovisual distraction is a potentially good technique to reduce medical treatment procedure-related fear and anxiety among children. However, few studies have assessed its effectiveness. Objective: To conduct a systematic review and meta-analysis for evaluating the effectiveness of audiovisual distraction in reducing pain anxiety in pediatrics. Methods: Randomized control trials and experimental studies that reported the use of audiovisual distraction during medical/dental treatments among children aged 3-8 years, used the Face, Legs, Activity, Cry, Consolability (FLACC) scale to assess pain, and were published between 2005-2021 and in English were retrieved from PubMed, Scopus, and Web of Science. A random-effects model was used for evidence analysis. Results: A total of four studies were included in the systematic review and meta-analysis: two were from South Asia and one each were from Africa and North America. Three of these studies were randomized control trials. The variability among the studies was high. Three of the four studies found that AV techniques were significantly effective in reducing pain during procedures compared with the control group (P < 0.00001), while one study found no difference; the cumulative evidence in the forest plot was similar. Conclusion: Cumulative evidence suggests that the use of audiovisual distraction is an effective strategy in reducing medical/dental procedures-related pain anxiety among children aged 3-8 years. However, evidence on this is currently limited, and thus further studies are required using various AD techniques and on different populations to substantiate these findings. Funding: None. Registration: PROSPERO (Ref no.: CRD42021245874). [ABSTRACT FROM AUTHOR]

Objective: This clinical study was aimed to investigate the clinical and radiographic outcomes of NeoPutty MTA® (Nusmile), a novel mineral trioxide aggregate (MTA) pulpotomy material, in primary teeth of children aged 4-6 years. Methods: An in vivo study was done in children aged 4-6 years old. A total of 50 primary second molar teeth were included in the study, with 25 of them undergoing treatment with formocresol (FC) and 25 receiving treatment with NeoPutty MTA®. The subjects were divided into two groups for treatment: the first group received a treatment involving a 1:5 dilution of Buckley's FC. The second group, however, underwent treatment with NeoPutty MTA®. This study employs a meticulous approach to evaluate the impact of different treatments on a significant number of molar teeth, using FC and NeoPutty MTA® as the respective treatment methods. The demographics of the subject pool are well-documented, comprising a balance of male and female participants. The technique employed for pulp removal and the subsequent management of bleeding are outlined, underscoring the thoroughness of the process. Results: At 12 months, the NeoPutty MTA® pulpotomy group showed a significantly higher success rate clinically (96%) compared to the FC group (72%) (P < 0.05), but radiographically although NeoPutty MTA® was better (92%) than FC (82%), it was not statistically significant. NeoPutty®-treated teeth exhibited no signs of pain or discomfort and demonstrated better pulp vitality compared to the FC group. Conclusion: NeoPutty MTA® demonstrated superior clinical success rates and better radiographic outcomes compared to traditional FC pulpotomy. [ABSTRACT FROM AUTHOR]

Background: Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. Aim: The aim of this study was to compare 1 μ/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects. Materials and Methods: In this cross‑over trial, 15 children aged 6–8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week. Results: All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post‑treatment. Conclusion: 0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 μ/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/ kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children. [ABSTRACT FROM AUTHOR]

Aim: Mineral trioxide aggregate (MTA) is a relatively new versatile dental material. MTA has many advantages as well as disadvantages. To reduce most of the drawbacks of MTA, a premixed bioceramic MTA, NeoPutty MTA, was introduced in 2020. In this study, we assessed the antimicrobial activity of the newer MTA, NeoPutty MTA. We modified NeoPutty MTA and compared both against Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Materials and Methods: Using the agar diffusion method, NeoPutty MTA was tested for antibacterial activity against the above-mentioned microorganisms. A base layer of Petri plates was done using Muller–Hinton agar for S. aureus, E. coli, and P. aeruginosa and brain heart infusion agar for E. faecalis. A total of 32 plates were employed; the plates were divided randomly into four test groups having eight plates each, so microorganisms were tested eight times. Three cavities were made in agar and filled with freshly mixed materials after 24 h. A pour plate seeded the microorganisms. The plates were pre-incubated for 2 h at room temperature and incubated at 37°C for 24 h. An independent observer measured the inhibition zone diameters. Results: NeoPutty MTA, when tested alone, did not show much antibacterial activity against E. faecalis, S. aureus, and E. coli but had significant antimicrobial activity against P. aeruginosa when used at different concentrations. Modified NeoPutty (NeoPutty with antibiotics added individually) showed significant antibacterial activity against these microorganisms, as seen by the zone of inhibition of these bacteria. Conclusion: Modified NeoPutty with antibiotics has a better antimicrobial effect than NeoPutty MTA. [ABSTRACT FROM AUTHOR]

Aim: There has been a search for bioactive, biocompatible material for quite some time now which can be utilized for various endodontic procedures for better palliative care of teeth. These materials could reduce the chances of extraction of teeth. Here we will discuss the journey of MTA (mineral trioxide aggregate) as a unique, bio-active material from inception till now in pediatric dental practice. Materials and Methods: Web-based databases such as Scopus, Web of Science, and PubMed were explored from January 2012 till June 2022. Thus found types of writeups were review articles. This review article will give an insight into MTA—its evolution and use in pediatric dentistry. The following search terms were used: MTA (all fields, MeSH terms), AND pediatric dentistry (all fields) (MesH terms, all fields) AND advances (all fields) OR “Mineral” and “Trioxide” and “Aggregate” (all fields) OR pediatric and “Dentistry” (all fields) or “Advances.” An electronic literature search in PubMed database using the free-text terms “MTA”, and “Pediatric Dentistry” showed 253 articles from 2012 to 2022, of which 30 were review articles and systematic reviews. Results: The initial search retrieved 531 articles. After a full-text review of all the articles, only 12 were included. The original MTA has some known disadvantages, such as prolonged setting time, being expensive, and can lead to discoloration of tooth later in time. Owing to the disadvantages of the material, researchers have been searching materials which can show improved physiological, chemomechanical, and better biologic characteristics. Conclusion: MTA has come a long way as a bioceramic, bioactive material with improved physical and chemical properties. The introduction of newer fast-setting MTA and pre-mixed MTA have shown excellent handling properties. MTA is now getting more attention in pediatric dentistry as a bioactive agent with the scope for many studies and clinical trials. [ABSTRACT FROM AUTHOR]