Evaluation of Clinical Success, Caries Recurrence, and Oral Health-Related Quality of Life of Children Undergoing Full Mouth Rehabilitation for Early Childhood Caries: A Prospective Cohort Study

AIM

This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management.

METHODOLOGY

The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance.

RESULTS

272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment.

CONCLUSION

Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.

Comparison of shear bond strength of composite resin, compomer, and resin-modified glass-ionomer cements in primary teeth: An in-vitro study

OBJECTIVE

The contemporary esthetic restorative materials such as composite resin and glass-ionomer cements and their modifications have all been developed keeping in mind the requirements of permanent teeth. There have been plenty of studies that have focused on the characteristics of these materials in relation to permanent teeth with a relative dearth of such studies as regard to the primary teeth. The present study was undertaken to compare and evaluate the shear bond strength of composite resin, compomer, and resin-modified glass-ionomer cements in primary teeth.

METHODS

Thirty non-carious primary molars that were indicated for extraction because of physiological resorption or, for orthodontic reasons, were selected. The selected teeth were randomly allocated to three groups of 10 each for composite, compomer, and resin-modified glass-ionomer cements. The enamel from the occlusal surface of all teeth was removed to expose the superficial dentin and was wet polished with 400 grit sand paper. Composite, compomer, and resin-modified glass-ionomer stubs were bonded on to the occlusal surfaces using a plastic tube as a template. All samples were, then, subjected to thermocycling and evaluation of shear bond strength using the universal testing machine at a cross-head speed of 0.5 mm/min, whereas the results obtained were subjected to statistical analysis. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), whereas one-way analysis of variance (ANOVA) and Tukey's multiple post-hoc procedures were used for statistical analysis. A P < 0.05 was considered statistically significant.

RESULTS

The mean shear bond strength values for Groups I, II, and III were found to be 11.7 ± 3.07 MPa, 7.74 ± 4.16 Mpa, and 4.43 ± 2.08 Mpa, respectively, whereas one-way ANOVA and Tukey's multiple post-hoc procedures indicated that there were remarkable differences among the three groups with the results being statistically significant (P < 0.05).

CONCLUSIONS

Composite resin showed the highest shear bond strength in relation to primary dentin when compared to compomer and resin-modified glass-ionomer cements.

Reasons for Crown Failures in Primary Teeth: Protocol for a Systematic Review and Meta-Analysis

BACKGROUND

There is a tendency nowadays to restore large defects in primary dentition with pediatric crowns instead of conventional restorations. Thus, understanding the factors contributing to the survival or failure of dental crowns in pediatric dentistry is essential for optimizing treatment outcomes.

OBJECTIVE

The primary objective of this protocol is to outline the methodological approach for analyzing data from observational studies and randomized controlled trials to investigate reasons for the failure of dental crowns in primary teeth and to compute their survival and failure rates.

METHODS

A comprehensive literature review will be performed in electronic databases, including PubMed (MEDLINE), Cochrane, Embase, and Web of Science. As per predefined inclusion criteria, we will include observational studies (prospective clinical studies) and randomized clinical trials that have an English abstract and involve children aged 1-10 years undergoing crown restorations. Two independent reviewers will independently screen all retrieved records and full-text articles and extract data. The study's methodological quality will be appraised using suitable tools. Assessments of publication bias will be performed using funnel plots. The findings will be described qualitatively for the systematic review. If possible, a meta-analysis will be performed to estimate failure rates by dividing the number of failures by the total exposure time. A Poisson regression model, assuming constant event rates, will be used to compute 3-year and 5-year survival proportions. The Pearson goodness-of-fit statistics will be used to assess the heterogeneity of the model. A P value <.05 will be considered significant. All analyses will be performed using R Statistical software (version 4.1.2; R Core Team).

RESULTS

This systematic review and synthesis aim to assess the survival and failure rates of dental crowns in pediatric dentistry. By following this rigorous methodology, we seek to provide valuable insights into the factors contributing to the success or failure of these restorations. The results of our full review will have implications for pediatric dentists, researchers, and policy makers, helping to improve dental care for children.

CONCLUSIONS

This systematic review protocol helps in establishing a thorough approach for reviewing failures in pediatric crowns. By following this methodology, standardization and transparency of the process as well as accountability for the stated methods and outcomes will be ensured. The findings of this review and analysis will provide useful data on the survival of crowns to pediatric dentists and researchers.

TRIAL REGISTRATION

PROSPERO CRD42023442266; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=442266.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/51505.

Parental beliefs in and attitudes toward teething signs and symptoms: A systematic review

BACKGROUND

Parents believe that teething is associated with signs and symptoms, which may induce them to give medications that could harm their children. Some children may require alleviation of symptoms and overall attention.

AIM

To assess parents' beliefs in and attitudes toward teething.

DESIGN

Through electronic databases and gray literature, this systematic review identified cross-sectional studies reporting parents' beliefs in, knowledge about, and attitudes toward the signs and symptoms of primary tooth eruption in children aged between 0 and 36 months. Three reviewers independently selected the studies, collected the information, assessed methodological quality, and checked for accuracy with disagreements solved by a fourth reviewer. The Agency of Research and Quality in Health questionnaire for cross-sectional studies was used for quality assessment. Descriptive analysis with median and interquartile ranges was adopted.

RESULTS

Twenty-nine studies comprising 10 524 participants from all geographic regions were included. The methodological quality of the studies was moderate. Most parents have beliefs in signs and symptoms during dentition, the most reported symptom being the desire to bite. Oral rehydration was the most exposed attitude in the studies included. Only a small proportion of parents reported no attitude.

CONCLUSIONS

The majority of parents believed in at least one sign or symptom associated with teething, and only few of them would do nothing or just wait for the signs or symptoms to pass, with no difference among countries (Protocol doi: 10.17605/OSF.IO/S2KZ3).

Toll-like receptor expression profile of stem/progenitor cells from human exfoliated deciduous teeth

BACKGROUND

Stem/progenitor cells from human exfoliated deciduous teeth (SHED) show remarkable pluripotent, regenerative, and immunological capacities. During in vivo regenerative processes, there could be the presence of SHED in the surrounding inflammatory microenvironment, through toll-like receptors (TLRs).

AIM

The aim of this paper was to present a characteristic TLR expression profile on SHED for the first time.

DESIGN

Cells were harvested from extracted primary teeth (n = 10), anti-STRO-1 immunomagnetically sorted and cultivated, through colony-forming units (CFUs). SHED were examined for mesenchymal stem/progenitor cell traits, including the expression of clusters of differentiation (CDs) 14, 34, 45, 73, 90, 105, and 146, and their multilineage differentiation aptitude. TLRs 1-10 expression was investigated for SHED in uninflamed and inflamed (25 ng/mL IL-1β, 103 U/mL IFN-γ, 50 ng/mL TNF-α, and 3 × 103  U/mL IFN-α; SHED-i) microenvironmental conditions.

RESULTS

SHED were negative for CDs 14, 34, and 45, but were positive for CDs 73, 90, 105, and 146, and demonstrated characteristic multilineage differentiation. In an uninflamed microenvironment, SHED expressed TLRs 1, 2, 3, 4, 6, 8, 9, and 10. The inflammatory microenvironment downregulated TLR7 significantly on gene level and upregulated TLR8 on gene and protein levels (p < .05; Wilcoxon signed-rank test).

CONCLUSION

There appears to be a unique TLR expression profile on SHED, which could modulate their immunological and regenerative abilities in oral tissue engineering approaches.

The risk of healing complications in primary teeth with root fractures: A retrospective cohort study

BACKGROUND/AIM

Primary teeth are frequently affected by traumatic dental injuries. Root fractures are rare and have a reported incidence of 2% in the primary dentition. Hence, there is limited evidence on this topic. This study aims to evaluate the risk of healing complications in primary teeth with root fracture and to identify possible sequelae in the permanent dentition following root fracture in the primary dentition.

MATERIALS AND METHODS

A retrospective analysis of a cohort of 53 patients with 74 root fractured primary teeth. The standard follow-up program included clinical and radiographic examination after 4 weeks, 8 weeks, 6 months, and 1 year after the trauma and when the patient was 6 years of age. The following complications were registered: pulp necrosis (PN), pulp canal obliteration (PCO), ankylosis with replacement root resorption (ARR), infection-related root resorption (IRR), premature tooth loss (PTL), and repair-related resorption (RRR).

STATISTICS

The Kaplan-Meier and Aalen-Johansen estimators were employed. The level of significance was 5%.

RESULTS

A total of 74 teeth were included. 42 teeth were extracted at the initial examination. Risks estimated after 3 years: PTL 45.9% [95% CI: 28.8-63.0], PCO 12.9% [95% CI: 2.3-23.4], PN 14.9% [95% CI: 3.9-25.9], RRR 2.6% [95% CI: 0.0-7.5]. No teeth showed ARR or IRR. All complications were diagnosed within the first year. Most common sequelae in the permanent dentition was demarcated opacities, with an estimated risk of 20% [95% CI: 8.2-41.3].

CONCLUSIONS

There is a low risk of healing complications following a root fracture in the primary dentition. Root fractures often result in early extraction of the coronal fragment. The remaining apical fragment will undergo a physiological resorption. Aside from opacities, there is a low risk of sequelae in the permanent dentition.

Success Rate and Related Factors of Vitapex Pulpectomy in Primary Teeth: A Retrospective Study

OBJECTIVES

 Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth.

MATERIAL AND METHODS

 This retrospective study evaluated the clinical records of Vitapex PE-treated patients at the Pediatric Dental Clinic, Faculty of Dentistry, Mahidol University, from 2013 to 2019. The patient's and pulpectomized tooth's characteristics, procedure, materials used, and type of operator were recorded. A dentist evaluated and compared the periapical lesion, root status, obturation quality, and Vitapex resorption on preoperative, immediate, and follow-up digital radiographs. PE failure was defined as radiographic lesion progression.

STATISTICAL ANALYSIS

 The Kaplan-Meier method was used to estimate the Vitapex PE success rate and Vitapex resorption rate. Multivariate Cox regression was used to determine the related factors.

RESULTS

 In total, 647 Vitapex PE teeth from 448 patients (19-121-month-old) were analyzed. The follow-up periods ranged from 6 to 60 months. The success rate was 88.9 and 68.1% at the 12- and 24-month follow-up, respectively, and remained stable at 53.8% at the 36 to 60-month follow-ups. The factors related to Vitapex PE failure were age and a preoperative pathologic lesion. More than 50% of the pulpectomized teeth presented Vitapex resorption faster than physiologic root resorption at the 12-month follow-up. The patients' age at treatment and the obturation quality were significantly related to the Vitapex resorption rate.

CONCLUSIONS

 The success rate of Vitapex PE decreased time dependently and was related to the patient's age at treatment and a preoperative lesion. The Vitapex resorption was faster than root resorption and was associated with the patient's age at treatment and the root filling extravasation.

Efficacy of orthoMTA, retroMTA and ferric sulphate as pulpotomy agents in primary molars: a randomized clinical trial

Purpose

The purpose of this study is to evaluate the clinical and radiographic success rates of RetroMTA, OrthoMTA, and ferric sulfate as pulpotomy agents in primary molars.

Materials and methods

Ninety-six primary second molars from 32 children aged 5 to 9 years were enrolled in this study. The teeth were randomly divided into three groups based on the pulpotomy agent used: O-MTA, R-MTA, and FS. Clinical and radiographic follow-up examinations were conducted at 3, 6, 9, and 18 months postoperatively.

Results

At the end of the study period, 84 teeth were evaluated. The clinical success rates were 75% for FS, 96.4% for O-MTA, and 92.8% for R-MTA groups. In the radiographic analysis, the success rates at the 18-month follow-up period were 50% for FS, 85.8% for O-MTA, and 82.2% for R-MTA groups. According to the Chi-square test and Kaplan-Meier survival analysis, there was a statistically significant difference among the success rates and survival probabilities of the groups (p<0.05).

Conclusion

OrthoMTA and RetroMTA demonstrated better treatment outcomes for pulpotomy of primary second molars than ferric sulfate at the 18-month follow-up period.

Maternal Factors in Relation to Early Childhood Caries Among Preschool Children in Myanmar

A cross-sectional study was conducted among 3- to 5-year-old preschool children in Yangon City in 2016-2017 to investigate the association between their caries experience and maternal factors. Children's oral examination and questionnaire surveys to their mothers were conducted. Children's caries prevalence was 82.9% with mean dmft of 6.4 ± 4.9. Mean oral health knowledge score of their mothers was 8.5 ± 2.8. Mother's educational level and oral health knowledge were significant predictors of childhood caries. Third- or later-born children were twice more likely to have dental caries than first-born children (P = .022). Mother's regular dental check-up resulted in significantly lower odds ratios for caries development in her child. Children's caries experience was high and mother's oral health knowledge regarding the importance of primary teeth was unsatisfactory. It is, therefore, necessary to improve awareness and attentiveness for prevention of childhood caries among parents and guardians in Myanmar.

Effect of Chronic Apical Periodontitis in Primary Molars on Succedaneous Permanent Teeth: An Observational Retrospective Study

INTRODUCTION

Periapical infection of primary molars affects the development of permanent teeth (premolars). Therefore, the present study was conducted to test the null hypothesis in children aged 4-10 years with chronic apical periodontitis (CAP) of the primary molars.

MATERIALS AND METHODS

A retrospective, cross-sectional study was conducted on 185 panoramic radiographs of healthy children aged 4-10 years with CAP in the primary molars. A total of 256 infected primary molars (144 teeth in females, 112 teeth in males) were analyzed, radiographically, and compared with 245 healthy primary molars on the contralateral side. Permanent successors were evaluated for follicular damage, maturation, morphology, and deviation in the eruption path. Primary molars were evaluated for root resorption. Sixteen permanent teeth on the affected side and five teeth on the control side were excluded due to abnormal development. Student's t-test and the chi-square test were used to analyze the data.

RESULTS

The null hypothesis is rejected. There were significant differences in the developmental status of permanent successors on the affected side, compared to the normal side at four to seven years (p<0.05). There were no significant sex differences in the abnormalities of permanent successors on the affected side (p>0.05). As the root resorption of the primary molars increased, the follicular damage observed in the permanent successors also increased (p<0.05), which suggests that, as the infection of primary molars increases, more damage is caused to underlying permanent successors (premolars).

CONCLUSION

Apical periodontitis of the primary molars retards the development of permanent successors (premolars), affects their shape, causes follicular damage, and alters the eruption path.

The Remineralization Effect of Calcium Glycerophosphate in Fluoride Mouth Rinse on Demineralized Primary Enamel: An in vitro Study

Aim

To evaluate the remineralization effect of a fluoride mouth rinse containing calcium glycerophosphate in fluoride mouth rinse based on the surface microhardness of demineralized primary enamel.

Materials and Methods

40 sound primary incisors were placed into self-curing acrylic resin and subjected to a demineralizing solution for 5 days, resulting in the formation of artificial caries. The teeth were categorized into four groups (n = 10): group I artificial saliva, group II sodium fluoride, group III sodium fluoride + sodium monofluorophosphate, and group IV sodium monofluorophosphate + calcium glycerophosphate. The specimens received a pH cycling procedure and were submerged twice in their assigned groups for 7 days. The baseline, after demineralization, and after remineralization surface microhardness values were determined. One-way analysis of variance (ANOVA) was used to analyze the mean surface microhardness between groups and one-way repeated measures ANOVA for the mean surface microhardness within each group and Bonferroni's for multiple comparisons at 95% confidence level. The percentage recovery surface microhardness was determined by calculating the average surface microhardness.

Results

After demineralization, the mean surface microhardness in all groups significantly decreased. After remineralization, group I had the lowest surface microhardness values and the percentage recovery surface microhardness (P value < 0.001), and group IV had the highest surface microhardness values and the percentage recovery surface microhardness (P value < 0.001). No significant difference was found between groups II and III (P value = 0.365).

Conclusions

Fluoride mouth rinse containing calcium glycerophosphate has a remineralization effect on demineralized primary enamel.

Dentin Bonding Performance of Universal Adhesives in Primary Teeth In Vitro

(1) Background: The aim of this in vitro study was to evaluate the micro-tensile bond strength (µ-TBS) of universal adhesives to primary tooth dentin after different storage periods. (2) Methods: Dentin of 100 extracted primary molars was exposed. Dentin surfaces were bonded with six universal adhesives (Adhese®Universal [AU], All-Bond Universal® [ABU], G-Premio Bond [GPB], iBond®Universal [IBU], Prime&Bond active™ [PBa], and Prime&Bond®NT as control [PBN]) and restored with a resin composite build-up (Filtek™ Z250). After 24 h, 6 months, and 12 months of water storage, specimens were cut into sticks, and µ-TBS was measured and analyzed using one-way ANOVA (p < 0.05) for normal distributions and the Mann-Whitney U-test (p < 0.05) for non-normal distribution. Pretesting failures were recorded as 0 MPa. Fracture modes were analyzed under a fluorescence microscope; interfaces were visualized with SEM/TEM. (3) Results: Compared with the reference group (PBN: 32.5/31.2 MPa after 6/12 months), two adhesives showed a significantly higher bond strength after 6 months (AU: 44.1 MPa, ABU: 40.9 MPa; p < 0.05) and one adhesive after 12 months (AU: 42.9 MPa, p < 0.05). GPB revealed significantly lower bond strengths in all storage groups (16.9/15.5/10.9 MPa after 24 h/6 months/12 months; p < 0.05). AU and IBU did not suffer pre-test-failures [PTF]. (4) Conclusions: After 12 months, PBN, IBU, AU, and GPB showed significantly lower results compared ithw initial µ-TBS, whereas AU revealed the highest µ-TBS and no PTF.

Temperature Changes in Primary and Permanent Teeth Dentine of Varying Thicknesses Following Irradiation by Two Light Curing Units

AIM

This study was performed to determine the temperature rise under human dentin discs of different thicknesses from primary and permanent teeth during the photo-curing process using quartz tungsten halogen (QTH) or light-emitting diode (LED).

MATERIALS AND METHODS

The current experimental study sample consisted of 160 dentin discs of different thicknesses (0.5, 1, 1.5, and 2 mm), of which 80 dentin discs were prepared from sound lower second primary molars, and the remaining 80 dentin discs were prepared from sound lower third permanent molars extracted surgically for various reasons. A "K" type of thermal tentacle was placed in the center of an acrylic resin base, followed by the placement of a dentin disc. Then, the thermal changes were measured during the photo-curing of the composite using a second LED or QTH light curing unit for 20 s. Statistical evaluation was performed using the IBM SPSS Statistics® Version 20.0 software system (SPSS Inc., Chicago, IL, USA).

RESULTS

The current study found that the temperature rise in primary teeth (1.17-2.96°C) is significantly lower compared to the rise in permanent teeth (1.55-3.33°C), regardless of the dentin disc thickness or light curing unit used. The temperature rise decreases significantly when the thickness of dentin discs increases, regardless of the type of teeth or light curing unit used (P<0.05). Furthermore, QTH causes less temperature rise (1.17-2.65°C) compared to LED (1.61-3.33°C).

CONCLUSIONS

The temperature rise during polymerization of the resin composite with the second-generation LED appeared to be below 5.5°C. Hence, it appears to be safe for use during the restoration of primary teeth. Primary teeth dentin might be more effective than permanent teeth dentin in protecting the dental pulp.

Working length determination in primary teeth pulpectomy: A systematic review and meta-analysis

The present meta-analysis aimed to describe the methods to determine the working length in primary teeth pulpectomy, also evaluating and comparing their reliability. A systematic review was performed following the PRISMA Statement. The electronic search was conducted on PubMed, Scopus, Cochrane Library and Web of Science. After the screening protocol, a number of 14 studies were included in the qualitative analysis, while seven were included in the quantitative one. The mean working length determined by the electronic apex locator was 11.8 mm (9.0-15.55), while 12.42 mm (11.0-13.52) and 12.3 mm (9.73-15.93) were the mean working length observed with the conventional radiography and the digital radiography, respectively. No statistically significant difference was detected in quantitative analysis between the investigated methods. The present meta-analysis showed that electronic apex locator, conventional radiography and digital radiography are similar in determining working length in primary teeth.

Survival Rate of Atraumatic Restorative Treatment Restorations in Primary Posterior Teeth in Children with High Risk of Caries in the Republic of Kosovo-1-Year Follow-up

OBJECTIVE

 Atraumatic restorative treatment (ART) may be beneficial for disadvantaged populations with no or limited access to dental services. This study aimed to evaluate the survival rate of single-surface ART restorations in primary posterior teeth in children with high caries risk.

MATERIALS AND METHODS

 This study was conducted in six rural areas of the Republic of Kosovo, and 100 children aged 3 to 8 years participated in the study. Information was obtained from each parent/guardian regarding their children, such as sociodemographic characteristics, general health, dental history, dietary habits, oral hygiene, and fluoride exposure. The reduced Cariogram was used to estimate the risk of caries in the participants based on the seven factors specified in the program, and all the provided information were collected and entered in a computer program of the Cariogram. A pediatric dentist, accompanied by two assistants, performed 100 ART restorations in school settings using high-viscosity glass-ionomer cement (Fuji IX) following the nine steps of the ART procedure. The restorations were evaluated at 3, 6, 9, and 12 months using the ART restoration criteria.

STATISTICAL ANALYSIS

 Percentages, mean value, standard deviation, mean interquartile range, and difference test between arithmetic mean values were used to analyze the research results.

RESULTS

 Review of the average of reduced Cariogram showed that the majority of children, 72%, were at high risk of developing caries, with only 28% having a good chance of avoiding caries in the future. A total of 77% of the children in the study had never visited dentists before due to poor economic conditions and the lack of dentists in the area. The success rates of ART restorations performed in single-surface cavities in primary teeth were very encouraging, with more than 97% success rates after a 1-year follow-up period.

CONCLUSION

 Our results demonstrate that ART is efficient, affordable, and practical for the treatment of single-surface cavities in primary posterior teeth. Owing to its low price and atraumatic nature, ART can potentially help disadvantaged children in Kosovo access dental care.

Evaluation of Microleakage of Stainless Steel Crowns and Pedo Jacket Crowns after Cementation With Different Luting Cements

Aim

The present research was conducted to assess the microleakage of stainless steel crowns along with pedo jacket crowns following cementation with different luting cements.

Materials and Methods

A total of 60 deciduous teeth subjected to extraction were employed in this in vitro research. These 60 specimens were randomly divided into two groups: Group I: Stainless steel crowns and Group II: Pedo Jacket crowns. Both crowns were subjected to cementation using self-cure resin-modified glass ionomer (RMGI) cement as well as by means of self-adhesive universal resin cement (RelyX luting cement). The specimens were subjected to storage in distilled water at 37°C for 24 h and were subjected to 500 thermal cycles between 5°C and 55°C using a dwell span of 30 s. Individual surfaces were assessed for the amount of dye infiltration at the boundaries by the side of the tooth-cement border beneath a stereomicroscope under 50× magnifying power. At the mesial and distal surfaces, the amount of microleakage was measured in micrometers (μm), and the mean value was computed for each sample.

Results

Stainless steel crowns subject to cementation with RelyX luting cement exhibited the lowest microleakage (0.88 ± 0.78) versus self-cure RMGI cement (0.94 ± 0.78). There was no statistically significant difference found between the groups. Pedo Jacket crowns subject to cementation with RelyX luting cement exhibited the lowest microleakage (0.96. ± 0.32) while self-cure RMGI cement (1.83 ± 0.16) depicted the maximum microleakage. There was an extremely statistically noteworthy dissimilarity noted among the groups.

Conclusion

The current research concluded that Pedo Jacket crowns subjected to cementation with RelyX luting cement can be regarded as an esthetically pleasing restorative alternative for numerous young patients. Applying RelyX luting cement to Pedo Jacket crowns provides a strong bolstering by composite materials that ensures the success of the therapy provided.

Impact of Various Remineralizing Agents on Artificial White Spot Lesion on Primary Teeth-A Comparative Study

Aim

The aim of the current research was to assess the effectiveness of different remineralizing substances on artificial white spot lesions on deciduous teeth.

Materials and Methods

45 deciduous teeth without dental caries constituted the study group for this in vitro research. A 3 mm by 3 mm window of enamel was uncovered at the occluso-gingival midpoint of the coronal labial surface; an acid-resistant nail varnish was coated alongside the uncovered enamel surface of all specimens, employing vertical strokes. Demineralization was executed for the tenure of 72 hours at 37°C temperature in an incubator. The forty-five specimens, fifteen in each group, were assigned to the investigational groups plus a control group as: Group A: Control, Group B: Calcium sucrose phosphate (CaSP), Group C: Casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACPF). Microhardness tester was employed for testing the microhardness of the enamel surface using a Vickers diamond indenter laden with twenty-five milligrams for approximately ten seconds. Vickers hardness number (VHN) calculations for the microhardness were performed at baseline and on the fourteenth day.

Results

The CPP-ACPF group exhibited greater mean microhardness value at 236.14 ± 2.12, in pursuit by CaSP group with a score of 231.98 ± 3.16 and then the control group at 220.22 ± 5.08. An extremely statistically significant difference was seen amid the groups.

Conclusion

The current research arrived at a conclusion that both the remineralizing substances were certainly efficient in handling early dental caries, and additionally, casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACPF) was found highly efficient as a remineralizing substance, in pursuit by calcium sucrose phosphate (CaSP).

Comparative Evaluation on the Effects of Three Pediatric Syrups on Microhardness, Roughness and Staining of the Primary Teeth Enamel: An In-Vitro Study

​​​​​Introduction One of the most prevalent oral diseases is dental caries. Syrups are commonly used by children who have difficulty swallowing tablets and capsules. Some medications can make dental caries worse and cause the enamel to erode. Most of the time, parents are unaware that a number of foods, drinks, and syrup-formulated pediatric drugs include sugar, which can cause erosion of primary teeth, resulting in plaque accumulation and dental caries. Henceforth, the aim of this study is to assess the effects of pediatric syrups on the microhardness, roughness, and staining ability of primary tooth enamel as a result of daily intake of syrup. Methods Eighty primary teeth, including both anterior and posterior, that required extraction due to pre-shedding mobility were randomly divided into four groups of twenty samples each. Samples were exposed to multivitamin syrup (Rudimin), iron syrup (C Pink), and diuretic syrup (Furosemide). The samples were submerged in 10 mL of the respective medication once daily for five minutes for 21 days. On days 0 and 21, enamel surfaces were assessed for changes in microhardness, roughness, and staining. The microhardness was assessed using a Micro Vickers microhardness tester machine; the roughness was assessed using a Mitutoyo surface roughness tester; and the staining ability was assessed using a spectrophotometer, and data processing was done using the analysis of variance (ANOVA) test and Tukey's post hoc analysis. Results The changes in enamel surface for microhardness, roughness, and staining were assessed twice, at days 0 and 21. Group 4 (Furoped) showed a significant difference in surface microhardness and staining ability of enamel surfaces with a statistically significant p-value (<0.05). When roughness was compared, all three interventions had a significant difference from the control group, whereas there was no statistically significant difference between the intervention groups. Conclusion This study concludes that pediatric syrups can significantly weaken the enamel of primary teeth, resulting in loss of enamel surface microhardness and roughness making them vulnerable to caries. Since frequent consumption of these syrups is correlated with tooth decay, certain precautions like oral hygiene maintenance and rinsing with water after taking the syrup should be done to prevent dental caries, as consumption of medicinal syrups by children cannot be avoided.

Comparative Evaluation of Extrusion of Apical Debris in Primary Maxillary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study

Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in postoperative complications. The aim of this study was to evaluate and compare the number of debris apically extruded during canal preparation using two different pediatric rotary file systems and conventional hand file systems in primary teeth. 60 primary maxillary central incisors that were extracted due to trauma or untreated dental caries with no signs of resorption were taken. Canal preparation was executed using three different file systems: Group A: Group A hand K file system, Group B Kedo S Plus, Group C Kedo SG Blue. For each of these files using the Myers and Montgomery model, the pre- and post-weight of the eppendorf tube was assessed to quantify the number of apical debris. The maximum extrusion of apical debris was noticed with the Hand K-file system. The least debris was noticed in the Kedo S Plus file system. Statistical analysis revealed that there were highly significant differences in apical extrusion and debris when comparing hand files and rotary files and also between the two rotary files used. Apical debris collection is an unavoidable outcome of canal instrumentation. Among the file systems compared, rotary files had lesser extrusion when compared to hand files. Among the rotary files, Kedo S plus showed normal extrusion compared to SG Blue.

Non-syndromic Oligodontia in Primary Dentition: A Report of a Rare Case

The congenital absence of teeth is the most common dental anomaly affecting 2.2% to 10% of the population. It could be present in the form of anodontia, hypodontia, or oligodontia, excluding wisdom teeth. Oligodontia is most commonly associated with several syndromes like ectodermal dysplasia, Down syndrome, and Van der Woude syndrome that involve the mutation of the MSX-1 and PAX-1 genes. Few cases have been reported in the literature on how oligodontia affects primary dentition. In this case report, a total of 17 primary teeth were missing. This case report investigates whether the features of non-syndromic oligodontia are present in the primary dentition in a two-year-old boy.

Exploring a Paradigm Shift in Primary Teeth Root Canal Preparation: An Ex Vivo Micro-CT Study

Traditional hand instrumentation is a commonly used technique to perform pulpectomy in deciduous teeth by most specialists in pedodontics. Lately, dentists have embraced rotary instrumentation as a safe and effective alternative. This study aimed to compare the efficacy of root canal preparation in extracted primary molars between manual and two rotary file systems using micro-CT. Thirty-six extracted human second primary mandibular molars were divided into three groups according to the instrumentation method: (1) Manually instrumented (MI) group (n = 9) in which the teeth were treated using K-files up to size 30; (2) Kedo-Ssystem (KS) group (n = 9); (3) ProTaper Gold system (PTG) group (n = 10) and control group (n-8). Each tooth was scanned before and after the retrograde root canal preparation. Residual dentin volume was calculated using micro-CT scans to evaluate the technique's efficacy. Additionally, the preparation time and procedural errors were recorded for each tooth preparation. A one-way ANOVA test was carried out to compare the groups' dentin volume and preparation time. The mean preparation time using the manual method (13.14 min) was more than two times longer than that of the rotary techniques (4.62 min and 6.45 min). The manual preparation method using a K-file removed almost half the root canal material when compared with the rotor method (p = 0.025). Conclusion: our results suggest that rotary instrumentation is more efficient for root canal preparation in primary teeth than the traditional manual method. This finding may call for a paradigm shift in current clinical practices, where manual instrumentation is still commonly preferred.

Effect of enamel surface coating on staining capability due to iron containing supplements on primary teeth: An in vitro study

Background

Iron supplements prescribed to anemic children may results in teeth staining. Possible methods for preventing staining of primary teeth following exposure to iron supplements are need of an hour.

Aim

This study was conducted with the aim to assess effect of enamel surface coating on staining capability of iron containing supplements in primary teeth.

Settings and Design

This is an in vitro Experimental study.

Methods

Hundred and forty-four primary incisors with intact crowns were sequentially numbered and randomly divided into four main groups of 36 samples receiving different enamel surface coating such as no surface coating, MI fluoride varnish™, GC G-coat Plus™ and GC-Equia®-forte-coat. Each group was subdivided into two groups, namely A (sound teeth) and B (artificially demineralized teeth). All the samples were immersed in 250 ml artificial saliva containing 10 ml of iron supplement to make the iron concentration 100 mg. The shade of the teeth was measured at baseline and at 90 days, using VITA Easy shade® V digital spectrophotometer. The data was statistically analyzed using the Kruskal-Wallis test and Mann-Whitney U test. Descriptive and inferential statistical analyses was made via SPSS 23.

Results

Overall color change was found to be significantly less at the end of 90th day in sound samples when GC-Equia®-forte-coat was used as an enamel surface coating with pvalue of 0.017. In demineralized samples the overall color change was least at the end of 90th day when MI Varnish™ used as an enamel surface coating with P = 0.042.

Conclusions

GC-Equia®-forte-coat, MI Varnish™ and GC-G-coat-plus™ can be used as a preventive or a precautionary measure to minimizes the staining of teeth. The amount of color change at the end of 90 days with GC-Equia®-forte-coat was least followed by MI varnish™, GC G coat Plus™ and control group.

Shear Bond Strength and Fluoride Release of a Universal Adhesive: An In-Vitro Study on Primary Teeth

This investigation aimed to assess the shear bond strength and fluoride-releasing capabilities of Clearfil Universal Bond Quick (Kuraray Noritake Dental Inc., Tokyo, Japan). Forty-four extracted primary molars were divided into two groups, and the enamel substrate was prepared for evaluating shear bond strength. Scotchbond (3M ESPE) and Clearfil UBQ were used to bond composite-to-enamel substrates in each group (n = 22). Shear bond strength was measured using a universal testing device and compared. Sixteen discs (6 mm diameter and 3 mm thickness) were fabricated from each Clearfil UBQ, Fuji IX, and Fuji II LC. Over the course of 30 days, each materials' fluoride release was examined and compared using ion analysis. Results revealed that Clearfil UBQ had statistically similar shear bond strength to Scotchbond. Between the three materials, Clearfil UBQ had the lowest fluoride release at baseline (0.11 ± 0.25) and the lowest cumulative fluoride release (0.12-0.27 ppm) over 30 days. Fuji IX had the highest fluoride release at baseline (19.38 ± 2.50) and cumulatively (40.87 ± 4.03 ppm), followed by Fuji II LC. We conclude that Clearfil UBQ and Scotchbond showed comparable bond strengths to the enamel. Fluoride release was seen in Clearfil UBQ in the initial two days of the 30-day period. The amount of fluoride release was significantly less than with glass ionomer cements.

Dental enamel defects and dental caries of primary teeth among Indigenous children in Western Australia

BACKGROUND

Teeth affected with enamel defects (EDs) are at an increased risk of dental caries. In spite of improving oral health status overall in Australia, Indigenous Australians still experience higher rates of dental caries than non-Indigenous Australians. This study reports on the prevalence of EDs and dental caries experience among Indigenous children in the Kimberley region of Western Australia.

METHODS

Health status of all the primary teeth (ICDAS II criteria) and the presence of EDs on index teeth (modified Dental Defects of Enamel index; DDE) of young Indigenous children who participated in a 2-arm intervention trial was recorded. Generalized estimating equations were used to estimate the association between EDs and dental caries and effect estimates were presented as odds ratios and associated 95% confidence intervals.

RESULTS

Person-level prevalence, from 237 children (mean age 3.6 years, standard deviation 1.7) assessed for EDs, was 58% and tooth-level prevalence was 24%. Teeth affected with demarcated or diffuse defects were associated with a twofold higher odds of having caries experience, odds ratio (OR) 2.5, 95% confidence interval (CI) 1.7-3.7 and OR 2.7, 95% CI 1.7-4.0 respectively.

CONCLUSIONS

The presence of EDs among young Indigenous children was associated with a higher odds of caries experience among affected teeth.

Comparative evaluation of antimicrobial efficacy of nanosilver solution, Azadirachta indica, sodium hypochlorite, and normal saline as root canal irrigants in primary teeth

Background

Microorganisms are the main cause of pulpal and periapical diseases. Hence, the elimination of such potential microbes is achieved by endodontic treatment. Mechanical preparation is the main mechanism to reduce the bacterial load in canals which is enhanced by intracanal irrigants. Despite these procedures, some bacteria might persist within the canals. It is important to disinfect the pulp space and dentinal tubules thoroughly with an effective endodontic irrigant to prevent reinfection of a treated root canal.

Aim

This study aimed to evaluate and compare the antimicrobial efficacy of nanosilver (NS) Solution, Azadirachta indica, sodium hypochlorite, and normal saline when used as irrigants in infected root canals of primary teeth.

Settings and Design

The study was a prospective randomized control trial which was conducted as per the consort statement.

Materials and Methods

Eighty pulpally involved primary teeth requiring endodontic treatment of children aged 5-12 years were selected for this study. The subjects were randomly allocated to 4 groups (3 irrigant and control groups) consisting of 20 children each where Group I = NS solution, Group II = A. indica, Group III = Sodium hypochlorite (2.5%), and Group IV = Control group. Microbiological samples were collected at the baseline (before irrigation) and postirrigation after biomechanical preparation using the selected irrigant. The samples were subjected to an anaerobic bacterial culture test. Microbial colonies were identified and expressed as colony forming units per milliliter.

Statistical Analysis

Data were analyzed using one-way analysis of variance, Paired t-test, and Post hoc Bonferroni test.

Results

NS solution showed the highest mean of 4.384 × 10³ ± 1.019 followed by Sodium hypochlorite with a mean of 3.500 × 10³ ± 1.193 and A. indica of 2.590 × 10³ ± 0.778.

Conclusion

Based on the results of this study, NS solution can be used as an alternative to other root canal irrigating solutions in primary teeth.