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The objective of this study was to investigate knowledge, attitude, and practices of dental practitioners in Thiruvananthapuram, India regarding dental management of children with special healthcare needs (CSHCN). MATERIALS AND METHODS: A structured questionnaire was given to 400 dental practitioners. The data were analyzed using SPSS software (version 23.0) and Chi-square test was used. RESULTS: The response rate was 94%. An estimated 73.8% treated children, 66.5% showed willingness to treat CSHCN, and 70.8% had attended CSHCN in their practice. A partial knowledge in dental management of CSHCN was reported by 67.5%. An estimated 36% had undergone training in special care dentistry (SCD) but 45% were not sure whether they can provide dental care with the graduate-level training. Knowledge regarding guidelines for CSHCN was known to 19.5% and that regarding timing of the first dental visit was known to 69% of participants. Tooth extraction (43.1%) and a subsequent caries treatment (39.1%) were the most frequently done procedures, and nonpharmacological management (46.5%) was the mostly used behavior management technique. Among the barriers faced by dentists in treating CSHCN, time consumption (55.6%) and lack of training (55.1%) were commonly enlisted. Further training and improved facilities would motivate the respondents in providing better care to CSHCN. CONCLUSION: This study suggests that majority of the dentists participated had a partial knowledge on SCD and were willing to treat CSHCN. Insufficient training in the field of SCD was a major drawback, which prevented most general dentists from effectively managing CSHCN. Additional training and improving facilities can improve dental care to CSHCN. HOW TO CITE THIS ARTICLE: Rajan S, Kuriakose S, et al. Knowledge, Attitude, and Practices of Dental Practitioners in Thiruvananthapuram on Oral Health Care for Children with Special Needs. Int J Clin Pediatr Dent 2019;12(4):251-254.

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INTRODUCTION: Assessment of difference in caries prevalence among twins may help determine the character and the extent of the influence exercised by the environment, as a complement of the genetic constitution. AIM: To investigate the inter-pair differences in caries prevalence among South Indian monozygotic twins in relation to birth weight, birth order, and gender. Possible correlation among other attributes such as breastfeeding, socioeconomic status, oral habits, frequency of brushing, and sweet intake were also assessed. MATERIALS AND METHODS: A sample of 40 monozygotic children between the age group of 6 and 12 was selected. The parents were asked to complete the questionnaire and report with their children. Then dental examinations were carried out and the prevalence of dental caries among the twins were assessed. RESULTS: Among the total samples, 61.5% exhibited caries. Lower birth weight twins showed an increased chance of caries (72.22%), compared to higher birth weight twins (68.18%). Second of the twins had an increased risk of dental caries (70%) compared to the first (60%). 90% of the male twins and 45% of the female twins had caries. The association between dental caries and other variables were also assessed; those who were exclusively breastfed had an increased risk (70%) of caries. Evaluation of socioeconomic status and caries revealed a risk of for the high (65%), middle (62.5%), and lower groups (58.33%). Children without oral habits showed a higher prevalence (73.3%) of caries when compared to those without any habits (50%). It was noticed that the brushing frequency is not related to the severity of caries. The strongest association was noticed between excessive sweet liking and prevalence of dental caries. CONCLUSION: The study revealed difference in caries prevalence among monozygotic twins in relation to birth weight, birth order, and gender. It was found that variations in caries prevalence existed with other attributes also. HOW TO CITE THIS ARTICLE: Zarina R, Kuriakose S, et al. Evaluation of Inter-pair Differences in Caries among South Indian Monozygotic Twins: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(4):318-324.

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BACKGROUND: Early childhood caries (ECC) is a severe form of dental decay with multi-factorial origin. OBJECTIVES: The aim of this cross-sectional study was to determine the prevalence and related risk factors of ECC among preschool children residing in rural and urban areas of Trivandrum district in Kerala. METHODS: A sample size of 1329 preschool children of <60 months of age was randomly selected from rural and urban areas of Trivandrum and decayed missing filled teeth indices were recorded. A standardized questionnaire was distributed to the parents. The data were subjected to SPSS version 16 and statistically analyzed with Chi-square test. RESULTS: Prevalence of ECC in the study sample was found to be 54%. Furthermore, a positive association was obtained between ECC and age of the child, location of residence, dietary habits, and oral hygiene habits. CONCLUSION: There is an urgent need to implement preventive and curative oral health programs for preschool children in rural and urban areas.

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OBJECTIVES: The purpose of this study was to evaluate the surface micromorphological changes of conventional glass ionomer cement (GIC) (Fuji II, GC Corporation, Tokyo, Japan) and high strength, high viscosity GIC (Fuji IX GP, GC Corporation) subjected to 1.23% acidulated phosphate fluoride (APF) gel for 4 min. It also evaluated the surface micromorphological changes that occurred in these materials when they were coated with a layer of glass ionomer varnish prior to the application of 1.23% APF gel. MATERIALS AND METHODS: A total of 60 uniform glass ionomer cylinders were prepared (30 of each Fuji II and Fuji IX) and stored in distilled water for 48 h, following which they were divided into six groups depending on the surface treatment. Group 1: Fuji II alone, Group 2: Fuji IX alone, Group 3: Fuji II + 1.23% APF gel for 4 min, Group 4: Fuji IX + 1.23% APF gel for 4 min, Group 5: Fuji II + varnish + 1.23% APF gel for 4 min, and Group 6: Fuji IX + varnish + 1.23% APF gel for 4 min. After the required surface treatment had been done, the specimens were mounted, coated, and evaluated under scanning electron microscope. STATISTICAL ANALYSIS: Kruskal-Wallis test applied to compare the level of degradation among the groups subjected to treatment was highly significant (P < 0.001). Mann-Whitney test was applied to test the association between glass ionomer varnish and level of surface degradation and was also statistically significant (P = 0.001). RESULTS: The results indicated that APF gel etched the surface of both Fuji II and Fuji IX. However, Fuji IX showed to possess better resistance to the erosive effect of APF than Fuji II. It was also observed that application of glass ionomer varnish prior to APF gel application protected the glass ionomer from the erosive effect of APF gel. CONCLUSION: APF gel caused erosive wear of the GICs esp. Fuji II. Hence, it is advisable to avoid the use of APF containing preparations for regular home use especially in children having glass ionomer restoration. If APF gel is indicated or preferred for professional application, it is recommended to apply glass ionomer varnish on the restored teeth prior to the APF gel application.

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UNLABELLED: Ameloblastomas are locally aggressive, benign odontogenic neoplasms having a wide variety of histologic patterns. It is essential to distinguish between the three clinical types of ameloblastomas - the intra-osseous solid lesion, the unicystic type and the extra-osseous lesion, as they differ in their biological behaviour and rate of recurrence and therefore require different forms of treatment. The case presented here is of a 9-year-old boy who reported to the department with pain and swelling along the right side of the mandible of 3 months'duration. Previous histopathological examination of the lesion, performed at a local hospital, produced a picture consistent with unicystic ameloblastoma. The lesion was managed by enucleation and the patient has been followed up for the past 5 years. Radiographic and clinical examinations reveal signs of healing without recurrence. CLINICAL RELEVANCE: Conservative management of unicystic ameloblastomas may be justified in children provided that the patient can be followed up at regular intervals.

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AIM: The aims of the present study are to determine the causes and pattern of loss of permanent teeth among patients attending a dental teaching institution in southern India. METHODS AND MATERIALS: Data collected from patients attending the outpatient wing of the Sri Sankara Dental College, Kerala, during a three month period was used for the study. The cause for extraction was classified as follows: (1) caries and its sequelae, (2) periodontal disease, (3) orthodontic purposes, (4) impactions, (5) prosthodontic purposes, and (6) other reasons. RESULTS: A total of 1791 permanent teeth were extracted of which 708 (39.5%) teeth were extracted due to caries and its sequelae, 508 (28.4%) due to periodontal disease, 347 (19.4%) for orthodontic purposes, 29 (1.6%) due to impactions, 155 (8.7%) for prosthodontic purposes, and 44 (2.5%) for other reasons. CONCLUSION: The results of the present study suggest caries and periodontal disease are the major causes of tooth mortality in the study population. CLINICAL SIGNIFICANCE: Data regarding the causes of tooth loss indirectly provides invaluable information on the pattern of oral health in a population which can be utilized for planning public health policies designed to address the burden of oral diseases.

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Mouth breathing due to obstructive adenoids and tonsils has deleterious effects on craniofacial morphology especially on dentition and dental arches. Reports confirm that removal of nasal obstruction, adenoids and tonsils has not given beneficial development of circumoral musculature. Use of muscles to correct malocclusion was first recommended by Alfred Paul Rogers. This study highlights the imaging of circumoral musculature using ultrasound to evaluate the effectiveness of muscle exercises in adenotonsillectomized children. Definite changes in muscle thickness were noted in subjects, who were given muscle exercises.

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