Megha Patel
@karnavatiuniversity.edu.in
Professor and Head, Dept. of Pediatric and Preventive Dentistry
Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India.
RESEARCH INTERESTS
Pediatric Dentistry, Dental Traumatology, Pain Management, Cariology, Behaviour Guidance, Preventive Dentistry
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Megha Patel, Rohan Bhatt, Miral Mehta, Chhaya Patel, Foram Patel, and Disha Makwani
Medknow
ABSTRACT Background: Managing pain in children is the most challenging task as it forms the foundation for instilling positive behavior toward dental treatment. Adequate local anesthesia (LA) is the cornerstone of pain management. However, the fear of needles, particularly in young children, can result in complete avoidance and refusal of treatment. Aim: This study aimed to evaluate and compare the efficacy and preference between needleless device INJEX and insulin syringe for anesthetizing primary maxillary teeth in children aged 4–9 years. Materials and Methods: This randomized clinical study included 46 children aged 4–9 years. The patients were digitally allotted to receive 4% articaine for extractions of primary maxillary teeth, either using needleless device INJEX or insulin syringe on each side of the maxillary arch, in two different appointments after a 1-week washout period. Pain perception was measured by the subjective (Faces Pain Scale–Revised [FPS-R]) and objective pain scores (Face, Legs, Activity, Cry, and Consolability [FLACC]) and hemodynamic parameters (heart rate and oxygen saturation) during LA administration and during extractions. After the second appointment, children were asked about their preference between needleless device INJEX and insulin syringe. Results: On evaluating subjective pain scores with FPS-R, intergroup differences between the INJEX and insulin syringe groups were found statistically insignificant, both during LA administration (P = 0.101) and extraction (P = 0.080). However, on assessing pain objectively during extraction using FLACC, the mean pain score was less with insulin syringe (2.78) as compared to INJEX (4.72) and the difference was statistically significant (P = 0.000). There was no significant difference in patient preference between the two methods. Conclusion: Pain perception was minimal during local anesthesia administration using needleless device INJEX; however, its clinical efficacy during extractions was reported to be lower than insulin syringe.
Roshni A. Bhatt, Megha Patel, Rohan Bhatt, Chhaya Patel, Kaushal Joshi and Disha Makwani
Background: Minimally invasive techniques should be employed to maintain pulp vitality without affecting physiological tooth resorption for pediatric patients. This study aims to evaluate clinical and radiographic success of light cure calcium silicate and resin-modified glass ionomer (RMGI) as indirect pulp-capping agent in primary molars in children between 5 and 9 years. Materials and Methods: In this randomized clinical trial study, 40 primary molars with the International Caries Detection and Assessment System criteria 4–6 score were divided randomly into two groups after computerized randomization method. After caries excavation by minimally invasive dentistry principle, affected dentin was lined by either light cure calcium silicate (Group I) or RMGI (Group II) liner followed by composite restoration. Clinical success was determined with the absence of symptoms and bitewing radiographs were taken at baseline, 3, and 6 months' interval to measure increase in dentin increment using ImageJ software. Statistical analysis for intergroup comparison was done using Paired t-test, and Independent t-test was used for intragroup comparison. The level of statistical significance was set at P < 0.05. Results: Change in dentin increment seen from baseline to 6 months in Group I was 0.19 mm and in Group II was 0.20 mm (P = 0.924). Intragroup increment was statistically significant during all follow-up intervals for both the groups (Group I – P ≤ 0.001, Group II – P = 0.009). For baseline remaining dentin thickness >1.5 mm, statistically significant increase was observed in the dentin increment at 3 months' interval between both the groups. Conclusion: Both TheraCal LC and Vitrebond show acceptable clinical and radiographic results when used in primary molars as indirect pulp treatment agents. Both the liners are equivalent to each other in terms of feasibility and cost-effectiveness but TheraCal LC can be preferred due to better handling and avoiding the manipulation step thereby reducing treatment time.
Megha C Patel, Disha Makwani, Rohan Bhatt, V. Raj, Chhaya Patel and Foram Patel
Background: Lately, a paradigm shift from radical to conservative approach has popularized the selective caries removal over complete excavation in deep caries. Indirect pulp therapy over pulpotomy is being preferred due to risk of questionable pulp vitality in carious exposure of pulp. Silver diamine fluoride can be a useful tool for noninvasive caries management due to its antimicrobial and remineralization properties. Aim: The study aims to evaluate the success of minimum intervention approach using silver-modified atraumatic restorative technique (SMART) as indirect pulp treatment compared to conventional vital pulp therapy in symptomless deep carious lesions of primary molars. Materials and Methods: In this comparative, prospective, double-blinded, clinical interventional study, 60 asymptomatic primary molar teeth with international caries detection and assessment system score 4–6 were selected in children aged 4–8 years and were randomly allocated into SMART and conventional groups. The success of the treatment approach was assessed using clinical and radiographic criteria at baseline, 3, 6, and 12 months interval. Results: Data were analyzed using Pearson Chi-Square test at a significance level of 0.05. Conventional group showed 100% and SMART observed 96.15% clinical success at 12 months follow up (P > 0.05). One radiographic failure due to internal resorption at 6 months in SMART and one in the conventional group at 12 months was reported though the difference was insignificant (P > 0.05). Conclusion: Removal of all infected dentin in deep carious lesions is not required for successful caries treatment and SMART can be recommended as a potential biologic approach to manage asymptomatic deep dentinal lesions, based on optimal case selection.
Megha C Patel, Lilavanti L Vaghela, Rohan K Bhatt, Chhaya N Patel, and Kaushal R Joshi
Jaypee Brothers Medical Publishing
AIM
To compare clinical performance and parental satisfaction with composite strip crown and prefabricated zirconia crown for primary anterior teeth.
MATERIALS AND METHODS
The study compares clinical evaluation and parental satisfaction of two different crowns for primary anterior teeth. A total of 102 teeth in each group selected between ages 3 and 6 years, who met the inclusion criteria, were randomly allocated into two groups for further evaluation. Group A for strip crowns (55 teeth) and group B for zirconia crowns (47 teeth). The crowns were evaluated clinically with various criteria like-color match, crown retention, gingival health, crown contour, opposing tooth wear, marginal integrity, and recurrent caries. The samples were also evaluated for parental satisfaction based on 5-point Likert scale and child liking was also recorded with Smiley face Likert scale at baseline, 3 and 9 months. Statistical analysis was done using Chi-square test (p <0.05).
RESULTS
Zirconia crowns showed better color match, crown retention, crown contour, and gingival health. Strip crowns showed more discoloration and chipping of material over a period of time. None of the samples showed opposing tooth wear, open margins, and recurrent caries in strip and zirconia crown group. Parents and children both were highly satisfied with zirconia crowns.
CONCLUSION
Clinically zirconia crowns showed higher success rate as compared to strip crowns and parental overall satisfaction was higher for zirconia crowns.
CLINICAL SIGNIFICANCE
Zirconia crowns exhibited a higher clinical performance and parental satisfaction; hence, if affordability is out weighted, zirconia crown stands better with esthetics of the child.
S. Kiran, A. Relwani, M. S. Patel, and R. Bhatt
BMJ
Children often exhibit habitual behaviour involving the oral cavity. The occurrence of foreign bodies such as toothpicks, pencil leads,1 staple pins, metal screws, crayons, tomato seeds, beads and needles,2 stuck in the pulp chambers, exposing traumatically or carious injured permanent and deciduous teeth, are identified by chance on radiographic inspection.
A 10-year-old girl presented to the dental department with 3-day pain in the upper front tooth. Patient history revealed that the child had dental injury to the permanent upper right central incisor twice previously. Initial trauma occurred …