Journal of Nepalese Association of Pediatric Dentistry

Artificial Intelligence in Pediatric Dentistry

Raju Raj Shakya — Mon, 12 Dec 2022 00:00:00 +0000

Dentistry has evolved through a long journey. The incorporation of Artificial Intelligence (AI) is the present and future of dentistry. Artificial Intelligence is now gradually being used in various fields including medical healthcare and dentistry. Within the field of dentistry, Pediatric dentistry requires skills to perform procedures with proper patient behavior guidance skill. The present article aims to highlight the various AI innovations and its relation to pediatric dentistry with possible future supported with Robotics which might change the traditional way of clinical practice.

Effect of Fluoride Varnish application on Primary Dentition among Preschool Children in Dharan: A Randomized Controlled Trial

Santosh Kumari Agrawal, Ashish Shrestha, Tarakant Bhagat — Mon, 12 Dec 2022 00:00:00 +0000

Introduction: Topical application of fluoride varnish on the tooth surface prevents the dissolution rates of tooth materials and increases the re-precipitation of lost minerals.

Objective: To assess the effectiveness of fluoride varnish application in primary dentition among preschool children at high risk of dental caries.

Methods: A randomized controlled trial was conducted with two parallel-group, comprising 3–5-year-old children, 100 in each group (Fluoride varnish or Placebo varnish). Dental caries were recorded at baseline, three- and six-month using Caries Assessment and Treatment Instrument (CAST) scoring system. Statistical analysis was done using the Chi-square test for categorical data, Mann-Whitney U test, independent t-test, and Wilcoxon Signed Ranks test for quantitative data. The level of significance was set at p<0.05.

Results: Overall, dental caries progression from baseline to three months and six months was more in placebo varnish group children than fluoride varnish (38.98% and 31.3% respectively). The proportion of children with new caries lesions was more in placebo group than that in the fluoride varnish group at every three months interval. The difference between the groups was statistically significant (p<0.05). Fluoride varnish treatment once in six months had a better treatment effect with a preventive fraction of 62.1% in comparison to three months (59.0%).

Conclusions: Dental caries can be prevented effectively by the use of 5% sodium fluoride varnish. Fluoride varnish is efficacious when applied twice a year in children at high risk of dental caries.

Dental Caries Experience among the Children with Autism Spectrum Disorder in 3-15 Years

Manisha Malla, Senchhema Limbu, Parajeeta Dikshit, Sunita Khanal — Mon, 12 Dec 2022 00:00:00 +0000

Introduction: Dental caries remains the most prevalent, unmet health care need for children with special health care needs such as autism spectrum disorder. This study was carried out to help in providing a baseline data to enable comparison and future planning of dental services for autistic children.

Objective: The study aims to evaluate the oral health status among the 3-15 years old children with Autism Spectrum Disorder in Kathmandu.

Methods: A cross sectional study was done among 80 autistic children of age 3-15 years. Dental caries was measure by Decayed, Missing and Filled teeth. Data was entered and analyzed in SPSS.

Results: The prevalence of the dental caries was found to be 66.3% (53) with mean dmft of 3.03 ± 3.71 and DMFT of 0.51 ± 1.78 among children with Autism Spectrum Disorder. Caries prevalence was higher in females compared to males. Among the carious teeth 94% were untreated.

Conclusions: The prevalence of dental caries was high in children with Autism Spectrum Disorder with higher percentage of untreated decays, which emphasizes the need for immediate preventive as well as curative interventions.

Evaluation of Mineral Trioxide Aggregate and Biodentine as Direct Pulp-capping Agents in Human Teeth: An Ex-Vivo Study

Mon, 12 Dec 2022 00:00:00 +0000

Introduction: Biodentine (Tricalcium Silicate based) is a modern bioactive cement that is comparable to the broadly utilized mineral trioxide aggregate (MTA). It has dentin-like mechanical properties, which can be considered appropriate material for diseased dentin-pulp complex recovery such as direct pulp capping. The present study was to compare the reaction of the pulp-dentin complex in human teeth after direct pulp capping with use of MTA and Biodentine.

Objective: To assess the histomorphologic response of human dental pulps on direct pulp capping with MTA and Biodentine.

Methods: Pulps of 34 maxillary permanent intact human third molars planned for extraction were mechanically exposed with sterile rotary round bur and allotted to one of the two exploratory groups, MTA or Biodentine. After four weeks, the teeth were extracted, stained with hematoxylin- eosin, and categorized by employing a preset histologic scoring framework. The histopathologic evaluations scored data were recorded and statically analyzed using SPSS where Mann-Whitney U test was used and p<0.05 was considered statistically significant.

Results: No inflammatory pulp reaction seen in 34 (100%) teeth whereas 19 (55.9 %) showed complete dentinal bridge arrangement. Layers of well-arranged odontoblast and odontoblast-like cells were found to make tubular dentin beneath the osteodentin. Inferential statistics using showed insignificance between the MTA and Biodentine test groups amid the perception period, showing similar outcomes.

Conclusions: Biodentine had comparative adequacy in the clinical setting and may be considered an appropriate alternative to MTA as the pulp- capping agent.

Knowledge, Attitude and Practice on Dental Sedation among Pediatric Dentists in Nepal

Sneha Shrestha, Bandana Koirala, Mamta Dali, Gajendra Birajee — Mon, 12 Dec 2022 00:00:00 +0000

Introduction: Recent years have evidenced an increase in the use of sedation in children for their dental treatment, with a wide variation in the global practice among the pediatric dentists.

Objective: The purpose of this study was to assess the knowledge, attitude, and practice on dental sedation amongst the pediatric dentists of Nepal. Methods: This was an online-based questionnaire survey conducted from May to June 2021 among 29 pediatric dentists practicing in Nepal using a census sampling. Data were analyzed and presented in percentage, mean, and standard deviation along with charts and tabular forms.

Results: Majority of the respondents 26 (89.7%) had adequate knowledge and 22 (76%) had adequate practice on sedation with a total positive mindset. The mean (Mean ± Standard Deviation) scores for knowledge, attitude, and practice were 3.759 ± 0.9124, 6.897 ± 1.1131, and 3.414 ± 1.3501, respectively. Nineteen (65.5%) of them practiced dental sedation that included general anesthesia, oral, inhalational, intravenous and intra-nasal routes.

Conclusions: The study showed satisfactory knowledge, attitude, and practice of dental sedation among the pediatric dentists in Nepal. There was lack of training on emergency skills and formal sedation courses other than for inhalational sedation among the participants, and these were cited as the major barriers to their practice along with lack of adequate facilities. Hence, regular conduction of sedation trainings and life support skills targeting the pediatric dentists in Nepal is deemed essential.

Substance Abuse and Oral Health of Adolescence

Obehi O Osadolor, Nneka K Onyejaka — Mon, 12 Dec 2022 00:00:00 +0000

Substance abuse is a rising health trend that affects countries worldwide.It is associated with financial, social, medical, oral and economic effects that can affect the user, community and the society. Some substances have been used in the history of mankind for religious, cultural, recreational and medicinal purposes. Substance abuse among adolescents is increasing with possible associated factors like peer influence, availability and affordability of substances, favourable parental attitude to substance use, parental substance use problems, parental approval of substance use in early adolescence, family structure, locality of residence, social bonding, boredom, type of school, and adventurous personality. Oral health conditions among substance abusers may be attributed to the direct impact of the chemical qualities and nature of the illicit substances on oral tissues, decreased saliva production, concentration, personal preference, the frequency and amount of consumption of the abused substanceand the substance abuser associated oral health risk behaviours.

Barriers of Oral Care for Children with Special Health Care Needs in Nepal

Senchhema Limbu — Mon, 12 Dec 2022 00:00:00 +0000

Not Available

Radicular Cyst associated with Deciduous Molar: A Clinical Case Report

Senchhema Limbu, Subhani Vaidya, Parajeeta Dikshit, Manisha Malla — Mon, 12 Dec 2022 00:00:00 +0000

An association of radicular cyst with deciduous teeth is very rare contributing to 0.5–3.3% of the total number of cysts in deciduous dentition in 3–19 years of age. This paper describes the case of a radicular cyst associated with deciduous molar in a 9-year-old female patient, with a detailed description of clinical, radiographic, histopathologic features, and its surgical management. The treatment included complete enucleation of the cyst with proper curettage, extraction of the offending deciduous molar and preservation of the permanent tooth buds.

Accidental Ingestion of a Dental Bur during Endodontic Procedure: A Case Report

Sanchita Khadka, Bandana Koirala, Sneha Shrestha, Gajendra Birajee — Mon, 12 Dec 2022 00:00:00 +0000

Accidental ingestion of dental materials and instruments during the routine dental procedures especially in young children can occur at any time. The aim of this case report was to highlight on the recognition and management of such condition immediately for the prevention of any adverse complications. A 3-year-old male child accidentally swallowed a round diamond bur that popped out of the air-rotor handpiece during access cavity preparation on 65. There were no signs of airway obstruction and immediate postero-anterior view of chest and abdomen showed the presence of bur in the gastrointestinal tract which got eliminated in stool on the fourth day, uneventfully.

Modified Band and Loop Appliance for Retention of Periodontal Dressing on Denuded Bone: A Case Report

Shreebindu Sharma, Bandana Koirala, Mamta Dali, Sneha Shrestha — Mon, 12 Dec 2022 00:00:00 +0000

Intraoral lacerations without gape heal spontaneously, whereas lacerations gaping open need to be managed with primary closure or advancement flap. Fall injury leading to a laceration over the left maxillary vestibular region extending till the alveolar ridge with avulsed tooth where primary closure was not possible was planned for debridement followed by periodontal dressing. Due to the lack of retentive area, modified band and loop appliance with a T-loop was fabricated and used for the retention of periodontal dressing for the healing of denuded bone following trauma.

Management of Separated Endodontic Instrument and a Blocked Canal - A Case Report

Arbind Rai, Ashok Ayer, Mannu Vikram — Mon, 12 Dec 2022 00:00:00 +0000

The fracture of endodontic instruments and canal blockage is a procedural problem creating a major obstacle to normal routine endodontic therapy. The separated instrument, particularly a broken file, leads to metallic obstruction in the root canal while canal blockage,caused by packing dentin chips and/or tissue debris, impedes efficient cleaning and shaping. Negotiating the canal and achieving patency is a must but when attempts fail to bypass such a fragment or gaining patency becomes difficult, it should be achieved by newer techniques and equipments. Dental operating microscope and ultrasonics have found indispensable applications in a number of dental procedures. This clinical casedemonstrates the usage of anultrasonic device under operative microscope in the removal of separated NiTi instrument and achieving patency in symptomatic premolars.