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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.
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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
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Uhlen MM, Tseveenjav B, Wuollet E, Furuholm J, Ansteinsson V, Mulic A, Valen H. Stainless-steel crowns in children: Norwegian and Finnish dentists' knowledge, practice and challenges. BMC Oral Health 2021; 21:190. [PMID: 33845821 PMCID: PMC8040753 DOI: 10.1186/s12903-021-01556-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stainless-steel crowns (SSCs) are recommended for restorative treatment of young teeth severely affected by caries, fractures or dental developmental disorders (DDDs). However, despite recommendations and clinical evidence, SSCs are not widely used by general dentists, who favour extraction and more conventional restorations. The present study aimed to investigate the views of and use of SSCs among Norwegian and Finnish dentists. METHODS The present study was a cross-sectional survey among Norwegian and Finnish dentists. An electronic questionnaire was sent to Norwegian and Finnish dentists asking whether they used SSCs and on which indications. In addition, the questionnaire assessed reasons for non-use and dentists' perceptions regarding advantages and challenges in the use of SSCs, as well as the need for additional training. Distributions of background characteristics, use of and views on SSCs were calculated, and statistical significance of the associations between respondents' background and their answers were evaluated. RESULTS Of the 574 Norwegian and 765 Finnish respondents, only 12.0% and 12.9% reported to use SSCs, respectively. The most frequently reported barrier reported by those who did not use SSCs was lack of practical training. The most frequent challenge reported by those using SSCs was difficulties in crown adjustment followed by aesthetic issues, and the most frequently reported advantage was that SSCs maintain the function and occlusion. The majority of respondents reported a need for more information and practical training in the use of SSCs, with hands-on course as their most frequently preferred education type. CONCLUSION Although the value of SSCs for restoring young molars is recognized by Norwegian and Finnish dentists, SSCs are rarely used by general dentists. The majority of the respondents reported lack of training and materials and was interested in receiving more information and education.
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Affiliation(s)
- M M Uhlen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway.
| | - B Tseveenjav
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - E Wuollet
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - V Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A Mulic
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
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Staszczyk M, Jurczak A, Magacz M, Kościelniak D, Gregorczyk-Maga I, Jamka-Kasprzyk M, Kępisty M, Kołodziej I, Kukurba-Setkowicz M, Krzyściak W. Effect of Polyols and Selected Dental Materials on the Ability to Create a Cariogenic Biofilm-On Children Caries-Associated Streptococcus Mutans Isolates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103720. [PMID: 32466155 PMCID: PMC7277333 DOI: 10.3390/ijerph17103720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 01/13/2023]
Abstract
Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to assess the effect of sweeteners on the ability of clinical Streptococcus mutans strains to form biofilm on dental materials. Strains were isolated from plaque samples from 40 pediatric patients from the 3-6 ICADS II group. The ability to form biofilm was tested on composite and glass ionomer dental materials used for milk teeth filling in the presence of sucrose, xylitol, sorbitol, and erythritol. The bacterial film mass after 12, 24, 48, and 72 h and the number of bacterial colonies significantly decreased (p < 0.01) compared to the initial value for 5% erythritol and sorbitol on examined materials. A greater inhibitory effect was noted for glass ionomers compared to composites. Sucrose and xylitol supported biofilm formation, while erythritol had the best inhibitory effect. The use of fluoride-releasing glass ionomers exerted an effect synergistic to erythritol, i.e., inhibited plaque formation and the amount of cariogenic S. mutans. Selection of proper type of dental material together with replacing sucrose with polyols can significantly decrease risk of secondary caries development. Erithritol in combination with glass ionomer seems to be the most effective in secondary caries prevention.
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Affiliation(s)
- Małgorzata Staszczyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Anna Jurczak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Marcin Magacz
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Doctoral School of Health and Medical Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Dorota Kościelniak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Iwona Gregorczyk-Maga
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Małgorzata Jamka-Kasprzyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Magdalena Kępisty
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Iwona Kołodziej
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Magdalena Kukurba-Setkowicz
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Correspondence: ; Tel.: +48-12-620-57-60
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A randomized clinical trial comparing Hall vs conventional technique in placing preformed metal crowns from Sudan. PLoS One 2019; 14:e0217740. [PMID: 31158253 PMCID: PMC6546341 DOI: 10.1371/journal.pone.0217740] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 05/13/2019] [Indexed: 11/26/2022] Open
Abstract
Despite the high success rates of preformed metal crowns (PMCs) in children no randomized clinical trials compare methods of placement and none describe its use in Africa. Our aim was to compare survival and cost-effectiveness of PMCs placed by conventional techniques (CT) and biological Hall techniques (HT) using a prospective randomized control trial in a general dental practice from Khartoum. One hundred and nine and 103 PMCs were placed in randomly selected children (5-8years) with 1–2 carious primary molars using HT and CT respectively and followed for 2 years. Socioeconomic status, periodontal health, occlusion, anxiety, and procedure time were compared using student t-test. Kaplan–Meier survival rates and incremental cost effectiveness ratio (ICER) were compared between CT and HT. CT and HT groups were similar for age, gender, socio-economic status. Survival rates were high (over 90%) for both study arms and not statistically different (p>0.05). Anxiety scores were significantly higher in CT arm after 12 months compared to HT (p<0.001). Clinically, gingival and plaque indices were similar between groups (p>0.05) but occlusions were raised in nearly all subjects in the HT arm (p<0.05). Periodontal health improved, and occlusions adjusted over time in both arms. There were 3 (2.7%) and 6 (5.8%) minor failures, 7 (6.4%) and 6 (5.8%) major failures in HT and CT arms respectively. Mean procedure time was lower in HT (9.1 min) than CT (33.9 min); p<0.001. Mean PMC cost was US$2.45 and US$7.81 for HT and CT respectively. The ICER was US$136.56 more for each PMC placed by CT per life year. We show that PMCs have high survival outcomes in disadvantaged populations similar to results from developed countries. As HT can be carried out by less experienced dental operators and therapists, this biological approach provides a promising cost-effective option to manage caries in developing countries with limited resources. Trial registration: The trial is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT03640013
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Uhlen MM, Valen H, Karlsen LS, Skaare AB, Bletsa A, Ansteinsson V, Mulic A. Treatment decisions regarding caries and dental developmental defects in children - a questionnaire-based study among Norwegian dentists. BMC Oral Health 2019; 19:80. [PMID: 31077165 PMCID: PMC6509767 DOI: 10.1186/s12903-019-0744-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/24/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Current knowledge on treatment strategies and choice of restorative materials when treating deep caries or severe dental developmental defects (DDDs) in young individuals is scarce. Therefore, the aim was to investigate Norwegian dentists´ treatment decisions and reasons for treatment choice when treating deep caries in primary teeth and severe DDDs in permanent teeth in children. METHODS A pre-coded questionnaire was sent electronically to all dentists employed in the Public Dental Service (PDS) in Norway (n = 1294). The clinicians were asked about their background characteristics and how often they registered DDDs. Three clinical cases were presented to the dentists and asked to prioritize treatment options and reasons for their choice. RESULTS After three reminders, 45.8% of the dentists answered. Most clinicians were general practitioners (96.3%), females (77.9%), under 41 year-olds (59.4%), graduated in 2001 or later (61.1%), and representing all regions of Norway. The respondents registered molar incisor hypomineralisation (MIH), other DDDs and dental fluorosis (DF) frequently, 523 (91.1%), 257 (44.8%) and 158 (27.5%), respectively. In case 1a with severe dental caries in a primary molar, the preferred treatment was resin-modified glass ionomer cement (RMGIC) (58.3%), followed by glass ionomer cement (GIC) (17.9%) and zinc oxide-eugenol (ZOE) (13.2%). Extraction, compomer or stainless steel crowns (SSC) were preferred by 0.9, 0.7 and 0.4%, respectively. In case 1b, which was identical to case 1a, but treated under general anaesthesia, the preferred treatment alternatives were RMGIC (37.1%), resin composite (RC) (17.6%) and GIC (17.2%). Extraction and SSC were chosen by 15.1 and 7.2%, respectively. In case 2, showing a severely hypomineralised and symptomatic first permanent molar, the dentists preferred RC (38.4%), followed by RMGIC (26.6%) and GIC (19.0%). Extraction and SSC were chosen by 8.7 and 5.4%, respectively. The treatment choices were not significantly affected by the dentists' background characteristics. The reasons for dentists' treatment decisions varied for each patient case; patient cooperation, prognosis of the tooth and own experience were the dominant reasons. CONCLUSIONS A notable disparity in treatment choices was shown indicating that Norwegian dentists evaluate each case individually and base their decisions on what they consider best for the individual patient.
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Affiliation(s)
- M. M. Uhlen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - H. Valen
- Nordic Institute for Dental Materials (NIOM), Oslo, Norway
| | - L. S. Karlsen
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A. B. Skaare
- Oral Health Centre of Expertise in Southern Norway (OHCE-S), Arendal, Norway
- Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - A. Bletsa
- Oral Health Centre of Expertise in Western Norway Hordaland (OHCE-W Hordaland), Bergen, Norway
| | - V. Ansteinsson
- Oral Health Centre of Expertise in Eastern Norway (OHCE-E), Oslo, Norway
| | - A. Mulic
- Nordic Institute for Dental Materials (NIOM), Oslo, Norway
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Long-term clinical performance of heat-cured high-viscosity glass ionomer class II restorations versus resin-based composites in primary molars: a randomized comparison trial. Eur Arch Paediatr Dent 2019; 20:451-456. [PMID: 30820833 DOI: 10.1007/s40368-019-00423-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the long-term clinical performance of heat-cured high-viscosity glass ionomer (GIC) and posterior composite resin (CR) restorations in primary molars over a 3-year period. METHODS Photographs and radiographs of EQUIA GIC and Filtek™ P60 restorations were assessed. Study sample is comprised of healthy preschool/school children with proximal surface caries in primary molars. RESULTS 70 GI restorations were placed in 45 patients (aged 78 months ± 25) and were evaluated at 33 months ± 7. 61 composite resin restorations were placed in 42 patients (age 82 months ± 19) and were evaluated at 39 months ± 13. GI restorations failure was 17.1%, a significantly greater rate compared with 4.9% in the CR group. GI failures were due to either significant loss of the restoration or to loss of marginal ridge integrity. CR failures were due to loss of marginal ridge integrity. CONCLUSION Both GI and CR restorations were clinically successful during a 3-year period. GI restorations may be considered as an intermediate-lasting restoration option for proximal lesions in primary molars, with 83% of the restorations functioning up to 36 months. CR restorations showed a higher success rate than GIC during the same period.
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Comparison of high viscosity glass ionomer cement to composite restorations placed in primary teeth under general anesthesia. PEDIATRIC DENTAL JOURNAL 2018. [DOI: 10.1016/j.pdj.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Khodadadi E, Mohammadpour M, Motamedian SR, Kouhestani F. Failure Rate of Pediatric Dental Treatment under General Anesthesia. Dent J (Basel) 2018; 6:E25. [PMID: 29932133 PMCID: PMC6162701 DOI: 10.3390/dj6030025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/29/2018] [Accepted: 06/20/2018] [Indexed: 12/02/2022] Open
Abstract
Aim: To assess the failure rates of various pediatric dental treatments performed under general anesthesia (GA) after six months to five years of follow-up. Design: This multicenter retrospective cohort study was performed on patients treated by five pedodontists in two private hospitals located in northern Iran during 2010⁻2013 and comprised 155 patients. The patients were recalled and clinically examined. During the clinical examination of the primary teeth, oral hygiene, dmft index, and failure of previous treatments was evaluated. The data were analyzed using the Chi square and regression analyses with a significance level of 0.05. Results: 114 patients (74 males and 40 females, mean age: 37.17 ± 10.75 months) with 1155 primary teeth treated under GA participated in the follow-up. The overall failure rate was 6.59%. The failure rates of pulpectomy, pulopotomy, fissure sealant, stainless steel crown (SSC), amalgam, and composite fillings were 2.90%, 3.03%, 4.83%, 5.26%, 5.33%, and 9.63%, respectively. Among the confounding factors, only gender had a significant effect on the anterior composite failure rate (p = 0.029) and age had a significant effect on the failure rate of fissure sealant therapy (p = 0.015) and SSC (p = 0.018). Conclusion: The overall rate of treatment failure in pediatric patients, treated under GA, was 6.59%.
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Affiliation(s)
- Effat Khodadadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Babol University of Medical Sciences, Babol 47176-47745, Iran.
| | - Mehrnaz Mohammadpour
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahrekord University of Medical Sciences, Shahrekord 81639-48111, Iran.
| | - Saeed Reza Motamedian
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran.
| | - Farnaz Kouhestani
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran.
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The Editor recommends this issue's article to the reader: Survival of extensive restorations in primary molars: 15-year practice-based study. Int J Paediatr Dent 2018; 28:122. [PMID: 29436093 DOI: 10.1111/ipd.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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