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Background:Pharmacological methods have been used as an adjunct to enhance child cooperativeness and facilitate dental treatment.Objective:Purpose of this study was to evaluate and compare the effect of sedation by intranasal dexmedetomidine and oral combination drug midazolam–ketamine in a group of children with uncooperative behavior requiring dental treatment.Materials and Methods:This was a prospective, randomized, double-blind study that included patients 3–9 years old with American Society of Anesthesiologists-I status. About 36 children presenting early childhood caries were randomly assigned to one of three groups studied: Group MK received intranasal saline and oral midazolam (0.5 mg/kg) with ketamine (5 mg/kg) mixed in mango juice; Group DX received intranasal dexmedetomidine (1 μg/kg) and oral mango juice; and Group C received intranasal saline and oral mango juice. Patients' heart rate, blood pressure, and oxygen saturation were recorded before, during, and at the end of the procedure. Patients' behavior, sedation status, and wake up behavior were evaluated with modified observer assessment of alertness and sedation scale. Ease of treatment completion was evaluated according to Houpt scale.Results:Hemodynamic changes were statistically insignificant in Group MK and Group DX. About 75% patients in Group MK were successfully sedated as compared to 53.9% Group DX and none of the patients in Group C. Ease of treatment completion was better with Group MK as compared to Group DX and least with Group C. Around 50% patients in Group MK had postoperative complications.Conclusion:Oral midazolam–ketamine combination and intranasal dexmedetomidine evaluated in the present study can be used safely and effectively in uncooperative pediatric dental patients for producing conscious sedation.

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Context:Molar incisor hypomineralization (MIH) is a commonly occurring esthetic setback among patients. Depending on the graveness of the lesion, esthetics of MIH can be improved by treatments such as enamel microabrasion, bleaching, composite resin bonding, and the combination of some or all of these techniques.Aim:The aim of this study is to evaluate the esthetic results of resin infiltration treatment on incisors with Grade I molar incisor MIH.Materials and Methods:A total of 22incisor lesions with MIH were infiltrated with resin. Photographs were captured before infiltration, just after infiltration, and 6 months after infiltration. The photographic evaluation was done by the CIE L*a*b* scoring method. The means of each parameter such as ΔL and ΔE were calculated.Statistical Analysis:ANOVA in conjunction with Turkey's post hoc test was used to evaluate the means.Results:The total color change observed was equal just after treatment and 6 months after treatment, with no statistically significant difference (P = 0.87) between these two time points. The mean of difference in total color change (ΔE3) of white tooth discoloration was 13.2 SD 6.8, showing an overall color change.Conclusion:Infiltration can conceal the white opaque appearance of Grade I MIH lesions, and also reduction in lesion whiteness is seen with time.

MTA seems to be a promising pulpotomy medicament for future use.

Background:A new epidemiological index is introduced for full assessment of dental caries which is known as caries assessment spectrum and treatment (CAST). “Spectrum” is considered backbone of this index as it covers from no lesion to advanced stage progression of caries. We aimed to evaluate and compare the status of caries in primary and permanent molars of 7–8-year-old schoolchildren of Shimla using CAST index and to find if any correlation exists between the status of caries in evaluated teeth.Methods:Three hundred and one schoolchildren with age group of 7–8 years were selected from schools in Shimla. CAST codes were determined for primary molars and first permanent molars. The distribution of CAST codes in the examined molars is correlated with the help of Spearman's rank correlation coefficient. The level of statistical significance was established at P < 0.05. The intraexaminer reliability was determined by the unweighted kappa coefficient.Results:Caries was assessed in 6.3%–12.3% of the permanent molars in contrast to primary molars, in which caries was near about 50%. The correlation was stronger for first and second deciduous molars for the right side of the mouth than the left side (r = 0.293 and 0.257 in the maxilla and 0.503 and 0.319 in the mandible [P < 0.001], respectively, while correlation for teeth in opposite jaws was moderate [r = 0.20–0.47]). The intraexaminer reliability was examined (k = 0.90 for the primary and 0.85 for permanent molars).Conclusion:The correlation between primary and permanent molars regarding the caries status in primary molars is weak while strongest correlation was present on the right side of the mouth for first and second deciduous molars. The study also showed the applicability of the CAST index in epidemiological surveys.

Among sociodemographic factors, increasing age is directly related to child's positive behavior, whereas other factors such as gender and socioeconomic status (SES) are not significantly related. General anxiety significantly affects the child's behavior. BMI of the child is not related to child's behavior in dental operatory. Multimedia was not found to be significantly affecting the behavior of the child in dental operatory. Interpretations and Conclusion: The principle conclusion of this study is that there is a significant association of age and treatment procedure rendered with the CB in the dental operatory whereas gender, SES, general anxiety, BMI, and multimedia do not show any significant association with the CB in the dental operatory.