Pediatric dental emergency management were temporarily suspended during the COVID-19 pandemic, which worsened urgent dental needs. This retrospective study investigated the management of pediatric emergencies during COVID-19 lockdown and the trends in parental preferences from March to July in 2019 and 2020. Pediatric dental emergencies managed during pandemic was collated, procedures were categorized (emergency, restorative, preventive, elective) and trends in parental treatment preference was compared from March-July 2019/2020. Bivariate analysis was performed using fisher-exact test and statistical significance was set at 5%. Total 1081 children were treated during COVID-19 lockdown, and 1509 procedures were performed, of which 20.8% were emergency, 42% restorative, 24.4% preventive, 12.6% elective. In 2019, 7462 children were treated; and except for emergency (10.6%), other procedures were comparable to 2020. Extractions (267) predominated in 2020 followed by sealants (195); but in 2019, pulectomy (1268), scaling (1251) were predominant. None of the residents who performed aerosol procedures got infected with COVID-19 during the lockdown. Emergency dental needs among pediatric patients were very high during the COVID-19 pandemic in South India, and there was not much change in the trend in parental treatment preference in 2019 and 2020. Further, aerosol procedures did not increase the risk of COVID-19 during the pandemic provided proper universal precautions were followed.

Purpose: To evaluate the effect of Er:YAG laser on the roughness, surface topography, and bond strength to resin luting cement based on chemical and micro-abrasion pretreatments of different computer-aided design/computer-aided manufacturing materials. Methods: A polymer-infiltrated-ceramic-network (PICN) material (Vita Enamic, VE), three indirect resin composite (Cerasmart, CS; Shofu HC, SH; Lava Ultimate, LU), and one lithium disilicate ceramic (IPS e.max CAD, EM) blocks were subjected to one of the following pretreatments: no treatment (NC ), Er:YAG etching with one of two powers (either 3 or 6 W), hydrofluoric acid (HF) etching, self-etching ceramic primer (ME), or micro-abrasion (MA). The shear bond strength (SBS) of resin luting cement to pretreated materials was tested. Surface roughness was measured via atomic force microscopy, and surface topography was analyzed via scanning electron microscopy. Two-way analysis of variance, Tukey post-hoc test, and Pearson correlation were applied. Results: Etching EM and VE with HF or the ME resulted in the highest SBS values in their groups (P < 0.05). LU, SH, VE, and CS indicated similar SBS values when treated with 3 W, 6 W, and MA. The highest surface roughness (Sa ) values were obtained for the LU, CS, and VE groups when treated with 6 W, whereas the lowest Sa values were obtained for CS when treated with the ME and EM when treated with the ME or 3 W. Only SH and CS indicated a significant correlation between surface roughness and bond strength. Conclusions: Er:YAG laser etching is comparable to micro-abrasion when treating resin composite blocks and may induce fewer surface cracks. HF etching remains the gold standard for the treatment of glass-based ceramics and PICNs.

Objectives This study aimed to evaluate the effect of in-office bleaching on the enamel surface and the efficacy of calcium silicate-sodium phosphate-fluoride salt (CS) and NovaMin bioactive glass (NM) dentifrice in remineralizing bleached enamel. Materials and Methods Forty extracted premolars were sectioned mesio-distally, and the facial and lingual enamel were flattened and polished. The samples were equally divided into nonbleached and bleached with 38% hydrogen peroxide (HP). Each group was further divided according to the remineralization protocol (n = 10); no remineralization treatment (nontreated), CS, or NM, applied for 3 minutes two times/day for 7 days, or CS combined with NR-5 boosting serum (CS+NR-5) applied for 3 minutes once/day for 3 days. The average Knoop hardness number (KHN) and surface roughness (utilizing atomic force microscopy) were measured. Surface topography/elemental analysis was analyzed by using scanning electron microscopy/energy dispersive X-ray analysis. All the tests were performed at baseline, after bleaching, and following each remineralization protocol. Data were statistically analyzed by two-way analysis of variance and Bonferroni post hoc multiple comparison tests (α = 0.05). Results HP significantly reduced KHN and increased roughness (p < 0.05). All remineralization materials increased the hardness and reduced the surface roughness after bleaching except NM, which demonstrated significantly increased roughness (p < 0.05). Ca/P ratio decreased after bleaching (p < 0.05), and following treatment, CS and CS+NR-5 exhibited higher remineralization capacity in comparison to NM (p < 0.05). Conclusion Although none of the material tested was able to reverse the negative effect of high-concentration in-office HP on enamel completely, the remineralization efficacy of CS and CS+NR-5 was superior to that of NM.

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