Evaluation of pH and calcium ions release of two tricalcium silicate-based sealers through roots of primary teeth

Background

This study aimed to evaluate the pH and calcium ions (Ca2+) release from two tricalcium silicate-based sealers (Sealer Plus BC and Bio-C Pulpecto) through roots of primary teeth.

Methods

Forty root canals of primary incisors were prepared and distributed into four groups according to the filling material: GPlusBC (Sealer Plus BC); GBioC (Bio-C Pulpecto); GUltra (Ultracal); and GC (no filled). pH measurement was performed with a digital pH meter, and the Ca2+ release was measured in an atomic absorption spectrophotometer at baseline, 24 h and 1, 2, 3, and 4 weeks later. The data were analyzed using two-way ANOVA and Tukey's post hoc tests.

Results

The results did not reveal significant differences between the groups in terms of pH in 24 h, 1-, and 2-weeks' periods. After 4 weeks, there was a significant difference, with the highest mean pH values in GUltra, followed, respectively, by GPlusBC and GBioC. Regarding the Ca2+ release, the GUltra showed greatest mean values at all evaluated times, and the other groups showed no difference between them.

Conclusion

Both sealers were able to promote the elevation of the pH and Ca2+ release through roots of primary teeth, which brings favorable properties for their use as a filling material.

[Application of autofluorescence microscopy and laser Induced fluorescence methods to study the dynamics of the demineralization primary teeth process in vitro]

OBJECTIVE

Improvement of methods for studying the processes of demineralization of hard tissues of temporary teeth.

MATERIAL AND METHODS

The study included primaries second molars (n=11). Samples of primary teeth were placed in a test tube with a demineralizing solution for - 1, 4, 8, 21 and 31 days. The of primary teeth samples were examined using methods - laser induced fluorescence (LIF) and autofluorescence microscopy (AFM). Assessment of the degree of demineralization of samples of temporary teeth was carried out according to the score scale developed by us.

RESULTS

The enamel of the samples is demineralized slowly and evenly for up to 8 days with minimal objective signs, starting from the 8th day of the experiment, there is a significant increase in demineralization indicators. By the 21st day, the peak of demineralization is reached with partial dissolution of the enamel, an increase in the fluorescence effect to 80 UE, and reaches a maximum of 4 points on the evaluation scale. Dentin's hard tissues are demineralized gradually without "sudden jumps" in the fluorescence effect and at the same rate throughout the experiment, reaching a maximum on 31 days (30 UE - LIF). Dentin demineralization is characterized by less dissolution, however, the phenomenon of delamination is determined by the type of exfoliation of the organic dentin matrix, starting from the 21st day of the experiment.

CONCLUSION

Enamel and dentin of deciduous teeth demineralize at different rates and have a characteristic specificity of morphological changes. Logistic regression analysis showed the consistency of the classifier for the predictive accuracy of each unit of the proposed scale for assessing the degree of demineralization of temporary teeth samples.

Age-Related Variation of Pulpal Oxygen Saturation in Healthy Primary and Permanent Teeth in Children: A Clinical Study

(1) Background: Pulse oximetry (PO) is an effective method of dental pulp status monitorization but still lacks practical implementation in dentistry, as well as clear reference values for different tooth types. The study’s aim was to investigate the age-related variation of blood oxygen saturation (SpO2) from the dental pulp during different stages of tooth development in all types of primary and permanent teeth of children. (2) Methods: The pulps of 600 healthy primary and permanent teeth (incisors, canines, premolars, and molars) of patients aged 2−15 years were tested with an adapted PO device, and the results were statistically analyzed; (3) Results: Statistically significant differences (p < 0.05) were found between open-apex and closed-apex teeth and between the canines and other tooth types in both primary and permanent dentitions. (4) Conclusions: Values of SpO2 tended to decrease with age progression in both primary and permanent dentitions. Enamel and dentine thickness and their optical properties and the shape and volume of coronal pulp, which differed among tooth types, seemed to have some influence on the reading as well. The study indicates that factors such as the root development and the tooth type must be taken into account when establishing reference SpO2 values for the dental pulp.

Reciprocating instrumentation for endodontic treatment of primary molars: 24-month randomized clinical trial

BACKGROUND

Although reciprocating instrumentation has been extensively studied for permanent teeth, stronger evidence for its use in primary teeth is lacking.

AIM

The aim of this randomized clinical trial was to compare the efficacy of endodontic treatment in primary molars using reciprocating (RECIP) and manual (MAN) instrumentation techniques after 24 months.

DESIGN

Primary molars with indication of endodontic treatment were randomly divided into two groups: MAN and RECIP. Treatments were performed, and root canals were filled with calcium hydroxide and iodoform paste. Teeth were later restored with bulk-fill composite resin and re-evaluated after 6, 12, 18, and 24 months. The primary outcome was the success of the endodontic treatment evaluated by Cox regression analysis adjusted by cluster and success rate after 24 months in the intention-to-treat (ITT) population. Instrumentation time, discomfort, postoperative pain, and quality of root canal filling were also evaluated as secondary endpoints.

RESULTS

A total of 151 primary win 107 children were included, and 137 were followed up for 24 months. Success rate of teeth allocated to the MAN group was 57.3% and 55.3% for RECIP (p = .792); MAN instrumentation, however, was more time-consuming (p = .005).

CONCLUSION

The efficacy of endodontic treatment in primary molars using reciprocating and manual instrumentation is similar after 24 months.

A comparative evaluation of four regenerative materials for pulpotomy in primary molars: An in vivo study

Background

Preservation of pulpal vitality is of paramount importance as the vital functioning pulp is capable of initiating a unique reparative capacity. The present study aimed to evaluate and compare four regenerative materials for pulpotomy in primary molars.

Materials and Methods

This in vivo study included a total of 120 primary molars from 30 healthy children aged 3-9 years for regenerative pulpotomy procedure. The teeth were then divided by the lottery method (chits with names of materials on it) into four groups so that each child received all four of the regenerative materials; Group 1: Biodentine (BD)™, Group II: Mineral Trioxide Aggregate Plus (MTA Plus™), Group III: Retro MTA (Retro MTA^®), and Group IV: Calcium Enriched Mixture (CEM) cement. All the primary molars (1^st/2^nd molars) were evaluated clinically and radiographically at 6, 12, 18, and 24 months. Data were subjected to the statistical analysis using the Chi-square test. The level of significance was considered as P < 0.05.

Results

Clinical evaluation showed 100% success with BD™ and CEM cement; whereas 96.2% success was seen with MTA Plus™ and Retro MTA^®. On radiographic evaluation, MTA Plus™ and CEM cement showed 96.2% success, whereas BD™ and Retro MTA^® showed 92.59% success rate.

Conclusion

All four regenerative materials showed high success in the pulpotomy of primary molars.

Parents' and Children's Acceptance of Silver Diamine Fluoride Application on Primary Teeth in the United Arab Emirates

PURPOSE

To assess the acceptance of silver diamine fluoride (SDF) application on children's teeth among parents and children in the United Arab Emirates (UAE).

MATERIALS AND METHODS

A pre-tested questionnaire and clinical photographs of SDF-treated teeth were employed to determine preferences among 370 parents for its use in managing dental caries in their children's teeth. A similar number of children ages 4 to 8 years were also interviewed, and their reaction to SDF was assessed through a facial image scale after showing pictures of pre- and post-SDF treated primary teeth.

RESULTS

265 mothers and 105 fathers participated in this study. The Χ2 test was used to test for the statistically significant differences between parental perceptions. Almost all parents responded that SDF was either unacceptable or extremely unacceptable for their children's anterior teeth in comparison to 63% for posterior teeth (p = 0.009). Fathers were more comfortable with SDF treatment for posterior teeth on a scale of 3.1 out of 4, in comparison to 1.8 for mothers (p = 0.007). Parents with limited education (up to primary school) showed greater SDF acceptance in comparison to college-graduate parents (p = 0.000). The level of parental SDF acceptance increased with the children's behavioural barriers. The older children had a lower acceptance rate, at 1.2 and 2.5 for anterior and posterior teeth, respectively (p = 0.000).

CONCLUSIONS

SDF was acceptable to UAE-based parents for posterior teeth; however, they preferred it for anterior teeth only when advanced behavioural management (e.g., sedation) was advocated. Socioeconomic factors moderated their SDF preference regarding the location of tooth and treatment difficulty. Younger children were relatively more receptive to SDF use than were older children.

The Relationship between Obesity and Childhood Dental Caries in the United States

Background: Childhood obesity and dental caries are prevalent chronic, multifactorial conditions with adverse health consequences and considerable healthcare costs. The aims of this study were: (1) to evaluate the relationship between obesity and dental caries among young children using multiple definitions for both conditions, and (2) to evaluate the role of family socioeconomic status (SES) and the child’s intake of added sugars in explaining this association. Methods: Data from 2775 2−5-year-olds children from the National Health and Nutrition Examination Survey (NHANES) 2011−2018 were analysed. Three different international standards were used to define obesity, namely the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the International Obesity Task Force (IOTF). Dental caries was measured during clinical examinations and summarised as counts (dt and dft scores) and prevalence (untreated caries [dt > 0] and caries experience [dft > 0]). The association of obesity with dental caries was assessed in regression models controlling for demographic factors, family SES and child’s intake of added sugars. Results: In crude models, obesity was associated with greater dt scores when using the IOTF standards (RR: 2.43, 95% CI: 1.11, 5.29) but not when using the WHO and CDC standards; obesity was associated with greater dft scores when using the WHO (1.57, 95%CI: 1.11−2.22), CDC (1.70, 95%CI: 1.17−2.46) and IOTF standards (2.43, 95%CI: 1.73−3.42); obesity was associated with lifetime caries prevalence when using the WHO (1.55, 95%CI: 1.05−2.29), CDC (1.73, 95%CI: 1.14−2.62) and IOTF standards (2.45, 95%CI: 1.61−3.71), but not with untreated caries prevalence. These associations were fully attenuated after controlling for demographic factors, family SES and child’s intake of added sugars. Conclusions: The relationship between obesity and dental caries in primary teeth varied based on the definition of obesity and dental caries used. Associations were observed when obesity was defined using the IOTF standards and dental caries was defined using lifetime indicators. Associations were fully attenuated after adjusting for well-known determinants of both conditions.

Osteomyelitis Possibly Caused by Exfoliation of Primary Teeth in a Patient with Osteopetrosis

Osteopetrosis is a rare inherited skeletal disease characterized by increased density in the bones and can be detected by radiographs. Sclerosis makes the jaw bones extremely susceptible to infections, osteomyelitis, and fractures. Here, we report a case of osteomyelitis possibly caused by spontaneous exfoliation of primary teeth in a patient with osteopetrosis. A 2 years and 9 months (2Y9M)-old boy with osteopetrosis was referred to our clinic for oral management. Only four primary central incisors had erupted, and they all exhibited hypoplasia. The mandibular right central primary incisor suddenly became exfoliated at 4 years and 1 month. The mandibular right lateral primary incisor also became exfoliated at 4 years and 3 months, soon after eruption, and the mandibular left central primary incisor became exfoliated at 4 years and 5 months. Subsequently, we confirmed the eruption of calcified tissue at 4 years and 9 months in the location where the mandibular right lateral primary incisor had become exfoliated. The patient was admitted to the pediatrics clinic for mandibular cellulitis at 5 years and 2 months, then referred to our clinic for the management of osteomyelitis. The patient's acute inflammation was reduced by repeated irrigation and the administration of antibiotics; the inflammation gradually became chronic. When treating patients with osteopetrosis, dentists and oral surgeons should prioritize infection control in the jaw, periodic assessment of dental eruption, and the maintenance of oral hygiene.

A randomized controlled trial of 6-month dental home visits on 24-month caries incidence in preschool children

OBJECTIVES

This paper reports on the effect of 6-month dental home visits compared to no dental home visits on 24-month caries incidence in 5- to 6-year-olds.

METHODS

5- to 6-year-olds attending kindergartens were randomized to receive either 6-month dental home visits and education leaflets (Intervention group) or education leaflets alone (Control group) over 24 months. To detect a 15% difference in caries incidence with a significance level of 5% and power of 80%, 88 children were calculated to be needed in the Intervention group and 88 in the Control. Baseline clinical data included oral examinations at the kindergartens. Follow-up visits were made on the 6th, 12th and 18th month. At the end of the 24 months, both the Intervention and Control groups were visited for oral examinations. The primary outcome was caries incidence, measured by the number and proportion of children who developed new caries in the primary molars after 24 months. The secondary outcome was the number of primary molars that developed new caries (d-pms). Frequency distributions of participants by baseline socio-demographic characteristics and caries experience were calculated. The chi-square test was used to test differences between the caries experience in the Intervention and Control groups. The t test was used to compare the mean number of primary molars developing new caries between the Intervention Group and the Control Group. The number of children needed to treat (NNT) was also calculated.

RESULTS

At the 24-month follow-up, 19 (14.4%) developed new caries in the Intervention Group, compared to 60 (60.0%) in the Control Group (p = .001). On average, 0.2 (95% CI = 0.1-0.3) tooth per child in the Intervention Group was observed to have developed new caries compared to 1.1 (95% CI = 0.8-1.3) tooth per child in the Control Group (p = .001). The number of children needed to treat (NNT) to prevent one child from developing new caries was 2.2.

CONCLUSIONS

The present study has demonstrated that 6-month home visits to families of 5- to 6-year-olds are effective in caries prevention in 5- to 6-year-olds of low-income families in a middle-income country where access to health services, including oral health promotion services, is limited.

Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration

The current study aims to investigate a suitable adhesive for primary tooth enamel. Shear bond strength (SBS) of primary teeth and the length of resin protrusion were analyzed using one-way ANOVA with Bonferroni multiple comparison tests after etching with 35% H ₃PO ₄. SBS and marginal microleakage tests were conducted with Single Bond Universal (SBU)/Single Bond 2 (SB2) adhesives with or without pre-etching using a nonparametric Kruskal-Wallis test. Clinical investigations were performed to validate the adhesive for primary teeth restoration using Chi-square tests. Results showed that the SBS and length of resin protrusion increased significantly with the etching time. Teeth in the SBU with 35% H ₃PO ₄ pre-etching groups had higher bond strength and lower marginal microleakage than those in the SB2 groups. Mixed fractures were more common in the 35% H ₃PO ₄ etched 30 s + SB2/SBU groups. Clinical investigations showed significant differences between the two groups in cumulative retention rates at the 6-, 12- and 18-month follow-up evaluations, as well as in marginal adaptation, discoloration, and secondary caries at the 12- and 18-month follow-up assessments. Together, pre-etching primary teeth enamel for 30 s before SBU treatment improved clinical composite resin restoration, which can provide a suitable approach for restoration of primary teeth.

Clinical Efficacy of Biomimetic Bioactive Biomaterials for Dental Pulp Capping: A Systematic Review and Meta-Analysis

Recently, biomimetic bioactive biomaterials have been introduced to the market for dental pulp capping. This systematic review and meta-analysis aimed to determine any variation between the effect of using TheraCal LC and other bioactive biomaterials for pulp capping is different, as measured by dentin increment and clinical success. The risk of bias was assessed using the Risk of Bias 2 and Newcastle−Ottawa tools for randomized clinical trials and observational studies. A search for relevant articles was performed on five databases. Additionally, the quality of the included studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A summary of individual studies and a meta-analysis were performed. The odds ratio of data from clinical success was combined using a random-effects meta-analysis. The meta-analysis results showed homogeneity between the studies (I2 = 0%). They revealed that the clinical success showed no differences between the patients who received TheraCal LC, light-cured calcium silicate-based biomimetic biomaterial, for dental pulp capping or the comparator biomaterials (p > 0.5). However, the certainty of the evidence was low to moderate due to the risk of bias in the included studies.

Update in the Diagnosis and Treatment of Root Canal Therapy in Temporary Dentition through Different Rotatory Systems: A Systematic Review

The need to perform fast, effective and efficient pulpectomies has led to the development of numerous valid rotary systems. Its technical features allow the clinician to obtain good results in less working time. The objective of this study is to compare the characteristics of the different current rotary systems to favor a correct diagnosis and subsequent treatment. A systematic review of the literature has been carried out in accordance with the PRISMA recommendations. A search was carried out in PubMed, Embase Scopus, Cochrane and Web of Science databases, and was completed with a manual search. The following variables were extracted from the selected studies: author, year, sample, rotary systems used (length, diameter, taper, speed), obturation material and irrigant. From the initial electronic search of the five databases, 315 articles were identified. Once the duplicate articles were eliminated, a total of 233 remained. After reading both title and abstract, 200 articles were eliminated, leaving 33. On account of reading the full text, 22 were eliminated for not answering the research question or the inclusion criteria, leaving a total of 11 articles for the systematic review. Rotary systems which are able to adapt to the root anatomy of primary teeth and allow rapid and simple instrumentation, without producing excessive extrusion of debris at the root apex, will be the ones that provide the best results to the pediatric dentist during the performance of pulp treatment in primary teeth. Clinical success will only be achieved through proper prior diagnosis.

One-year clinical evaluation of class II bulk-fill restorations in primary molars: a randomized clinical trial

This double-blind, randomized clinical trial aimed to compare the clinical performance and clinical time to restore occluso-proximal cavities in primary molars withbulk-fillresin and conventional resin. A total of 140 class II restorations in primary molars of 65 participants (mean age of 6.7 + 1.5) were placed in two random groups:bulk-filland conventional resin. The restorations were evaluated using FDI criteria at the baseline, 6-month, and one year by a single calibrated examiner, and the clinical restorative time was measured with a digital timer. The success and survival of the restorations were evaluated with Kaplan-Meier graphs. The log-rank test compared the curves. Differences in restorative clinical time were compared using the Mann-Whitney U test. The level of significance was 5%. After one year, 115 restorations were evaluated. The success probability was 88.7% for Filtek Z350 XT and 85.9% for FiltekTM Bulk-fill, and for the survival probability, Filtek Z350 XT presented 90%, and FiltekTM Bulk-fill presented 93.7%. No significant difference was found between the success and survival curves (p=0.62), (p=0.51). The main reason for failure was marginal adaptation.Bulk-fillresin required 30% less time than the conventional resin (p<0.001).Bulk-fillresin presented similar clinical performance to the conventional resin and required less restorative clinical time. It is an option to restore class II lesions of primary molars.

Silver Diamine Fluoride (SDF) Efficacy in Arresting Cavitated Caries Lesions in Primary Molars: A Systematic Review and Metanalysis

A systematic review and meta-analysis were carried out to evaluate the efficacy of silver diamine fluoride (SDF) in controlling caries progression in cavitated primary molars. A search for randomized and non-randomized trials with follow-up > 6 months was performed using PubMed, Scopus and Embase. The Cochrane risk of bias tools were used for the quality assessment. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis. A total of 792 papers were identified and 9 were selected. A high variability regarding SDF application protocol was found; otherwise, caries arrest was always recorded using visual/tactile methods. Two studies were judged at low risk of bias, six at moderate risk and one at high risk. Data from five studies were aggregated for meta-analysis. Heterogeneity was found moderate (I2 = 35.69%, p = 0.18). SDF application was found to be overall effective (fixed effect model) in arresting caries progression (ES = 0.35, p < 0.01). In a total of 622 arrested lesions, out of 1205 considered, the caries arrest rate was 51.62% ± 27.40% (Confidence = 1.55) using SDF ≥ 38% applied annually or biannually. In conclusion, when applied to active cavitated caries lesions in primary molars, SDF appears to be effective in arresting dental caries progression, especially if applied biannually.

Influence of gestational age on eruption of primary teeth in Indian children - A prospective longitudinal study

Context

Eruption of primary teeth is the most anticipated event in a child's life. Genetics, gender, socio-economic status, gestational age are a few of the determinants of the primary teeth eruption. However, the effect of gestational age on the timing of primary teeth eruption among the Indian population has not been explored to date.

Aim

The study was conducted to evaluate the influence of gestational age on time and sequence of eruption of primary teeth among children of Mysore.

Settings and Design

A prospective longitudinal cohort study design was conducted at 'Baby Oral Health Promotion Clinic' at the Department of Paediatrics, JSS Hospital, Mysore.

Methods and Material

150 newborn babies were recruited by simple random sampling and followed up from birth to 36 months. Teeth present during each visit were recorded. Data were statistically analysed and interpreted.

Statistical Analysis Used

Descriptive statistics, t-test for an independent sample, and Pearson's Chi-squared test were applied.

Results

The mandibular central incisor was the first tooth to erupt. Statistically insignificant early eruption in males was noted in both term and preterm children. When the chronological ages were compared, the preterm group showed a statistically significant delay in the eruption of all the teeth. However, when the age was adjusted for prematurity, only the central incisors and second molars showed a statistically significant delay.

Conclusions

Gestational age has a strong significant association with the eruption of primary teeth and maybe one of the strong predictors for delayed eruption among children of Mysore.

Anti-microbial efficacy of root canal preparation in deciduous teeth with manual and rotary files: A randomized clinical trial

BACKGROUND

In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments.

AIMS

The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars.

MATERIALS AND METHODS

This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III.

RESULTS

Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation.

CONCLUSION

Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.

Evaluation of caries arresting potential of silver diamine fluoride and sodium fluoride varnish in primary molars: A randomized controlled trial

BACKGROUND

Caries management in the modern era has shifted away from the traditional surgical method toward a medical paradigm, which often includes fluoride therapy. Fluoride used in various forms has been proven to be effective in dental caries prevention. Silver diamine fluoride (SDF) and sodium fluoride (NaF) varnish are effective in arresting caries in primary molars.

AIM

This study aimed to evaluate the effectiveness of 38% SDF and 5% NaF varnish in arresting caries in primary molars.

SETTINGS AND DESIGN

This study was a split-mouth randomized controlled trial.

MATERIALS AND METHODS

The randomized controlled trial comprised 34 children aged 6-9 years with teeth having caries in both right and left primary molars without pulpal involvement. Teeth were randomly allocated into two groups. In Group 1 (n = 34), 38% SDF + potassium iodide was applied and in Group 2 (n = 34), 5% NaF varnish was applied. The second application was done after 6 months in both groups. Children were recalled at 6- and 12-month intervals and evaluated for caries arrest.

STATISTICAL ANALYSIS

Chi-square test was used to analyze the data.

RESULTS

Caries arresting potential was found to be higher in the SDF group compared to the NaF varnish group at both 6-month (SDF - 82% and NaF varnish - 45%) and 12-month intervals (SDF - 77% and NaF varnish - 42%) and the difference was found to be statistically significant (P = 0.002 and 0.004, respectively).

CONCLUSION

SDF was more effective in arresting dental caries in primary molars compared to 5% NaF varnish.

Ferric sulfate pulpotomy in primary teeth with different base materials: a 2-year randomized controlled trial

OBJECTIVE

To evaluate the effects of zinc oxide-eugenol, calcium hydroxide, and mineral trioxide aggregate as base materials on the clinical and radiographic success of ferric sulfate pulpotomies in primary molars.

METHOD AND MATERIALS

Following hemostasis with 15.5% ferric sulfate, 105 teeth were randomly allocated to three groups: Group 1, zinc oxide-eugenol; Group 2, calcium hydroxide; and Group 3, mineral trioxide aggregate. All teeth were restored with stainless-steel crowns. Clinical and radiographic examinations were conducted at 6, 12, 18, and 24 months.

RESULTS

After 24 months, clinical success rates for Groups 1 to 3 were 97.1% (34/35 teeth), 94.2% (33/35 teeth), and 97.1% (34/35 teeth), respectively (P > .05). Radiographic success rates were 65.7% (23/35 teeth), 65.7% (23/35 teeth), and 77.1% (27/35 teeth), respectively (P > .05). Internal resorption was the most observed radiographic finding (15/105 teeth).

CONCLUSIONS

The choice of zinc oxide-eugenol, calcium hydroxide, and mineral trioxide aggregate, as base materials, did not affect the clinical and radiographic success of ferric sulfate pulpotomies in primary teeth.

Efficacy of an iodoform-based filling material for pulpectomy of primary teeth: A 24-month non-inferiority randomized clinical trial

AIM

The aim of this non-inferiority randomized clinical trial was to compare the efficacy of an iodoform-based paste (Guedes-Pinto -(GP)) as a filling material in pulpectomies of primary teeth, and a standard material composed by calcium hydroxide and iodoform (CaOH/Iodof paste; Vitapex^® ).

DESIGN

A total of 104 teeth from 61 children (3-8 years old) were randomly allocated to two groups according to filling materials. Children were followed up for 24 months. The primary endpoint was the treatment success rate evaluated through clinical and radiographic examinations at follow-up, and the secondary outcome was the analysis of the canal filling quality. Differences in the proportion of treatment success was calculated based on 95% confidence intervals (95% CI) and with the Miettinen and Nurminen method in the intention-to-treat population, considering a -20% of the non-inferiority limit.

RESULTS

From 104 randomized teeth, 102 were followed up after 24 months (attrition rate of 1.9%). The success rate of teeth treated with the GP paste was 86.8% (95% CI: 69.9-94.9) and 78.4% (95% CI: 61.8-89.1) with the CaOH/Iodof paste. Consequently, a non-inferiority of the GP paste was observed when compared to the CaOH/Iodof paste (P < .001).

CONCLUSION

The GP paste has a non-inferior success rate than the CaOH/Iodof paste used as filling material for pulpectomy in primary teeth.

Efficacy of Biodentine versus formocresol in pulpotomy of primary teeth: a systematic review and meta-analysis

OBJECTIVE

To systematically evaluate and meta-analyze the short-and long-term clinical and radiologic failure rates of Biodentine versus formocresol as pulpotomy medicaments in primary teeth.

DATA SOURCES

Relevant medical databases were searched until May 2021 for randomized controlled trials that used Biodentine and formocresol as pulpotomy medicaments in primary teeth with deep caries. Primary outcomes included clinical and radiologic failure rates at 12 months. Secondary outcomes were clinical and radiologic failure rates at 3, 6, 9, 13 to 24, and 25 to 48 months.

RESULTS

Nine randomized controlled trials (N = 626) with low risk of bias were included. Pooled analysis showed that compared to formocresol, Biodentine had significantly lower clinical failure rates (relative risk [RR] 0.16; 95% confidence interval (CI) 0.03 to 0.87; six randomized controlled trials; N = 394; GRADE, low) and radiologic failure rates (RR 0.19; 95% CI 0.08 to 0.49; six randomized controlled trials; N = 393; GRADE, low) at 12 months. Radiologic failure rates at 6 and 9 months were significantly lower in the Biodentine group compared to the formocresol group.

CONCLUSION

Compared to formocresol, Biodentine may be a superior medicament when used for pulpotomy in primary teeth. Adequately powered randomized controlled trials are needed to substantiate this evidence.

Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial

Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare effectiveness of 38% SDF and 5% Sodium fluoride (NaF) varnish in arresting enamel caries in young children when applied semiannually over 18 months. Methods: A randomized controlled trial was conducted on children aged 1−3 years who had at least one active carious surface. They were allocated into two groups: Group 1 (38% SDF) and Group 2 (5% NaF varnish). Visual-tactile examination was used to assess extent of carious lesions. Enamel caries that did not progress to dentin were classified as having caries arrest. Intention-to-treat analysis was performed. Results: At baseline, 290 children with 1974 tooth surfaces with enamel caries were recruited. Caries arrest rates at the tooth surface level in Group 1 and Group 2 were 59.1% and 58.8%, respectively (p = 0.873), at 18 months. The multilevel logistic regression analysis revealed that tooth position, tooth surface, extent of enamel caries at baseline, caries experience, and brushing with fluoride toothpaste influenced caries arrest (p < 0.05). Conclusion: The semiannual application of 38% SDF and 5% NaF varnish had comparable effectiveness in arresting enamel caries in primary teeth.

Effect of CPP-ACPF, resin infiltration, and colloidal silica infiltration on surface microhardness of artificial white spot lesions in primary teeth: An in vitro study

Background

Remineralizing agents such as fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) are popular treatment choices for incipient enamel lesions. Recently introduced resin infiltration enhances the esthetics of teeth affected by these enamel lesions. Furthermore, few studies reported the utilization of colloidal silica infiltration for the white spot lesions. However, the potency of these materials for treatment in primary teeth necessitates investigation.Thus, this study evaluated and compared the effectiveness of CPP-ACP fluoride (CPP-ACPF), resin infiltration, and colloidal silica infiltration on surface microhardness in artificial white spot lesions in primary incisors using the Vickers microhardness testing machine.

Materials and Methods

In this in vitro study, on the labial surface of 45 primary incisors, artificial white spot lesions were created by immersing them in a demineralizing solution. According to the evaluation method, random distribution of specimens into three groups: Group 1: CPP-ACPF, Group 2: resin infiltration, and Group 3: colloidal silica infiltration. Specimens after treatment were stored in artificial saliva, followed by microhardness evaluation using Vickers microhardness. Microhardness readings at baseline, post demineralization, and after treating them with different materials were taken. The level of significance was 0.01.

Results

Enamel specimens treated with resin infiltration showed a high microhardness mean value compared to CPP-ACPF and colloidal silica infiltration.

Conclusion

Resin infiltration is a promising and effective treatment option for incipient enamel lesions followed by CPP-ACPF compared to colloidal silica infiltration in primary teeth.

Comparative evaluation of intracanal cryotherapy and curcumin as a final irrigant in reducing post endodontic pain in primary teeth

AIM

The aim of this study was to evaluate the intracanal effectiveness of cryotherapy, curcumin irrigant, and normal saline as a final irrigant in reducing postendodontic pain in primary teeth.

MATERIALS AND METHODS

A total of 120 teeth between the ages of 4 and 7 years requiring pulpectomy in primary teeth were included in the study. The teeth were randomly assigned to one of the three treatment groups: intracanal cryotherapy using 2.5°C cold saline, curcumin irrigant, or normal saline. Following completion of chemomechanical preparation, final irrigation with 2.5°C cold saline, curcumin irrigant, and normal saline solution at room temperature were employed in the groups. Participants were asked to rate the severity of their postoperative pain on the Visual Analog Scale before, immediate postoperative after wearing of local anesthetic effect, and 24 h after the procedure. The results were analyzed statistically.

RESULTS

The differences in reduction of postendodontic pain between the three irrigating regimens were statistically not significant. Cryotherapy utilizing 2.5°C cold saline or curcumin irrigant can be used instead of normal saline as a final irrigant in pulpectomy of primary teeth.

CONCLUSIONS

Cryotherapy can be a straightforward, cost-effective, and nontoxic treatment option for the management of postendodontic pain. Curcumin irrigant with its anti-inflammatory properties is also a better alternative as a final irrigant for reducing postoperative pain in primary teeth.

Clinical Effectiveness of Restorative Materials for the Restoration of Carious Primary Teeth: An Umbrella Review

Since untreated dental caries remain a worldwide burden, this umbrella review aimed to assess the quality of evidence on the clinical effectiveness of different restorative materials for the treatment of carious primary teeth. A literature search in electronic bibliographic databases was performed to find systematic reviews with at least two-arm comparisons between restorative materials and a follow-up period ≥12 months. Reviews retrieved were screened; those eligible were selected, and the degree of overlap was calculated using the 'corrected covered area' (CCA). Data were extracted and the risk of bias was assessed using the ROBIS tool. Fourteen systematic reviews with a moderate overlap (6% CCA) were included. All materials studied performed similarly and were equally efficient for the restoration of carious primary teeth. Amalgam and resin composite had the lowest mean failure rate at 24 months while high-viscosity and metal-reinforced glass ionomer cements had the highest. At 36 months, high-viscosity glass ionomer cements showed the highest failure rate with compomer showing the lowest. Most reviews had an unclear risk of bias. Within the limitations of the review, all materials have acceptable mean failure rates and could be recommended for the restoration of carious primary teeth.

Effect of three different remineralizing agents on artificial erosive lesions of primary teeth

BACKGROUND

This study aimed to investigate the efficacy of three remineralizing agents on dental erosion in primary teeth.

METHODS

Forty primary molars were randomly divided into four groups (n = 10 each): self-assembling peptide (P_11-4 ), casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), sodium fluoride (NaF) and artificial saliva (AS; control). The erosion-like formation was created by immersing the samples in citric acid (4 × 2 min, pH 2.3) and AS (4 × 2 h, pH 7). The eroded samples were then treated with remineralizing agents and subjected to further erosion consisting of 15 cycles (3x/8-h interval) of immersion in citric acid and AS for 6 s each. Alterations in the mineral content and morphology of the samples were quantified using a microhardness tester and atomic force microscope.

RESULTS

All agents had a significant remineralization effect on eroded primary tooth enamel. After further erosive challenge, enamel loss in the CPP-ACFP group was found to be significantly lower than in all other groups, and no significant difference was found between the P_11-4 and NaF groups.

CONCLUSIONS

This study showed that all tested materials had remineralization ability, and CPP-ACFP had a superior effect in inhibiting enamel loss due to dental erosion in primary teeth. © 2022 Australian Dental Association.