Dental Staining Research Articles

Formulation and physical stability analysis of red beetroots (Beta vulgaris l.) effervescent granules

ABSTRACTIntroduction: Red beetroots (Beta vulgaris L.) are a natural ingredient rich in nutrients and provide various notable health benefits. In dentistry, red beetroots have the potential to act as a plaque-disclosing agent. Previous studies showed that red beetroot preparation in gelform is more effective compared to chewable tablets, but has significant drawbacks in taste. Effervescent granules have the potential to conceal the unpleasant taste of beetroot substances. This study aims to determine the ideal formula and evaluate the physical properties and stability of effervescent granules made from red beetroot extract. Methods: This was an experimental design study with descriptive analysis. The maceration method was used to extract the red beetroot constituents. Fresh fruits were collected, air-dried, and macerated with 96% ethanol twice. The filtrates were then concentrated. The wet granulation method was used to formulate effervescent granules. The samples were grouped into formula 1 (F1), formula 2 (F2), and formula 3 (F3) using 1%, 3%, and 4% red beetroot extract, respectively. All sample groups were analyzed for physical stability, namely: organoleptic, flowability, density, dissolving time, and pH tests. Results: All samples surpassed the sensory evaluation for physical properties. Formula 1 (1%) and formula 2 (3%) models passed all the physical stability tests. Meanwhile, the 4% formula (F3) failed two physical tests. F1 (1%) samples also showed lighter brown color for its lower beetroot extract concentration, indicating under-qualification as dental plaque staining materials. Therefore, 3% concentration (F2) has the best formulation regarding physical properties and stability. Conclusion: Formulas F1 and F2 have the best physical properties and stability by passing all the tests, while Formula 3 failed the organoleptic and flow rate tests.KEYWORDSformulation, physical stability, Beta vulgaris L, effervescent granules

The influence of radio frequency-based toothbrush on the accumulation of calculus and periodontal health: A randomized double-blind controlled prospective study.

The use of a toothbrush with radio frequency (RF) has shown to be of benefit regarding the reduction of plaque, calculus, and dental staining and improving teeth shade compared to conventional powered and manual toothbrushes. To evaluate the efficacy of the RF toothbrush in the reduction of calculus accumulationand its effect on periodontal parameters as well as subject satisfaction as compared to an identical sham-tooth brush. Patients who are under a strict maintenance program were included. Patients were allocated to test (RF toothbrush) or control (sham) randomly and were examined at baseline, one and three months. Clinical photos were taken and a consequential calculus assessment via ImageJ software. Clinical assessment included the following: plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and recession (REC). Patient satisfaction was assessed via a questionnaire. Fifty-eight patients (29 control, 29 test) were included. At baseline mean PPD, BOP, PI, REC, and calculus accumulation were similar between the groups. Mean buccal calculus was lower in the test group at one month 4.0% versus 6.7%, p < .05. Calculus accumulation within the groups was lower in the test group at 1 and 3 months when compared to baseline at the buccal aspect (2.8% vs. 8.9%, p < .05% and 3.8% vs. 8.9%, p < .05) and lingual aspect (6.7% vs. 16.5%, p < .05% and 8.9% vs. 16.5%, p < .05). No statistically significant results were found regarding periodontal parameters PPD, BOP, PI, and REC. No difference was found between groups regarding patient satisfaction. RF seems to have an additive effect on preventing calculus accumulation on the buccal aspect of anterior mandibular teeth at 1 month. Nevertheless, at 3 months, no difference between the toothbrushes is seen regarding calculus formation and maintaining periodontal health (ClinicalTrials.gov, Identifier NCT04640857).

Assessing the Effect of Iron on Oral Health Status among the General Population Residing in High and Low Levels of Iron Blocks in Namakkal District, Tamil Nadu, India: A Cross-Sectional Study.

This study aims to assess the effect of iron on oral health status among the general population residing in high and low levels of iron blocks in the Namakkal district of Tamil Nadu, India. A cross-sectional study was conducted to assess the impact of iron on oral health among people in the Namakkal district of Tamil Nadu, India. The sample size was estimated to be 600, which were equally divided into two groups based on the high and low levels of iron (300 samples) content of water in the Namakkal district based on the multistage random sampling method. A pre-tested structured questionnaire was used to collect the demographic data and oral hygiene practices of the people. Dental stains were recorded using a modified Lobene stain index. P value < 0.05 was considered to be statistically significant. The area and intensity of the dental stains were not significant with age, gender, and blocks. There was no statistically significant difference between the high iron and low iron blocks for the area (A), intensity (I), and I × A of stains. The study concludes that the water samples with both high and low levels of iron had a strong impact on the oral health of the people.

Antibiotic Exposure and Dental Health: A Systematic Review.

The use of antibiotics in young children is widespread and may lead to adverse effects on dental health, including staining, developmental defects, and dental caries. To systematically review the effects of early childhood antibiotic exposure on dental health. Medline (Ovid/PubMed), Embase (Ovid) and Cochrane databases. Study bias was assessed using the Newcastle-Ottawa Scale. English language articles that reported antibiotic exposure before 8 years of age and 1 or more of the relevant outcomes (dental caries, intrinsic tooth staining, or developmental defects of enamel) were included. Data on study population, design, type of antibiotic, outcome measurement, and results were extracted from the identified studies. The initial search yielded 1003 articles of which 34 studies were included. Five of the 18 studies on tetracycline described a dose response relationship between exposure to tetracycline doses of > 20 mg/kg per day and dental staining. Early childhood exposure to doxycycline (at any dose) was not associated with dental staining. There was no clear association between any early childhood antibiotic exposure and dental caries or enamel defects. In all included studies, the main limitations and sources of bias were the lack of comparison groups, inconsistent outcome measures, and lack of adjustment for relevant confounders. There was no evidence that newer tetracycline formulations (doxycycline and minocycline) at currently recommended dosages led to adverse effects on dental health. Findings regarding antibiotic exposure and developmental defects of enamel or dental caries were inconsistent. Further prospective studies are warranted.

Efficacy Evaluation of DENTE91 Anti-Stain Toothpaste: Review of In-Vitro Studies

Background: Tooth stains on the front teeth are a common esthetic issue caused by tooth discoloration. Good oral hygiene habits, such as brushing your teeth twice daily with fluoride toothpaste and after meals, flossing daily, and using a whitening toothpaste, can help reduce staining and prevent cavities. Material &amp; Methods: Many in-vitro studies has conducted to develop Dente91 Anti-Stain Toothpaste that can help in resolving the issue of demineralization, hypersensitivity, microbial strains, plaque, dental caries/tooth decay, and dental stain more effectively than other marketed products. Its composition includes ingredients such as Sodium Hexametaphosphate (SHMP), Polyvinylpyrrolidone (PVP), Tetrasodium Pyrophosphate, Covarine Blue, Zinc Citrate, Potassium Citrate, and Xylitol. Results: DENTE91 Anti-Stain toothpaste has over 99.9% significant antimicrobial efficacy and effectively reduces demineralization while enhancing the remineralization process. It also provides protection against acid attacks, promotes cell proliferation in NIH/3T3 cells, and shows significant healing activity on dental cavities. Additionally, it has the ability to occlude dentine disc lesions and reduce hypersensitivity. The findings of this study suggest that the toothpaste after using it twice a day for three days removes 63.02 % stains and also shows 80.33% improvement in teeth whitening from baseline.Conclusion: These in-vitro studies of dente91 anti-stain toothpaste concluded that toothpaste helps in resolving demineralization, hypersensitivity, plaque, dental caries/tooth decay, and dental stains. It has antimicrobial activity and teeth whitening effect too.

Characterization of the oral microbiome and gut microbiome of dental caries and extrinsic black stain in preschool children.

A lower prevalence of dental caries (hereafter termed "caries") has been observed in children with dental extrinsic black stain (EBS). We investigated the epidemiologic characterization of EBS and explored the possible role of the oral microbiome (OM) and gut microbiome (GM) in EBS formation and caries prevention. In an epidemiologic survey, 2,675 children aged 3-6 years were included. Thirty-eight of these children (7 children had both caries and EBS, 10 had EBS only, 11 had caries only, and 10 were healthy children) were recruited for 16S rRNA sequencing and collection of samples of supragingival plaque and feces. Collected plaque samples were divided into four groups: BCP (EBS+, caries+), BP (EBS+, caries-), CP (EBS-, caries+), and P (EBS-, caries-). Fecal samples were also divided into four groups: BCF (EBS+, caries+), BF (EBS+, caries-), CF (EBS-, caries+), and F (EBS-, caries-). EBS was observed in 12.10% of this population. Children with EBS had a significantly reduced prevalence of caries and a lower mean value of decayed-missing-filled teeth (dmft; p < 0.01). According to analyses of dental plaque, the P group had the most complex microbiome. The BCP group exhibited greater operational taxonomic unit (OTU) richness but a reduced evenness compared with the BP group, and the CP group showed greater OTU richness than the BP group. At the genus level, higher abundance of Actinomyces and Cardiobacterium species was observed in the BCP group. Higher abundance of Lautropia and Pesudopropionibacteriumin species was observed in the BP group compared with P and CP groups, respectively (p < 0.05). Veillonella species were significantly more common in P and CP groups than in BP groups, whereas Porphyromonas and Fusobacterium species were more common in the CP group (p < 0.05). With regard to the GM, the CF group exhibited greater OTU diversity than the BF group. The GM in the BCF group exhibited the most complex relationships across all fecal groups. GM groups could be distinguished by various unique biomarkers, such as Escherichia and Shigella species in the BCF group, Agathobacter and Ruminococcus species in the CF group, Lactobacillus species in the BF group, and Roseburia species in the F group. Our results suggest that EBS is a possible protective factor against early-childhood caries. Dental plaque and the GM may be relevant to EBS in primary dentition.

Efficiency of 5% Sodium Hypochlorite in The Removal of Dental Fluorosis Stains

Dental fluorosis is a specific disturbance in tooth formation, and is defined as a chronic, fluoride-induced condition in which enamel development is disrupted. Objective: To test the efficiency of 5% sodium hypochlorite in removing dental fluorosis stains. Methods: A 5 percent solution of NaOCl was used in each case. It was administered with a cotton applicator to the whole surface of the teeth, and it was repeated until the NaOCl solution had evaporated. After treatment, a follow-up assessment was conducted by a vita shade guide. Results: Patients with dental fluorosis aged 12 to 20 were enrolled in the study. 32 men (59.3%) and 22 women were studied (40.7%). One patient (1.9%) had completed college. There were 23 (42.6%), 23 (42.6%) and 05 (09.3%) cases with inadequate socioeconomic status. One in ten people (or 18.5%) had a family history of fluorosis. 26 (48.1%) brushed once, 23 (42.6%) brushed twice, and just 05 (09.3%) brushed three times. There were 25 mild instances, 15 moderate cases, 10 severe cases, and 4 severe dental cases (DF). 5% sodium hypochlorite was efficacious in 40 (74.1%) and 14 (24.9%) cases of mild to severe dental fluorosis. Conclusion: The 5% sodium hypochlorite was found to be an efficient method for eliminating dental fluorosis lesions in this investigation. Non-invasive and safe procedure for these lesions. No additional supplies are needed, and it may be used on children's permanent teeth with ease. To support the efficacy of a bigger sample size, further studies are recommended.

Budaya Modifikasi Gigi dalam Konteks Antropologi Forensik di Indonesia

In a forensic anthropology context, the human identification process requires two equally important aspects—biological and sociocultural. Unfortunately, the latter is often overlooked. Albeit, culture can leave important markers on the human body. Thus, it may aid forensic anthropologists to identify the demographic and cultural characteristics of an unknown individual. This review article’s purpose is to discuss varieties of cultural dental modification in Indonesia and its significance in forensic identification. This paper reviewed at least 15 primary works of literature acquired from Google Scholar, while a handful of other literature is additional. Then, the data from said literature was extracted into four subchapters. Consumption of betel nut can influence various dental characteristics, such as dental staining and calculus. This paper also discusses dental sharpening and inlay. Dental ablation is a relatively ancient culture that symbolizes mourn or marriage and is often misidentified as other types of AMTL. Daily activities, e.g., diet and tooth brushing habits also influence human dentition. Based on the literature review, the author concluded that various types of dental modification are performed by many cultures across Indonesia, with one culture bearing unique features that differentiate them from other cultures. During the identification process, it is important to know what type of modification is performed, whose dentitions are modified, and which teeth are modified—since it may bare significance to the individualization process.

1335. Retrospective evaluation of doxycycline for the treatment of Lyme disease among young children

Abstract Background Lyme disease is the most common pediatric tickborne infection. Due to largely disproven concerns of doxycycline-related dental staining among patients &amp;lt; 8 years old, no prospective data exist on efficacy and adverse effects in young children with Lyme disease. Based on emerging data, our institution has used doxycycline during the past decade when alternatives cannot be given. Our study aims to describe short-term adverse effects and treatment failures among young children receiving oral doxycycline for Lyme disease. Methods Retrospective chart review of patients &amp;lt; 8 years old within the Stony Brook Medicine system from 2010-2020. Patients were identified by ICD-9/-10 codes for Lyme disease prescribed doxycycline at the same visit. We excluded those lacking an objective finding of Lyme disease, including single or multiple erythema migrans (EM), facial nerve palsy, carditis, meningitis (headache with pleocytosis &amp;gt;5 WBC/μL), and/or arthritis, those with an alternative diagnosis, and those receiving post-tick exposure prophylactic doxycycline. Data collected included demographics, symptoms, laboratory results, treatments, and outcomes. Descriptive statistics were calculated. Results 32 charts were included. Average age was 5.1 years. 66% were male. The majority of the patients presented with a single EM (Table for presenting symptoms). Initial antibiotics were doxycycline (63%) or a beta-lactam (37%). Rationale for doxycycline included beta-lactam allergy or intolerance (47%), required for treatment of clinical syndrome (such as CNS disease) (28%), concern for alternative tickborne infection (3%), and no reason given (22%). There were no severe adverse reaction to doxycycline; 2 patients stopped due to nausea/vomiting and 1 due to refusal of oral medications. Among the 29 patients who completed doxycycline, there were no known Lyme disease treatment failures. Presenting symptoms of children &amp;lt;8 years old treated with doxycycline for Lyme disease Total percent exceeds 100% due to patients presenting with multiple symptoms. Percent calculation based on all included patients (n = 32). Conclusion In this small cohort of young children with Lyme disease, doxycycline was generally well-tolerated, without severe short-term adverse effects, and resulted in no treatment failures. As there is no prospective data evaluating doxycycline in this population and future randomized trials are unlikely, the data presented provides reassurance that doxycycline is effective and safe for this indication. Disclosures All Authors: No reported disclosures.

Oral care measures for preventing nursing home-acquired pneumonia.

Pneumonia in residents of nursing homes can be termed nursing home-acquired pneumonia (NHAP). NHAP is one of the most common infections identified in nursing home residents and has the highest mortality of any infection in this population. NHAP is associated with poor oral hygiene and may be caused by aspiration of oropharyngeal flora into the lung. Oral care measures to remove or disrupt oral plaque might reduce the risk of NHAP. This is the first update of a review published in 2018. To assess effects of oral care measures for preventing nursing home-acquired pneumonia in residents of nursing homes and other long-term care facilities. An information specialist searched CENTRAL, MEDLINE, Embase, one other database and three trials registers up to 12 May 2022. We also used additional search methods to identify published, unpublished and ongoing studies. We included randomised controlled trials (RCTs) that evaluated the effects of oral care measures (brushing, swabbing, denture cleaning mouthrinse, or combination) in residents of any age in nursing homes and other long-term care facilities. At least two review authors independently assessed search results, extracted data, and assessed risk of bias in the included studies. We contacted study authors for additional information. We pooled data from studies with similar interventions and outcomes. We reported risk ratios (RRs) for dichotomous outcomes, mean differences (MDs) for continuous outcomes, and hazard ratios (HRs) or incidence rate ratio (IRR) for time-to-event outcomes, using random-effects models. We included six RCTs (6244 participants), all of which were at high risk of bias. Three studies were carried out in Japan, two in the USA, and one in France. The studies evaluated one comparison: professional oral care versus usual oral care. We did not include the results from one study (834 participants) because it had been stopped at interim analysis. Consistent results from five studies, with 5018 participants, provided insufficient evidence of a difference between professional oral care and usual (simple, self-administered) oral care in the incidence of pneumonia. Three studies reported HRs, one reported IRRs, and one reported RRs. Due to the variation in study design and follow-up duration, we decided not to pool the data. We downgraded the certainty of the evidence for this outcome by two levels to low: one level for study limitations (high risk of performance bias), and one level for imprecision. There was low-certainty evidence from meta-analysis of two individually randomised studies that professional oral care may reduce the risk of pneumonia-associated mortality compared with usual oral care at 24 months' follow-up (RR 0.43, 95% CI 0.25 to 0.76, 454 participants). Another study (2513 participants) reported insufficient evidence of a difference for this outcome at 18 months' follow-up. Three studies measured all-cause mortality and identified insufficient evidence of a difference between professional and usual oral care at 12 to 30 months' follow-up. Only one study (834 participants) measured the adverse effects of the interventions. The study identified no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining. No studies evaluated oral care versus no oral care. Although low-certainty evidence suggests that professional oral care may reduce mortality compared to usual care when measured at 24 months, the effect of professional oral care on preventing NHAP remains largely unclear. Low-certainty evidence was inconclusive about the effects of this intervention on incidence and number of first episodes of NHAP. Due to differences in study design, effect measures, follow-up duration, and composition of the interventions, we cannot determine the optimal oral care protocol from current evidence. Future trials will require larger samples, robust methods that ensure low risk of bias, and more practicable interventions for nursing home residents.

Effect of tobacco and nicotine in causing staining of dental hard tissues and dental materials: A systematic review and meta-analysis.

Dental staining is a common concern for tobacco users. However, little is known about which components of tobacco are responsible for the staining and whether nicotine may be implicated. This is of increasing relevance with the popularity of novel products such as heated-tobacco products and electronic cigarettes (E-cigarettes). This systematic review aimed to establish the evidence base for the effect if any, of the various tobacco and nicotine products in causing staining of dental hard tissues and materials. This systematic review was performed in accordance with the preferred reporting items for systematic reviews and meta-analysesguidelines. There were four structured population intervention comparison outcomesquestions. A search was conducted up to December 2021 in three databases: MEDLINE, EMBASE,and Web of Science, and manual searching of relevant sources was also completed. Two researchers individually reviewed the titles then abstracts and finally full articles. A reporting quality appraisal was conducted appropriately to the study methodology. Of the 815 records titles identified, 56 full-text articles were assessed for eligibility, of which 27 were included for analysis. The included studies were mainly laboratory studies of varying reporting quality. There was evidence from 18 studies that tobacco exposure caused staining of dental hard tissues (pooled results from three studies- enamel/dentine; mean difference [MD]: 16.22; 95%confidence interval[12.11, 20.32; I2 : 96%)and materials (pooled result from four studies-resin composite; MD: 11.90; 95% CI: 11.47, 12.34; I2 : 100%). There was limited evidence that E-cigarettes 99%) and heated tobacco products (HTPs; pooled results from three studies--1.07, 6.54; I2 : 99%) cause staining, but this was lower than with traditional tobacco/found 11 compounds, of which 8 were terpenoids, from tobacco products implicated in causing staining. Finally, there was some evidence that resin composites stained more than other materials. Tobacco smoking causes dental staining. There was limited evidence that E-cigarettes and HTPs did cause dental staining that was less intense than that caused by traditional tobacco products.

86 Multiple dysostosis in Hurler’s disease: a report of three cases

IntroductionHurler syndrome is the most severe form of mucopolysaccharidosis type I (MPS I), It is a hereditary, metabolic disorder due to an enzymatic deficiency in alpha-Liduronidase with tissue accumulation of glycosaminoglycans (GAGs) leading gradually to chronic multiple visceral dysfunction.We report three cases of multiple dysostosis in Hurler's disease.Case 1:Mr S.O, 26 years old man, presenting a dysmorphic syndrome associating short stature, facial dysmorphism, dental staining, gingival retractions, recurrent bronchial infections, mitral valve disease and joint deformities with a tunnel syndrome. Alpha L iduronidase dosage was performed confirming the diagnosis of Hurler's disease. The radiological assessment showed thickening of the cranial vault with poorly developed paranasal sinuses. Vertebral bodies collapse with oval shape, thoracolumbar kyphosis, hypoplasia of the iliac bones and the superior acetabular region, coxa-valga, with dysplastic femoral heads; cortical thinning of the long bones with a tapered appearance of the distal portions of the radius and ulna, small and deformed carpal bones, thin metacarpal bones, and dysplastic interphalangeal joints.Case 2:Patient B.M 17 years old girl, born of a consanguineous marriage, presenting with a malformation syndrome with short stature, facial dysmorphism, umbilical hernia, valvular heart disease, hepatomegaly, joint stiffness and deformity. Standard x-rays revealed macrocephaly with thickening of the cranial vault, flattened mandibular condyles, with hypertrophy of the clinoid processes; pectus excavatum, platyspondyly with thoracolumbar kyphoscoliosis, small and narrowed pelvis, enlarged and obliquus cotyles, coxa-valga with dysplastic femoral heads; long curved bones with metaphyseal and diaphyseal enlargement, short and enlarged proximal and intermediate phalanx and hypoplastic distal phalanx.Case 3:Patient D.W, 31-year-old female, born of a consanguineous marriage. The patient’s physical examination shows a dysmorphic syndrome with short stature, facial dysmorphism, corneal opacity, recurrent otorhinolaryngological and bronchial infections, joint deformities with carpal tunnel syndrome. An alpha L iduronidase assay was performed confirming the diagnosis. The radiological assessment revealed macrocephaly, thickening of the cranial vault, an elongated J-shaped sella turcica, a short thorax, short and thick clavicles, widened, oar-shaped ribs tapering at their vertebral insertion, “spur” vertebrae, thoracolumbar kyphoscoliosis, narrowed pelvis with coxa-valga and genu valgum, small and deformed carpal and tarsal bones with cortical thinning of long bones.DiscussionThe term dysostosis multiplex is used to describe skeletal abnormalities seen in MPS I that are often early and prominent. The progressive accumulation of GAGs led to an increase in chondrocyte apoptosis favoring the production of pro-inflammatory cytokines (TNFα, IL-1), chemokines and metalloproteases. This results in a degradation of the cartilaginous matrix, increased by the mechanical stresses, the disturbance of endochondral ossification, particularly in the sites subjected to articular mechanical stresses. That could explain the focal defect of the ossification of certain cartilaginous sites leading to this multiple dysplasia. At the axial level, the vertebrae can be oval shaped and flattened (platyspondyly). In the lower limbs, coxo-femoral abnormalities (coxa valga, splayed or flattened acetabulum), epiphyseal alterations, genu valgum, and hypoplasia of the iliac bones can be found. The metacarpal bones take on a tapered appearance like sucked candy cane and the interphalangeal joints of the hands and feet are dysplastic. Hypoplasia of the odontoid process leads to potentially serious cervical instability. Regular monitoring by MRI is necessary to avoid the risk of spinal cord section. The early introduction of enzyme replacement therapy led to a slower progression of symptoms, with improved growth, joint mobility and physical capacity, and stability over time, especially when associated with an appropriate rehabilitation care.ConclusionEven if Hurler syndrome is rare, it is still underdiagnosed, it can give various and varied clinico-radiographic features and potentially severe disabilities. Early diagnosis is essential since enzyme replacement therapy could stop or slow down the evolution to irreversible tissue damage.

Aggressive Systemic Mastocytosis with a Relatively Non-aggressive Course

Background: Mastocytosis is a heterogeneous group of disorders that is characterized by excessive proliferation and pathologic accumulation of mast cells in various body tissues. The mast cells also have abnormal morphology and aberrant expression of surface receptors. Clinical Description: A 4-year-old boy was brought with a history of generalized skin lesions since birth and abdominal distension for 3 years. The diagnosis had not been established to date. General physical examination revealed severe acute malnutrition, pallor, dental staining, facial hypertrichosis, polymorphous skin lesions (cicatricial alopecia, diffuse erythema, multiple plaques of variable diameter, skin-colored nodules, and hypertrophic irregular scars), and positive Darier's sign. He also had hepatosplenomegaly. The differentials considered were congenital erythropoietic porphyria, systemic mastocytosis (SM), multifocal Langerhans cell histiocytosis, and linear immunoglobulin A bullous dermatosis. The presence of mast cells on skin biopsy and elevated serum tryptase levels led us to suspect SM and perform bone marrow studies. The diagnosis of “aggressive” SM was initially made on the application of the diagnostic criteria but revised to “smoldering” SM with the emergence of Vitamin B12 deficiency as the probable cause of pancytopenia. Management: Management was planned by a multidisciplinary team: pediatrician, dermatologist, and hematopathologist. The parents were counseled about the nature, natural history, treatment options, and prognosis of the disorder. The child was provided with nutritional rehabilitation and medication for the cutaneous symptoms (selective histamine H1 receptor inverse agonist, H2-receptor antagonist, and application of topical tacrolimus and calamine lotion). Conclusion: The prognosis varies according to subtype. Careful correlation of clinical and laboratory investigations is required when applying the diagnostic criteria for staging.

Effect on Dental Stains by Potassium Tripolyphosphate Added Chewing Gum

Background: Today, people worldwide consider the discoloration of teeth the main concern, therefore, dental stains are an important problem for a lot of patients, especially for smokers, and tea and coffee consumers. Objective: This trial was planned to evaluate the effectiveness of a sugar-free chewing gum added with potassium tripolyphosphate, compared to a placebo chewing gum on the development or the removal of dental extrinsic stains preserving regular daily oral hygiene. Methods: This was a single-center, double-blind, randomized, 6-week parallel controlled clinical trial. Among those who were eligible for the trial, 162 adult participants were randomly allocated into two groups of 81 each and were instructed to maintain customary oral hygiene. All subjects started the trial period after an in-office dental visit to set the stain index baseline. They chewed one of the two chewing gums for six weeks, five pieces per day, preferably after meals and snacks, for 10 minutes. Both chewing gums were sugar-free, 2g of weight with the same size and shape. The test chewing gum contained potassium tripolyphosphate (24.4 mg per piece), the control chewing gum was identical without potassium tripolyphosphate, therefore, it did not contain any anti-stain agent. The dental extrinsic stain was measured at the first visit and at the end of six weeks by the Modified Lobene Stain Index (MLSI). Comparisons between the groups were performed using ANOVA after adjustment of the baselines, and comparisons between initial and final indexes inside the groups were performed using paired t-tests. Results: After the 6 weeks, 154 subjects completed the trial, 77 in each group. The mean difference in stain composite index for all sites after six weeks was 0.04±0.07 in the control group and -0.03±0.07 in the test group. This difference was statistically significant after baseline adjustment (p&lt;0.001). Moreover, the differences in stain indexes for both buccal or lingual-palatal sites showed a statistically significant difference (p&lt;0.001) for those using the test chewing gum versus the control chewing gum. Conclusion: The overall findings of this clinical study suggest that the use of chewing gum containing potassium tripolyphosphate can reduce dental stains versus placebo chewing gum on frontal teeth after six weeks of maintaining regular oral hygiene with normal tooth brushing.

Impact of particle morphology on abrasion, polishing and stain removal efficacy in a tooth cleaning model system

Toothbrushing with toothpaste is used for daily maintenance of oral hygiene, and aims to remove food debris, the dental plaque biofilm and dental stains from tooth surfaces. However, toothpastes can also cause tooth abrasion as different particle morphologies are known to exert differential cleaning and abrasivity. Consequently, silica and alumina particles with spherical and angular morphologies, at comparable size ranges and concentrations, were used to brush polished, partially roughened or stained bovine enamel specimens and their impact on tooth abrasion, surface polishing and stain removal in vitro, was determined. Spherical silica gel particles at concentrations as low as 0.5% (w/w) achieved greater dental stain removal and higher surface polishing compared with 15% (w/w) standard abrasive silica without producing significant increases in enamel wear. Comparable results were also found for alumina abrasive particles, whilst spherical alumina particles at concentrations as low as 0.25% (w/w) showed greater stain removal compared with 1% (w/w) angular alumina particles. Both particles achieved similar surface polishing and produced less enamel wear. These findings are important in underpinning the development of dentifrices which aim to achieve optimal cleaning whilst minimising dental hard tissue damage.

Esthetic treatments for white and yellow/brown enamel stains

In order to solve the dental aesthetic pattern of a patient, who has dental stains on the enamel surface, we carried out this case report where are presented the steps employed for bleaching of teeth with superficial yellow/brown enamel stains with carbamide peroxide and micrometric removal of hard white enamel stains using the enamel microabrasion technique. The worn of dental surface during enamel microabrasion technique was measured with a digital analysis, using a intraoral scanner. It was observed a surprisingly esthetic outcome as the superficial enamel stains were camouflaged by the at-home dental bleaching. Only the superficial white enamel stains that remained evident were removed by enamel microabrasion technique with a minimal average wear of 118 um of the dental enamel on all anterior teeth, showing to be a conservative technique. Dental bleaching can solve the discoloration of vital teeth, such as the superficial yellow/brown hard enamel stains, as well as can mask the superficial white enamel stains. But when necessary, enamel microabrasion technique is an effective minimally-invasive option that can also be adopted.

Comparative Evaluation of Esthetic Improvement of Resin Infiltration (RI), In-office Bleaching (B), Enamel Microabrasion (M) and Resin Infiltration with Double Application of Infiltrant (2RI) on Non-pitted Fluorosis Stains: A Randomized Six-month Interventional Study.

BackgroundNewer minimally invasive treatment options for improvement in appearance of dental fluorosis stains are gaining popularity in recent years.ObjectiveTo evaluate and compare the clinical success in esthetic improvement of resin infiltration, in-office bleaching with 35% hydrogen peroxide, enamel microabrasion, and resin infiltration with double infiltrant application on nonpitted fluorosis stains.Materials and methodsSeventy two patients aged between 6 and 12 years with nonpitted dental fluorosis stains on the upper anterior teeth were randomly selected and divided into four interventional groups: group 1- resin infiltration (RI), group 2- in-office bleaching using 35% hydrogen peroxide (B), group 3- enamel microabrasion (M), and group 4- resin infiltration with double infiltrant application (2RI). In each group, standardized photographs were taken preoperatively, immediate postoperatively and after 1, 3, and 6 months time interval postoperatively to assess the esthetic improvement (EI) and changes in white/brown surface opacities/stains (SC) using a Visual Assessment Scale (VAS).ResultsRI and 2RI showed statistically significant results (p ≤0.05) followed by microabrasion and bleaching, for both the evaluation criteria (EI and SC) at all the follow-up intervals.ConclusionResin infiltration is a promising procedure that demonstrated remarkable clinical success for improvement in esthetics of nonpitted fluorosis stains with stable long-term positive outcome.How to cite this articleGarg I, Kumar A, Kumar A. Comparative Evaluation of Esthetic Improvement of Resin Infiltration (RI) In-office Bleaching (B) Enamel Microabrasion (M) and Resin Infiltration with Double Application of Infiltrant (2RI) on Non-pitted Fluorosis Stains: A Randomized Six-month Interventional Study. Int J Clin Pediatr Dent 2022;15(1):20-34.

The Impact on Dental Staining Caused by Beverages in Combination with Chlorhexidine Digluconate.

There are several hypotheses regarding how chlorhexidine (CHX) digluconate causes staining with the role of beverages, specifically the precipitation of anionic dietary chromogens onto adsorbed cations, the most probable cause. The aim of this study was to investigate and compare the staining potential of common beverages using an in vitro staining and brushing model to better understand the interactions between chromogens from different beverage categories and the teeth. Human enamel samples were exposed to a cyclic treatment of artificial saliva and 0.2% CHX mouthwash combined with a range of beverages, with and without brushing, simulating a period equivalent to 2 weeks. Eleven beverages were tested: diet coke, diet lemonade, white wine, red wine, lager beer, black tea, coffee, black tea with milk, coffee with milk, ginger and lemon infusion, and water. Toothbrushing was performed in a brushing simulator with toothpaste and also with water. Colorimetric differences were determined by ΔE using a VITA Easyshade dental spectrophotometer. Statistical analyses were performed by one-way analysis of variance with post hoc Tukey's honestly significant difference test and Levene's test. Black tea and red wine produced highest staining, which agrees with the literature. Significant staining was also observed for a ginger and lemon infusion, coffee, coffee with milk, tea with milk, and lager beer compared with water (p < 0.05). The staining potential of diet coke in combination with brushing appeared to be connected to its low pH. Both white wine and diet lemonade produced stain comparable to the water control. After treatment with high staining beverages, scanning electron microscope evaluation confirmed the formation of a surface layer. The mechanical resistance of the stain differed depending on the beverage, black tea stain was the most resistant. The addition of milk to tea and coffee considerably modified the stain layer and the adhesion to the tooth surface. The data may help demonstrate that appropriate user guidance can avoid stain and in turn help improve user compliance during short-term use of this gold standard antimicrobial treatment.

Medical and psychosocial health status of adolescent school going girls

Aim: To evaluate medical and psychosocial health status of adolescent school going girls. Material and Methods: The present cross-sectional study was conducted in the Christian Medical College, Ludhiana from February 2017 to January 2019. The study group was consisted of 1000 adolescent girls of school aged 10-19 yrs in rural Ludhiana. Children were screened for any of adolescent morbidity based on questionnaire. The patients were interviewed that requests for the demographic, socioeconomic status, medical history and previous history of taking any medications and supplements. Girl’s socioeconomic status were classified according to Kuppuswamy scale. For skin related disease dermatologist was considered. Dental caries, dental staining and brushing habits were recorded based upon the examination. Informed pertaining to psychosocial morbidities were recorded i.e. depression, anxiety, stuttering and psychosomatic symptoms. Results: 37.1% girls belong to 10-14yr age group, likewise 25.5% to 15-17yrs and 37.4% to 18-19yr age group. Majority of girls (99.6%) attained menarche after 12yrs of age and dysmenorrhea (12.8%) was reported to be the most common menstrual problem among girls; majority of girls were using sanitary pads for menstrual hygiene purpose. In hearing assessment about 1.7% of girls were found in having hearing difficulty. 35.1% of girls were suffering from dental caries; dental staining was present in 15.8% of girls. Acne was the commonest skin problem (13%).5.2% of girls were found to be in depressed mood, 1.2% of total girls were anxious and stuttering was reported in 0.9% of total girls. Conclusion: To achieve wholesome adolescent health, we need to have a multidimensional approach covering all the adolescent health problems with special emphasis on mental health, behaviour change communication towards healthy lifestyle and positive social environment to acquire life skills.

Prevalence and description of dental disorders in skulls of free-living wild primates from Paraná State, Brazil.

Non-human primates can present oral diseases. However, differences among the dentition of the various species make it difficult to understand their dental features and associated diseases. This research hypothesizes that the prevalence of dental disorders varies in the species studied according to distinct types of diet. Forty-five syncraniums of the species Alouatta caraya, Alouatta guariba clamitans, Sapajus nigritus, Callithrix jacchus, and Callithrix penicillata were evaluated by visual inspection, magnifying glasses, and on cone-beam computed tomography. Disorders identified consisted of missing teeth before death, agenesis, dental calculus, dental wear, dental staining, dental fracture, exposure of pulp chamber, alveolar bone resorption, tooth discoloration, and persistence of deciduous teeth. Alouatta guariba clamitans presented the most disorders. The results suggest that neotropical primates have a high prevalence of dental changes, even in free-living conditions, and that the differences observed among them may be associated with different diet patterns.