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Having just one root canal in a primary mandibular first molar is an extremely unusual congenital defect. One possible cause of this odd root shape is the invagination of Hertwig's epithelial root sheath (HERS) failing. A pediatric dentist may successfully provide root canal therapy by drawing on extensive knowledge of root canal evaluation, morphological and anatomical differences of primary teeth, and other relevant topics. Herein, we detail the treatment of a singular root, single canal primary mandibular first molar that presented with a unique morphology. The patient underwent pulpectomy, obturation, and restoration. How to cite this article: Prakash S, Sharma V, Khan W, et al. Deciduous Mandibular First Molar with Single Root and Single Canal: An Astounding Occurrence. Int J Clin Pediatr Dent 2024;17(2):198-201.

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Aim: The aim of this case report is to present three different patients who had horizontal and vertical root fractures of young permanent teeth, its diagnosis, clinical and radiographic findings, treatment, and long-term follow-up and success rate. Background: Root fractures are relatively rare with the prevalence of 0.5-7% in permanent and 2-4% in deciduous dentition. Timely intervention and accurate treatment procedures are the main concerns for long-term success of root fractures. Case description: Case I and case II had horizontal fracture of immature permanent tooth. Patients reported with a chief complaint of pain in their upper central incisors. As a result of radiographic examination, horizontal root fractures were diagnosed. Teeth were treated with a mineral trioxide aggregate (MTA) plug (case I and case II) and repositioning and splinting (case II). Case III had vertical root fracture of immature permanent tooth. Tooth was treated with apexification (sectional obturation) and sealed with resin-modified glass ionomer cement (RMGIC) till the fracture site and flowable light cure restoration. Patients were scheduled for follow-up visits at different time intervals. Radiographic evidence indicated ongoing root development in these immature teeth. Normal color and mobility were observed, and no pain was noted during horizontal and vertical percussion tests. Conclusion: The present case report shows a favorable and stable outcome of timely treatment and sound healing of various types of root fracture. Long-term follow-up of patients with trauma is essential because pathological changes can occur several years following injury. Clinical significance: The latest treatment modalities and long-term follow-up showed clinical success. How to cite this article: Dhindsa A, Garg S, Poddar P, et al. Management of Root Fractures in Young Immature Permanent Teeth: Three Case Reports. Int J Clin Pediatr Dent 2024;17(3):352-356.

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Background: The impact of previous SARS-CoV-2 infection on the systemic immune response during tuberculosis (TB) disease has not been explored. Methods: An observational, cross-sectional cohort was established to evaluate the systemic immune response in persons with pulmonary tuberculosis with or without previous SARS-CoV-2 infection. Those participants were recruited in an outpatient referral clinic in Rio de Janeiro, Brazil. TB was defined as a positive Xpert-MTB/RIF Ultra and/or a positive culture of Mycobacterium tuberculosis from sputum. Stored plasma was used to perform specific serology to identify previous SARS-CoV-2 infection (TB/Prex-SCoV-2 group) and confirm the non- infection of the tuberculosis group (TB group). Plasmatic cytokine/chemokine/growth factor profiling was performed using Luminex technology. Tuberculosis severity was assessed by clinical and laboratory parameters. Participants from TB group (4.55%) and TB/Prex-SCoV-2 (0.00%) received the complete COVID-19 vaccination. Results: Among 35 participants with pulmonary TB, 22 were classified as TB/Prex-SCoV-2. The parameters associated with TB severity, together with hematologic and biochemical data were similar between the TB and TB/Prex-SCoV-2 groups. Among the signs and symptoms, fever and dyspnea were significantly more frequent in the TB group than the TB/Prex-SCoV-2 group (p < 0,05). A signature based on lower amount of plasma EGF, G-CSF, GM-CSF, IFN-α2, IL-12(p70), IL-13, IL-15, IL-17, IL-1ß, IL-5, IL-7, and TNF-ß was observed in the TB/Prex-SCoV-2 group. In contrast, MIP-1ß was significantly higher in the TB/Prex-SCoV-2 group than the TB group. Conclusion: TB patients previously infected with SARS-CoV-2 had an immunomodulation that was associated with lower plasma concentrations of soluble factors associated with systemic inflammation. This signature was associated with a lower frequency of symptoms such as fever and dyspnea but did not reflect significant differences in TB severity parameters observed at baseline.

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Aim and objective: The present case report aims to describe the nonsurgical management of an anterior tooth with a blunderbuss canal and an open apex using mineral trioxide aggregate (MTA) under magnification. Background: When pulp is traumatized before root formation, it results in pulpal necrosis, due to which dentin and root formation are interrupted. As a result, the canal remains broad due to thin and fragile dentin walls leading to the open apex. Therefore, root canal treatment is a big challenge currently. In such cases, we prefer MTA apexification to form the hard tissue apical barrier, which is a foreseeable treatment and has been used as another advanced method than calcium hydroxide (CaOH2) apexification due to its superior properties. Case description: A novel apexification technique was used by the Departments of Pediatric Dentistry and Conservative Dentistry and Endodontics for MTA placement in the central incisor with respect to 11 of a 9-year-old female patient. MTA was used to form an apical barrier using the micro-apical placement (MAP) system under a dental operating microscope (DOM). Following MTA hard set confirmation, obturation with bioceramic sealer and gutta percha with warm vertical condensation was done, followed by post-endodontic composite restoration. Conclusion: This case describes the nonsurgical management of an open apex using MTA, MAP system, magnification, and bioceramics, which aided in the management of this endodontic enigma. How to cite this article: Bhasin P, Saraf BG, Chauhan S, et al. The Successful Interdisciplinary Outcome of Blunderbuss Canal with an Open Apex Using MTA under Magnification: A Case Report. Int J Clin Pediatr Dent 2024;17(1):97-101.

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Purpose: The aim of present study was to assess the frequency, severity, and distribution of developmental defects of tooth enamel and correlate the etiology with the type of defect in 11-13-year-old Indian children. Materials and methods: The present study included examination of permanent maxillary incisors in 500 children in the age-group of 11-13 years to examine the occurrence of distribution of developmental defects of tooth enamel. Materials and methods: Only the buccal surface of four permanent maxillary incisors was examined for enamel defects using modified developmental defects of enamel (DDE) index by Clarkson which recognized three basic types of enamel defects; namely demarcated opacities, diffuse opacities, and hyploplsia. Personnel details, dental history which included dental infection, extraction, trauma, lifetime fluoride, fluoride in water, and medical history were also recorded. Data was coded and analyzed for distribution of developmental defects of tooth enamel by tooth type and gender using Statistical Package for the Social Sciences. Result: Out of 500, 114 (22.8%) children showed defective enamel in permanent maxillary incisors. Of all enamel defects, diffuse opacities were most prevalent with 48.25% occurrence followed by demarcated opacities 38.5%, hypoplasia 10.52%, and any other defects 1.75%. No significant difference was observed in males and females for the occurrence of developmental enamel defects. The occurrence of dental enamel defect significantly correlated with dental history as well as with medical history (Chi-squared statistical test, p-value = 0.001**). Conclusion: (1) High fluoride in water accounts for most prevalent diffuse opacity. (2) Demarcated opacities are associated mainly with positive dental history. (3) Hypoplasia of incisors was found to be least prevalent associated with trauma, periapical infections. How to cite this article: Sheoran N, Garg S, Dhindsa A, et al. Study of Developmental Defects of Enamel in Young Permanent Maxillary Incisors in 11-13-year-old Indian Children for Occurrence Distribution and Associated Factors. Int J Clin Pediatr Dent 2023;16(S-2):S176-S182.

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Ongoing SARS-CoV-2 infections are driven by the emergence of various variants, with differential propensities to escape immune containment. Single nucleotide polymorphisms (SNPs) in the RNA genome result in altered protein structures and when these changes occur in the S-gene, encoding the spike protein, the ability of the virus to penetrate host cells to initiate an infection can be significantly altered. As a result, vaccine efficacy and prior immunity may be diminished, potentially leading to new waves of infection. Early detection of SARS-CoV-2 variants using a rapid and scalable approach will be paramount for continued monitoring of new infections. In this study, we developed minor groove-binding (MGB) probe-based qPCR assays targeted to specific SNPs in the S-gene, which are present in variants of concern (VOC), namely the E484K, N501Y, G446S and D405N mutations. A total of 95 archived SARS-CoV-2 positive clinical specimens collected in Johannesburg, South Africa between February 2021 and March 2022 were assessed using these qPCR assays. To independently confirm SNP detection, Sanger sequencing of the relevant region in the S-gene were performed. Where a PCR product could be generated and sequenced, qPCR assays were 100% concordant highlighting the robustness of the approach. These assays, and the approach described, offer the opportunity for easy detection and scaling of targeted detection of variant-defining SNPs in the clinical setting.

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Introduction: Oral and/or tongue swabs have demonstrated ability to detect Mycobacterium tuberculosis (Mtb) in adults with pulmonary tuberculosis (TB). Swabs provide useful alternative specimens for diagnosis of TB using molecular assays however, the diagnostic pickup by culture requires further improvement and development. Several studies identified the presence of differentially culturable tubercle bacilli (DCTB) populations in a variety of clinical specimens. These organisms do not grow in routine laboratory media and require growth factors in the form of culture filtrate (CF) from logarithmic phase cultures of Mtb H37Rv. Methods: Herein, we compared the diagnostic performance of sputum and tongue swabs using Mycobacterial Growth Indicator Tube (MGIT) assays, Auramine smear, GeneXpert and DCTB assays supplemented with or without CF. Results: From 89 eligible participants, 83 (93%), 66 (74%) and 79 (89%) were sputum positive by MGIT, smear and GeneXpert, respectively. The corresponding tongue swabs displayed a lower sensitivity with 39 (44%), 2 (2.0%) and 18 (20%) participants respectively for the same tests. We aimed to improve the diagnostic yield by utilizing DCTB assays. Sputum samples were associated with a higher positivity rate for CF-augmented DCTB at 82/89 (92%) relative to tongue swabs at 36/89 (40%). Similarly, sputum samples had a higher positivity rate for DCTB populations that were CF-independent at 64/89 (72%) relative to tongue swabs at 26/89 (29%). DCTB positivity increased significantly, relative to MGIT culture, for tongue swabs taken from HIV-positive participants. We next tested whether the use of an alternative smear stain, DMN-Trehalose, would improve diagnostic yield but noted no substantial increase. Discussion: Collectively, our data show that while tongue swabs yield lower bacterial numbers for diagnostic testing, the use of growth supplementation may improve detection of TB particularly in HIV-positive people but this requires further interrogation in larger studies.

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Aim: The aim of our study was to assess the prevalence of dental caries and the body mass index (BMI) in included school-going children. Moreover, to examine the relationship between the prevalence of dental caries, BMI, and socioeconomic (SES) status and to evaluate sugar consumption and other dietary habits as risk factors for dental caries. Materials and methods: The present cross-sectional study was performed among 400 school-going children aged 6-12 years from Faridabad city, Haryana. Parents filled out questionnaires for their respective children. The clinical examination of dental caries was performed according to World Health Organization (WHO) 1997. The BMI calculation was done by measuring height and weight. Statistical analysis: The collected data were analyzed statistically using parametric and nonparametric tests. Results: The prevalence of dental caries in deciduous teeth was 95.5% and in permanent teeth was 47.3%, respectively. Conclusion: This study displayed the positive correlation of dental caries to BMI, oral hygiene practices, beverages, aerated drinks, chips, candy, and tea/coffee. Whereas the SES status and dietary habits Jam group variable had no significance in relation to dental caries. How to cite this article: Kapil D, Saraf BG, Sheoran N, et al. To Assess the Prevalence of Dental Caries and Its Association with Body Mass Index, Socioeconomic Status, Dietary Habits, and Oral Hygiene among 6-12-year-old Children in Faridabad. Int J Clin Pediatr Dent 2023;16(4):626-632.

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Aim: The aim of the study is to compare the effectiveness of visual and sign motivation on the oral hygiene of students with hearing and speech impairment studying in special schools of Meerut, Uttar Pradesh, India. Materials and methods: A cross-sectional study was carried out on 200 students. The sample was divided into two groups. Ethical clearance was obtained from the Institutional Ethical Committee. Data were collected at three points of time-at baseline, 1st and 3rd month. Results: In the age-group, 8-13 years, on intergroup comparison of mean oral hygiene index (OHI) score, no significant difference was observed on the first visit (p-value of 0.351) and second visit, respectively (p-value of 0.687), but on comparing the mean simplified oral hygiene index (OHI-S) score on third visit significant difference was observed (p-value of 0.03) and in the age 14-18 years, on intergroup comparison of mean OHI-S score no significant difference was observed on first visit (p-value of 0.593) and second visit, respectively (p-value of 0.404), but on comparing the mean OHI-S score on third visit, significant difference was observed (p-value of 0.018) Both the groups have shown that there was the positive impact of reinforcement on the oral hygiene of students in this age-group as well. Conclusion: There was a significant improvement in oral hygiene status and a significant improvement in participant satisfaction toward oral health in both groups. Sign language video playback is not as effective and efficient in improving the maintenance of oral health in hearing and speech-impaired children as compared to sign language. Clinical significance: This study has helped in the better understanding of different methods of maintaining good oral hygiene of hearing and speech-impaired children. How to cite this article: Singh R, Saraf BG, Sheoran N, et al. Comparison of Effectiveness of Visual and Sign Motivation on the Oral Hygiene of Students. Int J Clin Pediatr Dent 2023;16(5):671-677.

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COVID-19 has resulted in nearly 598 million infections and over 6.46 million deaths since the start of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in 2019. The rapid onset of the pandemic, combined with the emergence of viral variants, crippled many health systems particularly from the perspective of coping with massive diagnostic loads. Shortages of diagnostic kits and capacity forced laboratories to store clinical samples resulting in huge backlogs, the effects of this on diagnostic pickup have not been fully understood. Herein, we investigated the impact of storing SARS-CoV-2 inoculated dry swabs on the detection and viability of four viral strains over a period of 7 days. Viral load, as detected by qRT-PCR, displayed no significant degradation during this time for all viral loads tested. In contrast, there was a ca. 2 log reduction in viral viability as measured by the tissue culture infectious dose (TCID) assay, with 1-3 log viable virus detected on dry swabs after 7 days. When swabs were coated with 102 viral copies of the Omicron variant, no viable virus was detected after 24 hours following storage at 4°C or room temperature. However there was no loss of PCR signal over 7 days. All four strains showed comparable growth kinetics and survival when cultured in Vero E6 cells. Our data provide information on the viability of SARS-CoV-2 on stored swabs in a clinical setting with important implications for diagnostic pickup and laboratory processing protocols. Survival after 7 days of SARS-CoV-2 strains on swabs with high viral loads may impact public health and biosafety practices in diagnostic laboratories.

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Tuberculosis (TB) infected individuals harbor a heterogenous population of differentially culturable tubercle bacilli (DCTB). Herein, we describe how DCTB assays using culture filtrate either containing or deficient in resuscitation promoting factors can uncover mixed infections. We demonstrate that Mycobacterium tuberculosis (Mtb) strain genotypes can be separated in DCTB assays based on their selective requirement for growth stimulatory factors. Beijing mixed infections appear to be associated with a higher bacterial load and reduced reliance on growth stimulatory factors. These data have important implications for identifying mixed infections and hetero-resistance, which in turn can affect selection of treatment regimen and establishment of transmission links.

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Several studies described the presence of non-replicating, drug-tolerant differentially culturable tubercle bacteria (DCTB) in sputum from patients with active tuberculosis (TB). These organisms are unable to form colonies on agar but can be recovered in liquid media supplemented with culture filtrate as a source of growth factors. Herein, we undertook to investigate the response of DCTB during the treatment of individuals with drug-resistant TB. A cohort of 100 participants diagnosed with rifampicin-resistant TB were enrolled and prospectively followed to monitor response to therapy using routine culture and limiting dilution assays, supplemented with culture filtrate (CF) to quantify DCTB. Fifteen participants were excluded due to contamination, and of the remaining 85 participants, 29, 49, and 7 were infected with rifampicin mono-resistant (RMR), multidrug-resistant (MDR), or extremely drug-resistant (XDR) TB, respectively. Analysis of baseline sputum demonstrated that CF supplementation of limiting dilution assays detected notable amounts of DCTB. Prevalence of DCTB was not influenced by smear status or mycobacterial growth indicator tube time to positivity. CF devoid of resuscitation promoting factors (Rpfs) yielded a greater amount of DCTB in sputum from participants with MDR-TB compared with those with RMR-TB. A similar effect was noted in DCTB assays without CF supplementation, suggesting that CF is dispensable for the detection of DCTB from drug-resistant strains. The HIV status of participants, and CD4 count, did not affect the amount of DCTB recovered. During treatment with second-line drug regimens, the probability of detecting DCTB from sputum specimens in liquid media with or without CF was higher compared with colony forming units, with DCTB detected up to 16 weeks post treatment. Collectively, these data point to differences in the ability of drug-resistant strains to respond to CF and Rpfs. Our findings demonstrate the possible utility of DCTB assays to diagnose and monitor treatment response for drug-resistant TB, particularly in immune compromised individuals with low CD4 counts.

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Aim: To determine the knowledge, attitude, and practice of parents toward the oral health of their school-going children in Faridabad city. Materials and methods: A cross-sectional study was conducted among 312 parents who reported in the outpatient department of Pedodontics and Preventive Dentistry at Sudha Rustagi College of Dental Sciences & Research, Faridabad, Haryana, India. Data was collected through a self-administered questionnaire. The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) (version 18) software for descriptive and multivariate analysis, and the level of statistical significance used in this study was chosen at p < 0.05. Result: The results of this study showed that the sample selected had relatively good knowledge regarding the number of teeth present in the mouth of their child, the importance of filling the primary teeth, and trauma-related knowledge. Parents were aware that excess sugar intake, germs/bacteria, and sticky food are responsible for causing caries. On the contrary, a few of the parents were not aware of the ideal time for the first dental visit. Parents showed a positive attitude regarding the importance of supervised brushing twice with fluoridated toothpaste. Conclusion: We concluded in the present study that the knowledge of parents regarding the oral health of their children in Faridabad city is relatively good, but in a few aspects, it's been observed that this knowledge is not implemented, and the attitude of the parents toward good oral health practices needs to be improved more. As pedodontists, we can help to bring this change to the present society as we can counsel parents to take appropriate care of their children's oral health. Clinical significance: This article will help to assess the awareness of parents toward the oral health of their school-going children, which will further help in improving their knowledge, attitude, and practices, hence improving the oral hygiene of children. How to cite this article: Singh R, Mendiratta P, Saraf BG, et al. Knowledge, Attitude and Practices of Parents toward the Oral Health of their School-going Children in Faridabad City. Int J Clin Pediatr Dent 2022;15(5):549-553.

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Aim: To assess the impact of upper incisor trauma on the quality of life (QoL) in young children studying between the age group 8 and 13 years in Faridabad, Haryana. Materials and methods: A cross-sectional, prospective study was conducted to assess the visible permanent maxillary incisor traumas according to the classification of traumatic dental injuries (TDI) and to determine the predisposing risk factors that affect TDI and their impact on QoL in children aged 8-13 years. Questionnaires were made to gather information on demographic and socioeconomic characteristics like age, gender, and the father's and mother's education. Data on dental caries in anterior teeth were also collected using current World Health Organization criteria. Result: There were a total of 66 males and 24 females. The total decayed, missing, and filled permanent teeth (DMFT) prevalence observed was 8.9%. The main reason for trauma was found to be an accident or accidental fall (36.7%). The most common place for trauma followed by road (21.1%). Time lapsed from the injury reported was >1 year in males (34.8%), while it was within 1 year (41.7%) in females (p = 0.014). The most prevalent and impacted performance was smiling (80.0%; m = 8.7778 ± 8.658), and the least affected was speaking (4.4%; m = 0.5111 ± 3.002). Conclusion: A number of risk factors need to be considered when assessing TDIs, as TDIs can have a negative impact on the functional, social, and psychological well-being of young children. As they are frequent in children, affecting teeth, their supporting structures, and adjacent soft tissues, they may cause both functional and esthetic problems. Clinical significance: When injuries to incisor(s) produce pain, disfigurement, poor aesthetics, or other psychological effects, children may avoid laughing or smiling, and this can affect their social relationships. So, it is important to address the risk factors that predispose upper front teeth to TDIs. How to cite this article: Elizabeth S, Garg S, Saraf BG, et al. Impact on Quality of Life and Risk Factors Associated with Visible Maxillary Incisors Trauma among Young Children in Faridabad, Haryana. Int J Clin Pediatr Dent 2022;15(6):652-659.

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Introduction: Routine efficacy assessments of new tuberculosis (TB) treatments include quantitative solid culture or routine liquid culture, which likely miss quantification of drug tolerant bacteria. To improve these assessments, comparative analyses using additional measures such as quantification of differentially culturable tubercle bacteria (DCTB) are required. Essential for enabling this is a comparative measure of TB treatment responses using routine solid and liquid culture with liquid limiting dilutions (LLDs) that detect DCTB in sputum. Methods: We recruited treatment-naïve TB patients, with and without HIV-infection, and serially quantified their sputum for DCTB over the course of treatment. Results: Serial sputum sampling in 73 individuals during their first 14 days of treatment demonstrated that clearance of DCTB was slower compared to routine solid culture. Treatment response appeared to be characterized by four patterns: (1) Classic bi-phasic bacterial clearance; (2) early non-responders with slower clearance; (3) paradoxical worsening with an increase in bacterial count upon treatment initiation; and (4) non-responders with no change in bacterial load. During treatment, LLDs displayed greater bacterial yield when compared with quantitative solid culture. Upon treatment completion, 74% [46/62] of specimens displayed residual DCTB and within this group, two recurrences were diagnosed. Residual DCTB upon treatment completion was associated with a higher proportion of MGIT culture, GeneXpert, and smear positivity at two months post treatment. No recurrences occurred in the group without residual DCTB. Discussion: These data indicate that DCTB assays detect distinct subpopulations of organisms in sputum that are missed by routine solid and liquid culture, and offer important alternatives for efficacy assessments of new TB treatments. The residual DCTB observed upon treatment completion suggests that TB treatment does not always eliminate all bacterial populations, a finding that should be investigated in larger cohorts.

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CONTEXT: Dental arch morphology is an important consideration in the orthodontic treatment of dentofacial deformities. The size and shape of the arches have considerable implications in treatment planning, affecting space available, dental esthetics, and stability of dentition. The data provided by this study will be of considerable importance and relevance for practicing orthodontists and pedodontists in the region of Faridabad. AIM AND OBJECTIVE: This study aims to determine and compare the intercanine width, intermolar width, arch length, and arch perimeter in the early adolescent group (12-14 years) and middle adolescent group (15-17 years) of Faridabad. MATERIALS AND METHODS: Maxillary and mandibular impressions were made, study casts were prepared then the measurement of the individual intercanine widths, intermolar widths, arch length of maxillary and mandibular casts with the digital caliper, and arch perimeter with the help of brass wire was taken, obtained values were calculated, hence the results were evaluated. STATISTICAL ANALYSIS: Data were entered into a Microsoft Excel spreadsheet. It was analyzed using Statistical Package for Social Sciences (SPSS) version 21. Graphs were prepared using Microsoft Excel. Data were normally distributed as tested using the Shapiro-Wilk W test (p value was <0.05). Inferential statistics were performed using independent Student's t-test. The level of significance was set at 0.05. RESULTS: In the present study, all the parameters measured were increased in males in both the age-groups, i.e., the early adolescent group (12-14 years) and the mid adolescent group (15-17 years), and a significant increase was seen in the intercanine and intermolar widths in males. HOW TO CITE THIS ARTICLE: Singh S, Saraf BG, Indushekhar KR, et al. Estimation of the Intercanine Width, Intermolar Width, Arch Length, and Arch Perimeter and Its Comparison in 12-17-year-old Children of Faridabad. Int J Clin Pediatr Dent 2021;14(3):369-375.

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BACKGROUND: Pulmonary tuberculosis (TB) in people living with HIV (PLH) frequently presents as sputum smear-negative. However, clinical trials of TB in adults often use smear-positive individuals to ensure measurable bacterial responses following initiation of treatment, thereby excluding HIV-infected patients from trials. METHODS: In this prospective case cohort study, 118 HIV-seropositive TB patients were assessed prior to initiation of standard four-drug TB therapy and at several time points through 35 days. Sputum bacillary load, as a marker of treatment response, was determined serially by: smear microscopy, Xpert MTB/RIF, liquid culture, and colony counts on agar medium. RESULTS: By all four measures, patients who were baseline smear-positive had higher bacterial loads than those presenting as smear-negative, until day 35. However, most smear-negative PLH had significant bacillary load at enrolment and their mycobacteria were cleared more rapidly than smear-positive patients. Smear-negative patients' decline in bacillary load, determined by colony counts, was linear to day 7 suggesting measurable bactericidal activity. Moreover, the decrease in bacterial counts was comparable to smear-positive individuals. Increasing cycle threshold values (Ct) on the Xpert assay in smear-positive patients to day 14 implied decreasing bacterial load. CONCLUSION: Our data suggest that smear-negative PLH can be included in clinical trials of novel treatment regimens as they contain sufficient viable bacteria, but allowances for late exclusions would have to be made in sample size estimations. We also show that increases in Ct in smear-positive patients to day 14 reflect treatment responses and the Xpert MTB/RIF assay could be used as biomarker for early treatment response.

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Rapid detection of tuberculosis (TB) infection is paramount to curb further transmission. The gold standard for this remains mycobacterial culture, however emerging evidence confirms the presence of differentially culturable tubercle bacteria (DCTB) in clinical specimens. These bacteria do not grow under standard culture conditions and require the presence of culture filtrate (CF), from axenic cultures of Mycobacterium tuberculosis (Mtb), to emerge. It has been hypothesized that molecules such as resuscitation promoting factors (Rpfs), fatty acids and cyclic-AMP (cAMP) present in CF are responsible for the growth stimulatory activity. Herein, we tested the ability of CF from the non-pathogenic bacterium Mycobacterium smegmatis (Msm) to stimulate the growth of DCTB, as this organism provides a more tractable source of CF. We also interrogated the role of Mtb Rpfs in stimulation of DCTB by creating recombinant strains of Msm that express Mtb rpf genes in various combinations. CF derived from this panel of strains was tested on sputum from individuals with drug susceptible TB prior to treatment. CF from wild type Msm did not enable detection of DCTB in a manner akin to Mtb CF preparations and whilst the addition of RpfABMtb and RpfABCDEMtb to an Msm mutant devoid of its native rpfs did improve detection of DCTB compared to the no CF control, it was not statistically different to the empty vector control. To further investigate the role of Rpfs, we compared the growth stimulatory activity of CF from Mtb, with and without Rpfs and found these to be equivalent. Next, we tested chemically diverse fatty acids and cAMP for growth stimulation and whilst some selective stimulatory effect was observed, this was not significantly higher than the media control and not comparable to CF. Together, these data indicate that the growth stimulatory effect observed with Mtb CF is most likely the result of a combination of factors. Future work aimed at identifying the nature of these growth stimulatory molecules may facilitate improvement of culture-based diagnostics for TB.

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AIM AND OBJECTIVE: To assess the effect of various arch parameters, bigonial angle, and caries occurrence on mandibular incisors crowding during the early mixed dentition period. MATERIALS AND METHODS: Sixty children (mean age of 7.5 years) with mandibular anterior incisors crowding and class I molar relationship in early mixed dentition were selected. Bigonial width (BW) and caries occurrence were recorded during patient examination. The study casts were prepared divided into a normal group (NG) and crowded group (CG). Different vertical and transverse arch perimeters along with space available for the permanent mandibular incisors were measured manually. Statistical analysis was done to establish the association of all these variables with two crowding groups. RESULTS: The total incisor width or the tooth material was significantly more, and all arch parameters were less in measurements in CG than NG. The available space, BW, and caries occurrence did not differ significantly between NG and CG. CONCLUSION: The amount of tooth material and individual variations in arch parameters significantly contribute to mandibular anterior crowding in the early mixed dentition period irrespective of the age and gender of the child. CLINICAL SIGNIFICANCE: All cases of early mixed dentition mandibular incisors crowding should be individually assessed for arch length discrepancy, and transverse discrepancy results of this study help in the prediction of crowding before an establishment of a customized treatment plan with the use of lingual arch or lip bumper appliances in patients with anterior mandibular crowding may be valuable. HOW TO CITE THIS ARTICLE: Paul S, Garg S, Saraf BG, et al. Arch Measurements, Bigonial Width, Dental Caries, and Their Effect on Occurrence of Mandibular Incisors Crowding in Early Mixed Dentition Period. Int J Clin Pediatr Dent 2021;14(S-1):S57-S62.

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INTRODUCTION: Self-insertion of foreign objects in teeth is a common occurrence in children facing dental problems in an attempt to alleviate irritation, drainage, or other symptoms from teeth. However, this could lead to the development of infection and may worsen the condition if not intervened at an early stage. The removal of such objects and the preservation of involved teeth pose a challenge and, in some cases, the tooth must be extracted to resolve the infection. AIMS AND OBJECTIVES: The aim of this article is to report cases of foreign object insertion and discuss the related consequences, thereby, stressing the importance of regular dental visits and maintenance of oral hygiene so as to minimize dental neglect. CASE STUDIES: The article discusses four case reports of children in the age group 2-14 year old who reported with self- inserted foreign objects in their teeth. DISCUSSION: Regular dental visits and timely dental management can help reduce the complications associated with such incidents. Ultrasonic instruments, the Masserann kit, periapical surgery and various other techniques have been recommended by the authors for successful removal of foreign objects from the pulp chamber and the canal. HOW TO CITE THIS ARTICLE: Lakhani B, Garg S, et al. Self-insertion of Foreign Objects in Teeth. Int J Clin Pediatr Dent 2019;12(2):145-149.