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Background: The primary maxillary molars occasionally remain sensitive during operative procedures even post the buccal supraperiosteal injection. This could be due to the widely flared palatal roots receiving accessory innervation from the palatal nerves. Identifying inadequate anesthesia upfront using the electric pulp test (EPT) would give vital information to the clinician on the need of a supplemental palatal injection. Aim: The aim of this study was to assess and evaluate the reliability of the EPT as an indicator of pulpal anesthesia in primary maxillary molars. Methodology: Fifty one primary maxillary molars were subjected to the EPT following a buccal supraperiosteal injection. During the operative procedure, the “ Face Legs Activity Cry Consolability” (FLACC) scores were recorded. The outcome of the EPT was correlated with the results of the FLACC score using Pearson's Chi-square test. Results: The EPT results were correlated to the FLACC scores. Five out of the 10 primary maxillary second molars which responded to the EPT scored 0 on the FLACC scale. The remaining 5 teeth scored 1 on the FLACC scale. The P value was 0.056 which was not statistically significant. This infers that the EPT is not a reliable tool to assess the adequacy of pulpal anesthesia in primary maxillary second molars. Conclusion: From the results of the present study, it can be concluded that the EPT is not a reliable tool to be used as an indicator of pulpal anesthesia in primary maxillary molars.

Pediatric dentists very commonly encounter patients with carious primary maxillary anterior teeth demanding esthetic treatment. Meeting this need of the patient and their parents is the greatest challenge to the clinician, considering the tender age of the patient and limited cooperation available during the treatment. Strip crowns were popularly used conventional esthetic restorative option to treat such teeth with a good degree of acceptance from patients and their parents. However, they are technique sensitive and have other disadvantages. The process of overcoming these drawbacks introduced zirconia crowns to the primary anterior esthetic armamentarium. This review discusses the comparison between strip crowns and zirconia crowns for primary anterior tooth restoration. The PubMed database was accessed to search for relevant articles using key terms: (primary anterior teeth) AND (strip crown) and (primary anterior teeth) AND (zirconia crowns). [ABSTRACT FROM AUTHOR]

Dentigerous cyst is one of the most commonly seen odontogenic cyst in children. It is characterized by a unilocular radiolucent lesion that encloses permanent tooth buds. Buccal bony expansion and a missing tooth is the most common clinical feature. Various treatment modalities have been mentioned in the literature for management of dentigerous cysts. This case report presents the management of a left mandibular dentigerous cyst in a 10-year-old boy by surgical enucleation and its follow up. [ABSTRACT FROM AUTHOR]

Aim: To comparatively evaluate the protecting efficiency of mandarin collar aprons as against the open collar aprons. Settings and Design: Cross-sectional randomized comparative study Methods and Material: Ten post graduate students were given a verbal written set of instructions to be followed during the study. Each study participant was made to wear an open collar and a mandarin collar aprons separately on two different days. The microbial samples were collected using a sterile swab from the chest area of the street clothing at the beginning of the day at dental clinic (Pre patient care) and at the end of the day at dental clinic (Post patient care). The obtained samples were microbiologically analyzed and the difference in the colony count between the two types of aprons were compared. Results: Significantly more number of gram positive cocci were seen in open collar apron group, when the difference between the pre work and post work colony counts were compared (p=0.031). Conclusion: Mandarin collar aprons offer significantly better protection of the street clothing of the dental health care providers than the closed collar aprons against the colonization of gram positive cocci. [ABSTRACT FROM AUTHOR]

Introduction: Managing an uncooperative child is the major issue in paediatric dentistry. In such cases general anaesthesia provides safe and effective dental treatment. Thus this study aims to elucidate the knowledge gaps and preconceived ideas that parent brings into a discussion with a paediatric dentist about GA through a questionnaire given to parents. Material and Method: A 17-question questionnaire, administered to parents of children presenting for care in paediatric dental practices, collected demographic information, media exposure, and parental knowledge/opinions regarding GA procedures, and parental acceptance of treatment scenarios. Results: Maximum respondents were not aware (56.3%) and only few were aware (43.7%) that dental treatments for children is sometimes carried out under GA; 68% of respondents think that GA is safe and 32% think it’s not safe; 52.5% respondent said GA and conscious sedation are not same, 24.1% said yes and 23.4% said they don’t know. Cross tabulations and Pearson’s chi-square statistics were used to examine relationships between categorical variables. Conclusion: Previous GA experience in the family or child had improved parents knowledge on GA but education level of the parents had no influence. Father feels GA is safe. Parents are generally unaware of news coverage pertaining to GA use in Paediatric Dentistry. [ABSTRACT FROM AUTHOR]

Aim: The aim of this case report is to present a rare case of a mandibular first molar with four completely separated roots and its successful non- surgical endodontic management. It also emphasizes on the role of radiographs in effectively managing such cases. Background: The successful outcome of a root canal treatment invariably depends on proper identification of the canals, adequate biomechanical preparation and obturation. Though the presence of an extra canal in the mandibular molars has often been reported in literature, but the incidence of four completely separated roots is extremely rare. Case discussion: A 9-year-old male patient visited our department with chief complaint of pain in the lower right back tooth. Intra oral examination showed advanced Class I cavity with exposed pulp in the lower right first mandibular molar with tenderness on vertical percussion with no associated swelling, sinus or fistulous tract. Radiographic examination revealed an interesting finding, that is, the outline of 2 periodontal ligament spaces in both mesial and distal roots with the presence of four separate roots of similar length. Non-surgical endodontic treatment followed by placement of a stainless steel crown was planned for the tooth. Confirmation of the canals length and obturation was done using cone beam computed tomography (CBCT). Conclusion: A thorough knowledge of the intricacies of the root canal morphology is important to the clinician for a successful treatment outcome. These aberrations in root morphology though uncommon do exist and can be missed if thorough radiographic evaluations are not instigated at the initial stages Clinical significance: This case report will tend to reinforce awareness in clinicians on capricious root canal morphology in permanent mandibular first molar. [ABSTRACT FROM AUTHOR]

Introduction: Maternal and child health services have potentially critical role in improvement of reproductive and neonatal health thereby, reduce infant mortality rate (IMR). Delay in access to the health care involves problem in decision making and availability of health services. Health care seeking behavior (HCSB) is an important component of Health Systems Research (HSR) which is necessary for planning health policies. Aims and Objectives: To study (1) Antenatal HCSB of mothers. (2) Source of healthcare sought during antenatal period (3) Pattern of initiation of breast feeding among mothers. Methodology: This was a cross sectional community based study wherein, 1903 mothers of under 5 (U-5) were interviewed. Data were coded, analyzed using SPSS package, results expressed as rates and proportions. Predictors of HCSB was estimated by odds ratios (OR) calculation and 95% confidence intervals (CIs) and a P value of less than 0.05 was considered significant. Results: All mothers in study had at least one Antenatal Checkup (ANC). Most of the mothers, 1629 (85.6 %) were informed regarding importance of breastfeeding during ANC and 1668(87.6%) had at least one antenatal ultra-sonogram done. Private Health Care System (PHCS) was most preferred for delivery and 1884 (99%) were hospital delivery. 1693(88.9%) of mothers had breast fed their babies within first 2 hours of life and 376 (19.7%) gave pre lacteal feeds on day one. Conclusions: Large section of the society are still dependent on PHS for antenatal services. Realistic formulations of heath policies are needed based on utilization of health care services. [ABSTRACT FROM AUTHOR]

Radicular cysts are among the most commonly occurring cystic lesions of the jaw, but are relatively rare in the primary dentition. This report presents a case of radicular cyst associated with a grossly carious primary molar. The treatment consisted of enucleation of the cystic sac and extraction of the involved primary teeth with preservation of the permanent tooth bud. At one year follow up, patient showed a complete healing, along with the eruption of the permanent successor. However, the erupted tooth had developmental defects. [ABSTRACT FROM AUTHOR]

Talon cusp is a rare dental anomaly that manifest’s as an accessory cusp like structure most commonly seen on the crown of the anterior teeth. This report describes the conservative management of a tooth with a Talon cusp with pulp extension. A 5-year-old female reported to our department with the chief complain of decayed teeth. On examination Talon cusp was noticed on the palatal aspect of 51. Caries excavation followed by restoration and fluoride varnish was applied. Cusp reduction was done to avoid occlusal interference. Depending on the type of Talon cusp a proper diagnosis and treatment plan needs to be formulated. Treating a tooth with talon does not always require endodontic management and can be treated conservatively. Clinical significance: Early diagnosis of this anomaly and management of the same by the clinician will help prevent further complications. [ABSTRACT FROM AUTHOR]

This is the case of a 12 year old, male child who reported with a 9mm midline diastema due to two mesiodens. The diastema was unusual as the central incisors were displaced unequally from the midline. Tooth 21 and 22 were displaced more distally from the midline leaving inadequate space for eruption of tooth 23. The challenge in this case was to close this unequal diastema. Thus the conventional fixed appliance which relies on reciprocal anchorage could not be used to close the diastema. Hence the fixed appliance was modified by using a Nance palatal arch with a labial wire extension to close this unequal diastema. The presentation discusses this unusual presentation of diastema and the modified fixed appliance used to treat the case. Clinical Relevance: This case report explains the biomechanics during midline diastema closure where the space is unequally distributed across the midline. [ABSTRACT FROM AUTHOR]

Newborns have the highest risk of death in the first 4 weeks of their life. Umbilical cord of a child is an important site for microorganism colonization and also forms a portal of entry for invasive pathogens. This study focuses on the bacterial colonization with 2 separate cord care regimens: dry cord and 4% chlorhexidine care group. This is a randomized control time-bound study conducted at a tertiary health care centre in Mangalore. A total of 144 newborns fulfilling the inclusion criteria were included and then divided randomly into two groups: dry cord care and 4% chlorhexidine. Two swabs were collected, baseline swab (swab 1) within 3 hours of birth and second swab (swab 2) at 120± 10 hours of birth and these samples were cultured for gram negative and positive organisms. Results were evaluvated with Chi-Square test. Out of 144 samples, in 115 showed no growth at the baseline and only 29 showed growth. In the dry cord care group, 38.9% showed growth of microorganism in comparison with chlorhexidine group which was 1.4% in swab 1 (baseline) and in swab 2, 87.5% in dry cord care group and 18.1% in chlrohexidine group in swab 2 respectively. It was observed that methicilin susceptible Staphylococcus aureus (MSSA) and methicillin resistant Staphylococcus aureus (MRSA) were the most common microorganisms isolated with others being Pseudomonas species, coagulase-negative Staphylococci (CoNS), Enterobacter species and Citrobacter species. Use of 4% chlorhexidine is effective in reducing colonization of bacteria and infection in comparison with dry cord care method. Therefore, decontamination of the umbilical cord with 4% of chlorhexidine should be recommended in a newborn child. However, both cord care methods did not lead to any infections.