Pain during dental procedure has a profound effect on the behavior of children. The comfort controll injection system is a compact, portable design that injects the LA solution with constant speed and pressure control. Insulin syringe needles are short and very thin that are made to lesser discomfort during LA administration. Aim: To evaluate the pain perception while administering bilateral mandibular local infiltration, in children undergoing dental procedures, by using comfort controll injection and insulin syringe. Material and methods: Children between 5 and 9 years of age requiring local anesthesia on both sides of arch for various dental procedures were divided into 2 Groups: Group A, comfort controll injection system and Group B, insulin syringe. The mandibular local infiltration was administered using comfort control device on the left side and the insulin syringe on the opposite side at the first appointment and subsequent appointment respectively. Prior, during and after the procedure, the heart rate and saturated oxygen rate were measured using pulse oximeter and FLACC (Face, Legs, Activity, Cry and Consolability) and MCDAS (modified child dental anxiety) were recorded. Result: The statistical analysis showed non-significant difference in the mean of heart rate before and after local infiltration, whether significant difference seen during local infiltration. Highly non-significant difference of mean values of SpO₂ and highly significant difference of mean value of FLACC scale was observed before, during and after local infiltration. The mean of MCDAS scale, during and after local infiltration showed significant difference whether non-significant difference seen before local infiltration. Conclusion: Comfort control device is introduced several years back and best alternative to other syringe system still it did not get popularity. It is important for clinicians to be familiar with these devices for dental procedures to best explore them.

Objective: The purpose of the study was to assess the preference of colored restorative material based on gender and age-groups in 3–12-year-old children. Materials and method: A Survey was conducted, where children were divided into three groups depending on Age, Group A (3–6 years) Group B (7–9 years) Group C (10–12 years). Class 1 cavity preparation followed by different colored composite restorations of FLUO and PEARL JEN-RAINBOW were done on typodont. All the preferences were recorded according to ranking and visual analog scale. Result: Overall ratings showed difference in preferences of all age-groups. It was difficult to rely on the results revealed by evaluating overall ranking, further it was evaluated based on different age-groups and showed significant difference. For overall preferences recorded using visual analog scale was only significant for one color, pearl white (p=0.018). Conclusion: The findings of this survey suggest that great diversity in preferences was observed not only among gender but even different age-groups.

Introduction: Many dentists perform extraction of deciduous teeth that could be preserved by pulpectomy, claiming that the tedious and longer duration of endodontic treatment leads to development of anxiety and negative behavior in children. Aim: To determine and compare the anxiety experienced and behavior exhibited by children undergoing endodontic treatment using manual and rotary file systems. Methods: This clinical study comprised 150 children. The pulpectomy procedure was carried out in the two visits. The first visit consisted of administration of local anesthesia, isolation, access cavity preparation, and pulp extirpation. In the second visit, the children were grouped into 3 groups (Group 1, Group 2, and Group 3) consisting of 50 children each. In groups 1, 2, and 3, root canals were instrumented using the Kedo-S pediatric rotary file system, HERO shaper rotary file systems, and manual Ni-Ti K files, respectively. Root canal instrumentation time was calculated. Anxiety and behavior of children during root canal instrumentation were assessed. Results: The mean instrumentation time for groups 1, 2, and 3 were 14.56 ± 2.89 minutes, 17.93 ± 3.51 minutes, and 29.00 ± 2.08 minutes, respectively. The children in groups 1 and 2 experienced significantly less anxiety and exhibited positive behavior than children in group 3. Conclusion: The children treated with rotary file systems experienced less anxiety and exhibited positive behavior compared to children treated with the manual file systems.

Background: Schoolteachers can motivate a large number of children and that offers an interactive way for children to learn good oral health habits. Hence, this study was undertaken with the objective of assessing the schoolteacher's oral health knowledge, attitude, and practices which can benefit the schoolchildren by improving the oral health of the child and a resultant disease-free mouth. Materials and methodology: This was a cross-sectional survey conducted among Schoolteachers of Nalgonda district, Telangana. A structured questionnaire was formulated and sample of 226 Schoolteachers from both rural and urban areas were assessed. Data related to knowledge on oral health, attitude, and practice regarding their personal oral health was obtained. The obtained data was tabulated and statistically analyzed. Results: About 59.3% teachers have knowledge that inappropriate and inadequate brushing may lead to gum diseases, but only 8% have conversance regarding the prevention of gum diseases. Whereas 11.9% insight regarding etiology and prevention of dental caries. Nearly 49.2% said that they have visited dentist in the last 6–12 months, 52.7% reported that they will visit the dentist only when they had pain. Around 60.6% of teachers never advised the parents of children to seek dental care. Conclusion: Knowledge, attitude, and practices regarding oral hygiene measures among Schoolteachers were inadequate. Therefore health educational programs regarding the importance of oral health and the oral hygiene measures among Schoolteachers should be conducted.

Rare diseases, however intriguing they may seem, are often a dilemma in terms of diagnosis and treatment planning, especially owing to scanty literature among various age-groups. Being presented is a case of a 10-month-old child with congenital insensitivity to pain, otherwise known as Hereditary Sensory Autoneuropathy (HSAN) Type 5. The child was reported with Self-injurious Behavior (SIB), recurrent infections, corneal scarring, and spontaneous tooth mobilities. Upon a series of stepwise diagnostic workup, this was found to be a rare case of HSAN5. The genetic basis of the disorder was found to be a mutation in the NTRK1 gene, which is otherwise most commonly involved in HSAN4, however phenotypic features of the latter were not evident. Supportive treatment and counseling were key in providing care to the child.

Odontomes are hamartomous lesions or malformations rather than true neoplasms. They frequently cause impaction, delay in eruption of permanent teeth or even at times deciduous teeth retention. This case report describes treatment for compound odontome in an 11-year-old male who had presented with the chief complaint of excessive space with respect to upper front teeth on left side. Radiographically, a calcified mass was apparent in association with the impacted permanent left maxillary central incisor, which led to failure of permanent upper left central incisor eruption and provisional diagnosis of odontome was made. A sequential surgical approach, odontome removal and exposure followed by orthodontic traction of the impacted tooth with closed eruption technique was followed to achieve proper incisor positioning. Management and close monitoring resulted in successful esthetics, good periodontal health and functional occlusion.

Management of complicated crown fracture is one of the frequently faced clinically challenging situations. Crown fracture of anterior teeth is a common form of dental trauma affecting children and adolescents. One of the methods of managing such a situation is reattachment of the fractured crown segment to the parent tooth. This case report describes the treatment of complicated crown fractures in maxillary right and left central incisors of an eight-year-old girl child who reported to the Pedodontics Department. The fractured segments were reattached and apexification was done, and the patient was reviewed to evaluate the treatment plan's success.

The adenomatoid odontogenic tumor (AOT) is an uncommon benign, non-invasive tumor also known as “two-thirds tumor,” which is either intra or extraosseous. The extraosseous AOT is also referred to as peripheral, gingival or soft tissue odontogenic tumor. Gingiva is a common site for reactive lesions, benign neoplasms and distant metastasis. Peripheral adenomatoid odontogenic tumor (PAOT) is a rare entity with an incidence of only 3% of all reported AOTs. It is primarily described as a slow-growing gingival swelling with minimum or no bone involvement. It presents highest predilection for maxillary gingiva of anterior teeth and predominantly affects children. Till date 22 PAOT's have been reported worldwide and their behavior is similar to intraosseous AOTs. Thus, the clinician should be aware while treating them. The present case describes an additional case of PAOT on the maxillary anterior gingival region of a 15-year-old female. Key messages: AOTs called as “master of disguise” and peripheral ones commonly resemble gingival lesions. Gingiva is a common site for reactive and neoplastic conditions. So, care must be taken for its proper diagnosis, timely treatment and follow-up.

Apicoectomy in children is considered as an anticipated treatment option to salvage a tooth with periapical pathology unresolved by conservative root canal treatment protocol. This methodology is a multidisciplinary systematic approach which includes endodontic procedures like root canal treatment, oral surgical procedures like resection of root apex, cavity preparation of root apex, and retrograde restoration of the root apex to achieve a bacteria-tight seal of the root canal system. This paper presents case series of 3 cases of children with complicated crown fractures of anterior teeth with periapical pathologies treated with apicoectomy and root end treatment with three different retrograde materials. The retrograde restorative approaches chosen were composite with bone grafting in Case 1, MTA in Case 2 and amalgam with bone grafting along with GTR membrane in Case 3 respectively. All the three cases showed successful treatment outcome during follow-up visits and presented with clinical and radiographic signs of eventful healing.

Human teeth manifest high degree of diversity in both primary and permanent dentition. Paramolar tubercle (parastyle) is one of the rare morphological variations particularly if present in primary dentition with a prevalence ranging from 0.3–1.5%.¹ These deviations are thought to be the remnants of buccal cingulum in lower primates. Morphological aberrations of such kind give an insight to development and evolution of dentition. However, these can also predispose to a variety of clinical problems. A complete understanding of dental anatomy and its variations is therefore imperative for successful completion of dental procedures. These aberrations also hold a great importance in forensic field such as in the identification of criminals or victims during mass causalities. This case series presents a rare finding of occurrence of paramolar tubercles in primary molars in four North Indian children and presence of a similar parastyle in one of the siblings. This paper is an attempt to educate the clinicians towards the existence of such a trait and its clinical significance so that it can be studied in larger numbers.

Research question: Are zirconia crowns clinically superior to stainless steel crown in restoring primary molars. Materials and methods: Articles in electronic databases from 2000 to 2020 via PubMed, Google Scholar, Science Direct and Cochrane Central were searched by 2 reviewers and full text of the article was included for assessment based on inclusion and exclusion criteria. Electronic data base search was complemented by manual search of reference of the entire selected full-text article. Study design, sample size, criteria for evaluation and follow-up period were assessed. Results: Search yielded 4,609 titles and 61 articles were considered for full text. Seven randomized control trials on primary molars were included in the review, with follow-up from 12 months to 36 months. Studies have evaluated restorative success and gingival health in zirconia and stainless steel groups. Only one study evaluated radiographic success rate of zirconia and stainless steel crowns in primary molars. As the follow-up period progressed, no plaque accumulation was seen on both the zirconia and stainless steel groups. Six articles were considered for meta-analysis. The study data was found to be heterogeneous and random effects model was used. No differences were found in clinical success rate between zirconia and stainless steel group. Conclusion: Gingival health was superior for zirconia crowns when compared to stainless steel crowns. However clinically, stainless steel crowns are as effective as zirconia crowns.

Objective: To scrutinize and consolidate treatment protocols and infection control measures to be practiced in pediatric dentistry during COVID-19 pandemic. Study design: A systematic search pertaining to pediatric dental practice during COVID-19 was conducted using various electronic databases from 1st March to 31st July, 2020. The search resulted in a total of 145 records, out of which only 12 studies met our inclusion and exclusion criteria which were included in the present review. Results: Data analysis was compiled under the following categories: Triage, waiting area and operatory changes, dentist's safety, procedures to be undertaken during COVID-19, specific guidelines for trauma and children with special healthcare needs (SHCN) and infection control. Teledentistry, personal protective equipment (PPE), minimally invasive dentistry and non-aerosol-generating procedures are highly recommended. Urgent care should be provided to patients with dental trauma and SHCN. Surface disinfection and hand hygiene are considered important. Conclusion: Transmission risk among children should not be overlooked and all the standard measures of prevention must be ensured in the pediatric practice.