Background: Mandibular retrognathism or functional mandibular retrusion is commonly associated with the reduced pharyngeal airway. Functional appliances that are used to treat mandibular retrusion have been found to improve airway dimensions. However, this improvement in the airway has never been assessed in the long-term. Therefore, the purpose of this study was to assess the effects of standard twin-block appliance on pharyngeal airway space in subjects with skeletal class-II pattern and the maintenance of changes achieved after debonding. Materials and methods: Twenty-five subjects (14 females and 11 males) in the age-group of 10–14 (mean 12.08 ± 0.91) underwent treatment of a class II division 1 malocclusion via standard twin-block appliance followed by fixed orthodontic therapy. Pre-treatment (T1), post-twin block (T2), and post-fixed appliance (T3) lateral cephalograms were taken and skeletal and soft tissue landmarks were hand-traced. A pairwise comparison was used to assess whether there were any significant differences in the cephalometric variables of the upper and lower pharyngeal airway between each phase of treatment (T1, T2, T3). Results: There was a significant increase in sagittal dimensions of upper and lower pharyngeal space with a mean increase of 1.34 and 1.26 mm, respectively, following twin-block therapy. There was a significant increase in upper pharyngeal space from pre-treatment till the end of the fixed appliance phase (p < 0.003) and the change in lower pharyngeal space from pre-treatment till the end of the fixed appliance phase was non-significant (p = 0.13). Conclusion: Correction of mandibular retrusion in class II malocclusion subjects by twin-block therapy increased the sagittal dimension of the upper and lower pharyngeal space. This significant improvement in the upper pharyngeal space was maintained till the end of fixed orthodontic treatment. However, the improvement in the lower pharyngeal space was found to be unstable post-debonding.

Aim and objective: To assess the child's anxiety level for various dental procedures using a standard questionnaire and by measuring the salivary cortisol level. Study design: Cross-sectional study. Materials and methods: A sample of 24 healthy children (8–10 years) visiting the Department of Pedodontics and Preventive Dentistry, DAPM RV Dental College, Bengaluru were selected. They were divided into three groups: group I—eight children having their first dental visit, group II—eight children requiring oral prophylaxis after their first visit, group III—eight children requiring extraction of 1 or 2 teeth after their first visit. Levels of dental anxiety were assessed in children using the State-Trait Anxiety Inventory for Children State (STAIC-S) before and after the treatment. Salivary cortisol was assessed in children before and after the treatment using the ELISA test. Statistical analysis used: Student paired t-test was used to compare the mean anxiety score and cortisol levels between pre- and post-time intervals for different procedures within the child group. Results: In children, the mean anxiety score was reduced after the treatment. There was a proportionate decrease in the mean anxiety level among children irrespective of the procedure. Also, there was a reduction in the cortisol level from pre- to post-procedure among children. Conclusion: Assessment of cortisol level in children could be a significant factor that can be used as one of the physiological parameters for various dental procedures.

Aim and objective: Describe the basics of the mixed-method type of research. Background: Traditionally, the research has been quantitative in nature which provided measures for the parameter of interest. This was followed by the era of qualitative research which helped in a detailed understanding of a phenomenon. This is especially important in healthcare research as it also gives an account of the individual interaction with their environment which is a significant contributor to health. Around the 1970s, the concept of combining both these approaches was used in social sciences. Recently, this mixed-method approach was integrated into health research and educators. However, there has been a continuing debate on the basic nature of this research design. Thus, a complete understanding of this type of research is important. Review results: Various authors described various purposes of the mixed-method approach. The main ones being triangulation, complementarity, development, initiation, and expansion. Theoretical drives, timings, and point of integration are the three factors that need to be considered for the development of studies using this design. Throughout times, different classifications for mixed-method studies have evolved, however, the most accepted one, based on the utility and internal consistency is the classification by Creswell and Clarke. They describe four major designs for mixed-method research as triangulation design, embedded design, explanatory design, and exploratory design. The application, principle, variants, strengths, challenges, and examples of each have been described extensively in this article. Conclusion and clinical significance: Mixed-method approach is a valuable research type as it capitalizes on the strength of both qualitative and quantitative research. It is of significance in health research as it gives a broader range of perspectives to the complex phenomena studied. Thus, proper knowledge of the basics is required to accurately combine and interpret findings of the qualitative and quantitative aspects. This article is a contribution to this basic understanding of mixed-method research.

Achondroplasia also known as “chondrodystrophia fetalis” is a rare disorder that affects the growth of long bones and cartilages. This disorder is characterized by dwarfism with marked disproportionate short limbs. Considering the complications that may emerge during the treatment of a patient with achondroplasia, it is pertinent that the pediatric dentist should be familiar with the marked features of this syndrome as dental management is duly restricted by practical problems associated with this condition. Patients with achondroplasia not only require specific medical management but also need special attention with definite dental management along with psychological support to help them lead a normal life and cope up with the medical and social challenges of life. We report in this paper about children aged between 3 years and 9 years with achondroplasia with extremely short stature, frontal bossing, macrocephaly, and various dental problems.

Aim and objective: Emphasis on reflective practice in pediatric dentistry on implementing “Emotional Protective Environment” (EPE) while donning Personal Protective Equipment (PPE). Background: The concept of reflective practice is seldom talked about in dentistry and is still in its budding stages. Reflecting on every case in my routine clinical practice turned my personal experiences into invaluable precious learnings; helped me to understand my strengths, weaknesses; questioned my underlying values, identified my personal limitations or areas for improvement. Conclusion: Reflection does demand from clinicians, a dare to accept individual's limitations and uneasiness encountered during clinical practice by unmasking it all while simultaneously inviting others to view the prudence when you yourself are looking into the mirror of self-image. Reflective practice takes time from the hindsight experiences of the clinical practices in formulating and executing fruitful insights. Clinical significance: We must work on Self-distancing (Adaptive self-reflection) while implementing the “Social Distancing” in professions dealing with children. Time for some earnest reasoning on visualizing our thoughts on some kind of reflector glass of minds in promoting the delivery of an Emotional Protective Environment along with the practice of Personal Protective Equipment!