1
|
Pötter LA, Vollmer M, Santamaría RM, Splieth CH, Schmoeckel J. Performance of restorations in primary molars over a seven-year period. J Dent 2024; 147:105121. [PMID: 38857648 DOI: 10.1016/j.jdent.2024.105121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the use and reintervention rate of fillings compared to preformed metal crowns in the everyday clinical practice of German dentists. METHODS In this retrospective, longitudinal analysis, fee codes from the Kassenzahnärztliche Vereinigung Westfalen-Lippe for restorations placed in primary molars between 2012 and 2015 in children until 7 years of age followed for a 7-year period (latest until December 2022) were filtered and analyzed with the Fine and Gray competing risk regression and Cox proportional hazards regression to calculate the risk of reintervention divided into the main outcomes "Successful", "Minor Failure/Repair" and "Major Failure/Endodontic Treatment/Extraction". 367,139 primary molars (one-surface fillings: n = 117,721; two-surface fillings n = 198,815; three-surface fillings n = 36,695; more than three-surface fillings n = 8,267 and preformed metal crowns n = 5,641 were included in this study. RESULTS Teeth treated with preformed crowns needed significantly less re-interventions. Subdistribution hazard ratio for minor events was 0.117 (95 %-CI: 0.097 to 0.141) and hazard ratio of major events (HR=0.786; 95 %-CI: 0.695 to 0.890) when compared to one-surface fillings in multivariable adjusted analysis. Within 7-year follow-up preformed crowns required less repairs (80.6 % success rate, minor failure 4.4 %, major failure 16.3 %) than the teeth treated with composite fillings (46.2 %-52.6 % success rate, minor failure 27.0 %-39.5 %, major failure 15.5 %-28.4 %, p < 0.001). CONCLUSION Within the German healthcare system fillings are the first choice for treating primary molars despite considerably higher reintervention rates. This encourages a discussion on the indication of fillings and the more durable preformed metal crowns to reduce unnecessary reintervention in young children. CLINICAL SIGNIFICANCE This study gives an unprecedented insight into the German healthcare system regarding the reintervention rates of the most relevant treatment techniques for caries in primary molars.
Collapse
Affiliation(s)
- Linus A Pötter
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Fleischmannstraße 42-44, Greifswald D-17475, Germany.
| | - Marcus Vollmer
- Institute of Bioinformatics, University Medicine Greifswald, Greifswald D-17475, Germany
| | - Ruth M Santamaría
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Fleischmannstraße 42-44, Greifswald D-17475, Germany
| | - Christian H Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Fleischmannstraße 42-44, Greifswald D-17475, Germany
| | - Julian Schmoeckel
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Fleischmannstraße 42-44, Greifswald D-17475, Germany
| |
Collapse
|
2
|
Rajkumari L, Verma RK, Rajmohan M, Thakkar R, Menon I, Kumar S. Clinical Evaluation of the Retention of Four Different Pit and Fissure Sealants on the First Permanent Molars - An Original Research. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S250-S253. [PMID: 38595527 PMCID: PMC11001111 DOI: 10.4103/jpbs.jpbs_482_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 04/11/2024] Open
Abstract
Objective In this study, the retention rates of four different pit and fissure sealant materials on the first permanent molars were clinically assessed and compared. Materials and Methods A total of 120 kids aged 7 to 10 participated in a randomized controlled experiment. On their first permanent teeth, the subjects each got one of the four sealant materials (A, B, C, or D). Over the course of 24 months, the retention rates were evaluated every 6 months. The Chi-square test and Kaplan-Meier survival analysis were used for statistical analysis. Results At 6, 12, 18, and 24 months, the following retention rates were observed overall: A (85%, 78%, 65%, 52%), B (90%, 82%, 70%, 60%), C (78%, 70%, 55%, 42%), and D (95%, 88%, 75%, 62%). At each time point, the sealant materials showed significant variations in retention rates (P 0.05). While sealants A and C showed lower retention rates, sealant D showed the best retention rates, followed by sealant B. Conclusion This study shows that different materials have different retention rates for pit and fissure sealants on first permanent molars. Higher retention rates for sealants D and B suggest that they may be superior than sealants A and C. These results highlight how crucial it is to choose the right sealant materials to guarantee long-term retention and effectiveness in avoiding dental cavities.
Collapse
Affiliation(s)
- Laleena Rajkumari
- Pedodontics and Preventive Dentistry, Dentofacial and Kids Dental Care, Imphal East, Manipur, India
| | - Rajnish K. Verma
- Department of Pediatric and Preventive Dentistry, Kalinga Institute of Dental Sciences, Campus 5, KIIT University, Patia, Bhubaneswar, Odisha, India
| | - M. Rajmohan
- Department of Dental Surgery, KAPV Government Medical College and Hospital, Trichy, Tamil Nadu, India
| | - Radhika Thakkar
- BDS, Eastman Institute for Oral Health, University of Rochester, New York, United States
| | - Ipseeta Menon
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Sandeep Kumar
- Department of Public Health Dentistry, Dental Institute, RIMS Ranchi, Jharkhand, India
| |
Collapse
|
3
|
Souza TF, Leonel Martins M, Jural LA, Maciel IP, Magno MB, da Silva Coqueiro R, Pithon MM, Leal SC, Fonseca-Gonçalves A, Maia LC. Brazilian dentist's knowledge of minimum intervention dentistry for caries management: application of a developed knowledge scale (MIDDeC-KS) and evaluation of its psychometric properties. Eur Arch Paediatr Dent 2024; 25:27-38. [PMID: 37770814 DOI: 10.1007/s40368-023-00844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 09/02/2023] [Indexed: 09/30/2023]
Abstract
AIM To assess the knowledge of Brazilian dentists about Minimum Intervention (MI) using a Minimum Intervention Dentistry to Dental Caries-Knowledge Scale (MIDDeC-KS) and evaluate its psychometric properties. MATERIALS AND METHODS An online scale was developed to evaluate dentists' knowledge about MI. The higher the score, the greater the knowledge and vice versa. A preliminary study was carried out with 143 dentists to validate the MIDDeC-KS. For psychometric properties analysis, convergent and discriminant validity, test-retest reliability, and internal consistency of the instrument were assessed. After validation, MIDDeC-KS was applied to a representative sample of Brazilian dentists. T test for independent samples, Chi-square, and/or ANOVA one-way tests were applied. RESULTS The MIDDeC-KS convergent (Spearman's = 0.48) and discriminant (P = 0.001) validity and reliability (ICC = 0.85, α = 0.72 and ω = 0.74) were proved. The participants (n = 637) obtained an overall mean score of 7.4 ± 2.5. The sample was mainly composed of females (P < 0.01), who graduated over 10 years prior (P = 0.02), from public colleges (P < 0.01), and most were pediatric dentists (38.2%). The highest and lowest scores were reached by pediatric dentists (9.2 ± 1.6) and bucomaxillofacial professionals (3.1 ± 2.1), respectively. Brazilian dentists demonstrated more knowledge about diet, biofilm, and topical fluoride control (84.3%), while the Hall technique (31.9%), resin infiltrant (47.6%), and chemical mechanical caries removal (48.4%) were the least known MI techniques. CONCLUSION Brazilian dentists demonstrated more knowledge about preventive measures and less about more recent protocols, such as the Hall technique, resin infiltrant, and chemical mechanical caries tissue removal. Sufficient psychometric evidence of the MIDDeC-KS was found. CLINICAL RELEVANCE Identify dentist's knowledge about MI.
Collapse
Affiliation(s)
- T F Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - M Leonel Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - L A Jural
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - I P Maciel
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - M B Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - R da Silva Coqueiro
- Department of Health I, Universidade Estadual Do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil
| | - M M Pithon
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - S C Leal
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - A Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - L C Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil.
| |
Collapse
|
4
|
Valentim FB, Moreira KMS, Carneiro VC, do Nascimento LJ, Colares V, Imparato JCP. Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023; 24:1016-1025. [PMID: 38317401 DOI: 10.5005/jp-journals-10024-3607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIMS The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry. BACKGROUND The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols. REVIEW RESULTS Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials. CONCLUSION The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice. CLINICAL SIGNIFICANCE Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, et al. Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.
Collapse
Affiliation(s)
- Flavia Bridi Valentim
- Department of Dentistry, São Leopoldo Mandic College, Campinas, São Paulo, Brazil, Orcid: https://orcid.org/0000-0003-1927-1591
| | - Kelly Maria Silva Moreira
- Department of Dentistry, São Leopoldo Mandic College, Campinas, São Paulo, Brazil, Orcid: https://orcid.org/0000-0002-1137-3908
| | - Vinícius Cavalcanti Carneiro
- Department of Dental Clinic, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil, Orcid: https://orcid.org/0000-0001-7567-0365
| | - Lidiane Jacinto do Nascimento
- Department of Dentistry, Dental School of Pernambuco, University of Pernambuco (UPE), Recife, Pernambuco, Brazil, Phone: +55 81 99690-8042, e-mail: , Orcid: https://orcid.org/0009-0009-6840-5227
| | - Viviane Colares
- Department of Dentistry, Dental School of Pernambuco, University of Pernambuco (UPE), Recife, Pernambuco, Brazil, Orcid: https://orcid.org/0000-0003-2912-2100
| | - José Carlos Pettorossi Imparato
- Department of Dentistry, São Leopoldo Mandic College, Campinas, São Paulo, Brazil, Orcid: https://orcid.org/0000-0002-1990-2851
| |
Collapse
|
5
|
Chiu HHC, Lam PPY, Yiu CKY. The Impact of Minimal Intervention Dentistry on Patient-Reported and Observation-Based Outcomes in the Pediatric Population: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:2241. [PMID: 37628440 PMCID: PMC10454713 DOI: 10.3390/healthcare11162241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
This review aimed to systematically investigate the effect of minimal intervention dentistry on patient-reported and observation-based outcomes of anxiety, pain and patient cooperation in the pediatric population. Microinvasive treatments (MITs) were compared to conventional treatments, home-based and professionally applied non-invasive treatments (NITs), and between MITs. Two reviewers independently screened studies from four electronic databases, extracted data, assessed the risk of bias and certainty of evidence with the GRADE approach. Ultimately, 26 studies were included for qualitative synthesis, with the data from 12 studies being incorporated into the meta-analysis. No statistically significantly differences in terms of anxiety were noted between MITs and conventional treatments, or between MITs from the meta-analyses. The treatment durations of MITs were not necessarily shorter than conventional treatments but varied with the use of local anesthesia, behavioral and clinical approach, and other confounding factors. The certainties of evidence were deemed low due to high risk of bias of the included studies. NITs evoked less anxiety and pain compared to MITs. Minimal intervention dentistry is an alternative treatment to manage dental caries among children and does not arouse different levels of dental anxiety and pain compared to other treatment modalities. However, further well-designed studies are required to draw an evidence-based conclusion.
Collapse
Affiliation(s)
| | | | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; (H.H.C.C.); (P.P.Y.L.)
| |
Collapse
|
6
|
Alzahrani AY, Alamoudi NMH, El Meligy OAES. Contemporary Understanding of the Etiology and Management of Molar Incisor Hypomineralization: A Literature Review. Dent J (Basel) 2023; 11:157. [PMID: 37504223 PMCID: PMC10378579 DOI: 10.3390/dj11070157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is a significant health problem that can affect the child's quality of life by negatively affecting their esthetics and function. This review aimed to summarize the etiology and pathogenesis of MIH. It also aimed to summarize the recent studies on MIH in children and adolescents, focusing on diagnosis, prevention, and clinical management. An electronic search on the PubMed, Cochrane Database of Systematic Reviews, MEDLINE, MedlinePlus, WHO reports, and Google Scholar databases was performed. The volume of research on the etiology, presentation, and clinical management of MIH is still expanding. The creation and validation of indices for the diagnosis and management of MIH, as well as any potential genetic aspects appear to be the main areas of current research. Notably, MIH was linked to childhood illnesses, the use of antibiotics, and early childhood fever. Although many studies discuss the different options for managing MIH lesions, evidence-based studies that address the long-term outcomes of MIH are still lacking. Indeed, future clinical studies should be directed to evaluate the impact of each systemic etiological factor and its different types of management on normal amelogenesis. Regarding the diagnosis, future research should focus on the pre-eruption diagnosis and early approaches to prevent the post-eruption breakdown and caries. Regarding the treatment of MIH, future investigations should emphasize further improvements in adhesion and the use of new materials and techniques, such as digital dentistry.
Collapse
Affiliation(s)
- Ahmed Yahya Alzahrani
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
- Pediatric Dentistry, Taif Dental Centre, Ministry of Health, Taif 26511, Saudi Arabia
| | | | - Omar Abd El Sadek El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
- Pediatric Dentistry & Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria 21521, Egypt
| |
Collapse
|
7
|
Oz E, Kırzıoglu Z, Kale C. The clinical success of ART restorations and Hall technique in primary molars: a randomized 18-month follow-up study. Restor Dent Endod 2023; 48:e19. [PMID: 37284348 PMCID: PMC10240095 DOI: 10.5395/rde.2023.48.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives The aim of the study was to evaluate the clinical and radiographic success of the Hall technique (HT) and atraumatic restorative treatment (ART) restorations using high-viscosity glass-ionomer cement for the management of occlusal carious lesions in primary molars. Materials and Methods This randomized clinical study observed 40 children (aged 5-6 years). For each child, one tooth was treated with HT and one with ART. The primary outcome measures for HT restorations were successful, minor, and major failure rates. Clinical evaluations of ART restorations were performed according to the modified United States Public Health Service criteria during 18-month follow-up. McNemar test was used for statistical analysis. Results Thirty of 40 (75%) participants returned for 18 months of follow-up. In the clinical evaluations of teeth that were treated with HT, the patients did not have complaints of pain or other symptoms, all crowns remained in the oral cavity, the gums were healthy, and the teeth were functional in all evaluations. At the end of the 18-month follow-up, the surface texture and marginal integrity criteria of ART restorations were recorded as 26.7% and 33.3%, respectively. In the radiographic evaluation of 30 patients treated with ART and HT, all restorations were considered successful. Conclusions The 18-month clinical and radiographic results after treatments applied to single-surface cavities in anxious children showed that both treatment methods were successful.
Collapse
Affiliation(s)
- Esra Oz
- Department of Pediatric Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Zuhal Kırzıoglu
- Department of Pediatric Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Canan Kale
- Papatya Oral and Dental Health Clinic, Antalya, Turkey
| |
Collapse
|
8
|
Chua DR, Tan BL, Nazzal H, Srinivasan N, Duggal MS, Tong HJ. Outcomes of preformed metal crowns placed with the conventional and Hall techniques: A systematic review and meta-analysis. Int J Paediatr Dent 2023; 33:141-157. [PMID: 36151937 DOI: 10.1111/ipd.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/08/2022] [Accepted: 09/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preformed metal crowns (PMCs) have been used to restore carious primary molars and have a high success and survival rate. There are two methods currently employed for PMC placement - the conventional technique (CT) and Hall technique (HT). AIM This systematic review aims to compare the outcomes of PMCs placed using the CT and HT. DESIGN This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A literature search of five databases was performed up to 23 August 2022. Clinical studies comparing carious primary molars restored with PMCs using either technique with a minimum 12-month follow-up were included. Risk of bias (RoB) assessment was performed using the National Institutes of Health Quality Assessment tool. RESULTS Five articles met the inclusion criteria, and four were included for meta-analysis. The 12- and 24-month success and survival rates were above 85% for both groups, with no significant differences shown at 12 and 24 months. The HT requires a shorter treatment duration, is more cost-effective and has a high level of acceptability among parents when compared to the CT. Four articles were rated fair, and one article was rated good in the RoB assessment. CONCLUSION Greater consideration may be given towards using the HT as part of standard treatment procedures in managing carious primary molars. Future studies should standardise reporting of outcomes to facilitate a more homogeneous pool of data for future meta-analysis.
Collapse
Affiliation(s)
- Doris Ruyi Chua
- Paediatric Dentistry Unit, National Dental Centre Singapore, Singapore City, Singapore
| | - Bing Liang Tan
- Youth Preventive Dental Service, Health Promotion Board, Singapore City, Singapore
| | - Hani Nazzal
- Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.,College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | - Huei Jinn Tong
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| |
Collapse
|
9
|
Reynolds L, Sohal G, Barry S. Confidence-level of foundation dentists in the North West of England in the placement of preformed metal crowns using the Hall technique. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:158-166. [PMID: 35147276 DOI: 10.1111/eje.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/23/2021] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The Hall technique is a biological caries management approach commonly used within the field of paediatric dentistry. The technique involves the placement of a preformed metal crown (PMC) without local anaesthetic, caries removal or tooth preparation. Despite being widely taught across dental schools in the United Kingdom, evidence from the literature suggests that PMCs are seldom used in general dental practice, even by newly qualified dentists. This study aimed to evaluate the experience and self-reported confidence of Foundation Dentists (FDs) in the North West of England in the placement of preformed metal crowns using the Hall technique. MATERIALS AND METHODS An anonymous questionnaire was distributed to 117 Foundation Dentists in the North West of England. RESULTS Forty-six questionnaires were returned, giving a response rate of 39%. The results revealed that 80.4% of FDs felt "somewhat," "quite" or "extremely" confident with the Hall technique at the point of graduation. This increased to 85.3% upon completion of Dental Foundation Training. CONCLUSION Foundation Dentists' self-reported confidence in the Hall technique was reasonably high both at the point of qualification and upon completing Dental Foundation Training. Nevertheless, many of the Foundation Dentists felt that they would benefit from further postgraduate training on the technique.
Collapse
Affiliation(s)
- Laura Reynolds
- Child Dental Health Department, University Dental Hospital of Manchester, Manchester, UK
| | | | - Siobhan Barry
- Child Dental Health Department, University Dental Hospital of Manchester, Manchester, UK
| |
Collapse
|
10
|
Gomide RT, Frencken JE, Faber J, Kuijpers-Jagtman AM. Does treating proximal cavities in primary molars non-restoratively affect intra-arch space and alignment of successor teeth negatively? A 4-year longitudinal study. PeerJ 2022; 10:e14008. [PMID: 36213499 PMCID: PMC9536320 DOI: 10.7717/peerj.14008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/14/2022] [Indexed: 01/19/2023] Open
Abstract
Background Removing plaque with toothbrush and toothpaste from proximal cavities in primary molars without restoring them follows sound cariological principles. But does this treatment affect space for and alignment of their permanent successors negatively? Hypothesis There is no difference in impaction and displacement of the premolars, as well as in the D+E space in quadrants with three different statuses of the proximal surface of primary molars over a 4-year period. Methods A total of 936 quadrants (466 maxillary and 470 mandibular quadrants) in 233 children were assessed. Treatment of cavities in the proximal surfaces of the primary molars consisted of amalgam and ART restorations using high-viscosity glass-ionomer cement, and cleaning of open large- and medium-sized cavities with toothbrush and toothpaste (UCT) under supervision for 220 days per year over 3 years. Dental casts were made at baseline, and after two, three, and 4 years. The D+E spaces were measured digitally. Status of the proximal surface of the primary molars was assessed by two calibrated examiners, and quadrants were grouped into normal anatomy, defective restoration, and proximal cavity. ANCOVA, ANOVA and LSD tests were applied. Results There was a statistically significant difference between groups (p <= 0.001) and between evaluation times (p < 0.001), for the D+E space in both the maxilla and mandible. A sex difference related to the D+E space in the maxilla was found (p = 0.007). For boys, quadrants in the maxilla of the group 'proximal cavity' showed a significant shorter D+E space when compared to quadrants of the group 'normal anatomy' at the 3- and 4-year evaluation time. For girls the difference between the two groups was only present at the 3-year evaluation time. There was no significant difference between the D+E space in quadrants with defective restorations and those with normal anatomy in the mandible and in the maxilla. Displacement and impaction of the premolars showed no significant difference between groups. Conclusion Primary molars with open proximal cavities that are cleaned with toothbrush and toothpaste do not result in displacement and impaction of the successor teeth, neither do primary molars with defective restorations in proximal tooth surfaces.
Collapse
Affiliation(s)
- Rafael T. Gomide
- Department of Pediatric Dentistry, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Jo E. Frencken
- Department of Dentistry – Oral function and Prosthetic Dentistry, Radboud University Nijmegen, Nijmegen, Netherlands
| | | | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Berne, Berne, Switzerland,Faculty of Dentistry, Universitas of Indonesia, Jakarta, Indonesia
| |
Collapse
|
11
|
Zou J, Du Q, Ge L, Wang J, Wang X, Li Y, Song G, Zhao W, Chen X, Jiang B, Mei Y, Huang Y, Deng S, Zhang H, Li Y, Zhou X. Expert consensus on early childhood caries management. Int J Oral Sci 2022; 14:35. [PMID: 35835750 PMCID: PMC9283525 DOI: 10.1038/s41368-022-00186-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.
Collapse
Affiliation(s)
- Jing Zou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qin Du
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Lihong Ge
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jun Wang
- Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Pediatric Dentistry, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiaojing Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Military Stomatology, Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Guangtai Song
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhao
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, China
| | - Xu Chen
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Beizhan Jiang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yufeng Mei
- Department of Pediatric Dentistry, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Yang Huang
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, China
| | - Shuli Deng
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Hongmei Zhang
- Department of Pediatric Dentistry, The Affiliated Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yanhong Li
- Department of Pediatric and Preventive Dentistry, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| |
Collapse
|
12
|
Kumar D, Bolskar RD, Mutreja I, Jones RS. Methacrylate Polymers With “Flipped External” Ester Groups: A Review. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.923780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Current resin composites have favorable handling and upon polymerization initial physical properties that allow for efficient material replacement of removed carious tooth structure. Dental resin composites have long term durability limitations due to the hydrolysis of ester bonds within the methacrylate based polymer matrix. This article outlines the importance of ester bonds positioned internal to the carbon-carbon double bond in current methacrylate monomers. Water and promiscuous salivary/bacterial esterase activity can initiate ester bond hydrolysis that can sever the polymer backbone throughout the material. Recent studies have custom synthesized, with the latest advances in modern organic chemical synthesis, a novel molecule named ethylene glycol bis (ethyl methacrylate) (EGEMA). EGEMA was designed to retain the reactive acrylate units. Upon intermolecular polymerization of vinyl groups, EGEMA ester groups are positioned outside the backbone of the polymer chain. This review highlights investigation into the degradation resistance of EGEMA using buffer, esterase, and microbial storage assays. Material samples of EGEMA had superior final physical and mechanical properties than traditional ethylene glycol dimethacrylate (EGDMA) in all degradation assays. Integrating bioinformatics-based biodegradation predictions to the experimental results of storage media analyzed by LC/GC-MS revealed that hydrolysis of EGEMA generated small amounts of ethanol while preserving the strength bearing polymer backbone. Prior studies support investigation into additional custom synthesized methacrylate polymers with “flipped external” ester groups. The long term goal is to improve clinical durability compared to current methacrylates while retaining inherent advantages of acrylic based chemistry, which may ease implementation of these novel methacrylates into clinical practice.
Collapse
|
13
|
Review on Preformed Crowns in Pediatric Dentistry—The Composition and Application. MATERIALS 2022; 15:ma15062081. [PMID: 35329535 PMCID: PMC8950869 DOI: 10.3390/ma15062081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 11/23/2022]
Abstract
The purpose of this review is to compare and contrast the various types of preformed crowns that can be used to restore the primary teeth in children. Historically, preformed crowns have been widely available for the past 50 years. The clinical performance of preformed crowns has evolved to meet higher functional, mechanical, and aesthetic demands. Preformed crowns are available in a range of prefabricated sizes and shapes. Preformed crowns can vary depending on their properties, compounds, methods of preparation, and biocompatibility.
Collapse
|
14
|
The Use of Hall's Technique Preformed Metal Crown (HTPMC) by Pediatric Dentists in Malaysia. BIOMED RESEARCH INTERNATIONAL 2022; 2021:8424206. [PMID: 34977246 PMCID: PMC8716193 DOI: 10.1155/2021/8424206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/24/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
Introduction Hall's technique preformed metal crown (HTPMC) has been used widely by pediatric dentists in developed countries as a new approach for managing decayed primary molars without local anesthesia, caries removal, and tooth preparation. Currently, inadequate information is available regarding the implementation of this technique (HTPMC) in Malaysia. This study is aimed at evaluating the implementation of HTPMC by Malaysia's pediatric dentists and identify the co-occurrence frequencies of the HTPMC implementation with the respondents' demographic profile. Materials and Methods A cross-sectional questionnaire-based research was conducted among 65 pediatric dentists in Malaysia. Online questionnaires were distributed to the pediatric dentists employed at public hospitals (MOH) and universities in Malaysia. Result It was found that over half of the respondents (65.6%) employed HTPMC. The analysis of the co-occurrence network frequency revealed that a high frequency of female pediatric dentists who were within the age group of 31-40 years old had fulfilled their postgraduation overseas and was employed in the university mainly applied HTPMC. Conclusion The application of HTPMC among respondent pediatric dentists in Malaysia was high. However, most respondents considered HTPMC a treatment option only to manage carious primary molar rather than a treatment of choice.
Collapse
|
15
|
Ezzeldin T, Al-Awasi KA, Bader RM, Alshaikhi AY, Hakami AH, Siddiqui IA, Almulhim AA, Alsubaie TM. A Study to assess the awareness and use of Silver Diammine Fluoride and Hall Technique among dental professionals and dental students in the Eastern Province. Saudi Dent J 2021; 33:1166-1173. [PMID: 34938063 PMCID: PMC8665155 DOI: 10.1016/j.sdentj.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/06/2020] [Accepted: 01/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background A major shift has occured in the trend of dealing with dental caries from primary to secondary prevention, specially after SDF approval off-label by US FDA in recent years and Hall Technique (HT) in the last decade. Objectives To determine the frequency of awareness and use of Silver Diammine Fluoride (SDF) and Hall technique among dental professionals in the Eastern province of Saudi Arabia. Methods This cross-sectional study was conducted in a public hospital, metropolitan city of Middle Eastern region between March 15, 2019 & January 31, 2020. Dental practitioners were requested, with their consent, to fill up a digitally designed survey. Chi-square test on SPSS-20.0 was applied to compare frequency of awareness and use of SDF and HALL Technique among the survey participants. Results The awareness of SDF was found to be 73.6% among specialists, 54.9% among graduates and 29.6% among students whereas awareness of HALL technique for stainless steel crown in pediatric dentistry was found statistically similar in all participants groups i.e. 42.7% in students, 55.5% in graduates and 54.9% in specialist group (p = 0.125). Conclusion The results show potential with regards to awareness of dental specialists & postgraduate residents but inadequate among general dentists and students though all were keen advocates and found committed to its use to help the community. It points towards a further need of the of education for all groups. Those non- invasive techniques are very useful tools in general but specifically during Covid-19 pandemic where they can play a major role in preventing the spread of infection, arresting decay, alleviating pain and anxiety without resorting to aggressive treatment like pulp treatment/extraction. Low response rate may be improved in future through the respondents’ counselling and regular follow up.
Collapse
Affiliation(s)
- Tarek Ezzeldin
- Medical Program Director Saudi Board Pediatric Dentistry, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| | - Khalaf A Al-Awasi
- Medical Program Director Saudi Board Endodontics, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| | - Rawan M Bader
- Pediatric Dentistry Specialist, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| | - Abdulaziz Y Alshaikhi
- Advanced Restorative Dentistry, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| | - Ashwaq H Hakami
- Pediatric Dentistry, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| | | | - Ahmad A Almulhim
- Orthodontics Saudi Board Resident, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| | - Turki M Alsubaie
- Prosthodontics Fellowship Resident, Dammam Specialized Dental Center, Dammam Medical Complex, Ministry of Health, Saudi Arabia
| |
Collapse
|
16
|
BaniHani A, Santamaría RM, Hu S, Maden M, Albadri S. Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. Eur Arch Paediatr Dent 2021; 23:667-693. [PMID: 34784027 DOI: 10.1007/s40368-021-00675-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This umbrella review systematically appraised published systematic reviews on Minimal Intervention Dentistry interventions carried out to manage dentine carious primary teeth to determine how best to translate the available evidence into practice, and to provide recommendations for what requires further research. METHOD An experienced information specialist searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, and the NIHR Journals Library. In addition, the PROSPERO database was searched to identify forthcoming systematic reviews. Searches were built around the following four concepts: primary teeth AND caries/carious lesion AND Minimal Intervention Dentistry AND systematic review/meta-analysis. Searches were restricted to English language, systematic reviews with/without meta-analyses published between January 2000 and August 2020. Two reviewers independently screened all titles and abstracts. Interventions included involved no dentine carious tissue removal (fissure sealants, resin infiltration, topical application of 38% Silver Diamine Fluoride, and Hall Technique), non-restorative caries control, and selective removal of carious tissue involving both stepwise excavation and atraumatic restorative treatment. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers. Studies overlap was calculated using corrected covered area. RESULTS Eighteen systematic reviews were included in total; 8 assessed the caries arresting effects of 38% Silver Demine Fluoride (SDF), 1 on the Hall Technique (HT), 1 on selective removal of carious tissue, and eight investigated interventions using atraumatic restorative treatment (ART). Included systematic reviews were published between 2006 and 2020, covering a defined time frame of included randomised controlled trials ranging from 1969 to 2018. Systematic reviews assessed the sealing efficacy of fissure sealants and resin infiltration in carious primary teeth were excluded due to pooled data reporting on caries arrest in both enamel and outer third of dentine with the majority of these carious lesions being limited to enamel. Therefore, fissure sealants and resin infiltration are not recommended for the management of dentinal caries lesions in primary teeth. Topical application of 38% SDF showed a significant caries arrest effect in primary teeth (p < 0.05), and its success rate in arresting dental caries increased when it was applied twice (range between 53 and 91%) rather than once a year (range between 31 and 79%). Data on HT were limited and revealed that preformed metal crowns placed using the HT were likely to reduce discomfort at time of treatment, the risk of major failure (pulp treatment or extraction needed) and pain compared to conventional restorations. Selective removal of carious tissue particularly in deep carious lesions has significantly reduced the risk of pulp exposure (77% and 69% risk reduction with one-step selective caries removal and stepwise excavation, respectively). ART showed higher success rate when placed in single surface compared to multi-surface cavities (86% and 48.7-88%, respectively, over 3 years follow-up). CONCLUSION Minimal Intervention Dentistry techniques, namely 38% SDF, HT, selective removal of carious tissue, and ART for single surface cavity, appear to be effective in arresting the progress of dentinal caries in primary teeth when compared to no treatment, or conventional restorations. There is clear need to increase the emphasis on considering these techniques for managing carious primary teeth as a mainstream option rather than a compromise option in circumstances where the conventional approach is not possible due to cooperation or cost.
Collapse
Affiliation(s)
- A BaniHani
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - R M Santamaría
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - S Hu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - M Maden
- Liverpool Reviews & Implementation Group, University of Liverpool, Liverpool, UK
| | - S Albadri
- School of Dentistry, University of Liverpool, Pembroke place, Liverpool, L3 5PS, UK.
| |
Collapse
|
17
|
Tseveenjav B, Furuholm J, Mulic A, Valen H, Maisala T, Turunen S, Varsio S, Auero M, Tjäderhane L. Survival of primary molars with pulpotomy interventions: public oral health practice-based study in Helsinki. Acta Odontol Scand 2021; 79:636-641. [PMID: 34087081 DOI: 10.1080/00016357.2021.1928747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess long-term survival of pulpotomized primary molars and factors related to the survival of the teeth. MATERIALS AND METHODS This retrospective longitudinal study was based on electronic dental health records of children who attended public health service. Eligible children were <12 years and had a pulpotomy procedure code in their dental treatment history. Data were obtained in the period between 2002 and 2016. Chi-squared test, t-test, and one-way ANOVA were used to assess for statistical differences. Kaplan-Meier analyses were performed to create survival estimates, and the log-rank test was performed to compare differences in survival distributions. A multivariate Cox regression was conducted, and hazard ratios were calculated to estimate the hazard rate for failure. RESULTS Of interventions, 40% were registered in children 3-6 years of age; 56% were boys. Mean estimated survival of such molars was 82 months (SEM = 0.6) and differed by dental operator's work setting and choice of restorative materials used after pulpotomy intervention. Using a stainless steel crown (SSC) to restore pulp-intervened primary molars had the strongest effect on survival (111 months with SEM = 1.8), followed by if the intervention was performed by a specialist or specializing dentist in paediatric dentistry (99 months with SEM = 2.6). CONCLUSIONS The estimated survival time of pulpotomized primary molars is affected by dental operator-related factors, which should be considered in management of extensively carious primary molars of paediatric patients, both at the clinical and organizational decision-making levels. An increased focus on the use of SSC is recommended to be in the learning objectives of dental education programs.
Collapse
Affiliation(s)
- Battsetseg Tseveenjav
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
- Department of Maxillofacial Surgery, Päijät-Häme Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Aida Mulic
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Tuomo Maisala
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
| | - Seppo Turunen
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
| | - Sinikka Varsio
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
| | - Merja Auero
- Department of Health, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Leo Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Unit of Oral Health Sciences and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| |
Collapse
|
18
|
Lam PP, Sardana D, Lo EC, Yiu CK. FISSURE SEALANT IN A NUTSHELL. EVIDENCE-BASED META-EVALUATION OF SEALANTS' EFFECTIVENESS IN CARIES PREVENTION AND ARREST. J Evid Based Dent Pract 2021; 21:101587. [PMID: 34479663 DOI: 10.1016/j.jebdp.2021.101587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/31/2021] [Accepted: 05/03/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This meta-evaluation aimed to summarize all available evidence regarding different fissure sealants on occlusal caries prevention, arrest, retention rate, adverse effect, and cost-effectiveness; when compared with no intervention, other preventive or minimally-invasive procedures. MATERIALS AND METHODS The systematic reviews and meta-analyses were identified via four electronic databases and manual searching. Two independent reviewers performed study selection, data extraction, quality assessment with AMSTAR-2. RESULTS Among the 366 records yielded, 38 systematic reviews were identified as eligible 24 of them included meta-analyses. Moderate evidence has supported the efficacies of resin-based sealants (RBS) in occlusal caries prevention, arrest and cost-effectiveness compared to no interventions. Low to very low certainty of evidence suggested similar effectiveness of glass-ionomer cements in caries prevention with RBS and more superior performance of resin infiltration in arresting non-cavitated occlusal lesions. CONCLUSION This meta-evaluation supports the use of RBS on permanent molars to reduce occlusal caries occurrence, arrest lesion progression and alleviate oral health inequalities between individuals of different socioeconomic status. This meta-evaluation also advocates further research on glass-ionomer cements and resin infiltration with respect to their efficacies in caries prevention and arrest.
Collapse
Affiliation(s)
- Phoebe Py Lam
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Divesh Sardana
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Edward Cm Lo
- Community Dental Care, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Cynthia Ky Yiu
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong.
| |
Collapse
|
19
|
Dentists' Perception and Clinical Use of Preformed Metal Crowns to Restore Primary Molar Defects in Chengdu City, China: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6200083. [PMID: 34395620 PMCID: PMC8355980 DOI: 10.1155/2021/6200083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 02/05/2023]
Abstract
Background Preformed metal crowns (PMCs), as an effective technique recommended for the enduring restoration of primary molar defects, have not been widely implemented in China as well as that in Western countries. This study is aimed at assessing the knowledge on the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China. Thus, the present study is aimed at providing the best available evidence on clinical decision-making to manage dental caries in children and the overall benefits. Methods The self-designed questionnaire in this study consisted of two main sections, including the sociodemographic characteristics of the respondents and their perception and use of PMCs. The anonymous questionnaire was distributed among 1000 dentists practicing in Chengdu via SO JUMP. Results The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty, and professional experience were associated with dentists' use of PMCs. The lack of knowledge about the PMC technique was the main obstacle to the dental practitioners' use of PMCs (41.7%). The lack of understanding of the rationale behind PMCs was the main reason for parents' acceptance of PMC restorations (43.6%). Attending continuing education programs was the main approach to learning the PMC restorative technique (59.1%). Conclusions The clinical use of PMCs was not very popular in Chengdu city. To promote this restorative technique, knowledge and practical training should be incorporated into routine courses of undergraduate dental education.
Collapse
|
20
|
Zhang Q, Deng X, Wang Y, Huang R, Yang R, Zou J. Postoperative complications in Chinese children following dental general anesthesia: A cross-sectional study. Medicine (Baltimore) 2020; 99:e23065. [PMID: 33157964 PMCID: PMC7647524 DOI: 10.1097/md.0000000000023065] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Dental general anesthesia (DGA) is a safe and high-quality restorative and preventive treatment option for children with severe early childhood caries (S-ECC), who require extensive dental treatment and exhibit anxiety and emotional or cognitive immaturity or are medically compromised. However, several postoperative complications have been reported in children under DGA. This study aimed to evaluate and analyze the prevalence of the relevant factors of postoperative complications in healthy Chinese children following DGA to provide a foundation for pre-, intra-, and postoperative overall health management for healthy and disabled children after DGA.A total of 369 systematically healthy Chinese children (36-71 months old) undergoing a DGA were studied. Data were collected on patients' histories, characteristics, anesthesia, and dental procedures. Parents or caregivers were interviewed before and 72 hours after the procedure. Data were analyzed using logistic regression.Approximately 94.86% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain (62.70%), followed by weariness, agitation, masticatory problems, drowsiness, oral bleeding, coughing, fever, sore throat, nausea, constipation, epistaxis, vomiting, excitement, and diarrhea. The long duration of the operation was a risk factor for postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever.Prolonged operation means complex treatment, such as pulp therapy or extraction. We speculate that the longer the duration is, the more difficult the dental procedures are. The accumulation of discomfort leads to pain. We suspect that children in lower nutritional levels are more likely to suffer from bacteremia or dehydration, resulting in fever.Postoperative pain was the most prevalent complication after the DGA. A decrease in dental procedure duration might reduce the odds of postoperative pain and weariness. A high nutritional status could be a protective factor for postoperative fever. Children with low nutritional status could be more susceptible to postoperative fever.
Collapse
|
21
|
Grindrod M, Barry S, Albadri S, Nazzal H. How is paediatric dentistry taught? A survey to evaluate undergraduate dental teaching in dental schools in the United Kingdom. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:715-723. [PMID: 32567794 DOI: 10.1111/eje.12560] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/25/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION The quality assurance of undergraduate dental education in the UK is regulated by the General Dental Council who describe the competencies expected of the newly qualified dentist or "safe beginner." Whilst the literature has explored the level of undergraduate training in a number of dental specialties within the UK, there is a paucity of information on the UK curriculum for undergraduate paediatric dental teaching. AIMS This study aimed to assess the undergraduate teaching of paediatric dentistry within dental schools in the UK. METHODS An anonymous questionnaire was distributed to all 16 UK dental schools via email. RESULTS Twelve questionnaires were completed, giving a response rate of 75%. First exposure to both academic teaching and clinical teaching in paediatric dentistry ranged from years 1-4. Whilst there were broad similarities between units with regard to core components of the curricula, there were notable differences including the teaching of regenerative endodontics (75%) and the use of the titanium trauma splint (58%). Silver diamine fluoride was only used clinically in one unit (8%), and non-vital pulpotomy was taught by two units (16%). There was also considerable heterogeneity in assessment methods between universities. CONCLUSION The undergraduate paediatric dental curriculum is broadly similar between UK dental schools. However, there are discrepancies in assessment methods and the teaching of new advances.
Collapse
Affiliation(s)
- Matthew Grindrod
- University of Manchester and University Dental Hospital of Manchester, Manchester, UK
| | - Siobhan Barry
- University of Manchester and University Dental Hospital of Manchester, Manchester, UK
| | - Sondos Albadri
- School of Dentistry, University of Liverpool, Liverpool, UK
| | - Hani Nazzal
- Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
22
|
Crystal YO, Janal MN, Yim S, Nelson T. Teaching and utilization of silver diamine fluoride and Hall-style crowns in US pediatric dentistry residency programs. J Am Dent Assoc 2020; 151:755-763. [PMID: 32979954 PMCID: PMC7510543 DOI: 10.1016/j.adaj.2020.06.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/10/2020] [Accepted: 06/20/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nonsurgical caries management, particularly silver diamine fluoride (SDF) and Hall-style crowns, present alternative options for populations that have barriers to traditional treatment. The authors aimed to assess changes in the teaching and utilization of these modalities in pediatric dental residency programs. METHODS The authors e-mailed a 29-question electronic survey regarding the utilization and teaching of nonsurgical caries management agents to US pediatric dentistry residency program directors. Data were compared with results from a similar survey conducted in 2015 to analyze trends, report protocols, barriers for utilization, and possible reasons for changes. RESULTS Respondents from 82 programs completed the surveys (89% response rate). Although only 26% of respondents reported using SDF in 2015, 100% reported its utilization in 2020 (P < .001). The Hall-style crown technique is taught didactically in 90% of programs, and 69.5% of respondents use it at least sporadically in their clinics. Long wait times for the operating room (4 weeks-14 months) and sedation (1 week-12 months) motivate increased utilization of SDF, interim therapeutic restorations, and Hall-style crowns. Guidelines supporting off-label utilization of SDF have also resulted in its increased utilization. CONCLUSIONS US pediatric residency programs have universally adopted SDF for caries arrest in the primary dentition, and this trend seems to extend to other nonsurgical caries management agents. These changes are likely driven by diverse barriers to delivery of traditional restorative care. PRACTICAL IMPLICATIONS The rapid increases in teaching and utilization of minimal intervention techniques provide clinicians with more options for caries management in patients with barriers to traditional treatment.
Collapse
|
23
|
Chen X, Zhang H, Zhong J, Yan W, Lin B, Ding M, Xue S, Xia B. Comparison of indirect pulp treatment and iRoot BP Plus pulpotomy in primary teeth with extremely deep caries: a prospective randomized trial. Clin Oral Investig 2020; 25:3067-3076. [PMID: 33063220 DOI: 10.1007/s00784-020-03627-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/07/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this randomized controlled trial was to compare the 24-month success rates of indirect pulp treatment (IPT) and iRoot BP Plus pulpotomy of primary molars with extremely deep caries. MATERIALS AND METHODS Generally healthy children aged 3-7 years requiring general anesthesia for treating primary molars with extremely deep caries or reversible pulpitis were recruited. Patients with systemic disease, mental health problems, or manifestations of irreversible pulpitis were excluded. In total, 175 molars were randomized and blinded for either IPT (n = 87) or iRoot BP Plus pulpotomy (n = 88). All teeth were restored with stainless steel crowns and evaluated after 6, 12, 18, and 24 months by two blinded calibrated investigators. Kaplan-Meier survival curves were used to compare the survival rates between the groups. The correlations between success rate and patient characteristics were explored with the Cox proportional hazards model. RESULTS A total of 168 primary molars in 67 patients (average age: 3.83 years) were evaluated. The cumulative survival probability at 24 months was not significantly different between the IPT (93.8%) and pulpotomy (97.7%) groups (P = 0.238). IPT treatment success was significantly associated with age (odds ratio = 2.347; 95% CI: 1.068-5.156; P = 0.034) and preoperative sensitivity (odds ratio = 9.742; 95% CI: 1.079-87.970; P = 0.043). CONCLUSIONS The 24-month success rates of IPT and iRoot BP Plus pulpotomy performed in primary molars with extremely deep caries were not significantly different. Increasing age and preoperative sensitivity were found to be associated with the cumulative survival probability in IPT-treated primary molars with extremely deep caries. Primary teeth with extremely deep carious lesions without signs of irreversible pulpitis can be treated successfully by either indirect pulp capping or iRoot BP Plus pulpotomy. TRIAL REGISTRATION ChiCTR2000032462.
Collapse
Affiliation(s)
- Xiaoxian Chen
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Hongmei Zhang
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jie Zhong
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Wenjuan Yan
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Bichen Lin
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Meili Ding
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Shihua Xue
- Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology, Jia No.37 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Bin Xia
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Zhongguancun South Avenue 22, Haidian District, Beijing, 100081, China.
| |
Collapse
|
24
|
Eden E, Frencken J, Gao S, Horst JA, Innes N. Managing dental caries against the backdrop of COVID-19: approaches to reduce aerosol generation. Br Dent J 2020; 229:411-416. [PMID: 33037360 PMCID: PMC7546139 DOI: 10.1038/s41415-020-2153-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/10/2020] [Indexed: 11/08/2022]
Abstract
The COVID-19 pandemic resulted in severe limitation and closure of dental practices in many countries. Outside of the acute (peak) phases of the disease, dentistry has begun to be practised again. However, there is emerging evidence that SARS-CoV-2 can be transmitted via airborne routes, carrying implications for dental procedures that produce aerosol. At the time of writing, additional precautions are required when a procedure considered to generate aerosol is undertaken.This paper aims to present evidence-based treatments that remove or reduce the generation of aerosols during the management of carious lesions. It maps aerosol generating procedures (AGPs), where possible, to alternative non-AGPs or low AGPs. This risk reduction approach overcomes the less favourable outcomes associated with temporary solutions or extraction-only approaches. Even if this risk reduction approach for aerosol generation becomes unnecessary in the future, these procedures are not only suitable but desirable for use as part of general dental care post-COVID-19.
Collapse
Affiliation(s)
- Ece Eden
- Ege University, School of Dentistry, Department of Paediatric Dentistry, Bornova, Izmir, 35100, Turkey.
| | - Jo Frencken
- Radboud University, Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, 6525 GA, The Netherlands
| | - Sherry Gao
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong
| | - Jeremy A Horst
- Director of Clinical Innovation, DentaQuest, Boston, MA 02129 USA; University of Washington, Department of Oral Health Sciences, Seattle, 98195, USA
| | - Nicola Innes
- Professor and Honorary Consultant, Paediatric Dentistry, School of Dentistry, College of Biomedical & Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| |
Collapse
|
25
|
Seifo N, Cassie H, Radford J, Innes N. "It's really no more difficult than putting on fluoride varnish": a qualitative exploration of dental professionals' views of silver diamine fluoride for the management of carious lesions in children. BMC Oral Health 2020; 20:257. [PMID: 32933507 PMCID: PMC7490474 DOI: 10.1186/s12903-020-01243-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/31/2020] [Indexed: 11/30/2022] Open
Abstract
Background Despite evidence that Silver Diamine Fluoride (SDF) can be effective in managing carious lesions in primary teeth, the use of SDF in the UK remains limited. This study explored dental professionals’ views and experiences of using SDF for managing carious lesions in children. In addition, it explored what they perceived to be the advantages, disadvantages, barriers and enablers to the use of SDF in practice. Methods Fifteen semi-structured face-to-face or over-the-phone interviews were conducted with 14 dental professionals from NHS Tayside and NHS Grampian in Scotland. Interviews were transcribed verbatim, coded and analysed using a thematic approach. Results Thirteen of 14 dental professionals interviewed were familiar with, or had some existing knowledge of, SDF. Four had used it to treat patients. The majority of participants thought that the main advantage of SDF was that it required minimal patient cooperation. SDF was also perceived as a simple, pain-free and non-invasive treatment approach that could help acclimatise children to the dental environment. However, SDF-induced black staining of arrested carious lesions was most commonly reported as the main disadvantage and greatest barrier to using it in practice. Participants believed that this discolouration would concern some parents who may fear that the black appearance may instigate bullying at school and that others may judge parents as neglecting their child’s oral health. Participants thought that education of clinicians about SDF use and information sheets for parents would enhance the uptake of SDF in dental practice. Participants believed that younger children might not be as bothered by the discolouration as older ones and they anticipated greater acceptance of SDF for posterior primary teeth by both parents and children. Conclusion Dental professionals were aware that SDF can be used for arresting carious lesions. They pointed out that the staining effect of carious lesions is a major disadvantage and had preconceived ideas that this could be a barrier for many parents. Participants considered the application process to be simple and non-invasive and requires a minimum level of child cooperation. Participants appreciated the potential of SDF in paediatric dentistry and suggested actions that could help overcome the barriers they highlighted.
Collapse
Affiliation(s)
- Nassar Seifo
- School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HR, UK
| | - Heather Cassie
- School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HR, UK
| | - John Radford
- School of Dentistry, University of Dundee, Park Place, Dundee, DD1 4HR, UK
| | - Nicola Innes
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK.
| |
Collapse
|
26
|
Kaya MS, Kınay Taran P, Bakkal M. Temporomandibular dysfunction assessment in children treated with the Hall Technique: A pilot study. Int J Paediatr Dent 2020; 30:429-435. [PMID: 31991506 DOI: 10.1111/ipd.12620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 01/08/2020] [Accepted: 01/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Hall technique (HT) involves the placement of stainless steel crowns for treating asymptomatic carious primary teeth without tooth preparation or caries excavation. AIM To investigate whether temporomandibular dysfunction (TM-D) manifests in children after HT. DESIGN Healthy children (age: 5-9 years) with dentin caries were treated with HT in a university clinic, and TM-D signs and symptoms were monitored in this cohort clinical trial. The primary outcome was TM-D signs recorded using the clinical dysfunction index (Di) at pre-treatment: 0-, 1-, 3-, 6-, and 12-month follow-up visits. The secondary outcome was TM-D symptoms recorded using a questionnaire. The Di and symptoms were compared over time using McNemar's tests. RESULTS Thirty-nine children were followed for 12 months after HT treatment. Four children were detected as having dysfunction signs throughout the study: muscle pain on palpation and clicking. The symptoms 'hearing a sound within the jaw joint' or 'bite felt uncomfortable or unusual' were reported by another four children. The Di and TM-D symptoms were not significantly different between pre-treatment and follow-up visits (P > .05). CONCLUSIONS The HT does not seem to be connected to TM-D. Alternative TM-D assessment tools for studying non-persistent symptoms more comprehensively might be useful for future studies.
Collapse
Affiliation(s)
- Mustafa Sarp Kaya
- Faculty of Dentistry, Department of Pediatric Dentistry, Bezmialem Vakif University, İstanbul, Turkey
| | - Pınar Kınay Taran
- Faculty of Dentistry, Department of Pediatric Dentistry, Bezmialem Vakif University, İstanbul, Turkey
| | - Meltem Bakkal
- Faculty of Dentistry, Department of Pediatric Dentistry, Bezmialem Vakif University, İstanbul, Turkey
| |
Collapse
|
27
|
Deng XY, Zhang YH, Zou J, Zhang Q. [Investigation of postoperative complications in children after dental therapy under general anesthesia]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:284-289. [PMID: 32573136 DOI: 10.7518/hxkq.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to evaluate the postoperative complications undergoing dental general anesthesia in children and analyze the prevalence and related factors. METHODS This prospective study involved 292 systematically healthy children (36 to 71 months old) who received extensive dental treatment under general anesthesia. Data about patients' histories, characteristics, dental and anesthesia procedure were collected. Parents or caregivers were interviewed face to face preoperation and 72 h postoperation. Data were analyzed using logistic regression. RESULTS Approximately 93.5% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain, followed by weariness, agitation, problem in eating, drowsiness, oral bleeding, cough, fever, etc. The length of operative time and femininity were the risks of the postoperative pain. Nutrition status was the factor probably in association with fever. CONCLUSIONS The children receive longer operative time and girls show to be more susceptible to the postoperative pain. High nutrition status could be the protective factor of postoperative fever.
Collapse
Affiliation(s)
- Xiao-Yu Deng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yun-Han Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jing Zou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qiong Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
28
|
Abstract
Background The Hall technique (HT) is popular with UK paediatric dentists (PDs). Global PDs perception/use of HT is unknown.Aim To investigate global PDs opinions/use of HT.Materials and methods A cross-sectional questionnaire of 26 questions was sent to specialist PDs across the globe.Results Responses of 709 PDs from six continents were obtained. The majority (n = 654, 92.32%) had heard about HT but only 50.6% (n = 358) used it, with wide country variations. Respectively, 37.5%, 31.5% and 31% were neutral, against or supportive of HT when they initially heard about it. Only 17% of HT users said it was always the treatment of choice for non-pulpal asymptomatic carious primary molars (NPACPMs), 62% would take a pre-operative radiograph, 65% would consider using high speed drills before HT, 63% would never consider HT under general anaesthesia, 56% would use HT under N2O sedation. Finally, in a clinical scenario of a NPACPM in a cooperative 6-year-old, 75% of PDs would choose conventional restorative methods over the HT.Conclusion The HT is recognised, but not used, by an outright majority of PDs across the globe. Identifiable barriers such as lack of training, perception as substandard dentistry and perceived lack of evidence reduced its use.
Collapse
|
29
|
Abstract
Introduction There has been speculation about early exfoliation of carious primary molar teeth treated with the Hall Technique (HT).Aim To investigate the hypothesis that there is a difference in exfoliation times between teeth treated with the HT and contralateral teeth not treated with the HT.Methods Split-mouth retrospective cohort study of children treated in Dundee Dental Hospital and School (DDH&S). Radiographs and clinical records were assessed to compare children's ages at exfoliation for HT-treated primary molars and their contralateral teeth not treated with the HT. Primary molars' root resorption was also evaluated to assess whether the HT influenced the rate of root resorption.Results Using DDH&S's clinical systems, children's records (n = 13,160) were screened for children's ages and sequential radiographs, with 192 children potentially eligible. After assessing radiographs and clinical records, 39 children met the inclusion criteria. Their mean age at time of HT treatment was 7.2 years (range = 4.0 to 11.0; SD = 1.5). There was no evidence of a difference (p = 0.41) between children's ages at exfoliation of HT teeth (10.7; SD = 1.2 years) and contralateral teeth (11.0; SD = 1.4 years).Conclusion There is no evidence that use of the Hall Technique is associated with early exfoliation of primary molars.
Collapse
|
30
|
Kamarudin A, Jesmin F, Baharin F, Wan Ahmad WM, Mohammed M. Acceptability of Hall’s technique: A systematic literature review. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_312_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
31
|
Bjørndal L, Simon S, Tomson PL, Duncan HF. Management of deep caries and the exposed pulp. Int Endod J 2019; 52:949-973. [PMID: 30985944 DOI: 10.1111/iej.13128] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 04/10/2019] [Indexed: 01/12/2023]
Abstract
Caries prevalence remains high throughout the world, with the burden of disease increasingly affecting older and socially disadvantaged groups in Western cultures. If left untreated, caries will advance through dentine stimulating pulpitis and eventually pulp infection and necrosis; however, if conservatively managed, pulpal recovery occurs even in deep carious lesions. Traditionally, deep caries management was destructive with nonselective (complete) removal of all carious dentine; however, the promotion of minimally invasive biologically based treatment strategies has been advocated for selective (partial) caries removal and a reduced risk of pulp exposure. Selective caries removal strategies can be one-visit as indirect pulp treatment or two-visit using a stepwise approach. Management strategies for the treatment of the cariously exposed pulp are also shifting with avoidance of pulpectomy and the re-emergence of vital pulp treatment (VPT) techniques such as partial and complete pulpotomy. These changes stem from an improved understanding of the pulp-dentine complex's defensive and reparative response to irritation, with harnessing the release of bioactive dentine matrix components and careful handling of the damaged tissue considered critical. Notably, the development of new pulp capping materials such as mineral trioxide aggregate, which although not an ideal material, has resulted in more predictable treatments from both a histological and a clinical perspective. Unfortunately, the changes in management are only supported by relatively weak evidence with case series, cohort studies and preliminary studies containing low patient numbers forming the bulk of the evidence. As a result, critical questions related to the superiority of one caries removal technique over another, the best pulp capping biomaterial or whether pulp exposure is a negative prognostic factor remain unanswered. There is an urgent need to promote minimally invasive treatment strategies in Operative Dentistry and Endodontology; however, the development of accurate diagnostic tools, evidence-based management strategies and education in management of the exposed pulp are critical in the future.
Collapse
Affiliation(s)
- L Bjørndal
- Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Simon
- Paris Diderot University, Paris, France.,Hôpital de Rouen Normandie, Rouen, France.,Laboratoire IN SERM UMR 1138, Paris, France
| | - P L Tomson
- School of Dentistry, Institute of Clinical Sciences, Birmingham, UK
| | - H F Duncan
- Division of Restorative Dentistry & Periodontology, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| |
Collapse
|
32
|
游 文, 窦 桂, 夏 斌. [Twoyear outcomes and the influence factors of indirect pulp treatment in primary teeth: a retrospective study]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:65-69. [PMID: 30773546 PMCID: PMC7433554 DOI: 10.19723/j.issn.1671-167x.2019.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the outcomes and to find out the influence factors of indirect pulp treatment in primary teeth. METHODS Children who received indirect pulp treatment in primary teeth in the Department of Pediatric Dentistry in Peking University School and Hospital of Stomatology from August, 2014 to September, 2016 were collected in the Electronic Medical Record Database of Peking University School and Hospital of Stomatology, via the database for scientific research provided by the corporation of Kaientai. The children selected as the subjects of this study were followed up over 1.5 years, and they were under 9 years old if in the group of primary molars while the children in the group of primary anterior teeth were under 4 and a half years old. Those children who were not reviewed regularly or didn't have complete medical records were removed. Basic information, the relevant medical records and radiographic records of those children were collected. All teeth were examined clinically and classified into 2 outcomes, teeth in group H were regarded as succeeded, and teeth in group P were regarded as failed. Survival analysis was applied. The survival rate and survival time of the deciduous teeth calculated. Multivariate analysis was performed by using Cox proportional hazard model. RESULTS One hundred and six children were finally included, aged from 1.6 to 8.8 years, with the mean age of (5.0±1.7) years. 168 primary teeth (122 primary molars, 46 primary anterior teeth) were included, and the average follow up time was (729±244) days. Thirty-five primary teeth (23 primary molars, 12 primary anterior teeth) failed upon clinical or radiographic examinations by September, 2018. The cumulative survival probability of half a year, one year, one year and a half, two years, two and a half years for the indirect pulp treatment was 93.5%, 92.9%, 87.5%, 82.7%, and 75.5% through the KaplanMeier method, respectively. Through the analysis of Cox proportional hazard model, in primary molars, the survival probability tended to be lower when the number of tooth surface affected by caries was greater (OR=1.709, P<0.05). Compared with primary molars, the survival probability of primary anterior teeth was lower, but the difference was not significant. CONCLUSION Complying the current instructions in our department, the cumulative survival probability of two and a half years after the indirect pulp treatment in primary teeth was 75.5%. In primary molars, the survival probability tended to be lower when the number of tooth surfaces affected by caries increased.
Collapse
Affiliation(s)
- 文喆 游
- />北京大学口腔医学院·口腔医院,儿童口腔科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 桂丽 窦
- />北京大学口腔医学院·口腔医院,儿童口腔科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 斌 夏
- />北京大学口腔医学院·口腔医院,儿童口腔科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室, 北京 100081Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| |
Collapse
|
33
|
Ghadimi S, Seraj B, Ostadalipour A, Askari E. Comparison of Canine Overlap in Pediatric Patients Requiring Stainless Steel Crown Placement under General Anesthesia before and after the Procedure. Front Dent 2019; 16:78-87. [PMID: 31608340 PMCID: PMC6778619 DOI: 10.18502/fid.v16i1.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/07/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives Despite the increasing popularity of pediatric dental treatments under general anesthesia, information is scarce regarding occlusal changes in patients receiving stainless steel crowns (SSCs) under general anesthesia. This study sought to compare canine overlap before and after general anesthesia in children receiving SSCs. In case of a change, the possibility of returning to the preoperative state and the time required for this process were also evaluated. Materials and Methods This interventional, before-and-after study was performed on 60 children between 2 to 7 years of age requiring dental treatment under general anesthesia. The contact point of the most prominent area of the maxillary primary canine and mandibular primary canine was marked before and immediately after general anesthesia and at one and two weeks postoperatively. The change in canine overlap was analyzed using repeated measures analysis of variance (ANOVA) and linear regression test. Results Canine overlap significantly decreased immediately after general anesthesia (P<0.05). The mean bite opening was 0.51±0.22 mm at the site of the right canine and 0.50±0.185 mm at the site of the left canine. These values returned to their normal preoperative state after one week (P<0.05). Repeated measures ANOVA showed significant differences in this respect between the time points (P=0.002). Conclusion The occlusion and vertical dimension of pediatric patients may change following dental treatment under general anesthesia; the magnitude of change in canine overlap may vary depending on the class of occlusion and number of SSCs placed. These changes are temporary and often resolve within a week.
Collapse
Affiliation(s)
- Sara Ghadimi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Seraj
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ostadalipour
- Department of Anesthesiology and Critical Care, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Askari
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
34
|
Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2018; 120:816-878. [DOI: 10.1016/j.prosdent.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 02/08/2023]
|
35
|
The use of Hall technique preformed metal crowns by specialist paediatric dentists in the UK. Br Dent J 2018; 224:48-52. [PMID: 29326453 PMCID: PMC5770477 DOI: 10.1038/sj.bdj.2018.4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/25/2022]
Abstract
Examines treatment planning involving Hall technique preformed metal crowns by specialists in paediatric dentistry. Explores clinical situations in which specialists in paediatric dentistry feel it is appropriate or not to fit Hall technique preformed metal crowns. Investigates which types of carious lesions are being treated with Hall technique preformed metal crowns by specialists in paediatric dentistry.
Background Hall technique preformed metal crowns (HTPMCs) have been increasing in use recently, but little is currently known about their use by specialists. Aim To investigate the views and usage of HTPMCs by UK specialist paediatric dentists. Design This was a prospective questionnaire-based study, distributed online to all specialists on the British Society of Paediatric Dentistry email list between July and September 2014. Results Ninety-four questionnaires were completed. The majority of respondents, 65% (61) worked in teaching hospitals, followed by community dental services, 37% (35). Ninety-six percent (89) reported that they used HTPMCs in their practice. Fifty-eight percent (54) used HTPMCs as a treatment option for restoring symptomless carious primary molars, and 15% (14) only when unable to provide conventional restoration. Twenty-three percent (21) used HTPMCs as the treatment of choice. Only 4% (4) of respondents never used them. Sixty percent (53) had been using HTPMCs for over five years. Seventy-six percent (68) would consider placing HTPMCs under inhalation sedation, and 26% (23) under general anaesthesia. Over 90% (85) believed that HTPMCs are suitable for undergraduate teaching, general practice, postgraduate training and specialist practice. Conclusion HTPMCs are widely used among specialist paediatric dentists in the UK.
Collapse
|
36
|
Santamaría RM, Pawlowitz L, Schmoeckel J, Alkilzy M, Splieth CH. Use of stainless steel crowns to restore primary molars in Germany: Questionnaire-based cross-sectional analysis. Int J Paediatr Dent 2018; 28:587-594. [PMID: 30066455 DOI: 10.1111/ipd.12415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/23/2018] [Accepted: 07/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Stainless steel crowns (SSCs) have shown substantial clinical success and are the restoration of choice to treat multisurface carious primary molars. AIM To evaluate the use of and views on SSCs for treating primary molars in Germany. METHODS This is a questionnaire-based cross-sectional study, which assessed the views of dentists and dental schools on the use of SSCs (conventional and the Hall Technique [HT]) in Germany. Dentists were randomly selected (n = 267) and contacted by telephone, and a self-administered questionnaire was sent to all German dental schools (n = 27). RESULTS A total of 104 (39%) dentists agreed to participate. The majority of respondents (66%) do not use SSCs, being the main drawbacks: technique complexity (29%) and aesthetic concerns (23%). The majority of respondents (77%) were not familiar with the HT. The response rate from the universities was 85%. In 96% of the dental schools, the value of using SSCs is taught; however, in 27%, no practical training is provided. In addition, the dental schools' questionnaire revealed that the HT was known (91%), but neither taught to nor used for most of the dental students (76%). CONCLUSION Independent of the technique used, SSCs are considerably underutilized in the dental practice in Germany, although SSCs are well accepted by the universities, however, predominantly using the conventional approach.
Collapse
Affiliation(s)
| | | | - Julian Schmoeckel
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Mohammad Alkilzy
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Christian Heinz Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| |
Collapse
|
37
|
Jones RJ, Cowpe JG, Bullock AD, Gilmour ASM. Clinical skills of a new foundation dentist: the experience of dental foundation educational supervisors. Br Dent J 2018; 225:177-186. [PMID: 30050194 DOI: 10.1038/sj.bdj.2018.536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/09/2022]
Affiliation(s)
- R J Jones
- Cardiff University, School of Dentistry, Heath Park, Cardiff, UK
| | - J G Cowpe
- Cardiff University, School of Dentistry, Heath Park, Cardiff, UK
| | - A D Bullock
- Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE), School of Social Sciences, Cardiff University, 12 Museum Place, Cardiff, CF10 3BG, UK
| | - A S M Gilmour
- Cardiff University, School of Dentistry, Heath Park, Cardiff, UK
| |
Collapse
|
38
|
Schwendicke F, Krois J, Splieth CH, Innes N, Robertson M, Schmoeckel J, Santamaria RM. Cost-effectiveness of managing cavitated primary molar caries lesions: A randomized trial in Germany. J Dent 2018; 78:40-45. [PMID: 29859224 DOI: 10.1016/j.jdent.2018.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 05/27/2018] [Accepted: 05/29/2018] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVES The Hall Technique (HT), Non-Restorative Cavity Control (NRCC) and conventional carious tissue removal and restoration (CR) are strategies for managing cavitated caries lesions in primary molars. A randomized controlled three-arm parallel group trial in a university clinic in Germany was used to measure the cost-effectiveness of these strategies. METHODS 142 children (HT: 40; NRCC: 44; CR: 58) were followed over a mean 2.5 years. A German healthcare perspective was chosen. The primary outcome was estimated molar survival; secondary outcomes were not needing extraction, not having pain or needing endodontic treatment/extraction, or not needing any re-intervention at all. Initial, maintenance and endodontic/restorative/extraction re-treatment costs were derived from fee items of the statutory insurance. Cumulative cost-effectiveness and cost-effectiveness acceptability were estimated from bootstrapped samples. RESULTS HT molars survived longer (estimated mean; 95% CI: 29.7; 26.6-30.5 months) than NRCC (25.3; 21.2-28.7 months) and CR molars (24.1; 22.0-26.2 months). HT was also less costly (66; 62-71 Euro) than NRCC (296; 274-318 Euro) and CR (83; 73-92 Euro). HT was more cost-effective than NRCC and CR in >96% of samples, and had acceptable cost-effectiveness regardless of a payer's willingness-to-pay. This superior cost-effectiveness was confirmed for secondary health outcomes. Cost-advantages were even more pronounced when costs were calculated per year of tooth retention (mean annual costs were HT: 29, NRCC: 154, CR: 61 Euro). CONCLUSIONS HT was more cost-effective than CR or NRCC for managing cavitated caries lesions in primary molars, yielding better dental health outcomes at lower costs. CLINICAL SIGNIFICANCE If choosing between these three strategies for managing cavitated caries lesions in primary molars, dentists should prefer HT over NRCC or CR. This would also save costs for the healthcare payer.
Collapse
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin, Berlin, Germany.
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin, Berlin, Germany
| | - Christian H Splieth
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Nicola Innes
- Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - Mark Robertson
- Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - Julian Schmoeckel
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Ruth M Santamaria
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| |
Collapse
|
39
|
Innes NPT, Robertson MD. Recent advances in the management of childhood dental caries. Arch Dis Child 2018; 103:311-315. [PMID: 29463521 DOI: 10.1136/archdischild-2017-313196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/06/2017] [Indexed: 11/04/2022]
|
40
|
Beyond Streptococcus mutans: clinical implications of the evolving dental caries aetiological paradigms and its associated microbiome. Br Dent J 2018; 224:219-225. [PMID: 29449651 DOI: 10.1038/sj.bdj.2018.81] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/09/2022]
Abstract
Aetiological concepts of dental caries have evolved over the years from being considered as a disease initiated by nonspecific microorganisms, to being regarded as an 'infectious' disease caused by specific bacteria, to the current paradigms that emphasise a 'mixed bacterial-ecological approach' as being responsible for lesion initiation and pathogenesis. These aetiological paradigms are not just intellectual concepts but have important implications on how clinicians manage this age-old disease in the twenty-first century. Despite evidence-backed recommendations for adopting more biological measures to counter the disease, a significant proportion of dentists continue following traditional caries management guidelines in their daily clinical practice. This paper will review the evolving dental caries aetiological concepts and highlight the current evidence for adopting a more ecological approach to caries prevention, risk assessment, and treatment.
Collapse
|
41
|
Lee H, Milgrom P, Huebner CE, Weinstein P, Burke W, Blacksher E, Lantos JD. Ethics Rounds: Death After Pediatric Dental Anesthesia: An Avoidable Tragedy? Pediatrics 2017; 140:peds.2017-2370. [PMID: 29114060 DOI: 10.1542/peds.2017-2370] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 11/24/2022] Open
Abstract
Early childhood caries (ECC) is the single most common chronic childhood disease. In the treatment of ECC, children are often given moderate sedation or general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. The most common medications are benzodiazepines, opioids, local anesthetics, and nitrous oxide. All are associated with serious adverse events, including hypoxemia, respiratory depression, airway obstruction, and death. There is no mandated reporting of adverse events or deaths, so we don't know how often these occur. In this article, we present a case of a death after dental anesthesia and ask experts to speculate on how to improve the quality and safety of both the prevention and treatment of ECC.
Collapse
Affiliation(s)
- Helen Lee
- Department of Anesthesiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | | | | | | | - Wylie Burke
- Bioethics and Humanities, University of Washington, Seattle, Washington; and
| | - Erika Blacksher
- Bioethics and Humanities, University of Washington, Seattle, Washington; and
| | - John D Lantos
- Pediatric Bioethics Center, Children's Mercy Kansas City, Kansas City, Missouri
| |
Collapse
|