BACKGROUND Topical anaesthesia is fundamental in enhancing pain control during the process of dental injections. The study compared the effect of cooled and uncooled topical anaesthetic gel before infiltration anaesthesia in assessing pain perception in paediatric patients undergoing dental treatment procedures. METHODS This is a split-mouth study where 16 children aged between 8 and 10 years who required bilateral local anaesthesia administration for various dental procedures were selected. Before infiltration anaesthesia, topical anaesthetic gel cooled to 40 C was applied on one side in the first visit followed by application of uncooled gel on the contralateral side in the subsequent visit. The patients were asked to individually rate their pain experience on each side using the Wong-Baker Faces Pain Rating Scale (WB-FPRS). Anxiety was assessed using pulse oximeter and FLACC scale (face, legs, activity, cry, and consolability). Data was analysed statistically using the paired ‘t’-test and a P value less than or equal to 0.05 was considered as statistically significant. RESULTS Patients reported less pain on Wong-Baker Faces Pain Rating Scale by using cooled topical anaesthetic gel. Discomfort and anxiety levels were also seen to be low when assessed using pulse oximeter and FLACC Scale for the same group (P < 0.05). CONCLUSIONS Cooling the soft tissue site with anaesthetic gel helped reduce pain perception during infiltration in children and was seen to be a more feasible technique. Hence this technique can be used as a successful adjunct to the local anaesthesia administration prior to dental procedures. KEY WORDS Anaesthesia, Cooling, Topical Gel, Injection, Pain

BACKGROUND We wanted to clinically evaluate the efficacy of lidocaine bioadhesive patches for extraction in paediatric dentistry and assess the comfort and pain response by sound eye motor (SEM) scale and intensity of pain using the visual analogue scale (VAS). METHODS A total of thirty-five co-operative children of age group 8 - 12 years without systemic diseases who needed dental extraction participated in the study. Extraction was carried out using customized lidocaine bioadhesive patches as anaesthetic agent. Evaluation of comfort and pain response was done by sound eye motor scale and intensity of pain using the visual analogue scale. Statistical analysis was done with SPSS version 2.0. Comparison of SEM scale and VAS scores between different subgroups was done using a chi-square test. P value less than 0.001 was considered statistically significant. RESULTS Children of higher age groups belonging to both the genders demonstrated less perception to pain during extractions using lidocaine patch. During extraction of firm teeth and teeth with Grade I mobility, perception of pain was more in girls. Maxillary arch extraction in children with various grades of mobility perceived less pain. Irrespective of age, gender and arches,teeth with Grade II and Grade III mobility were extracted with minimal VAS and SEM score. CONCLUSIONS Bioadhesive patches serve as a potential non-invasive alternative to traditional modes of local anaesthetic delivery with the advantage of eliminating needle phobia and possible negative influence on the behaviour. KEY WORDS Bioadhesive Patches, Lidocaine, Extraction, Paediatric Dentistry

BACKGROUND The vitality of dental pulp is essential for long-term survival of the tooth. Vital pulp therapy (VPT) intends to maintain healthy pulp tissue by eliminating bacteria from the dentin-pulp complex. There are many treatment options for vital pulp therapy in extensively decayed teeth. Pulp capping or pulpotomy procedures rely upon an accurate assessment of the pulp status, and careful management of the remaining pulp tissue. We wanted to evaluate as to whether biodentine total pulpotomy is an effective alternative to conventional endodontic therapy for young permanent teeth. METHODS Full coronal pulpotomy was performed in young permanent molars diagnosed with acute irreversible pulpitis with Biodentine as the pulpotomy medicament. Follow up evaluation was done clinically and radiographically at 3, 6 and 12 months. RESULTS During follow-up periods clinical signs/symptoms were absent including pulpal pain, swelling or presence of sinus and percussion pain. Continuous root development and healing of periapical radiolucency were noticed in the study which were indicative of maintenance of vitality of the pulp. CONCLUSIONS Within the limitations of this clinical study, it is concluded that total pulpotomy with Biodentine has a promising scope in regenerative approaches in the treatment of carious young permanent teeth. KEY WORDS Biodentine, Coronal Pulpotomy, Permanent Teeth, Total Pulpotomy

BACKGROUND Glass ionomer cement (GIC) is a versatile restorative cement in paediatric dentistry. Due to its less flexural strength, alternative materials have been developed. Cention N is one such material, but since it’s a new material evidence is lacking regarding its physical properties, especially flexural strength for evaluating its clinical outcome. We wanted to compare the flexural strength of glass ionomer cement and Cention N stored in artificial saliva and its variation over different time intervals, i.e., after 24 hours, 1 week and 4 weeks. METHODS A total of 30 specimens were prepared for GIC (Fuji IX) and Cention N and were further categorized according to the duration of storage time of 24 hours, 1 week and 4 weeks (N = 10). A 3 - point bending test using a universal testing machine was used to evaluate the flexural strength. RESULTS GIC Fuji IX showed a mean flexural strength of 35.296 ± 1.61 Mpa at the end of 24 hours, 47.234 ± 4.12 after 1 week and 66.039 ± 11.05 Mpa at the end of 4 weeks. GIC showed a statistically significant increase of flexural strength from 24 hours to one week and a further increase after 4 weeks of storage. The flexural strength of Cention N at 24 hours was 175.985 ± 22.11 Mpa, at the end of one week was 163.486 ± 17.55 MPa, and after 4 weeks was 175.437 ± 27.22 Mpa. Cention N did not show any statistically significant change in flexural strength value from 24 hours to 4 weeks. Cention N showed highly significant difference between flexural strength compared to GIC at all - time intervals. CONCLUSIONS Cention N has a superior flexural strength compared to GIC at all - time intervals. KEY WORDS Cention N, Flexural Strength, Glass Ionomer Cement