Assessment of Microleakage of a Composite Resin Restoration in Primary Teeth Following Class III Cavity Preparation Using Er, Cr: YSGG laser: An In Vitro Study

Introduction: Marginal seal integrity is important for a successful adhesive dental restoration. Alterations caused by laser irradiation in the enamel and dentin surface can affect the marginal integrity of adhesive restorations. The aim of this study was to evaluate the microleakage of a composite resin restoration in primary teeth following laser irradiation of enamel and dentin. Methods: Forty freshly extracted sound human primary maxillary and mandibular anterior teeth were used in this study. The teeth were randomly divided into two groups (I and II), with 20 teeth in each. In group I, proximal cavities (Class III) were prepared using an airotor hand -piece and diamond bur. The cavities were etched for 15 seconds with 35% phosphoric acid gel, rinsed with water for 15 seconds, air dried and a bonding agent was applied onto the cavity surfaces and light cured for 20 seconds. The cavities were restored with composite resin and light cured for 40 seconds. In group II, proximal (Class III) cavities were prepared using Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) (Er,Cr:YSGG) (Biolaseiplus, wave length 2.78 μm). The cavity was then rinsed, air dried and without etching, a bonding agent was applied and light cured for 20 seconds. The cavities were restored in the same manner as that of group I. The treated teeth were mounted on acrylic resin blocks and were subjected to a thermocycling regimen. Following, the teeth were immersed in 2% methylene blue for 24 hours. The teeth were sectioned longitudinally in a bucco-lingual direction using a diamond disc at slow speed. The sections of all the groups were examined under a stereomicroscope for micro-leakage. Results: The mean scores for microleakage in group I was 1.95 ± 1.31 and in group II it was 1.4 ± 1.27. There was no significant difference between the two groups (P = 0.882). Conclusion: No significant difference in microleakage was noticed between the composite resin bonded to lased enamel and dentin and the teeth preparedwith conventional method.

Comparison of removal of endodontic smear layer using ethylene glycol bis (beta-amino ethyl ether)-N, N, N', N'-tetraacetic acid and citric acid in primary teeth: A scanning electron microscopic study

Background:

Root canal irrigants are considered momentous in their tissue dissolving property, eliminating microorganisms, and removing smear layer. The present study was aimed to compare the removal of endodontic smear layer using ethylene glycol bis (beta-amino ethyl ether)-N, N, N', N'-tetraacetic acid (EGTA) and citric acid solutions with saline as a control in primary anterior teeth.

Materials and Methods:

Thirty primary anterior teeth were chosen for the study. The teeth were distributed into three groups having ten teeth each. Following instrumentation, root canals of the first group were treated with 17% EGTA and the second group with 6% citric acid. Only saline was used as an irrigant for the control group. Then, the teeth were subjected to scanning electron microscopy (SEM) study. The scale given by Rome et al. for the smear layer removal was used in the present study.

Results:

The pictures from the SEM showed that among the tested irrigants, 17% EGTA + 5% sodium hypochlorite (NaOCl) group showed the best results when compared to other groups.

Conclusion:

The results advocate that the sequential irrigation of the pulp canal walls with 17% EGTA followed by 5% NaOCl produced efficacious and smear-free root canal walls.

Arresting Dentine Caries with Different Concentration and Periodicity of Silver Diamine Fluoride

Different regimens of silver diamine fluoride (SDF) have been used to manage early childhood caries. So far, there is limited information regarding the concentrations and frequency of applications for effective caries control in primary teeth. This study aimed to compare the efficacy of 2 commercially available SDF solutions at preprepared concentrations of 38% and 12% when applied annually or biannually over 18 mo in arresting dentine caries in primary teeth. This randomized double-blinded clinical trial recruited kindergarten children aged 3 to 4 y who had at least 1 tooth with dentine caries. The children were randomly allocated to receive 4 treatment protocols: group 1, annual application of 12% SDF; group 2, biannual application of 12% SDF; group 3, annual application of 38% SDF; and group 4, biannual application of 38% SDF. Clinical examinations at 6-mo intervals were conducted to assess whether active carious lesions became arrested. Information on the children's background and oral hygiene habits was collected through a parental questionnaire at baseline and follow-up examinations. A total of 888 children with 4,220 dentine carious tooth surfaces received treatment at baseline. After 18 mo, 831 children (94%) were examined. The caries arrest rates were 50%, 55%, 64%, and 74% for groups 1, 2, 3, and 4, respectively (P < 0.001). Lesions treated with SDF biannual application had a higher chance of becoming arrested compared with those receiving SDF annual application (odds ratio, 1.33; 95% confidence interval, 1.04-1.71; P = 0.025). The interaction between concentration and lesion site was statistically significant (P < 0.001). Compared with 12% SDF, the use of 38% SDF increased a chance of becoming arrested (P < 0.05), except lesions on occlusal surfaces. Based on the 18-mo results, SDF is more effective in arresting dentin caries in the primary teeth of preschool children at 38% concentration than 12% concentration and when applied biannually rather than annually. Knowledge Transfer Statement: The results of this study can be used by clinicians and dental public health professionals when deciding which concentrations and frequency of application of silver diamine fluoride solution should be adopted for arresting dentine caries. With consideration of caries arrest treatment with silver diamine fluoride, which is painless, simple, and low cost, this information could lead to more appropriate therapeutic decisions for caries control in young children or those who lack access to affordable conventional dental care.

Risk factors for traumatic dental injuries in the primary dentition: concepts, interpretation, and evidence

The purpose of this comprehensive review is to explore the main concepts related to quantification and interpretation of risk factors and investigate characteristics associated with traumatic dental injuries (TDI) in the primary dentition. Initially, the main concepts related to causality and risk factors were summarized, including how to measure, express, and compare risk as well as interpret statistical significance. Based on a structured search through PubMed, original research articles regarding TDI and associated factors in the primary dentition were then reviewed by two examiners. Studies with a sample size of at least 300 children aged between 0 and 6 years were summarized according to journal, country, study design, and type of statistical analysis. Variables associated with TDI in primary teeth were identified from studies with multivariable analysis. Measures of effect size and P values were presented. Thirty-two studies were retrieved: most were cross-sectional in design and only 17 (53.1%) performed multivariable analysis. Most investigations did not find an association between gender and socioeconomic variables with TDI. Increased overjet was the only factor consistently identified as an associated factor. Behavioral characteristics have been recently investigated and suggested as potential risk factors for TDI in the primary dentition. In conclusion, increased overjet is undoubtedly associated with TDI in the primary dentition. As behavioral factors may be targeted by preventive strategies, their role on TDI occurrence should be clarified in future cohort studies. Clinicians should understand the terms and measures described in studies on risk factors to properly apply knowledge and benefit patients.

Comparison of microleakage from stainless steel crowns margins used with different restorative materials: An in vitro study

Background:

Obtaining optimal marginal adaption with prefabricated stainless steel crowns (SSCs) is difficult, especially after removing dental caries or defects in cervical areas. This situation requires the use of an SSC after tooth reconstruction. This study evaluated microleakage and material loss with five restorative materials at SSC margins.

Materials and Methods:

One hundred and twenty primary molar teeth were randomly divided into six groups (n = 20). Class V cavities were prepared on the buccal surfaces of the teeth in groups 1-5. Cavities were restored with amalgam, resin-based composite, glass ionomer (GI), zinc phosphate, or reinforced zinc oxide eugenol (Zonalin). Group 6 without cavity preparation was used as a control. Restorations with SSCs were prepared according to standard methods. Then, SSCs were fitted so that the crown margins overlaid the restorative materials and cemented with GI. After thermocycling, the specimens were placed in 0.5% fuchsin and sectioned. The proportions of mircoleakage and material loss were evaluated with a digital microscope. Statistical analysis was performed with Kruskal–Wallis and Mann–Whitney tests.

Results:

The groups differed significantly (P < 0.001). Amalgam and GI showed the least microleakage. Amalgam restorations had significantly less microleakage than the other materials (P < 0.05). Microleakage was greatest with resin-based composite, followed by Zonalin. Material loss was greater in samples restored with Zonalin and zinc phosphate.

Conclusion:

When SSC margins overlaid the restoration materials, cavity restoration with amalgam or GI before SSC placement led to less microleakage and material loss. Regarding microleakage and material loss, resin-based composite, zinc phosphate, and Zonalin were not suitable options.

Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study

Objectives:

To evaluate the outcome of vital pulp therapy in primary teeth with irreversible pulpitis by using calcium-enriched mixture (CEM) cement according to clinical and radiographic assessment.

Participants and Methods:

Fifty primary molar teeth with irreversible pulpitis in 50 children aged 6-8 years underwent pulpotomy using CEM cement as the dressing material. Following pulpotomy, pain intensity was evaluated by use of a visual analog scale at 1 and 7 days from the treatment and in clinical appointments at 3, 6 and 12 months after baseline. Radiographic evaluation was performed at 6 and 12 months. Data were analyzed using the McNemar test.

Results:

A total of 42 children (mean age 7.26 ± 0.82 year) completed the study. After one day treatment 56 % of children reported complete relief of pain and after 7 days 62% reported the same. However, two children complained of increased pain 1 day after treatment. None of the children reported pain in the subsequent appointments. One child complained of tenderness in percussion after 6 months. Pulp canal obliteration was the most common change in the radiographic assessment. There was no significant difference between clinical (92.8%) and radiographic (90.4%) success (p=0.990).

Conclusion:

Pulpotomy using CEM cement could present a successful treatment in primary molar teeth with irreversible pulpitis.

Effect of laser preparation on adhesion of a self-adhesive flowable composite resin to primary teeth

The aim of the study was to evaluate the adhesion of a self-adhering flowable composite resin to primary tooth enamel and dentin after silicon carbide paper (SiC) and laser pretreatment. Adhesive properties were evaluated as shear bond strength (SBS) and scanning electron microscopic (SEM) characteristics. A total 120 primary canine teeth were randomly divided into two groups to study enamel and dentin. Each group was divided into 6 subgroups (n = 10) according to type of surface preparation (SiC or Er:YAG laser) of enamel or dentin. Three methods were used to build cylinders of restoration on tooth surface: OptiBond All-In-One + Premise Flowable composite, OptiBond All-In-One + Vertise Flow and Vertise flow. After restoration, samples were tested for SBS and failure mode. Twenty eight samples were examined by SEM. The results of the study showed SBS of Vertise Flow was lower than others in enamel and dentin samples pretreated with SiC and in dentin samples pretreated with laser (P < 0.001). Compared to SiC pretreatment, laser pretreatment led to a significantly higher SBS with Vertise Flow on enamel (P < 0.001). Vertise Flow associated with the adhesive led to a higher SBS in enamel and dentin compared to Vertise Flow alone. Adhesive and mixed failure modes were observed more frequently in Vertise Flow groups. SEM images showed that Vertise Flow led to more irregularities on enamel and more open dentinal tubules after laser ablation compared SiC pretreatment.

Assessment of simulated lesions on primary teeth with near-infrared imaging

Previous studies have demonstrated that the structural changes on enamel due to demineralization and remineralization can be exploited through optical imaging methods such as QLF, thermal and NIR imaging. The purpose of this study is to investigate whether PS-OCT and NIR reflectance imaging can be utilized to assess lesion structure in artificial enamel lesions on the smooth surfaces of primary teeth exposed to fluoride. The smooth coronal surfaces of primary teeth (n=25) were divided into 4 windows: sound, demineralization, demineralization with remineralization and APF with demineralization. Windows were treated with either acidulated phosphate fluoride (APF) for 1 minute, a demineralization solution for 4 days, and/or an acidic remineralization solution for 12 days. The samples were imaged using PS-OCT, QLF and NIR reflectance at 1400-1700 nm wavelengths. This study demonstrated that both PS-OCT and NIR reflectance imaging were suitable for assessing lesion structure in the smooth surfaces of primary dentition.

Trends in the prevalence of traumatic crown injuries and associated factors in Brazilian preschool children: 10-year observational data

OBJECTIVE

To assess trends in the prevalence of traumatic crown injuries (TCI) in children aged 1-4 years living in Diadema city (Brazil) and to investigate whether TCI were associated with socio-demographic and clinical variables.

METHODS

Six cross-sectional surveys with representative samples were carried out from 2002 to 2012 following the same criteria and methodology. A total of 6389 children were evaluated and systematically selected on the National Children's Vaccination day. Calibrated examiners performed the children's oral examination for TCI according to Andreasen's criteria. Chi-square test for trends was used to perform comparative analysis. Poisson regression was used to associate TCI to socio-demographic and clinical variables.

RESULTS

The prevalence of TCI in 2002 for preschool children aged 1, 2, 3 and 4 years was 4.5%, 11.4%, 14% and 13.9%, respectively, and the prevalence in 2012 for the same age groups was 10.4%, 15.9%, 25.7% and 28.1%, respectively. There was a significant increase in the prevalence of TCI for all age groups and for the total sample (P < 0.05). Children's age was associated with TCI in all the surveys. Male gender, presence of anterior open bite and inadequate lip coverage were associated with TCI in some surveys along the years (P < 0.05).

CONCLUSION

This study has shown an increase of TCI prevalence in Brazilian preschool children in the last 10 years and its association with children's age, male gender, presence of anterior open bite and inadequate lip coverage. However, this increase does not seem to be relevant to decisions on public policy.

Dentin Optical Density in Molars Subjected to Partial Carious Dentin Removal

AIM

This study aimed to evaluate changes in the optical density of dentin in primary molars with deep caries three to six months after they were subjected to partial carious dentin removal.

STUDY DESIGN

This was a blind controlled, clinical therapy study. Standardized digitalized bitewing radiographs of 42 teeth were analyzed using Adobe Photoshop(®) to quantitatively determine the gray scale of the affected dentin beneath the restoration, in comparison with healthy dentin. A mixed-effects model was used for statistical analysis. The gray tone level was considered a dependent variable; the tooth region and the time, in addition to the interaction between them, were the independent variables. Values of p < 0.05 were significant.

RESULTS

During the interval between time zero and three months, the gray tone levels of affected dentin varied from 80.99 ± 3.17 to 98.57 ± 3.17; i.e., an estimated increase of 18 (p < 0.0001). The values for healthy dentin ranged from 118.22 ± 3.17 to 122.02 ± 3.17; i.e., a mean increase of four in the gray tone levels (p = 0.0003). During the interval between three and six months, both healthy and affected dentin showed similar behavior (98.57 ± 3.17 to 103.32 ± 3.20 and 122.02 ± 3.7 to 126.56 ± 3.20, respectively) (p = 0.0001).

CONCLUSIONS

Significant increments were observed in the optical density of the affected dentin after three months compared to that of healthy dentin in primary molars treated using the partial carious dentin removal technique.

Adverse birth outcomes and childhood caries: a cohort study

OBJECTIVES

To examine the association between adverse birth outcomes and dental caries in primary teeth.

METHODS

This study included children in Khon Kaen, Thailand, who participated in the Prospective Cohort Study of Thai Children. Preterm was defined as a birth at <37 weeks gestation, low birthweight (LBW) as birthweight <2500 g, and small-for-gestational age (SGA) as birthweight <10th percentile of expected weight for gestational age. Two calibrated dentists measured dental caries in primary teeth when the children were 3-4 years old using decayed, missing and filled surfaces (dmfs) index following the World Health Organization criteria. We used negative binomial regression with generalize linear models to estimate relative risks (RRs) and their 95% confidence intervals (CIs), adjusted for confounding factors. Of 758 children with gestational age data and 833 with birthweight data, the 544 (follow-up rate of 71.8% in preterm and 65.3% in LBW) who had dental data available were included in the analysis.

RESULTS

Dental caries was observed in 480 children (88.2%), with a mean dmfs of 14.3 (standard deviation 12.8). The adjusted RR for dental caries was 0.61 (95% CI 0.43, 0.85) for preterm, 0.89 (95% CI 0.67, 1.21) for LBW, and 0.96 (95% CI 0.74, 1.26) for SGA.

CONCLUSIONS

There was an inverse association between preterm and childhood caries. LBW and SGA were not associated with dental caries in this population.

Fracture strength of restorations in proximal cavities of primary molars

This study evaluated the fracture strength of various restorative materials for primary molars in dovetail and box-only class II cavity designs. Eighty extracted noncarious human primary molars were used. The teeth were randomly divided into two groups for either dovetail or box-only preparations. The teeth were then divided into four subgroups for each restorative material: glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), compomer, and composite. The restorations were tested for fracture strength. The loads at fracture and fracture mode were recorded and a scanning electron microscopy analysis was performed to observe the micromorphology of the borders between the teeth and the materials. The nonparametric Kruskal-Wallis and Mann-Whitney U-tests were used. Although there were significant differences between the restorative materials (p < 0.05), there were no differences between the fracture strength of the box-only and the dovetail cavity designs in any of the groups (p > 0.05) except the composite group. The fracture strength of the compomer and composite groups was significantly higher than that of the GIC and RMGIC groups (p < 0.05). A class II cavity could be selected as dovetail or box-only and compomer and composite are more resistant to fracture than GIC and RMGIC.

Clinical and radiographic comparison of indirect pulp treatment using light-cured calcium silicate and mineral trioxide aggregate in primary molars: A randomized clinical trial

Aim:

To clinically and radiographically evaluate the reparative dentin formation in indirect pulp treatment (IPT) using mineral trioxide aggregate (MTA) and light cured calcium silicate (TheraCal) in primary molars over a period of 6 months.

Materials and Methods:

A clinical trial on IPT on 43 primary molars in 21 patients between the age of 4–7 years, divided into two groups: 22 teeth in MTA group and 21 in TheraCal group. Measurement of the variation in dentin thickness was done on the digitalized radiograph at baseline, 3 months and 6 months using CorelDRAW X3 software.

Results:

Statistical analysis using an independent t-test for intragroup and intergroup comparison showed a significant increase in dentin thickness in both the MTA and TheraCal group (intragroup comparison [P < 0.05]). However, intergroup comparison between MTA and TheraCal showed no statistical difference in reparative dentin formation (P > 0.05).

Conclusion:

Clinically and radiographically, both MTA and TheraCal are good IPT materials. The better handling characteristics and comparable reparative dentin-forming ability of TheraCal make this material an alternative to MTA in pediatric restorative procedures.

Advanced endodontic developments in pulpectomy of primary teeth

INTRODUCTION

To appraise studies about pulpectomy in primary teeth with nickel-titanium rotary files and smear layer removal and to find out may these developments enhance pulpectomy outcomes in primary teeth.

MATERIAL AND METHODS

A systematic search was implemented for PubMed, Google and Google Scholar between the years 1995-January 2016 to identify eligible studies. Studies design was established according to the CEBM recommendations. Evidence quality of studies was appraised by risk of bias.

RESULTS

Six studies about pulpectomy met the inclusion criteria, of which five were randomized controlled trials. Only one research demonstrates the enhanced outcome of pulpectomy in primary teeth with smear layer removal. Chosen studies have low overall evidence quality.

CONCLUSIONS

Given the paucity, high heterogeneity of high-quality articles and their level of bias, recommendation for the use of nickel-titanium rotary files and smear layer removal in pulpectomy in primary teeth can yet not be formulated.

Clinical Evaluation of Restorative Materials in Primary Teeth Class II Lesions

OBJECTIVE

The aim of this study was to evaluate clinical success of primary teeth class II lesions restored with different restorative materials [Hybrid Composite Resin (HCR), Resin Modified Glass Ionomer Cement (RMGIC), compomer, and Giomer Composite Resin (GCR)] followed up for 24 months.

STUDY DESIGN

This study was carried out on 146 primary molars of 41 children in the age range of 5-7 years. The class II lesions in primary molars of a patient were restored using different restorative materials. Restorations were evaluated according to FDI-criteria and their survival rates were determined. Data were analysed with Pearson chi-square, Kaplan-Meier and Wilcoxon (Breslow) tests (α = 0.05).

RESULTS

The failure rates of restorative materials were as follows: compomer 33.3%, RMGIC 28.1%, HCR 22.5% and GCR 21.1%.

CONCLUSIONS

While the functional failure was the most important factor in restorative material failure, RMGIC was the most successful material in terms of biological evaluation criterion and GCR had the longest survival rate.

Nanomechanical characterization of exfoliated and retained deciduous incisors

OBJECTIVES

The anisotropic natures of dental tissues result in variable properties from one point to the other within the same tooth. The aim of this study was to analyze deciduous incisors enamel and dentin for elastic modulus and hardness. In addition, retained deciduous incisors were assessed to compare properties with exfoliated teeth.

METHODS

Deciduous mandibular incisors either exfoliated at physiological age or retained were included in this study. Samples were prepared by dissecting teeth in transverse sections and surfaces under investigation were prepared and polished for nanoindentation. Nanoindentation was performed at multiple sites using Hysitron [TI 725 Ubi] testing instrument. Data analysis was performed using SPSS software (version 20) to calculate absolute hardness and elastic modulus. The statistical significance was calculated using the t-test.

RESULTS

The hardness of human deciduous incisor varies between 0.01-7 GPa. The highest value of hardness was observed for the incisal edge (5.09 ± 0.64 GPa) followed by mid-surface enamel and cervical enamel. The hardness of mantle dentin was (0.56 ± 0.19 GPa) and the inner dentin was (0.34 ± 0.12 GPa).

CONCLUSIONS

The average hardness of primary teeth enamel is lower than permanent teeth enamel. The hardness of retained teeth enamel is greater than exfoliated teeth however lower than permanent teeth enamel of the equivalent region.

Impact of traumatic dental injury on the quality of life of young children: a case-control study

There are no longitudinal studies that assess the impact of traumatic dental injury (TDI) on the oral health-related quality of life (OHRQoL) of preschool children. To investigate the impact of TDI on OHRQoL among preschool children, a population-based case-control study was carried out with a representative sample of 335 children, 3-5 years of age, enrolled at public and private preschools in the city of Campina Grande, Brazil. The case group and the control group were matched for age, gender, type of preschool and monthly household income at a ratio of 1:4 (67 cases and 286 controls). Impact on the OHRQoL of children was assessed through administration of the Early Childhood Oral Health Impact Scale (ECOHIS). The occurrence of TDI was determined through clinical examinations performed by three calibrated dentists. Data analysis involved descriptive statistics, McNemar's test, the chi-square test with linear trend and conditional logistic regression analysis [P≤0.05; 95% confidence interval (95% CI)]. The most frequent responses were 'felt pain' (19.4%) and 'difficulty eating' (16.4%). The prevalence of TDI was 37.3% in the case group and 33.9% in the control group. No statistically significant differences were found between case and control groups regarding the presence of TDI (odds ratio=1.16; 95% CI: 0.66-2.02). TDI had no impact on the quality of life of preschool children.

Fracture resistance of three different posts in restoration of severely damaged primary anterior teeth: An in vitro study

Background:

Restoration of anterior primary teeth with severe caries lesion is a big challenge. The aim of this study was to compare the fracture resistance of three types of post, including composite resin, customized quartz fiber and prefabricated glass fiber in restoration of severely damaged primary anterior teeth.

Materials and Methods:

Sixty extracted human primary maxillary incisors were randomly divided into three groups: Group 1: Customized quartz fiber post, Group 2: Composite post and Group 3: Prefabricated glass fiber post. Due to the effect of bonded area on the fracture resistance, the bonded surface of each sample was measured 1 mm above cementoenamel junction. An increasing force was subjected with a crosshead speed of 0.5 mm/min by a universal testing machine until fracture occurred, and the failure mode was assessed afterwards. Data were analyzed using One-way analysis of variance and Kruskal–Wallis tests. The level of significance was considered at P < 0.05.

Results:

The mean fracture resistance values of three groups were 343.28 N, 278.70 N and 284.76 N, respectively. Although customized quartz fiber post showed the greatest fracture resistance, statistical analysis revealed no significant difference between groups (P = 0.21). The mean fracture strength values of three groups were 12.82 N/mm^–2, 11.93 N/mm^–2 and 11.31 N/mm^–2, respectively; however, the differences were not statistically significant (P = 0.72). Favorable failure mode was more frequent in all groups (P = 0.12).

Conclusion:

Within the limitations of this study, it can be concluded that all three types of studied posts can be successfully used to restore badly destructed primary anterior teeth.

C, Gupta A, Kalaria D, Kumar P. 24% Indigenously Prepared Ethylene Diamine Tetra Acetic Acid Compared to Self-Etching Adhesives and their Effect on Shear Bond Strength of Composites in Primary Teeth: An In-vitro Study

BACKGROUND

Over the years, it has been known that 34% phosphoric acid is the benchmark in etchants with the best shear bond strength shown with composites in primary teeth. However, with latest technological advancements and innovations, in order to reduce the number of steps and less damage to the tooth structure, non-rinse conditioner (NRC) & Single-Etch and various other etchants have been tried and tested. These etchants have been found to have shear bond strength comparable to phosphoric acid. In this study, indigenously prepared 24% ethylenediaminetetraacetic acid (EDTA) has been compared with established etchants, as to prove if their shear bond strength was closely related. As it is a well-known fact that EDTA could be less damaging to the enamel during etching and hence can be an alternative for etching of primary teeth.

MATERIALS AND METHODS

For the study 60 caries-free primary molars were used, they were sectioned in the middle, after making area for bonding; the marked area was then etched using different etchants for 30 s. Each of the teeth was then rinsed and bonded with composite resin and thermocycling was done. Shear bond strength testing was done on the composite using Universal Testing Machine.

RESULTS

Results of the study showed that phosphoric acid showed the highest bond strength, closely followed by Single Etch (Adper Prompt) and NRC, then by EDTA.

CONCLUSIONS

About 24% EDTA can be another comparable replacement for phosphoric acid if used with a Single Etch Primer, like Prime and Bond NT on primary teeth. 34% phosphoric acid has the highest bond strength values with composite resin. Single etch followed by NRC has the second and third highest bond strength values, which are comparable to phosphoric acid.

Regional odontodysplasia: Report of an unusual case involving mandibular arch

Regional odontodysplasia (RO) is a rare developmental anomaly involving both mesodermal and ectodermal components in primary or permanent dentition. It affects the maxilla and the mandible or both; however, maxilla is more commonly involved. This article reports the case of 33-month-old boy who came with the chief complaint of delayed eruption of mandibular teeth. Findings of clinical and radiographic examination were consistent with those of RO. Maxillary dentition was unaffected. Clinical and radiographic features and treatment options are discussed.

Clinical Success Rate of Compomer and Amalgam Class II Restorations in First Primary Molars: A Two-year Study

Background and aims. The majority of failures in Class II amalgam restorations occur in the first primary molar teeth; in addition, use of compomer instead of amalgam for primary molar teeth restorations is a matter of concern. The aim ofthe present study was to compare the success rate of Class II compomer and amalgam restorations in the first primary molars.

Materials and methods. A total of 17 amalgams and 17 compomer restorations were placed in 17 children based on a split-mouth design. Restorations were assessed at 12- and 24-month intervals for marginal integrity, the anatomic form and recurrent caries. Data were analyzed with SPSS 11. Chi-squared test was applied for the analysis. Statistical significance was set at P<0.05.

Results. A total 34 restorations of 28 restorations (14 pairs) of the total restorations still survived after 24 months. Compomerrestorations showed significantly better results in marginal integrity. Recurrent caries was significantly lower incompomer restorations compared to amalgam restorations. Cumulative success rate at 24-month interval was significantlyhigher in compomer restorations compared to amalgam restorations. There was no statistically significant difference inanatomic form between the two materials.

Conclusion. Compomer appears to be a suitable alternative to amalgam for Class II restorations in the first primary mo-lars.

Comparative Analysis of Root Dentin Morphology and Structure of Human Versus Bovine Primary Teeth

This study evaluated the structural and morphological differences between human and bovine primary root canals. Primary human maxillary central incisors (H) (n=9) and primary bovine incisors (B) (n=9) were selected. The roots were sectioned in the vestibular-lingual direction, planed and delimited in cervical, middle, and apical thirds. Tubule density (number of tubules per mm2) and diameter were analyzed by scanning electron microscopy (1,000 and 5,000×) using Image J 1.47 software. Data were submitted to two-way repeated measures ANOVA and Tukey tests (α=0.05). The highest tubule density was observed for B (28.527±1.717 mm2) compared with H (15.931±0.170 mm2) (p<0.01). Regarding root thirds, the cervical third presented a greater tubule density (26.417±11.654 mm2) than the apical third (17.999±5.873 mm2). The diameter of the dentin tubules was not different for cervical (3.50±0.08 µm), middle (3.45±0.30 µm) and apical thirds (3.42±0.33 µm) and substrate (H-3.29±0.14 µm; B-3.63±0.06 µm). It could be concluded that: (1) the radicular dentin structure of human and bovine primary teeth and root thirds differ in terms of the tubule density; (2) the radicular dentin morphology of human and bovine primary teeth and root thirds are similar in terms of the diameter of the dentin tubules.

Clinical outcomes of indirect composite restorations for grossly mutilated primary molars: a clinical observation

This study was conducted to report the clinical outcomes and the parental and child satisfaction of onlays for restoring mutilated primary molars. Twenty subjects, ages 3-8 years, with the presence of at least 1 mutilated primary molar (≥3 carious surfaces and a carious surface area ≥3/4 of the occlusal surface) were recruited. This study assessed the clinical success, gingival health, and parent/child satisfaction of 28 indirect composite onlays. The onlays showed a 100% retention rate at 12 months follow-up and a marginal integrity of 96.43%. High rates of satisfactory Alpha ratings for color stability (92.86%), surface texture (92.86%), and anatomic form (100%), coupled with significant improvements in gingival health of the restored teeth (P < 0.05), were reported. Indirect composite onlays successfully restored anatomic form and function of the grossly decayed primary molars--with shorter chairside times--while satisfying the esthetic demands of the young pediatric patients.

Appraisal of the remineralizing potential of child formula dentifrices on primary teeth: An in vitro pH cycling model

AIM

To evaluate the remineralizing potential of child formula dentifrices on primary teeth using an in vitro 7 days pH cycling model.

MATERIALS AND METHODS

Twenty-one primary teeth were placed in demineralizing solution for 96 h to produce artificial carious lesions; then cut longitudinally into 100-150 μm thick sections and randomly assigned to three groups. Sections in Group A were treated with dentifrice containing 458 ppm monofluorophosphate (MFP) and sections in Group B with 500 ppm sodium fluoride (NaF). Group C sections were treated with a nonfluoridated dentifrice.

RESULTS

Group A (458 ppm MFP) and Group B (500 ppm NaF) showed significant decrease in lesion depth, whereas Group C (non F) showed a significant increase in depth (P ≤ 0.05, paired t-test).

CONCLUSION

Though dentifrices containing 458 ppm MFP and 500 ppm NaF demonstrated remineralization of carious lesions, it was not complete. Therefore, it is also important to emphasize on other preventive methods in the prevention and/or reversal of carious lesions.

The prevalence of premature loss of primary teeth and its impact on malocclusion in the Eastern Province of Saudi Arabia

OBJECTIVES

The present study was designed to determine the prevalence of premature loss of primary teeth and its effect on malocclusion in Eastern Province, Saudi Arabia.

MATERIALS AND METHODS

This is an observational, cross-sectional study that included 307 male children aged 9-11 years old. Clinical examinations were performed using a disposable sharp explorer, a UNC periodontal probe and a dental mirror. The samples were examined clinically to detect the following traits: Angle's classification of malocclusion, overjet, overbite, anterior open-bite, lateral open-bite, midline shift and cross-bite. Additionally, a dental caries examination was performed using WHO methods. Questionnaires in Arabic were coded and sent to the students' parents.

RESULTS

The mean DMFT was 5.61 (SD = 3.01). The d-component was the highest, with a mean of 4 (SD = 2.83). Of the 307 children, it was found that 204 (66.4%) had a high DMFT score, which is defined as a score above 4. It was found that 156/307 (51%) children had premature loss of deciduous teeth.

CONCLUSION

A high prevalence of premature loss of teeth was found in this study. This finding emphasizes the importance of increasing awareness levels about this issue and focuses attention on the need for more preventive efforts to maintain healthy and normal dentitions that would improve the masticatory function and aesthetics of individuals and the whole population. In addition, the findings emphasize the importance of the early detection of premature loss of primary teeth to prevent future malocclusion.